Dimensions of character are often overlooked in professional practice at the expense of the development of technical competence and operational efficiency. Drawing on philosophical accounts of virtue ethics and positive psychology, the present work attempts to elevate the role of ‘good’ character in the professional domain. A ‘good’ professional is ideally one that exemplifies dimensions of character informed by sound judgement. A total of 2340 professionals, from five discrete professions, were profiled based on their valuation of qualities pertaining to character (...) and judgement. Profile differences were subsequently examined in the self-reported experience of professional purpose towards a wider societal ‘good’. Analysis of covariance, controlling for stage of career, revealed that professionals valuing character reported higher professional purpose than those overweighting the importance of judgement or valuing neither character nor judgement, F = 7.92, p <.001. No differences were found between the two groups valuing character, irrespective of whether judgement was valued simultaneously. This profiling analysis of entry-level and in-service professionals, based on their holistic character composition, paves the way for fresh philosophical discussion regarding what constitutes a ‘good’ professional and the interplay between character and judgement. The empirical findings may be of substantive value in helping to recognise how the dimensions of character and judgement may impact upon practitioners’ professional purpose. (shrink)

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...) on the pathway to an eventual certification process for clinical ethics consultants. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 10.1 (2000) 103-108 [Access article in PDF] Letters "Small Sacrifices" in Stem Cell Research Madam: I agree with Professors McGee and Caplan (in their article "The Ethics and Politics of Small Sacrifices in Stem Cell Research," KIEJ, June 1999) that the question of the nature and status of the source of stem cells must be addressed. However, in their eagerness to convince us of (...) the smallness of the sacrifices, I think the authors use some unfortunate rhetorical devices and move much too quickly over some necessary distinctions.The rhetorical display is unfortunate if the article is intended to be a fair and rational development of an argument--e.g., those who hold a position in opposition to the authors do not argue they "inveigh." The section on the political area of the controversy seems particularly dismissive of other's positions.However, I will focus on just two areas where I think a more nuanced consideration would make the question of the moral legitimacy of the "small sacrifices" of embryos less obvious than the authors' rhetoric would suggest.First, they claim that opponents of such research assume some sort of "super status" for an embryo. The rights generally conceded to born human beings may not be as "weak" as they characterize. But even considering only the "negative right against unwarranted violence," I think the authors misdescribe the situation. Contrary to their assertion, I do not know when "adults and even children are... forced to give life... in the defense or at least interest of the community's highest ideals and most pressing interests" (p. 153). Could they be speaking of capital punishment, justified in the name of protecting the community? But then why mention children?It is true that not everyone can be guaranteed every means to preserving and enhancing life. But this limitation on positive rights is not a "forced giving." Adults may be compelled to risk life--e.g. in a draft for the sake of a war. But, again, the more or less justifiable imposition of a risk is not the same as selecting out one particular individual or class to be directly killed. Neither adults nor born children are compelled to be killed for the sake of organ "donation," even if a greater number might be saved. If one grants equivalent status to the embryo (as the authors seem to do here for the sake of argument), opponents do not have to claim a "super status" for embryos, just the ordinary human right not to be killed even for "compassionate" motives.A second area where I think the authors move too quickly is in their impoverished definition of the essential humanity of the early embryo as exhaustively represented by the physical structure of its DNA. The authors seem to recognize [End Page 103] that, ordinarily, there is more to personhood than sheer physical structure. For example, they mention memories and habits (p. 154). They could also speak of relationships, attitudes, and the like. Since an early embryo has no such components of personality as we experience it, the authors hold that its identity could only be contained in its DNA. Since this DNA is preserved, even spread far and wide, by the use of stem cells, it almost seems as if we are doing the early embryo a favor by breaking it up.However, just because the embryo does not have any conscious memories or other attributes of character or personality, that does not mean its identity is constituted only by its physical structure described statically. The early embryo is not just a bundle of discrete structures, and its DNA is not just an inert lump made up of certain smaller lumps. Both the embryo and its DNA are active. Thus the identity of even an early embryo includes both its current processes and the innate potential for further activity and development. Although lacking a conscious will, the early embryo is already in a sense an agent, already doing things--growing, changing, and heading toward something that... (shrink)

Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient’s interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians (...) have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. (shrink)

Clinical ethics consultation is largely outside the scope of regulation and oversight, despite its importance. For decades, the bioethics community has been unable to reach a consensus on whether there should be accountability in this work, as there is for other clinical activities that influence the care of patients. The American Society for Bioethics and Humanities, the primary society of bioethicists and scholars in the medical humanities and the organizational home for individuals who perform CEC in the United States, has (...) initiated a two‐step quality attestation process as a means to assess clinical ethics consultants and help identify individuals who are qualified to perform this role. This article describes the process. (shrink)

This volume has 41 chapters written to honor the 100th birthday of Mario Bunge. It celebrates the work of this influential Argentine/Canadian physicist and philosopher. Contributions show the value of Bunge’s science-informed philosophy and his systematic approach to philosophical problems. The chapters explore the exceptionally wide spectrum of Bunge’s contributions to: metaphysics, methodology and philosophy of science, philosophy of mathematics, philosophy of physics, philosophy of psychology, philosophy of social science, philosophy of biology, philosophy of technology, moral philosophy, social and political (...) philosophy, medical philosophy, and education. The contributors include scholars from 16 countries. Bunge combines ontological realism with epistemological fallibilism. He believes that science provides the best and most warranted knowledge of the natural and social world, and that such knowledge is the only sound basis for moral decision making and social and political reform. Bunge argues for the unity of knowledge. In his eyes, science and philosophy constitute a fruitful and necessary partnership. Readers will discover the wisdom of this approach and will gain insight into the utility of cross-disciplinary scholarship. This anthology will appeal to researchers, students, and teachers in philosophy of science, social science, and liberal education programmes. 1. Introduction Section I. An Academic Vocation Section II. Philosophy Section III. Physics and Philosophy of Physics Section IV. Cognitive Science and Philosophy of Mind Section V. Sociology and Social Theory Section VI. Ethics and Political Philosophy Section VII. Biology and Philosophy of Biology Section VIII. Mathematics Section IX. Education Section X. Varia Section XI. Bibliography. (shrink)

This paper investigates the effect of the countervailing forces within organizations of formal systems that direct employees toward ethical acts and informal systems that direct employees toward fraudulent behavior. We study the effect of these forces on deception, a key component of fraud. The results provide support for an interactive effect of these formal and informal systems. The effectiveness of formal systems is greater when there is a strong informal “push” to do wrong; conversely, in the absence of a strong (...) push to do wrong, the strength of formal systems has little impact on fraudulent behavior. These results help to explain why the implementation of formal systems within organizations has been met with mixed results and identifies when formal systems designed to promote ethical behavior will be most efficacious. (shrink)

Trust is indispensable not only for interpersonal relationships and social life, but for good quality healthcare. As manifested in the increasing violence and tension in patient-physician relationships, China has been experiencing a widespread and profound crisis of patient–physician trust. And globally, the crisis of trust is an issue that every society, either developing or developed, has to face in one way or another. Yet, in spite of some pioneering works, the subject of patient-physician trust and mistrust – a crucial matter (...) in healthcare especially because there are numerous ethical implications – has largely been marginalized in bioethics as a global discourse. Drawing lessons as well as inspirations from China, this paper demonstrates the necessity of a trust-oriented bioethics and presents some key theoretical, methodological and philosophical elements of such a bioethics. A trust-oriented bioethics moves beyond the current dominant bioethical paradigms through putting the subject of trust and mistrust in the central agenda of the field, learning from the social sciences, and reviving indigenous moral resources. In order for global bioethics to claim its relevance to the things that truly matter in social life and healthcare, trust should be as vital as such central norms like autonomy and justice and can serve as a potent theoretical framework. (shrink)

To investigate the phenomenon of patient–physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi-structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient-physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust leads to increased levels of fear and self-protection by doctors which exacerbate difficulties (...) in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust. The vicious circle indicates not only the crisis of patient-physician relationship but the crisis of medicine as a profession and institution. Underlying the circle is the inherent conflict of interest in the healthcare system by which health professionals and hospitals have become profit-driven. This institutional conflict of interest seriously compromises the fundamental principle of medical professionalism—the primacy of patient welfare—as well as the traditional Chinese ideal of “medicine as the art of humanity”. Patient trust can be restored through rectifying this institutional conflict of interest and promoting medical professionalism via a series of recommended practical measures. (shrink)

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

We are sympathic with LeDoux’s primary goal here ─ to get a solid scientific grip on what has been dubbed one of the most elusive, important questions in scientific discourse, to identify the underlying biomolecular processes that give rise to consciousness. However, we have issues with the way he goes about it and have tried to present them in a constructive manner. Our commentary is built around our theory of the origins of minds, dubbed the Cellular Basis of Consciousness (CBC), (...) and the empirical research that supports it. The CBC is based on the proposition that life and sentience are co-terminous, that life without subjectivity, feeling, without valenced perception, without the capacity to learn and lay down memories would have been an evolutionary dead-end. It could not have survived in the hostile, chaotic world in flux that dominated our planet four billion years ago. The biological sciences operate on the principle that all species, extant and extinct, evolved from the first prokaryotes. The CBC theory is founded on the principle that all expressions of emotion, perception, and cognition did as well. (shrink)