This article critically questions the commercialization of hospice care and the ethical concerns associated with the industry's movement toward “market-driven medicine” at the end of life. For example, the article examines issues raised by an influx of for-profit hospice providers whose business model appears at its core to have an ethical conflict of interest between shareholders doing well and terminal patients dying well. Yet, empirical data analyzing the experience of patients across the hospice industry are limited, and general claims that (...) end-of-life patient care is inferior among for-profit providers or even that their business practices are somehow unseemly when compared to nonprofit providers cannot be substantiated. In fact, non-profit providers are not immune to potentially conflicting concerns regarding financial viability (i.e., “no margin, no mission”). Given the limitations of existing empirical data and contrasting ideological commitments of for-profit versus non-profit providers, the questions raised by this article highlight important areas for reflection and further study. Policymakers and regulators are cautioned to keep ethical concerns in the fore as an increasingly commercialized hospice industry continues to emerge as a dominant component of the U.S. health care system. Both practitioners and researchers are encouraged to expand their efforts to better understand how business practices and commercial interests may compromise the death process of the patient and patient's family — a process premised upon a philosophy and ethical tradition that earlier generations of hospice providers and proponents established as a trusted, end-of-life alternative. (shrink)
Financial ties between physicians and pharmaceutical companies are pervasive and controversial. However, little is known about how patients perceive such ties. This paper describes an experiment examining how a national sample of U.S. adults perceived a variety of financial relationships between physicians and drug companies. Each respondent read a single scenario about a hypothetical physician and his financial ties to the pharmaceutical industry; scenarios varied in terms of payment type of and amount. Respondents then evaluated the physician on several dimensions (...) . Findings revealed that perceptions of the physician were more strongly influenced by payment type than by payment amount. Specifically, respondents were quite critical of doctors who owned drug company stock or received industry payments for meals and lodging, but were more forgiving of physicians who received free drug samples or consulting fees . Interestingly, physicians who received no payments, while seen as honest, were also viewed by some respondents as inexperienced or uninformed about new treatments. Implications for public policy and future research are discussed. (shrink)
Writing in 1999, legal ethics scholar Brad Wendel noted that “[v]ery little empirical work has been done on the moral decision making of lawyers.” Indeed, since the mid-1990s, few empirical studies have attempted to explore how attorneys deliberate about ethical dilemmas they encounter in their practice. Moreover, while past research has explored some of the ethical issues confronting lawyers practicing in certain specific areas of practice, no published data exists probing the moral mind of health care lawyers. As signaled by (...) the creation of a regular column “devoted to ethical issues arising in the practice of health law” in the Journal of Law, Medicine & Ethics, the time to address the empirical gap in the professional ethics literature is now. Accordingly, this article presents data collected from 120 health care lawyers. Presenting this population with a number of hypothetical scenarios relating to how they would respond when confronting an ethical dilemma without an obvious solution or when facing a situation in which their personal values were in tension with their professional obligations, this article represents a first step toward better understanding how lawyers who practice in health care settings understand and resolve the moral discomfort they encounter in their professional lives. (shrink)
"Thinking like a lawyer" is a phrase familiar to every law student, and the development of these analytical skills are, of course, essential. In this essay, however, I reflect on the value of a more expansive approach to professional formation. I argue that legal education best serves students, the bar, and the society when it takes seriously the importance of moral imagination, interpersonal relationships, and personal wellness.
ExcerptThe Summer 2010 issue of Telos contained an article by Rebecca E. Karl in which she alleged that, as President of the Association for Asian Studies, I argued in an “inaugural AAS speech’” that “the current appeal to a Confucian-inspired harmonious society (hexie shehui) provides evidence for the fact that the old Confucian lack of rights-thinking is the cultural basis for the CCP's lack of rights thinking.”1 No citation or footnote was offered for this allegation. First, let me clarify that (...) I never delivered an “inaugural AAS speech.” My official speech as president of the Association for Asian Studies was…. (shrink)
The following is a joint report of the Committee on Philosophy in Education of the American Philosophical Association and of the Committee on Cooperation with the American Philosophical Association of the Philosophy of Education Society. The report has been approved by the Executive Committee of the Philosophy of Education Society and by the Board of Officers of the American Philosophical Association. The Committee of the American Philosophical Association was composed of the following: C. W. Hendel, Chairman, H. G. Alexander, R. (...) M. Chisholm, Max Fisch, Lucius Garvin, Douglas Morgan, A. E. Murphy, Charner Perry and R. G. Turnbull. The Committee of the Philosophy of Education Society consisted of Fr. R. J. Henle, S.J., Chairman, and Professors Barton, Clayton, Drake, and Hullfish. The American Philosophical Association subcommittee with primary responsibility for this report was composed of Charner Perry, Chairman, and Douglas Morgan. (shrink)
The following statement is a report of the Committee on Philosophy in Education of the American Philosophical Association and was approved by the Association's Board of Officers in December, 1958. The Committee was composed of the following: C. W. Hendel, Chairman, H. G. Alexander, R. M. Chisholm, Max Fisch, Lucius Garvin, Douglas Morgan, A. E. Murphy, Charner Perry and R. G. Turnbull. Primary responsibility for the preparation of this report belonged to a subcommittee composed of Douglas N. Morgan, Chairman, (...) and Charner Perry. (shrink)
Reck has rendered the philosophical community an invaluable service in providing these lucid, systematic and faithful expositions of the thought of the ten men he has selected: R. B. Perry, W. E. Hocking, G. H. Mead, J. E. Boodin, W. M. Urban, D. H. Parker, R. W. Sellars, A. O. Lovejoy, E. Jordan and E. S. Brightman. Included is a general introduction in which Reck offers a brief perspective upon the extra ordinary diversity and richness characteristic of the period (...) in American philosophy which these men represent. Bibliographical notes are given at the end of each chapter.—E. A. R. (shrink)
The diffusion of technology in the US has taken place in an environment of both regulation and free enterprise. Each has been subject to manipulation by doctors and medical administrators that has fostered unprecedented ethical dilemmas and legal challenges. Understanding these developments and historical precedents may allow a more rational diffusion policy for medical technology in the future.
The authors reject arguments by Professor Joseph Fletcher (author of Situation Ethics) that in some circumstances parents may be held responsible for producing genetically defective offspring, but offer arguments of their own for the same conclusion. Their arguments could, they suggest, justify `wrongful life' claims by the genetically defective infant against the mother. While researching this paper both authors were postdoctoral fellows in medical ethics in the Program on Human Values and Ethics at the University of Tennessee Center for the (...) Health Sciences. (shrink)
This paper examines the historical rise of both cardiopulmonary resuscitation and the do-not-resuscitate order and the wisdom of their continuing status in U.S. hospital practice and policy. The practice of universal presumed consent to CPR and the resulting DNR policy are the products of a particular time and were responses to particular problems. In order to keep the excesses of technology in check, the DNR policies emerged as a response to the in-hospital universal presumed consent to CPR. We live with (...) this historical concretion, which seems to perpetuate a false culture that the patient's wishes must be followed. The authors are critical of the current U.S. climate, where CPR and DNR are viewed as two among a panoply of patient choices, and point to UK practice as an alternative. They conclude that physicians in the United States should radically rethink approaches to CPR and DNR. (shrink)
Though we agree with their argument that language is shaped by domain-general learning processes, Christiansen & Chater (C&C) neglect to detail how the development of these processes shapes language change. We discuss a number of examples that show how developmental processes at multiple levels and timescales are critical to understanding the origin of domain-general mechanisms that shape language evolution.