Scientific breakthroughs rarely yield the potential to engage a foundational ethical question. Recent studies on direct reprogramming of human skin cells reported by the Yamanaka lab in Japan and the Thomson lab in Wisconsin suggest that scientists may have crossed both a scientific and an ethical threshold. The fascinating science of direct nuclear reprogramming highlights empirical data that may clarify the ontological status of cellular activity in the early stages of what could become a human fetus and justify ethical options (...) for research in this controversial field. The ontological and ethical implications that accrue here are connected with the biological or natural potentiality of these cells. (shrink)

There is an increasing need for quality in ethics consultations, though there have been significant achievements in the United States and Europe. However, fundamental concerns that place the profession in jeopardy are discussed from the perspective of the U.S. in a manner that will be helpful for other countries. The descriptive component of the essay (the first two points) explains the achievements in ethics quality (illustrated by the IntegratedEthics program of the Veterans Health Administration) and the progress on standards and (...) competencies for ethics consultations (represented by the Core Competencies of the American Society for Bioethics and Humanities). Based on these achievements, the analytical component of the essay (the final three points) identifies and seeks to resolve three fundamental concerns (with increasing levels of importance) that compromise quality in ethics consultations: standards of quality; professionalism; and credentialing. The analysis argues for clearer standards of quality in ethics consultation and urges further professionalism by explaining the need for the following: interpreting the ASBH core competencies in a normative manner, developing a Code of Ethics, and clarifying the meaning of best practices. However, the most serious concern that threatens quality in ethics consultations is the lack of a credentialing process. This concern can be resolved effectively by developing an independent Ethics Consultation Accreditation Council to accredit and standardize graduate degree programs, fellowship experiences, and qualifying examinations. This credentialing process is indispensable if we are to strategically enhance quality in ethics consultations. (shrink)

Whole eye transplantation (WET) remains experimental. Long presumed impossible, recent scientific advances regarding WET suggest that it may become a clinical reality. However, the ethical implications of WET as an experimental therapeutic strategy remain largely unexplored. This article evaluates the ethical considerations surrounding WET as an emerging experimental treatment for vision loss. A thorough review of published literature pertaining to WET was performed; ethical issues were identified during review of the articles.

Organizational ethics refers to the integration of values into decision making, policies, and behavior throughout the multi-disciplinary environment of a health care organization. Based upon Catholic social ethics, stewardship is at the heart of organizational ethics in health care in this sense: stewardship provides the hermeneutic filter that enables basic ethical principles to be realized practically, within the context of the Catholic theology of work, to concerns in health care. This general argument can shed light on the specific topic of (...) non-executive compensation programs as an illustration of organizational ethics in health care. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Direct Nuclear Reprogramming: Response to Condic, Lee, and GeorgeGerard Magill, Ph.D. and William B. NeavesWe read with great interest the response of Maureen Condic, Patrick Lee, and Robert George (2009) to our essay, “Ontological and Ethical Implications of Direct Nuclear Reprogramming” in the March 2009 issue of the Kennedy Institute of Ethics Journal (Magill and Neaves 2009). Much of their response addressed issues that are not in dispute: somatic (...) cells are not zygotes, neurons and hepatocytes are different, growth-factor signals from the trophoblast influence development of the inner cell mass, membranes derived from the trophectoderm are critically required for embryonic survival, and stem cells cannot produce a fetus “on their own.”The crucial point of disagreement deals with the fact that iPS cells are not totipotent but zygotes are. Zygotes can generate their own placental structures while iPS cells must be given them through tetraploid complementation. Condic, Lee, and George consider totipotency to be crucial to natural potentiality. We present an alternative view in our essay (Magill and Neaves 2009, pp. 28–29). Placental structures make no lasting contribution to the postnatal organism, and the equivalency of iPS cells with the inner cell mass of the blastocyst is apparent from tetraploid complementation experiments.The respondents acknowledge the following:... somatic cells can be “converted” into zygotes by the process of somatic cell nuclear transfer (SCNT) or direct reprogramming in combination with tetraploid complementation—just as sperm and egg cells can be “converted” into a zygote by the process of natural fertilization—....(Condic, Lee, and George 2009, p. 35)As the respondents recognize, different ways of manipulating cells can lead to embryogenesis: sperm and egg cells in the process of natural fertilization, the enucleated egg and an ordinary body cell in the process of somatic cell nuclear transfer, and reprogrammed skin cells and a tetraploid blastocyst in the case of induced pluripotent stem (iPS) cells. In each case, different cells are manipulated—or “converted” in the respondents’ terminology—in a process that alters their biological fate within a supportive environment facilitating embryogenesis.The developmental potential that resides in the human genome does not unfold in isolation, not even in a zygote. In all cases, whether involving a zygote or an iPS cell, interaction with a supportive environment is required to express the developmental program residing in the genome. [End Page 201]This biological reality supports what we have described as “early cellular development along the continuum of natural potentiality that can result in the formation of a fetus” (Magill and Neaves 2009, p. 30), and it presents a significant challenge to the natural potentiality argument.Gerard MagillVernon F. Gallagher Chair for the Integration of Science, Theology, Philosophy, and Law, and Professor, Center for Healthcare Ethics Duquesne University Pittsburgh, PA.William B. NeavesPresident and CEO Stowers Institute for Medical Research and Professor of Basic Medical Science University of Missouri at Kansas City School of Medicine Kansas City, MOReferencesCondic, Maureen L.; Lee, Patrick; and George, Robert P. 2008. Ontological and Ethical Implications of Direct Nuclear Reprogramming: Response to Magill and Neaves. Kennedy Institute of Ethics Journal 19: 33–40. Google ScholarMagill, Gerard, and Neaves William B. 2009. Ontological and Ethical Implications of Direct Nuclear Reprogramming. Kennedy Institute of Ethics Journal 19: 23–32. Google ScholarCopyright © 2009 The Johns Hopkins University Press... (shrink)

The fundamental interaction between discourse and context that pervades Newman’s many works provides the thread that weaves this collection together. There are five major divisions in the book.

This book is a systematic study of religious morality in the works of John Henry Newman (1801-1890). The work considers Newman's widely discussed views on conscience and assent, analyzing his understanding of moral law and its relation to the development of moral doctrine in Church tradition. By integrating Newman's religious epistemology and theological method, the author explores the hermeneutics of the imagination in moral decision-making: the imagination enables us to interpret complex reality in a practical manner, to relate belief with (...) action. The analysis bridges philosophical and religious discourse, discussing three related categories. The first deals with Newman's commitment to truth and holiness whereby he connects the realm of doctrine with the realm of salvation. The second category considers theoretical foundations of religious morality, and the third category explores Newman's hermeneutics of the imagination to clarify his view of moral law, moral conscience, and Church tradition as practical foundations of religious morality. The author explains how secular reason in moral discernment can elicit religious significance. As a result, Church tradition should develop doctrine and foster holiness by being receptive to emerging experiences and cultural change. John Henry Newman was a highly controversial figure and his insightful writings continue to challenge and influence scholarship today. This book is a significant contribution to that scholarship and the analysis and literature comprise a detailed research guide for graduates and scholars. (shrink)

Board oversight of community benefit constitutes an ethical imperative for nonprofit health care organizations. By "ethical imperative" we mean a health care organization's duty to fulfill value-based obligations that transcend compliance requirements in order to be consistent with its basic sense of purpose. We consider three points here: the existence of a distinctively ethical imperative for board oversight, the fact that the imperative is organizational in nature, and practical ways to fulfill its obligations. To explain the meaning of ethical imperative, (...) offer analytical clarification, and provide evidence-based guidelines we adopt an organizational ethics paradigm. Because community benefit for tax-exempt .. (shrink)

By appealing to the religious imagination Theology can make a distinctive contribution to business ethics. In the first part of the essay I examine what is entailed by appealing to the imagination to reason in ethics: through converging arguments the imagination enables us rationally to interpret reality and to infer obligations. In the following sections I consider the relevance of the religious imagination for business ethics. In the second part I explain the imagination''s use of religious metaphor to establish its (...) theological distinctiveness in ethical inquiry. Then in the final part I illustrate Theology''s contribution to business ethics by studying the imagination''s use of religious metaphor with regard to profit and to third world debt. (shrink)

Media reporting of recent business scandals, ranging from systemic accounting fraud to individual executive greed, has shed new light on the urgent need for organizational ethics in corporate America. The essay argues that organizational ethics can foster virtuous organizations by developing their sense of stewardship and integrity. This approach can inspire the ethical decision-making processes and standards of conduct for personnel throughout the organization. Another crucial role for organizational ethics is to regain lost trust and to recover the confidence of (...) our communities, whether we are discussing the business community or the health care community. Corporate America and organizations in health care need to win back the respect of skeptical customers, disheartened patients, and distrusting communities. But this task can be accomplished properly only when organizations and their business practices have a renewed commitment to ethics. The essay discusses how organizational ethics can permeate the entire organization in order to instill trust and confidence among its constituencies. Although the focus of the essay is upon the role of organizational ethics in health care, the argument also applies to the renewal of business practices in corporations across the nation. (shrink)