Bandersnatch is a unique piece of television. Like the eponymous choose your own adventure book at the center of its winding narrative, the episode lets the viewer actively make choices that shape the direction of the story. In this same spirit, we present this chapter in an equally novel way: as a collection of miniature essays on a dozen or so philosophical topics, loosely bound together. Just as in the episode, the reader's choices will determine the philosophical path she takes (...) through the chapter. The authors engage primarily with questions about freedom: Do we have free will? Is there any relationship between free will and moral responsibility? Can artistic expression provide us with socio‐political freedom? How does technology restrict freedom? In addition, we explore existential concerns about choice, consider the possibility of time travel and multiple universes, and ethically take viewers to task for decisions they made while watching the episode. (shrink)

Why do consumers who profess to be concerned about the environment choose not to buy greener products more regularly or even at all? This study explores how consumers’ perceptions towards green products, consumers and consumption practices contribute to our understanding of the discrepancy between green attitudes and behaviour. This study identified several barriers to ethical consumption behaviour within a green consumption context. Three key themes emerged from the study, ‘it is too hard to be green’, ‘green stigma’ and ‘green reservations’. (...) There is currently a perception, based on a number of factors, that it is too hard to be green, which creates a barrier to purchasing green products. Furthermore, some consumers were reluctant or resistant to participate in green consumption practices due to their unfavourable perceptions of green consumers and green messages. This article suggests that green perceptions may influence consumers’ intention to purchase green products. Accordingly, it discusses the implications, and suggests avenues for future research. (shrink)

With a growing number of genetic tests becoming available to the health and consumer markets, genetic health care providers in Canada are faced with the challenge of developing robust decision rules or guidelines to allocate a finite number of public resources. The objective of this study was to gain Canadian genetic health providers' perspectives on factors and criteria that influence and shape resource allocation decisions for publically funded predictive genetic testing in Canada. The authors conducted semi-structured interviews with 16 senior (...) lab directors and clinicians at publically funded Canadian predictive genetic testing facilities. Participants were drawn from British Columbia, Alberta, Manitoba, Ontario, Quebec and Nova Scotia. Given the community sampled was identified as being relatively small and challenging to access, purposive sampling coupled with snowball sampling methodologies were utilized. Surveyed lab directors and clinicians indicated that predictive genetic tests were funded provincially by one of two predominant funding models, but they themselves played a significant role in how these funds were allocated for specific tests and services. They also rated and identified several factors that influenced allocation decisions and patients' decisions regarding testing. Lastly, participants provided recommendations regarding changes to existing allocation models and showed support for a national evaluation process for predictive testing. Our findings suggest that largely local and relatively ad hoc decision making processes are being made in relation to resource allocations for predictive genetic tests and that a more coordinated and, potentially, national approach to allocation decisions in this context may be appropriate. (shrink)

Small and medium-sized enterprises (SMEs) play a critical role in the green economy due to their significant environmental footprint. Because more than 84% of the world’s population identifies with a religion, most SME top-executives are likely to identify with a religion that would influence their decision-making. Despite these recent advances, prior studies have focused on SMEs’ external drivers and did not consider the role of internal drivers, such as the characteristics of SMEs’ top-executives, in influencing green marketing strategy. We aim (...) to address this gap by focusing on religious identification as a key driver of green marketing by SMEs. Specifically, we examine the effects of top-executives’ religious identification on strategic green marketing orientation (SGMO), and how such effects are moderated by political ideology. Using respondents comprised of CEO and/or owner-managers of SMEs in the US, the results show empirical evidence supporting the importance of religious identification in influencing green marketing decisions. Moreover, we found that the effects of religious identification on SGMO are more pronounced among top-executives with Conservative ideology. (shrink)

The increased use of human biological material for cell-based research and clinical interventions poses risks to the privacy of patients and donors, including the possibility of re-identification of individuals from anonymized cell lines and associated genetic data. These risks will increase as technologies and databases used for re-identification become affordable and more sophisticated. Policies that require ongoing linkage of cell lines to donors’ clinical information for research and regulatory purposes, and existing practices that limit research participants’ ability to control what (...) is done with their genetic data, amplify the privacy concerns. (shrink)

Making better choices about future technologies that are being researched or developed is an important motivator behind lay ethics interventions. However, in practice, they do not always succeed to serve that goal. Especially authors who have noted that lay ethicists sometimes take recourse to well-known themes which stem from old, even ‘archetypical’ stories, have been criticized for making too little room for agency and decision-making in their approach. This paper aims to contribute to a reflection on how lay (...) class='Hi'>ethics can acquire more practical relevance. It will use resources in narrative ethics to suggest that in order to be relevant for action, facilitators of lay ethics interventions need to invite participants to engage in a narrative quest. As part of a quest, lay ethicists should be asked to reflect on a specific question or choice, use diverse input which is informative about the heterogeneity of viewpoints that are defended in society and argue for their standpoints. (shrink)

Making better choices about future technologies that are being researched or developed is an important motivator behind lay ethics interventions. However, in practice, they do not always succeed to serve that goal. Especially authors who have noted that lay ethicists sometimes take recourse to well-known themes which stem from old, even ‘archetypical’ stories, have been criticized for making too little room for agency and decision-making in their approach. This paper aims to contribute to a reflection on how lay (...) class='Hi'>ethics can acquire more practical relevance. It will use resources in narrative ethics to suggest that in order to be relevant for action, facilitators of lay ethics interventions need to invite participants to engage in a narrative quest. As part of a quest, lay ethicists should be asked to reflect on a specific question or choice, use diverse input which is informative about the heterogeneity of viewpoints that are defended in society and argue for their standpoints. (shrink)

The five narratives identified by the DEEPEN-project are interpreted in terms of the ancient story of desire, evil, and the sacred, and the modern narratives of alienation and exploitation. The first three narratives of lay ethics do not take stock of what has radically changed in the modern world under the triple and joint evolution of science, religion, and philosophy. The modern narratives, in turn, are in serious need of a post-modern deconstruction. Both critiques express the limits of humanism. (...) They do not imply, however, that these narratives should not be taken seriously. In particular, the enduring presence of three ancient narratives in laypeople’s symbolic thought is highly significant in terms of the role that the logic of the sacred keeps playing in the workings of modern societies. Lay people’s implicit understanding of how modern technology tends towards catastrophe and apocalypse provides the strongest argument for taking these narratives seriously. (shrink)

This paper contributes towards a lay ethics of nanotechnology through an analysis of talk from focus groups designed to examine how laypeople grapple with the meaning of a technology ‘in-the-making’. We describe the content of lay ethical concerns before suggesting that this content can be understood as being structured by five archetypal narratives which underpin talk. These we term: ‘the rich get richer and the poor get poorer’; ‘kept in the dark’; ‘opening Pandora’s box’; ‘messing with nature’; and ‘be (...) careful what you wish for’. We further suggest that these narratives can be understood as sharing an emphasis on the ‘giftedness’ of life, and that together they are used to resist dominant technoscientific and Enlightenment narratives of control and mastery which are encapsulated by nanotechnology. (shrink)

How can one discover the ethical issues associated with nanotechnologies? One heuristic is to tend closely to the ethical reflections of lay publics and the ways in which these are informed by experience with technological innovation, technology governance, and the (broken) promises of visionary science and technology. A close collaboration between social scientists and philosophers took this heuristic to its limits: On the one hand, it achieved remarkably fine–grained insights into public reflection about nanotechnologies. On the other hand, a philosophical (...) analysis of these reflections makes apparent that there is a profound disconnect between the lay ethics rooted in public talk and the ethical and normative commitments that are embedded in nanotechnological research programs and practices. Accordingly, critical engagement with the ways in which ordinary people try to make sense of nanotechnologies constitutes a novel heuristic for the discovery of ethical issues. This introduction and the subsequent four papers show this heuristic at work. (shrink)

Many consumers implicitly associate sustainability with lower product strength. This so-called ethical = less strong intuition (ELSI) poses a major threat for the success of sustainable products. This article explores this pervasive lay theory and examines whether it is a key barrier for sustainable consumption patterns. Even more importantly, little is known about the underlying mechanisms that might operate differently at the implicit and explicit levels of the consumer’s decision-making. To fill this gap, three studies examine how the implicit judgments (...) that consumers activate automatically shape their consumption behaviors, in concert with their more controlled explicit beliefs about sustainable products. The Main Study investigates the ELSI’s imprint on actual shopping patterns and disentangles the implicit and explicit mechanisms of the lay theory. This paper also asks how this negative influence can be attenuated by examining whether the consumer’s interest in sustainable consumption reduces reliance on the ELSI. Two follow-up studies confirm the robustness from different methodological and practical perspectives. Implications for companies and policy makers are derived. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Laying Medicine Open: Understanding Major Turning Points in the History of Medical EthicsLaurence B. McCullough (bio)AbstractAt different times during its history medicine has been laid open to accountability for its scientific and moral quality. This phenomenon of laying medicine open has sometimes resulted in major turning points in the history medical ethics. In this paper, I examine two examples of when the laying open of medicine has generated (...) such turning points: eighteenth-century British medicine and late twentieth-century American medicine. In the eighteenth century, the Scottish physician-philosopher, John Gregory (1724–1773), concerned with the unscientific, entrepreneurial, self-interested nature of then current medical practice, laid medicine open to accountability using the tools of ethics and philosophy of medicine. In the process, Gregory wrote the first professional ethics of medicine in the English-language literature, based on the physician’s fiduciary responsibility to the patient. In the late twentieth century, the managed practice of medicine has laid medicine open to accountability for its scientific quality and economic cost. This current laying open of medicine creates the challenge of developing medical ethics and bioethics for population-based medical science and practice.Reading the Histories of Medicine, Bioethics, and Medical EthicsThere are many ways in which to read the history of medi-cine and therefore of medical ethics and bioethics. For example, the history of medicine can be usefully understood in terms of successive advances or revolutions in biomedical science and its clinical applications, with medical ethics understood as a moral response to scientific and technological change. On this reading, which has been common in the history of bioethics for the past three decades, moral response is required to address scientific and technological changes that are unprecedented and therefore threaten to outstrip society’s moral capacities [End Page 7] to understand and manage those changes well. Much recent work on the ethical, legal, and social issues raised by the genome project appeals to this reading. The history of medicine can also be read in social terms, with medicine understood as a major social institution shaped by various factors, not limited to science. In this perspective, medicine and society are understood in terms of a complex and dynamic synergy. Bioethics and medical ethics become part of this synergy and are to be explained—perhaps even explained away—by social historical factors. There are, of course, other ways to read the history of medicine and therefore of bio-ethics and medical ethics—e.g., in terms of key figures and movements that are thought to have shaped developments in crucial ways.I want to suggest another way to read these histories, namely, the successive laying open of medicine to accountability that sometimes results in key turning points in the development of medical ethics and bioethics. On this reading, ethics is understood as an intellectual and practical discipline that makes medicine as a social institution and its practitioners, physicians, morally accountable for their clinical judgment, decision making, and behavior. This differs from Robert Veatch’s (1981) reading of the history of medical ethics either as particular—informed by intellectual, moral, and experiential resources thought to be available only to physicians—or universal—informed by intellectual, moral, and experiential resources generally available in the culture (present and past). Veatch sees medical ethics as open when it is universal and closed, and unacceptable, when it is particular. I read the history of medical ethics as always universal and medicine as a social institution and practice as sometimes closed—i.e, not accountable for its scientific and moral integrity—and sometimes as open, accountable for such integrity. When medicine is “laid open,” medical ethics itself is sometimes transformed. The same may well be the case for the other health care professions. The histories of medical ethics and bioethics, therefore, can be usefully read as responses to the laying open of medicine and the health care professions generally at various times in their histories. In what follows, I examine two important examples of laying medicine open that create key turning points in the history of medical ethics—Scottish medicine from the eighteenth century and American medicine from the end of the twentieth century.The... (shrink)

Despite societal concerns about the welfare of commercial laying hens, little attention has been paid to the welfare implications of the choices made by the genetics companies involved with their breeding. These choices regarding trait selection and other aspects of breeding significantly affect living conditions for the more than 7 billion laying hens in the world. However, these companies must consider a number of different commercial and societal interests, beyond animal welfare concerns. In this article we map some of the (...) relevant dilemmas faced by genetics companies in order to outline the scope of opportunities to improve welfare under current market conditions. This includes identifying cases where different animal welfare concerns conflict. We discuss the moral responsibility of laying hen genetics companies and the welfare implications that derive from the choices they make and the policies they follow. In addition to evaluating a selection of predominant current practices and breeding goals, we outline different angles from where to assess the moral legitimacy of various industry practices and policies. We discuss specific issues such as injurious pecking, bone health, induced moulting, chick culling and the circumstances of breeding stock. (shrink)

Since the 1988 Cartwright Inquiry, lay members of ethics committees have been tasked with ensuring that ordinary New Zealanders are not forgotten in ethical deliberations. Unlike Institutional Review Boards in North America, where lay members constitute a fraction of ethics committee membership, 50% of most New Zealand ethics committees are comprised of lay members. Lay roles are usually defined in very broad terms, which can vary considerably from committee to committee. This research queries who lay representatives are, (...) what they do, and what if anything they represent. Our findings are based on data collection with 12 participants: eight semi-structured interviews with lay members from diverse types of ethics committees who described their roles, and commentary from four ethics committee chairs, three of these lay members who commented on this article’s final draft. Findings indicate that the role of New Zealand lay persons – although distinctively valued – is otherwise similar to the documented role of lay persons within North American ethics committees. Lay members see their role as primarily protecting the research participant and at times offering a corrective to non-lay members’ views and the interests of their institutions. However, in spite of their numbers, most lay members do not see themselves as representing any particular constituent groups or institutionally unaffiliated areas of concern. On tertiary education committees especially, there is a good deal of ambiguity in the lay role. (shrink)

This paper seeks to clarify the process of ethical review primarily through a consideration of the lay member's role; it considers some of the conventional accounts of the role and portrays weaknesses in them. Its positive account places the ethical review service in a wide political context allowing the definition of lay member as a politically-positioned individual in the REC with the function of formally representing the public standards of morality in the medical research context.

ABSTRACT BackgroundIt isn’t clear how lay people balance the various ethical interests when addressing medical issues. We explored lay people’s ethical resolution models in relation to abortion. MethodsIn a tertiary healthcare setting, 196 respondents rank-ordered 42 opinion-statements on abortion following a 9-category symmetrical distribution. Statements’ scores were analyzed by averaging-analysis and Q-methodology. ResultsRespondents’ mean (SD) age was 34.5(10.5) years, 53% were women, 68% Muslims (31% Christians), 28% Saudis (26% Filipinos), and 38% healthcare-related. The most-agreeable statements were “Acceptable if health-benefit to (...) woman large,” “Acceptable if congenital disease risk large,” and “Woman’s right if fetus has congenital disease.” The most-disagreeable statements were “State’s right even if woman disagrees,” “Acceptable even with no congenital disease risk,” and “Father’s right even if woman disagrees.” Q-methodology identified several resolution models that were multi-principled, consequentialism-dominated, and associated with respondents’ demographics. The majority of Christian women and men identified with and supported a relatively “fetus rights plus State authority-oriented” model. The majority of Muslim women and men identified with and supported a “conception-oriented” model and “consequentialism plus virtue-oriented” model, respectively. One or more of three motives-related statements received extreme ranks on averaging-analysis and in 33% of the models. Conclusions1) On average, consequentialism, focusing on a woman’s health-benefit and congenital disease risk, was the predominant approach. This was followed by the rights approach, favoring a woman’s interest but taking context into account. 2) Q-methodology identified various ethical resolution models that were multi-principled and partially associated with respondents’ demographics. 3) Motives were important to some respondents, providing empirical evidence against adequacy of principlism. (shrink)

This paper considers the roles and definitions of expert and lay members of ethics committees, focussing on those given by the National Research Ethics Service which is mandated to review all research conducted in National Health Service settings in the United Kingdom. It questions the absence of a specified position for the ‘professional ethicist’ and suggests that such individuals will often be lay members of ethics committees, their participation being a reflection of their academic interest and expertise. (...) The absence of a specified position for professional ethicists and the concomitant but implicit denial of ethical expertise appear to be an anomalous state of affairs if one considers that the training offered to members of ethics committees is often delivered by academic ethicists. It is suggested that this is based on a misunderstanding of the concept ‘ethical expertise’ and that properly understood the ethicist can assist the work of ethics committees by drawing on their expert knowledge. (shrink)

-/- Policy regulations of ethically controversial genetic technologies should, on the one hand, be based on ethical principles. On the other hand, they should be socially acceptable to ensure implementation. In addition, they should align with ethical theory. Yet to date we lack a reliable and valid scale to measure the relevant ethical judgements in laypeople. We target this lacuna. -/- We developed a scale based on ethical principles to elicit lay judgments: the Genetic Technologies Questionnaire (GTQ). In two pilot (...) studies and a pre-registered main study, we validated the scale in a representative sample of the US population. -/- The final version of the scale contains 20 items but remains highly reliable even when reduced to five. It also predicts behaviour; for example, ethical judgments as measured by the GTQ predicted hypothetical donations and grocery shopping. In addition, the GTQ may be of interest to policymakers and ethicists because it reveals coherent and ethically justified judgments in laypeople. For instance, the GTQ indicates that ethical judgments are sensitive to possible benefits and harms (in line with utilitarian ethics), but also to ethical principles such as the value of consent-autonomy. -/- In conclusion, the GTQ can be recommended for research in both experimental psychology and applied ethics, as well as a tool for ethically and empirically informed policymaking. (shrink)

The rapid and dynamic nature of digital transformation challenges companies that wish to develop and deploy novel digital technologies. Like other actors faced with this transformation, companies need to find robust ways to ethically guide their innovations and business decisions. Digital ethics has recently featured in a plethora of both practical corporate guidelines and compilations of high-level principles, but there remains a gap concerning the development of sound ethical guidance in specific business contexts. As a multinational science and technology (...) company faced with a broad range of digital ventures and associated ethical challenges, Merck KGaA has laid the foundations for bridging this gap by developing a Code of Digital Ethics (CoDE) tailored for this context. Following a comprehensive analysis of existing digital ethics guidelines, we used a reconstructive social research approach to identify 20 relevant principles and derive a code designed as a multi-purpose tool. Versatility was prioritised by defining non-prescriptive guidelines that are open to different perspectives and thus well-suited for operationalisation for varied business purposes. We also chose a clear nested structure that highlights the relationships between five core and fifteen subsidiary principles as well as the different levels of reference—data and algorithmic systems—to which they apply. The CoDE will serve Merck KGaA and its new Digital Ethics Advisory Panel to guide ethical reflection, evaluation and decision-making across the full spectrum of digital developments encountered and undertaken by the company whilst also offering an opportunity to increase transparency for external partners, and thus trust. (shrink)

Most clinical ethics committees (CECs) have lay members. Why are they there, how are they chosen, and what do they do? Can their presence make health professionals less prone to jargon and hospital politicking, and can the lay members ever hope to represent the broad sweep of patients when many of them are white, middle class females? As hospital managers embrace CECs and even boast about them, will their informality be lost, with consequent exposure of professional and lay members (...) to public scrutiny and criticism? Will brave, open discussion be stifled, and the purpose of the committees ultimately be lost? (shrink)

Functional foods are a challenge tofood health policies, since they questioncentral ideas in the way that food healthpolicies have been developed over the lastdecades. Driven by market actors instead ofpublic authorities and focusing on the role ofsingle foods and single constituents in foodsfor health, they contrast traditional wisdombehind nutrition policies that emphasize therole of the diet as a whole for health.Sociological literature about food in everydaylife shows that technical rationality co-existswith other food related rationalities, such aspractical and economic rationalities, socialand (...) relational rationalities, and symbolicrationalities that influence citizens' ordinaryeating habits. An examination of lay views onexpert knowledge about food and health showthat skepticism exists with respect to thebasis of and balance of expert advice. Critical points with respect to how functionalfoods may influence routines in the populationswith relevance for public health include thefact, that they promote a way of thinking offood and health that is in conflict withwell-established practical ways of ensuring abalanced diet. (shrink)

Do psychotherapists' unethical practices influence how they are perceived? The 202 Israeli lay and professional psychology participants rated systematically varied descriptions of effective therapists and potential clients under conditions of no difficulties, practice without a license, and a previous sexual boundary violation on indexes of evaluation and willingness to refer. Participants completed a measure of important variables in therapist selection. Effective standard therapists were rated most favorably, unlicensed therapists were rated favorably, and therapists who violated sexual boundaries in the past (...) were rated least favorably. When results were analyzed by respondent characteristics, laypersons rated unlicensed professionals and sexual boundary violators more positively than did clinical psychologists. Men rated the violators more favorably than did women. Factor analysis of therapist selection measures identified professional and personal factors, but only the former were associated with ratings of "problem" therapists. The results underscore the gap between ethical standards and applied decisions made by professionals and laypersons. Further investigation is needed to ensure quality care in both professional and consumer approaches to psychotherapy. (shrink)

Objectives: To identify ethical attitudes about involuntary admission (known in Great Britain as formal admission) in mental health professionals and lay-people in England and Germany, especially looking at possible differences between Mental Health Professionals who are directly involved in the involuntary admission process and those who are not.Method: Three scenarios of potentially certifiable patients (known in Great Britain as sectionable patients) were presented to identify attitudes. A questionnaire asked about attitudes towards involuntary admission as well as treatment. A questionnaire analysis (...) was then performed.Results: There were similar attitudes towards involuntary admission between laypeople and mental health professionals involved in the involuntary admission process with the exception of professionals not actively involved in the involuntary admission process. Neither personal or professional experience with mental illness nor the different legal frameworks between Germany and England influenced attitudes much. Support for involuntary admission broadly increased with age.Conclusions: Psychiatrists and other mental health workers are in tune with society with regards to attitudes to involuntary admission. People involved with mentally ill patients but not in the involuntary admission process have negative attitudes towards involuntary admission. This may influence Mental Health Tribunals suggested in the new draft Mental Health Bill (2002) for England and Wales, because these Tribunals will potentially lack any involvement of professionals involved in the involuntary admission process. (shrink)

ABSTRACT Persons generally must give their informed consent to participate in research. To provide informed consent persons must be given information regarding the study in simple, lay language. Consent must be voluntary, and persons giving consent must be legally competent to consent and possess the capacity to understand and appreciate the information provided. This paper examines the relationship between the obligation to disclose information regarding risks and the requirement that persons have the capacity to understand and appreciate the information. There (...) has been insufficient attention to the extent to which persons must be able to understand and appreciate study information in order to have their consent deemed valid when the information is provided in simple, lay language. This paper argues that (1) the capacity to understand and appreciate information that should be deemed necessary to give valid consent should be defined by the capacity of the typical, cognitively normal adult and (2) the capacity of the typical, cognitively normal adult to understand and appreciate the concept of risk is limited. Therefore, (3) all things being equal, potential subjects must possess a limited capacity to understand and appreciate risk to be deemed competent to consent to research participation. (4) In some cases investigators ought to require that persons possess a greater than typical capacity to understand and appreciate risk. (shrink)

Background: There is a lack of empirical data on lay attitudes toward different sorts of deception in medicine. However, lay attitudes toward deception should be taken into account when we consider whether deception is ever permissible in a medical context. The objective of this study was to examine lay attitudes of U.S. citizens toward different sorts of deception across different medical contexts. Methods: A one-time online survey was administered to U.S. users of the Amazon “Mechanical Turk” website. Participants were asked (...) to answer questions regarding a series of vignettes depicting different sorts of deception in medical care, as well as a question regarding their general attitudes toward truth-telling. Results: Of the 200 respondents, the majority found the use of placebos in different contexts to be acceptable following partial disclosure but found it to be unacceptable if it involved outright lying. Also, 55.5% of respondents supported the use of sham surgery in clinical research, although 55% claimed that it would be unacceptable to deceive patients in this research, even if this would improve the quality of the data from the study. Respondents supported fully informing patients about distressing medical information in different contexts, especially when the patient is suffering from a chronic condition. In addition, 42.5% of respondents believed that it is worse to deceive someone by providing the person with false information than it is to do so by giving the person true information that is likely to lead them to form a false belief, without telling them other important information that shows it to be false. However, 41.5% believed that the two methods of deception were morally equivalent. Conclusions: Respondents believed that some forms of deception were acceptable in some circumstances. While the majority of our respondents opposed outright lying in medical contexts, they were prepared to support partial disclosure and the use of placebos when it is in the patient's interests or when it is what the person would want. These results support the position that physicians should be allowed a greater degree of authority to make a professional judgment about whether deception might be morally warranted by the circumstances, provided that it doesn't involve outright lying. (shrink)

Key to concerns about public involvement in technology governance is the concept of lay expertise, the idea that lay people possess some kind of special knowledge that neither trained experts in technology, ethics and social sciences nor professional politicians possess. There are at least four different meanings of "lay expert": (1) Lay people who are educated into quasi-experts on a particular issue or technology; (2) Lay people who turn themselves into experts in order to challenge scientific experts; (3) Lay (...) people with particular knowledge based on tradition and experience; (4) Lay people who represent an alternative perspective to expert views because they are non-experts. The challenge is that lay people are often ignorant in the relevant matters and wish to leave governance to experts. Still, there are normative reasons for lay engagement, either as stakeholders or as citizens in a deliberative democracy. According to the second approach, political decisions should be based on an inclusive open debate aimed at the better argument, providing lay people a crucial role in governance. In order to include lay people without making them hostage to experts, politicians or interest groups, we can engage them in focus group interviews which are analysed by social scientists and included in the interdisciplinary debate in journals and political forums. (shrink)

In this paper, I argue for an interpretation of Hume's Law that sees him as dismissing all possible arguments from is to ought on the basis of a comparison with his famous argument on induction.

Aim To study the views on the acceptability of physician-assisted-suicide of lay people and health professionals in an African country, Togo.Method In February–June 2012, 312 lay people and 198 health professionals in Togo judged the acceptability of PAS in 36 concrete scenarios composed of all combinations of four factors: the patient's age, the level of incurability of the illness, the type of suffering and the patient's request for PAS. In all scenarios, the patients were women receiving the best possible care. (...) The ratings were subjected to cluster analysis and analyses of variance.Results Most lay people were not systematically opposed to PAS, whereas most health professionals were systematically opposed to it. The most important factors in increasing acceptability among people not systematically opposed were advanced age of the patient and incurability of the illness. Additional acceptability was provided by the patient's request to have her life ended, although much less so than in studies in Western countries, and by suffering characterised by complete dependence rather than by extreme physical pain.Conclusions These empirical findings—the first ones gathered in the African continent—suggest that most Togolese lay people are not categorically for or against PAS, but judge its degree of acceptability as a function of concrete circumstances. (shrink)

In this essay I examine the formal structure of the concept of futility, enabling identification of the appropriate roles played by patient, professional, and society. I argue that the concept of futility does not justify unilateral decisions to forego life-sustaining medical treatment over patient or legitimate surrogate objection, even when futility is determined by a process or subject to ethics committee review. Furthermore, I argue for a limited positive ethical obligation on the part of health care professionals to assist (...) patients in achieving certain restricted goals, including the preservation of life, even in circumstances in which most would agree that that life is of no benefit to the patient. Finally, I address the objection that professional integrity overrides this limited obligation and find the objection unconvincing. In short, my aim in this essay is to see the concept of futility finally buried, once and for all. (shrink)

During a pandemic, demand for intensive care often exceeds availability. Experts agree that allocation should maximize benefits and must not be based on whether patients could have taken preventive measures. However, intensive care units are often overburdened by individuals with severe COVID-19 who have chosen not to be vaccinated to prevent the disease. This article reports an experiment that investigated the German public's prioritization preferences during the fourth wave of the coronavirus pandemic. In a series of scenarios, participants were asked (...) to decide on ICU admission for patients who differed in terms of health condition, expected treatment benefits, and vaccination status. The results reveal an in-group bias, as vaccinated individuals preferred to allocate more resources to the vaccinated than to the unvaccinated. Participants also favored admitting a heart attack patient rather than a COVID-19 patient with the same likelihood of benefiting from ICU admission, indicating a preference for maintaining regular ICU services rather than treating those with severe COVID-19. Finally, participants were more likely to admit a patient to intensive care when this meant withholding rather than withdrawing care from another patient. The results indicate that lay prioritizations violate established allocation principles, presaging potential conflicts between those in need of intensive care and those who provide and allocate it. It is therefore recommended that allocation principles should be explained to enhance public understanding. Additionally, vaccination rates should be increased to relieve ICUs and reduce the need for such triage decisions. (shrink)

In practice, the role of lay members of research ethics committees (RECs) often involves checking the accessibility of written materials, checking that the practical needs of participants have been considered and ensuring that a lay summary of the research will be produced. In this brief report, I argue that all these tasks would be more effectively carried out through a process of patient involvement (PI) in research projects prior to ethical review. Involving patients with direct experience of the topic (...) under investigation brings added value beyond the contributions typically made by lay REC members, who are often not patients themselves. This is because PI tailors the design and conduct of research to the specific interests and concerns of the people who will actually take part in a project and make use of its findings. If a project has PI in its early stages, then a similar input from lay REC members could at best result in duplication of effort and at worst create the potential for conflict. The rationale for lay REC membership will therefore need to change from ‘contributing a patient perspective’ to ‘ensuring transparency and public accountability in REC decisions’. This has implications for addressing more strategic questions about lay REC membership, including who is best recruited to the role and how they should be expected to contribute in practice. (shrink)

Background Factors that could potentially act as facilitators and barriers to successful recruitment strategies in perinatal clinical trials are not well documented. The objective was to assess lay persons’ understanding of the informed consent for randomized clinical trial in emergency obstetric and newborn care. Methods This was a qualitative study conducted among survivors of severe obstetric complications who were attending the post-natal clinic of Kawempe National Referral Hospital, Uganda, 6–8 weeks after surviving severe obstetric complications during pregnancy or childbirth. The (...) study that involved 18 in-depth interviews was conducted from June 1, 2019 to July 6, 2019. The issues explored included perceptions of the purpose and necessity to conduct such research how research-related information would be disclosed, and what could be the potential benefits and risks of participation. The data was analyzed by thematic analysis. Results Respondents felt that research was necessary to investigate the cause, prevention or complications of an illness, especially as much was known about some pregnancy and newborn complications. Most believed that the emergency contexts affects whether and what prospective participants may understand if information about research was disclosed. Whereas they did not see the value of procedures like randomization, they felt that if these and any other procedures necessary should be done transparently and fairly. The decisions to participate would significantly be influenced by possibility of risk to the unborn baby or the newborn. Solidarity was an important influence on decision-making. Conclusions Respondents valued participation in RCTs in emergency obstetric and newborn care. However, they expressed concerns and valued openness, transparency and accountability with regard to how clinical trials information is disclosed and the decision-making process for clinical trial participation. While autonomy and solidarity are contradictory values, they complement each other during decision-making for informed consent. (shrink)

Little has been written recently about the obligations of lay people in professional relationships. Yet the Code of Medical Ethics adopted by the American Medical Association in 1847 included an extensive statement on ‘Obligations of patients to their physicians’. After critically examining the philosophical foundations of this statement, I provide an alternative account of lay obligations in professional relationships. Based on a hypothetical social contract and included in a full specification of professional as well as lay obligations, this account (...) requires lay people to honor commitments and disclose relevant information. Ethically, the account assumes that all parties in lay-professional relationships should be given equal consideration and respect in determining rights and obligations. Factually, it assumes that the treatment of many illnesses and injuries requires collaboration and cooperation among lay persons and health professionals, that medical resources and personnel are limited, and that medicine, nursing, and related health professions, are, in MacIntyre's sense, practices. Keywords: patient-physician relationship, moral responsibility of patients, health professionals' duties, contract theory and lay-health professional relationship, health professions as "practices", commitments, truth-telling CiteULike Connotea Del.icio.us What's this? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Laying Medicine Open: Innovative Interaction Between Medicine and the HumanitiesLaurence B. McCullough and Warren Thomas ReichThe past three decades have witnessed the emergence and remarkable success of the fields of bioethics and medical humanities. The intellectual landscape of medicine and that of the humanities have been remarkably altered in the process. Twenty-five to 30 years ago in the United States there existed but a few courses in what came (...) to be called “bioethics” in departments of philosophy, religious studies, and theology in colleges and universities, a handful of programs of teaching in medical schools such as the University of Texas Medical Branch at Galveston and Pennsylvania State University School of Medicine at Hershey, and but one independent research center (the Hastings Center) and one university-based research center (the Kennedy Institute of Ethics at Georgetown University). Articles on bioethics began to appear in the peer-reviewed medical, nursing, and humanities literature and some books were published. There was only one journal in bioethics, The Hastings Center Report (which consolidated two previously separate journals from the Hastings Center). Graduate programs in bioethics and medical humanities in colleges and universities and fellowship training in bioethics and medical humanities in medical schools did not exist. Very little existed in colleges, universities, and medical schools in other countries. Now, of course, everything is different.Teachers, scholars, and students of bioethics and medical humanities should not take these remarkable changes for granted, for they represent a sustained and innovative interaction between medicine and the humanities. We have chosen the metaphor of “laying medicine open” to characterize the history of bioethics and medical humanities of the past three decades. This surgical metaphor was used in eighteenth-century Britain by a number of writers who wanted to make medical science and practice more accessible to the sick and to the lay public more generally (Lawrence 1975). We use the metaphor to characterize the efforts of teachers and [End Page 1] scholars over the past three decades and more to make the value-laden dimensions of biomedical science and practice and of health care policy more accessible to patients and to the lay public more generally. The result of this laying open of medicine has gone a long way toward bringing closer together the two cultures of science and the humanities that had, as C. P. Snow famously described, become significantly isolated from each otherAlbert Jonsen (1998) has recently contributed the first book-length history of what he calls the “birth” of bioethics, adding to the work of other scholars such as Warren Reich (1994; 1995) and Robert Baker (1993) and, before them, Corrado Viafora (1990) and David Rothman (1991). The articles in this issue of the Kennedy Institute of Ethics Journal make additional contributions to the developing understanding of the history of the past thirty years of interaction between medicine and the humanities.Laurence McCullough provides an historical context for the three accounts of the recent laying open of medicine that follow. McCullough examines two times in the history of medicine when it has been laid open to accountability (in addition to its being laid open to and by bioethics and medical humanities). The first laying open occurred in the work of the eighteenth-century Scottish physician and philosopher John Gregory, who set out to create a profession of medicine in a true moral sense of a fiduciary profession by making medicine accountable for its scientific and moral quality. The second occurred in the late twentieth century in which the managed practice of medicine in general, and managed care in particular, have begun to lay medicine open to accountability for its scientific and moral quality, as well as its cost and, at least in the public sector, its accessibility. McCullough argues that, just as Gregory responded to the ethical challenges of medicine laid open more than two centuries ago, bioethics should respond to the ethical challenges in the current laying open of medicine.Warren Reich provides an account of André Hellegers, whose premature death left an enormous gap in the field that will never be filled. Reich claims that Hellegers was engaged substantially in much more than the laying open of medicine: he... (shrink)

This paper focuses on experiences from a case study dealing with the Swiss type of a consensus conference called “PubliForum” concerning “Genetic Technology and Nutrition” (1999). Societal and ethical aspects of genetically modified food meanwhile can be seen as prototypes of topics depending on the involvement of the public through a participatory process. The important role of the lay perspective in this field seems to be accepted in practice. Nevertheless, there is still some theoretical controversy about the necessity and democratic (...) legitimacy of participatory processes in general, and especially about those dealing with technological or environmental problems (sustainable development) concerning society. From an ethical point of view, a lot of heterogeneous problems concerning contents and procedures of public participation can be pointed out, not only on the theoretical level but also in practice, e.g., concerning the communication process between laypersons and experts. The intention of our paper is to give hints and to clarify criteria that support the communication process leading to a dialog of autonomous citizens and which especially consider ethical aspects in the field. One important result is that there must be an orientation for all members of a consensus conference having clear rules and knowing their different roles that support transparency, credibility, and fairness of the whole procedure and a “good product”: a substantial final document or citizens’ report. (shrink)

The ethics of autonomous cars and automated driving have been a subject of discussion in research for a number of years :28–58, 2016). As levels of automation progress, with partially automated driving already becoming standard in new cars from a number of manufacturers, the question of ethical and legal standards becomes virulent. For exam-ple, while automated and autonomous cars, being equipped with appropriate detection sensors, processors, and intelligent mapping material, have a chance of being much safer than human-driven cars (...) in many regards, situations will arise in which accidents cannot be completely avoided. Such situations will have to be dealt with when programming the software of these vehicles. In several instances, internationally, regulations have been passed, based on legal considerations of road safety, mostly. However, to date, there have been few, if any, cases of a broader ethics code for autonomous or automated driving preceding actual regulation and being based on a broadly composed ethics committee of independent experts. In July 2016, the German Federal Minister of Transport and Digital Infrastructure, Alexander Dobrindt, appointed a national ethics committee for automated and connected driving, which began its work in September 2016. In June 2017, this committee presented a code of ethics which was published in German and in English. It consists of 20 ethical guidelines. Having been a member of this committee, I will present the main ethical topics of these guidelines and the discussions that lay behind them. (shrink)

In this article, we philosophically reflect on the nature of business management. We move beyond the political paradigm of the conceptualization of management in order to lay the ground for a philosophy of business management. First, we open-up the self-evident conceptualization of business management in contemporary management practices by comparing ancient and contemporary definitions of management. Second, we develop a framework with six dimensions of the nature of business management that can guide future philosophical and empirical work on the nature (...) of business management: management control, people management, asset management and entrepreneurial action, management as participation, management as responsive action and management as constituting meaning. (shrink)

Ethics and the Clinical Encounter explores the moral dimensions of clinical medicine and the phenomenon of illness, to determine what ethics must be in order to be fully responsive to clinical encounters. Written in a lively and conversational style with minimal technical terminology, and enhanced by actual experience or real clinical situations, this volume lays out a clinical ethics methodology both in practical and theoretical terms. Here's what the experts had to say: Professor Zaner has provided us (...) with a remarkably lucid and trenchant discussion of the interface of philosophy and the field of medicine. He brings into play an extraordinary range of historial knowledge, extensive observations based on firsthand experience with medical practices, and an acute sense of philosophical argumentation. This is a work that will be an exemplary and indispensable text in the philosophy of medicine for years to come. -- Calvin Schrag... it is a highly original contribution usable in a number of fields.... It really has no competition.... The genius of Zaner's approach is to ground ethics from the 'bottom up' and to direct us to the concrete particulars of therapeutic encounters wherein lie moral and ethical matters... meaty, challenging, and ultimately rewarding.... -- Paul R. Dokecki Richard M. Zaner founded the Center for Clinical and Research Ethics at Vanderbilt University Medical Center. Having established Vanderbilt's first Hospital Ethics Committee (1985), he served as co-chair of VUMC's Ethics Committee since its inception in 1990. Zaner has published five original books, edited ten, and translated four more, and has published more than 100 sections of books and professional journals. (shrink)

Ethics and Business: An integrated approach for business and personal success equips students with business ethics concepts and pragmatic knowledge they need to identify and solve ethical dilemmas, understand their own and others' ethical behavior, promote ethical behavior in their organization, and begin the process of living a life rich in meaning and happiness. Ethics and Business: An integrated approach for business and personal success provides a systematic and logical framework for understanding ethical challenges and thinking about (...) how to respond. The chapters build on each other. Part 1 (chapters 2-4) lay a foundation for a holistic view of individual ethics. Part 2 (chapters 5-7) provide important knowledge and language about organizational realities and how they deal with issues of ethics and compliance. Part 3 (chapters 8-12) offer students the opportunity to apply what they've learned around four common ethical challenges in business: Conflict of Interest, Bribery, Honesty/ Integrity, the Use and Abuse of Power, and Corporate Social Responsibility. Part 4 takes up some larger issues of ethics: the role of ethics in a market-based or planned economy and the ethical challenges that come with technological innovation. (shrink)

Biomedical research, on the one hand, contributes to important goals from generation of knowledge about the human body to the development and testing of therapeutics of all kinds. On the other hand, it can produce serious and sometimes unforeseeable consequences. In the ethical analysis of these two aspects of biomedical research, two important argumentative strategies play a major role. First, slippery slope arguments are used to warn of potential risks and to highlight knowledge-based limitations. Second, a dual-use problem describes the (...) challenge that already established techniques can be used for both morally wrong and morally right purposes. These two argumentative strategies appear to share several similarities, which will be investigated in this article. For this purpose, the article will first provide clear working definitions for both types of argument. This lays the foundation for the further ethical analysis. In a second step, and in order to investigate the similarities and differences of the argumentative strategies with an example from current ethical debates, CRISPR-Cas9, a currently very promising tool of genome editing, will be examined. The extent to which the possible applications of this genome editing tool can be addressed by slippery slope arguments or the dual use problem will be investigated. For this purpose, selected studies involving the use of CRISPR-Cas9 will be examined. Based on this two-step, analytic and example-based comparison of slippery-slope argumentation and dual-use considerations, the article will detail the ethically relevant difference between the two argumentative strategies and at the same time contribute to the ongoing ethical debate about CRISPR-Cas9. (shrink)

ALERT: Before you purchase, check with your instructor or review your course syllabus to ensure that you select the correct ISBN. Several versions of Pearson's MyLab & Mastering products exist for each title, including customized versions for individual schools, and registrations are not transferable. In addition, you may need a CourseID, provided by your instructor, to register for and use Pearson's MyLab & Mastering products. Packages Access codes for Pearson's MyLab & Mastering products may not be included when purchasing or (...) renting from companies other than Pearson; check with the seller before completing your purchase. Used or rental books If you rent or purchase a used book with an access code, the access code may have been redeemed previously and you may have to purchase a new access code. Access codes Access codes that are purchased from sellers other than Pearson carry a higher risk of being either the wrong ISBN or a previously redeemed code. Check with the seller prior to purchase. -- Students learn how traditional ethical theories can be applied to practical problems . Introducing Ethics is a brief text that encourages students to determine how the common wisdom of traditional ethical theories can be applied to practical problems such as the distribution of income and wealth, torture, terrorism, and gay and lesbian rights. The text begins by challenging students to think about whether or not ethics is useful for making choices. It poses three questions: 1) Is morality determined by religion rather than reason? 2) Is everything relative? 3) Is it better to be an egoist? Then, after laying out Utilitarian ethics, Kantian ethics, and Aristotelian ethics, the author poses an additional three challenges focused on the traditional conceptions of ethics: the environmental challenge, the feminist challenge, and the multicultural challenge. Learning Goals Upon completing this book readers will be able to: Answer the question: Do I make ethical or moral choices well? Determine their own responses to ethical challenges Note: MySearchLab does not come automatically packaged with this text. To purchase MySearchLab, please visit: www.mysearchlab.com or you can purchase a ValuePack of the text + MySearchLab (at no additional cost): ValuePack ISBN-10: 0205903843 / ValuePack ISBN-13: 9780205903849. (shrink)

Engaging with the philosophical writings of Iris Murdoch, we submit that there are difficulties associated with providing a good description of morality that are intimately connected with difficulties in understanding other human beings. We suggest three senses in which moral philosophical reflection needs to account for our understanding of others: (1) the failure to understand someone is not merely an intellectual failure, but also engages us morally; (2) the moral question of understanding is not limited to the extent to which (...) we understand a particular person, but also presents itself in how we picture difficulties in understanding people; and (3) “philosophical pictures of morality” fundamentally shape the conceptual framework we use to investigate morality, as well as the analysis of morality we find illuminative and satisfactory. Exploring the implications of these claims, we ask what it means to think of others as the same, or as different, from ourselves. We then consider the ethical significance of finding, or not finding, our feet in our encounters with others, dwelling on how the metaphor of movement reveals one way in which we are never at peace in the exploration of morality. (shrink)

In this article we consider what form a future supranational animal protection regime might take. We conclude that no such regime exists at present, although one is likely to develop over the next couple of decades, with two viable options already on the horizon. One model would see the role of the World Organisation for Animal Health (OIE) extended, whereas the other would occur within the context of the United Nations (UN). The former would suit agricultural interests, whereas the latter (...) would probably appeal to so-called new welfarists. However, neither is likely to satisfy animal rights advocates because both regimes assume animals can be legitimately traded and utilized as means to human ends. (shrink)

How the diversity of membership of research ethics committees is arrived at has, to date, largely been fairly arbitrary. However, a tool to help determine one's moral preference is now available and it is introduced here as, arguably, having the potential to assist with ensuring a more meaningful diversity amongst an ethics committee's membership. The tool is seen to be easily applied – but, it is argued, may be conceived on at least two false premises. Firstly, despite different (...) theories of ethics, none can be proved to give the ‘right’ answer other than in its own terms. Secondly, if there is an ethical hierarchy, as the model suggests, then ethical diversity must become redundant for the possibility of achieving ethical excellence. (shrink)

This essay assesses the oft‐made link between Walter Rauschenbusch and Martin Luther King Jr. Denying neither Rauschenbusch’s influence on King nor King’s social gospel status, it nevertheless questions the way historians locate Rauschenbusch’s legacy in King and the civil rights movement. This strategy, however unintentionally, reproduces the white social gospel’s “astigmatism” on race and undermines the contributions of black social gospel (and other neglected) leaders even as revised histories affirm them. After exploring King’s references to Rauschenbusch and Rauschenbusch’s reflections on (...) race, the paper compares their theologies. This comparison reveals key differences on race and economic justice that ramify across Rauschenbusch’s and King’s distinctive articulations of social gospel categories, further complicating historians’ claims on King. Oversimplifying the connection between these important figures in religious ethics distorts theological understanding of social gospel legacies and compromises their power for future generations. (shrink)