Variant Creutzfeldt–Jakob disease is a fatal, transmissible, neurodegenerative disorder for which there is currently no effective treatment. vCJD arose from the zoonotic spread of bovine spongiform encephalopathy. There is now compelling evidence for human to human transmission through blood transfusions from presymptomatic carriers and experts are warning that the real epidemic may be yet to come. Imperatives exist for the development of reliable, non-invasive presymptomatic diagnostic tests. Research into such tests is well advanced. In this article the ethical implications of (...) the availability of these tests are elaborated and comparisons drawn with predictive genetic testing for Huntington’s disease and screening for HIV. Paramount to considerations is the issue of whom to test, weighing up respect for personal autonomy against obligations to benefit and protect society. A paradigm is proposed similar to that used for HIV screening but with unique features: compulsory testing of all blood/organ donors and individuals undergoing surgery or invasive procedures who have a significant risk of disease transmission. (shrink)

Variant Creutzfeldt–Jakob disease is a fatal, transmissible, neurodegenerative disorder for which there is currently no effective treatment. vCJD arose from the zoonotic spread of bovine spongiform encephalopathy. There is now compelling evidence for human to human transmission through blood transfusions from presymptomatic carriers and experts are warning that the real epidemic may be yet to come. Imperatives exist for the development of reliable, non-invasive presymptomatic diagnostic tests. Research into such tests is well advanced. In this article the ethical implications of (...) the availability of these tests are elaborated and comparisons drawn with predictive genetic testing for Huntington’s disease and screening for HIV. Paramount to considerations is the issue of whom to test, weighing up respect for personal autonomy against obligations to benefit and protect society. A paradigm is proposed similar to that used for HIV screening but with unique features: compulsory testing of all blood/organ donors and individuals undergoing surgery or invasive procedures who have a significant risk of disease transmission. (shrink)

The concept of selecting for a disability, and deafness in particular, has triggered a controversial and sometimes acrimonious debate between key stakeholders. Previous studies have concentrated on the views of the deaf and hard of hearing, health professionals and ethicists towards reproductive selection for deafness. This study, however, is the first of its kind examining the views of hearing children of deaf adults towards preimplantation genetic diagnosis and prenatal diagnosis to select for or against deafness. Hearing children of deaf adults (...) straddle both the deaf and hearing worlds, and this dual perspective makes them ideally placed to add to the academic discourse concerning the use of genetic selection for or against deafness. The study incorporated two complementary stages, using initial, semistructured interviews with key informants as a means to guide the subsequent development of an electronic survey, completed anonymously by 66 individuals. The participants shared many of the same views as deaf individuals in the D/deaf community. The similarities extended to their opinions regarding deafness not being a disability, their ambivalence towards having hearing or deaf children and their general disapproval of the use of genetic technologies to select either for or against deafness. (shrink)

One aspect of the utility of gambling may evidence itself in failures of idempotence, i.e., when all chance outcomes give rise to the same consequence the `gamble' may not be indifferent to its common consequence. Under the assumption of segregation, such gambles can be expressed as the joint receipt of the common consequence and what we call `an element of chance', namely, the same gamble with the common consequence replaced by the status quo. Generalizing, any gamble is indifferent to the (...) joint receipt of its element of chance and a certain consequence, which is called the `kernel equivalent' of the gamble. Under idempotence, the kernel equivalent equals the certainty equivalent. Conditions are reported (Theorem 4) that are sufficient for the kernel equivalents to have the kind of utility representation first discussed by Luce and Fishburn (1991), including being idempotent. This utility representation of the kernel equivalents together with the derived form of utility over joint receipts yields a utility representation of the original structure. Possible forms for the utility of an element of chance are developed. (shrink)

Empirical evidence from both utility and psychophysical experiments suggests that people respond quite differently—perhaps discontinuously—to stimulus pairs when one consequence or signal is set to `zero.' Such stimuli are called unitary. The author's earlier theories assumed otherwise. In particular, the key property of segregation relating gambles and joint receipts (or presentations) involves unitary stimuli. Also, the representation of unitary stimuli was assumed to be separable (i.e., multiplicative). The theories developed here do not invoke separability. Four general cases based on two (...) distinctions are explored. The first distinction is between commutative joint receipts, which are relevant to utility, and the non-commutative ones, which are relevant to psychophysics. The second distinction concerns how stimuli of the form (x, C; y) and the operation of joint receipt are linked: by segregation, which mixes stimuli and unitary ones, and by distributivity, which does not involve any unitary stimuli. A class of representations more general than rank-dependent utility (RDU) is found in which monotonic functions of increments U(x)-U(y), where U is an order preseving representation of gambles, and joint receipt play a role. This form and its natural generalization to gambles with n > 2 consequences, which is also axiomatized, appear to encompass models of configural weights and decision affect. When joint receipts are not commutative, somewhat similar representations of stimuli arise, and joint receipts are shown to have a conjoint additive representation and in some cases a constant bias independent of signal intensity is predicted. (shrink)

This note addresses 3 issues that seem to pervade much of economic thought about individual decisions among uncertain alternatives: (1) Restricting primitives to just orderings of first-order gambles and not admitting, e.g., compound acts or joint receipt of consequences and gambles. (2) Great resistance to experimental findings that strongly suggest that most current theories fail descriptively. (3) Taking for granted the innocence of some assumptions when, in fact, they are not innocent, e.g., that constant acts are idempotent. My conclusion is (...) that these restrictions have greatly inhibited developments in utility theory. (shrink)

One aspect of the utility of gambling may evidence itself in failures of idempotence, i.e., when all chance outcomes give rise to the same consequence the `gamble' may not be indifferent to its common consequence. Under the assumption of segregation, such gambles can be expressed as the joint receipt of the common consequence and what we call `an element of chance', namely, the same gamble with the common consequence replaced by the status quo. Generalizing, any gamble is indifferent to the (...) joint receipt of its element of chance and a certain consequence, which is called the `kernel equivalent' of the gamble. Under idempotence, the kernel equivalent equals the certainty equivalent. Conditions are reported (Theorem 4) that are sufficient for the kernel equivalents to have the kind of utility representation first discussed by Luce and Fishburn (1991), including being idempotent. This utility representation of the kernel equivalents together with the derived form of utility over joint receipts yields a utility representation of the original structure. Possible forms for the utility of an element of chance are developed. (shrink)

In the face of environmental crises such as climate change, pollution and biodiversity loss—which all adversely impact on health—Gils-Schmidt and Salloch explore whether physicians can be justified in taking climate issues into account in clinical care.1 While their approach centres on the ‘climate-sensitive’ decisions, physicians can carry out on the micro-level of clinical decision-making, they encourage further discussions on how climate-related issues can be included across different levels of decision-making in healthcare. We propose a list of tasks and a model (...) to assist with navigating the range of factors and structural elements an environmentally sensitive ethics must address. Stephen Gardiner’s notion of a perfect moral storm is central to understanding these issues.2 Gardiner describes how a perfect moral storm occurs in the centre of three overlapping conditions for human action and policymaking in the face of climate change. This storm is driven by: (1) a lack of interest among current generations to meet global needs and accommodate the well-being of future generations, (2) a lack of ecological concerns for other parts of nature than humans and (3) weak ethical and political theories and institutions shaping policy decisions on issues with severe implications across borders and generations. Moreover, these conditions are embedded in the existing, complex world of ethically unjustified power imbalances and social injustice. The growing awareness of healthcare’s climate footprint has amplified and accelerated global, grassroots action to make healthcare more environmentally friendly. This includes incorporating environmental impacts into quality improvement methodologies, building communities of practice to explore how to make …. (shrink)

The thesis of this article is that there has never been any ground for the controversy between the doctrine of free will and determinism, that it is based upon a misapprehension, that the two assertions are entirely consistent, that one of them strictly implies the other, that they have been opposed only because of our natural want of the analytical imagination. In so saying I do not tamper with the meaning of either phrase. That would be unpardonable. I mean free (...) will in the natural and usual sense, in the fullest, the most absolute sense in which for the purposes of the personal and moral life the term is ever employed. I mean it as implying responsibility, merit and demerit, guilt and desert. I mean it as implying, after an act has been performed, that one " could have done otherwise " than one did. I mean it as conveying these things also, not in any subtly modified sense but in exactly the sense in which we conceive them in life and in law and in ethics. These two doctrines have been opposed because we have not realised that free will can be analysed without being destroyed, and that determinism is merely a feature of the analysis of it. And if we are tempted to take refuge in the thought of an "ultimate ", an "innermost" liberty that eludes the analysis, then we have implied a deterministic basis and constitution for this liberty as well. For such a basis and constitution lie in the idea of liberty. -/- The thesis is not, like that of Green or Bradley, that the contending opinions are reconciled if we adopt a certain metaphysic of the ego, as that it is timeless, and identifies itself with a desire by a " timeless act". This is to say that the two are irreconcilable, as they are popularly supposed to be, except by a theory that delivers us from the conflict by taking us out of time. Our view on the contrary is that from the natural and temporal point of view itself there never was any need of a reconciliation but only of a comprehension of the meaning of terms. (The metaphysical nature of the self and its identity through time is a problem for all who confront memory, anticipation, etc.; it has no peculiar difficulties arising from the present problem.) -/- I am not maintaining that determinism is true; only that it is true insofar as we have free will. That we are free in willing is, broadly speaking, a fact of experience. That broad fact is more assured than any philosophical analysis. It is therefore surer than the deterministic analysis of it, entirely adequate as that in the end appears to be. But it is not here affirmed that there are no small exceptions, no slight undetermined swervings, no ingredient of absolute chance. All that is here said is that such absence of determination, if and so far as it exists, is no gain to freedom, but sheer loss of it; no advantage to the moral life, but blank subtraction from it. -- When I speak below of "the indeterminist" I mean the libertarian indeterminist, that is, him who believes in free will and holds that it involves indetermination. (shrink)

This study represents an improvement in the ethics scales inventory published in a 1988 Journal of Business Ethics article. The article presents the distillation and validation process whereby the original 33 item inventory was reduced to eight items. These eight items comprise the following ethical dimensions: a moral equity dimension, a relativism dimension, and a contractualism dimension. The multidimensional ethics scale demonstrates significant predictive ability.

No one is excused from doing what he ought to do merely because he is unwilling to do it. But what if others are unwilling to play their necessary role in some joint venture that you all ought to undertake: might that excuse you from doing what you yourself ought to do as part of that? It would, if you were genuinely willing to play your necessary part if they were. But the unwillingness of everyone involved cannot reciprocally serve to (...) excuse one another from doing what they ought to do. (shrink)

Translational ethics (TE) has been developed into a specific approach, which revolves around the argument that strategies for bridging the theory‐practice gap in bioethics must themselves be justified on ethical terms. This version of TE incorporates normative, empirical and foundational ethics research and continues to develop through application and in the face of new ethical challenges. Here, I explore the idea that the academic field of bioethics has not yet sufficiently analysed its own philosophical foundation for how it can, and (...) should, be practically relevant; neither has it comprehensively discussed the limitations on what impacts bioethicists should pursue. As a result, there has not been adequate training on how to suitably and appropriately impact real‐world practices. Moreover, bioethical perspectives are often competing with other strong interests, for example, economic and political, which may weaken their impact on policy‐making. The TE approach I propose can not only facilitate practical impacts of academic bioethics by being better informed by real‐world ethical issues but it also supports targeted and ethical justifications of the actual impact of academic work in real‐world contexts. In this paper, I clarify the premises for this TE approach, identify further challenges and sketch out potential solutions for the implementation of this methodological framework. (shrink)

Book reviewed in this article: Protecting The Vulnerable: A Reanalysis of Our Social Responsibilities. By Robert E. Goodin. Chicago: University of Chicago Press.

Translational research in medicine requires researchers to identify the steps to transfer basic scientific discoveries from laboratory benches to bedside decision-making, and eventually into clinical practice. On a parallel track, philosophical work in ethics has not been obliged to identify the steps to translate theoretical conclusions into adequate practice. The medical ethicist A. Cribb suggested some years ago that it is now time to debate ‘the business of translational’ in medical ethics. Despite the very interesting and useful perspective on the (...) field of medical ethics launched by Cribb, the debate is still missing. In this paper, I take up Cribb’s invitation and discuss further analytic distinctions needed to base an ethics aiming to translate between theory and practice. (shrink)

I shall be dealing, throughout this book, with a set of related problems: the relationship between morality and reasoning in general, the way in which moral reasoning is properly to be carried on, and why morality is not arbitrary. The solutions to these problems come out of the same train of argument. Morality is not arbitrary, I shall argue, because the acceptance of certain qualities of character as virtues and the rejection of others as vices is forced on us by (...) the co-operative basis of human life. The co-operation in human life is unavoidable; the alternative is a literal Hobbesian state of nature, and that is impossible. It is not that co-operation between people is a good thing or even a very good thing; it is simply unavoidable in human life, and it is impossible unless the qualities of character counted as virtues are encouraged and are at least fairly common. The possibility of human life presupposes a theory of human nature, and working out that theory of human nature is the main job of moral philosophy. These virtues or qualities of character or attitudes lead us towards a theory of reasons. A person with a sense of justice is a person inclined to accept certain sorts of facts as reasons for acting, and if the virtues are presupposed by human life then the acceptance of those sorts of facts as reasons for acting is presupposed by human life. A condition of the life of reasoning beings (a more accurate term here than 'human beings') is that moral reasons are reasons for acting and are at the very basis of reasoning. And from this it follows that properly conducted moral reasoning is ultimately guided by the virtues rather than ultimately guided by a set of rules. (shrink)

David Benatar argues that coming into existence is always a harm, and that – for all of us unfortunate enough to have come into existence – it would be better had we never come to be. We contend that if one accepts Benatar’s arguments for the asymmetry between the presence and absence of pleasure and pain, and the poor quality of life, one must also accept that suicide is preferable to continued existence, and that his view therefore implies both anti-natalism (...) and pro-mortalism . This conclusion has been argued for before by Elizabeth Harman – she takes it that because Benatar claims that our lives are ‘awful’, it follows that ‘we would be better off to kill ourselves’ (Harman 2009: 784). Though we agree with Harman’s conclusion, we think that her argument is too quick, and that Benatar’s arguments for non-pro-mortalism deserve more serious consideration than she gives them. We make our case using a tripartite structure. We start by examining the prima facie case for the claim that pro-mortalism follows from Benatar’s position, presenting his response to the contrary, and furthering the dialectic by showing that Benatar’s position is not just that coming into existence is a harm, but that existence itself is a harm. We then look to Benatar’s treatment of the Epicurean line, which is important for him as it undermines his anti-death argument for non-pro-mortalism. We demonstrate that he fails to address the concern that the Epicurean line raises, and that he cannot therefore use the harm of death as an argument for non-pro-mortalism. Finally, we turn to Benatar’s pro-life argument for non-pro-mortalism, built upon his notion of interests, and argue that while the interest in continued existence may indeed have moral relevance, it is almost always irrational. Given that neither Benatar’s anti-death nor pro-life arguments for non-pro-mortalism work, we conclude that pro-mortalism follows from his anti-natalism, As such, if it is better never to have been, then it is better no longer to be. -/- . (shrink)

In this book, R.E. Allen provides a translation of the 'Parmenides' along with a structural analysis that procedes on the assumption that formal elements, logical and dramatic, are important to its interpretation and that the argument of the Parmenides is aporetic, a statement of metaphysical perplexities.

Corporate social responsibility is a recognised and common part of business activity. Some of the regularly cited motives behind CSR are employee morale, recruitment and retention, with employees acknowledged as a key organisational stakeholder. Despite the significance of employees in relation to CSR, relatively few studies have examined their engagement with CSR and the impediments relevant to this engagement. This exploratory case study-based research addresses this paucity of attention, drawing on one to one interviews and observation in a large UK (...) energy company. A diversity of engagement was found, ranging from employees who exhibited detachment from the CSR activities within the company, to those who were fully engaged with the CSR activities, and to others who were content with their own personal, but not organisational, engagement with CSR. A number of organisational context impediments, including poor communication, a perceived weak and low visibility of CSR culture, and lack of strategic alignment of CSR to business and personal objectives, served to explain this diversity of employee engagement. Social exchange theory is applied to help explore the volition that individual employees have towards their engagement with CSR activities, and to consider the implications of an implicit social, rather than explicit economic, contract between an organisation and its employees in their engagement with CSR. (shrink)