It is a welcome development when academic philosophy starts to concern itself with practical issues, in such a way as to influence people's lives. Recently this has happened with one moral issue in particular—but infortunately it is the wrong issue, and people's actions have been influenced in the wrong way. The issue is that of the moral status and treatment of animals. A number of philosophers have argued for what they call ‘animal liberation’, comparing it directly with egalitarian causes such (...) as women's liberation and racial equality and suggesting that, if racism and sexism are rationally indefensible, so is ‘speciesism’. If one ought to give equal consideration to the interests of all human beings, then, so they daim, one must on the same grounds and in the same way recognize that ‘all animals are equal’, be they human or non-human. We believe that this assimilation of ‘animal liberation’ to human liberation movements is mistaken. (shrink)

Liberalism welcomes diversity in substantive ideas of the good but not in the process whereby these ideas are formed. Ideas of the good acquire weight on the presumption that each is a person's own, formed independently. But people differ in their capacities to conceptualize. Some, appropriately characterized as cerebral, are proficient in and profoundly involved with conceptualizing. Others, labeled cognitively disabled, range from individuals with mild limitations to those so unable to express themselves that we cannot be sure whether their (...) behavior is mediated by concepts at all. Constricted cognitive capacities have been thought to prevent participation in the prescribed process for forming personalized ideas of the good. So liberal theory, when formulating principles and practices of justice, often disregards cognitively disabled peoples' perspectives. We put aside metaphysically driven notions about personhood and show how interpersonal processes of “prosthetic” thinking (different from surrogacy) can satisfy liberalism's standards, positioning cognitively disabled individuals as fully participating subjects of justice. (shrink)

Peterson, Karlawish and Largent offer a defense of supported decision making in health care for people with dynamic and diminishing capacity. They are to be warmly commended for bringing sup...

The growing use of interoperable electronic health records is likely to have significant effects on the physician-patient relationship. This relationship involves two-way trust: of the physician in patients, and of the patients in their providers. Interoperable records opens up this relationship to further view, with consequences that may both enhance and undermine trust. On the one hand, physicians may learn that information from their patients is — or is not — to be trusted. On the other hand, patients may learn (...) from the increased oversight made possible by electronic records that their trust in their physicians is — or is not — warranted. Release of information through new methods of surveillance may also undermine patient trust. The article concludes that because trust is fragile, attention to transparency and confidentiality in the use of interoperable electronic records is essential. (shrink)

The United States, like other countries facing rising health care costs, is pursuing a commitment to interoperable electronic health records. Electronic records, it is thought, have the potential to reduce the risks of error, improve care coordination, monitor care quality, enable patients to participate more fully in care management, and provide the data needed for research and surveillance. Interoperable electronic health records on a national scale — the ideal of a national health information network — seem likely to magnify these (...) advantages. Thus, the recent economic stimulus package contains considerable funding for the development of “health information technology architecture that will support the nationwide electronic exchange and use of health information in a secure, private, and accurate manner.”. (shrink)

Statutes criminalizing behavior that risks transmission of HIV/AIDS exemplify use of the criminal law against individuals who are victims of infectious disease. These statutes, despite their frequency, are misguided in terms of the goals of the criminal law and the public health aim of reducing overall burdens of disease, for at least three important reasons. First, they identify individual offenders for punishment, a paradigm that is misplaced in the most typical contexts of transmission of infectious disease and even for HIV/AIDS, (...) despite claims of AIDS exceptionalism. Second, although there are examples of individuals who transmit infectious disease in a manner that fits the criminal law paradigm of identification of individual offenders for deterrence or retribution, these examples are limited and can be accommodated by existing criminal laws not devoted specifically to infectious disease. Third, and most importantly, the current criminal laws regarding HIV/AIDS, like many other criminal laws applied to infectious disease transmission, have been misguided in focusing on punishment of the diseased individual as a wrongful transmitter. Instead of individual offenders, activities that enhance the scale of disease transmission—behaviors that might be characterized as ‘transmission facilitation’—are a more appropriate target for the criminal law. Examples are trafficking in human beings (including sex trafficking, organ trafficking, and labor trafficking), suppression of information about the emergence of infection in circumstances in which there is a legally established obligation to disclose, and intentional or reckless activities to discourage disease treatment or prevention. Difficulties remain with justifications for criminalizing even these behaviors, however, most importantly the need for trust in reducing overall burdens of disease, problems in identifying individual responsible offenders, and potential misalignment between static criminal law and the changing nature of infectious disease. (shrink)

Defenders of patient autonomy have successfully supported the legal adoption of advance directives. More recently, some defenders of patient autonomy have also supported the legalization of voluntary active euthanasia. This paper explores the wisdom of combining both practices. If euthanasia were to become legal, should it be permitted by advance directives? The paper juxtaposes the most significant doubts about advance directives, with the most significant doubts about euthanasia. It argues that the doubts together raise more concern about the combined practices (...) than about either euthanasia or advance directives separately. Not all cases of voluntary euthanasia by advance directive are equally problematic, however. Advance directives can help in the defense of euthanasia for patients who make the request in advance and reaffirm it under circumstances of severe suffering. Keywords: advance directives, durable power of attorney, euthanasia, living will, patient interests CiteULike Connotea Del.icio.us What's this? (shrink)

Many problems in environmental ethics are what have been called “global systemic problems,” problems in which what happens in one part of the world affects preservationist efforts elsewhere. Restoration of the Everglades is one such example. If global warming continues, the Everglades may well be flooded within the next quarter to half century and all restoration efforts will be for naught. Yet, the United States government is both pursuing restorationist efforts and withdrawing from the Kyoto Protocol on emissions of greenhouse (...) gases. One aspect of global systemic problems concerns whether there are interconnections between the preservationist obligations of the locals and the duties of others. There are three main lines of arguments for concluding that there are, indeed, interconnected obligations in such cases. First, the consequentialist case for imposing duties on locals assumes that others do not have inconsistent consequentialist obligations. In addition, a related consequentialist case can be made that when problems are systemic, others have positive supportive duties. Second, a weak principle of reciprocity supports the interconnectedness of obligations. Insistence that someone has an obligation that benefits you implies the duty not to act to undermine the efforts of that person to fulfill that obligation. Third, a weak principle of fairness—that it is only fair to expect one person to bear the burdens of producinga collective good if others have obligations to do their cooperative part—supports interconnected obligations with regard to global systemic problems. Because all three arguments point to the same conclusion, there is a very strong case for interconnected obligations as part of the solution to global systemic problems—problems that are all too prevalent in our world today. (shrink)

The American Journal of Bioethics, Volume 12, Issue 4, Page 15-17, April 2012.

This chapter contains sections titled: Understanding Disability in Relation to Social Justice Cognitive Disabilities and Equality Considering Disability under Conditions of Injustice.

Rothstein (2010) argues that groups may be harmed by research on deidentified data. He concludes that researchers are obligated to minimize group harms and demonstrate respect for a studied group t...

Many problems in environmental ethics are what have been called “global systemic problems,” problems in which what happens in one part of the world affects preservationist efforts elsewhere. Restoration of the Everglades is one such example. If global warming continues, the Everglades may well be flooded within the next quarter to half century and all restoration efforts will be for naught. Yet, the United States government is both pursuing restorationist efforts and withdrawing from the Kyoto Protocol on emissions of greenhouse (...) gases. One aspect of global systemic problems concerns whether there are interconnections between the preservationist obligations of the locals and the duties of others. There are three main lines of arguments for concluding that there are, indeed, interconnected obligations in such cases. First, the consequentialist case for imposing duties on locals assumes that others do not have inconsistent consequentialist obligations. In addition, a related consequentialist case can be made that when problems are systemic, others have positive supportive duties. Second, a weak principle of reciprocity supports the interconnectedness of obligations. Insistence that someone has an obligation that benefits you implies the duty not to act to undermine the efforts of that person to fulfill that obligation. Third, a weak principle of fairness—that it is only fair to expect one person to bear the burdens of producinga collective good if others have obligations to do their cooperative part—supports interconnected obligations with regard to global systemic problems. Because all three arguments point to the same conclusion, there is a very strong case for interconnected obligations as part of the solution to global systemic problems—problems that are all too prevalent in our world today. (shrink)