Health professionals faced with refusal of life-saving treatment may wish to override a person's wishes, especially if that person suffers from a mental disorder. Mental illness does not automatically mean a patient is incapable of making decisions of this nature. It is not always clear whether an individual is legally competent to decide whether to undergo treatment or not. This article discusses a clinical example and analyses some of the moral implications.

The book provides a detailed introduction to a major debate in bioethics, as well as a rigorous account of the role of conscience in professional decision-making. Exploring the role of conscience in healthcare practice, this book offers fresh counterpoints to recent calls to ban or severely restrict conscience objection. It provides a detailed philosophical account of the nature and moral import of conscience, and defends a prima facie right to conscientious objection for healthcare professionals. The book also has relevance (...) to broader debates about religious liberty and civil rights, such as debates about the rights and duties of persons and institutions who refuse services to clients on the basis of a religious objection. The book concludes with a discussion of how to regulate individual and institutional conscientious objection, and presents general principles for the accommodation of individual conscientious objectors in the healthcare system. This book will be of value to students and scholars in the fields of moral philosophy, bioethics and health law. (shrink)

Is it ethical to treat a death row inmate only to stabilize him or her for eventual execution? What happens when a military provider receives highly sensitive intelligence from a client? How can clinicians refuse costly gifts from clients without damaging the therapeutic relationship? Should a therapist disclose a client's suicidal intent to the authorities? In Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice, these and other real-life scenarios constitute a comprehensive and definitive ethics casebook for (...) mental health professionals. Inspired by the many difficult situations they themselves have faced, an eminent group of accomplished mental health clinicians provide first-hand accounts of ethical problems that defy boilerplate solutions. Each chapter begins with a compelling and ethically complex case followed by an illustrative yet succinct analysis of the key ethical issues present and a personal reflection on the case itself, along with the process of ethical reasoning used to arrive at a final decision. Every case concludes with key recommendations for promoting ethical practice within an often challenging work setting. Highlighting the human aspect of ethics in mental health practice through the use of mesmerizing narratives while also provoking the reader to reflect upon what is the "right" thing to do, Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice offers trainees and seasoned professionals alike invaluable informative models for dealing with ethical dilemmas, as well as the inspiration to confront seemingly insurmountable clinical problems. (shrink)

As a result of the coronavirus (COVID‐19) pandemic, health professionals are faced with situations they have not previously encountered and are being forced to make difficult ethical decisions. As the first group to experience challenges of caring for patients with coronavirus, Chinese nurses endure heartbreak and face stressful moral dilemmas. In this opinion piece, we examine three related critical questions: Whether society has the right to require health professionals to risk their lives caring for patients; whether health professionals (...) have the right to refuse to care for patients during the coronavirus pandemic; and what obligations there are to protect health professionals? Value of care, community expectations, legal obligations, professional and codes of practice may compel health professionals to put themselves at risks in emergency situations. The bioethical principles of autonomy, justice, beneficence and non‐maleficence, as well as public health ethics, guide nurses to justify their decisions as to whether they are entitled to refuse to treat COVID‐19 patients during the pandemic. We hope that the open discussion would support the international society in addressing similar ethical challenges in their respective situations during this public health crisis. (shrink)

The entwined history of humans and elephants is fascinating but often sad. People have used elephants as beasts of burden and war machines, slaughtered them for their ivory, exterminated them as threats to people and ecosystems, turned them into objects of entertainment at circuses, employed them as both curiosities and conservation ambassadors in zoos, and deified and honored them in religious rites. How have such actions affected these pachyderms? What ethical and moral imperatives should humans follow to ensure (...) that elephants are treated with dignity and saved from extinction? In Elephants and Ethics, Christen Wemmer and Catherine A. Christen assemble an international cohort of experts to review the history of human-elephant relations, discuss current issues of vital concern to elephant welfare, and assess the prospects for the ethical coexistence of both species. Part I provides an overview of the vexatious human-elephant relationship, from the history of our interactions to understanding elephant intelligence and sense of self. It concludes with a discussion of the issues of stress, pain, and suffering as experienced by elephants in human care and the problems inherent in assessing these subjectively. The second part explores how humans use elephants as tools and entertainment. It reviews domestic uses in Asia, examines the history and roles of elephants in zoos and circuses, and discusses the methods and ethics of training and caring for captive elephants. In Part III the contributors examine the fragile and conflict-filled world of human-elephant interactions in the wild. Each chapter delves into a different angle of the "elephant problem" -- the all-too-human problem of our growing populations taking over space that was historically the domain of these pachyderms. The chapters explore attempts to tame and "train" elephants in populous areas, the struggle over balancing species preservation while maintaining biodiversity in protected areas, and the conundrums posed by hunting, tourism, and human-elephant competition on rural land. That the future health and survival of elephants is dependent on human actions is irrefutable. In addressing these issues from multiple perspectives, Elephants and Ethics promotes mutual understanding of the cultural, conservation, and economic difficulties at the root of the many troublesome human-elephant interactions and poses new questions about our responsibility toward these largest of land mammals. (shrink)

The article considers the issues of modern German political philosophy in accordance with its formation, institutionalization and development. Germany’s political philosophy is analyzed in terms of its interaction with social and practical philosophy. The text states that political philoso- phy belongs to both social philosophy and political science. As a political theory, it is a compo- nent of social theories institutionalized in the modern era. As a political philosophy, it appears as a metatheory of political theory. Political philosophy is also (...) part of practical philosophy, exploring the problems of interaction between ethics and politics and the moral reclamation of the political system of modern society. These issues are themed in the context of the institution- alization of this discipline in the early twentieth century, its transformation into a political reli- gion during National Socialism, the revival after World War II, as well as actualization in such areas of socio-humanitarian sciences as discourse philosophy, functional-system theory of so- ciety, etc. according to the political situation of modern Germany. (shrink)

We live in a 'bimoral' society, in which people govern their lives by two contrasting sets of principles. On the one hand there are the principles associated with traditional morality. Although these allow a modicum of self-interest, their emphasis is on our duties and obligations to others: to treat people honestly and with respect, to treat them fairly and without prejudice, to help and are for them when needed, and ultimately, to put their needs above their own. On (...) the other hand there are the principles associated with the entrepreneurial self-interest. These also impose obligations, but of a much more limited kind. Their emphasis is competitive rather than cooperative: to advance our own interests rather than to meet the needs of others. Both sets of principles have always been present in society but in recent years, traditional moral authorities have lost much of their force and the morality of self-interest has acquired a much greater social legitimacy, over a much wider field of behavior, than ever before. The result of this is that in many situations it is no longer at all apparent which set of principles should take precedence. In this book, John Hendry traces the cultural and historical origins of the 'bimoral' society have also led to new, more flexible forms of organizing, which have released people's entrepreneurial energies and significantly enhanced the creative capacities of business. Working within these organizations, however is fraught with moral tensions as obligations and self-interest conflict and managers are pulled in all sorts of different directions. Managing them successfully poses major new challenges of leadership, and 'moral' management, as the technical problem-solving that previously characterized managerial work is increasingly accomplished by technology and market mechanisms. The key role of management becomes the political and moral one of determining purposes and priorities, reconciling divergent interests, and nurturing trust in interpersonal relationships. Exploring these tensions and challenges, Hendry identifies new issues of contemporary management and puts recognized issues into context. He also explores the challenges posed for a post-traditional society as it seeks to regulate and govern an increasingly powerful and global business sector. (shrink)

How far should we go in protecting and promoting public health? Can we force people to give up unhealthy habits and make healthier choices, or does everyone have the right to decide their own lifestyle? Should we stop treating smokers who refuse to give up smoking? Should we put a tax on fatty foods and ban vending machines in schools to address the obesity epidemic? Should parents be required to have their children vaccinated? Are some of our screening programmes unethical (...) Downs syndrome screening, for example or should we be screening people for more conditions, such as Huntington disease? Such questions are at the heart of public health ethics. Holland shows that to understand and debate these issues requires philosophy: moral philosophies, such as utilitarianism and deontology, as well as political philosophies such as liberalism and communitarianism. And philosophy informs other aspects of public health, such as epidemiology and health promotion. The aim of this book is to provide a lively, accessible and philosophically informed introduction to such issues. It is an ideal textbook for students taking courses in public health ethics. And since this book develops systematic discussions of issues in public health ethics, there is also much here to engage and challenge the more advanced reader. (shrink)

On the powerful qualities view, every fundamental property is both dispositional and qualitative. Identity theory is the standard account of the view, which makes the stronger claim that a property’s dispositionality and qualitativity are identical to each other, and identical to the property itself. Recent defences of the powerful qualities view have involved novel theories of powerful qualities which are not also variants of identity theory. Giannotti (Erkenntnis 86:603–621, 2021a) has suggested a novel theory of his own, the dual aspect (...) account, which makes use of a particular notion of aspects. For Giannotti, dispositionality and qualitativity are each an aspect of a property, and an aspect is a property’s way of being. The importance of aspects is twofold. Firstly, by introducing aspects to identity theory, the theory becomes more precise. Secondly, aspects allow for a novel theory of powerful qualities, the dual aspect account, which maintains that dispositionality and qualitativity are aspects, but rejects the identity claim. Giannotti’s aim is to show that even if identity theory is false, the dual aspect account remains an available theory for advocates of powerful qualities. This paper will be a critical examination of Giannotti’s ideas. Firstly, I will clarify Giannotti’s notion of aspects, explaining how it involves a misunderstanding of supervenience, and why it does not offer the advantages that he claims it does. Secondly, in light of my discussion of aspects, I will argue that the dual aspect account lacks relative advantages over the compound view of powerful qualities. (shrink)

The case of Terri Schiavo, a young woman who spent 15 years in a persistent vegetative state, has emerged as a watershed in debates over end-of-life care. While many observers had thought the right to refuse medical treatment was well established, this case split a family, divided a nation, and counfounded physicians, legislators, and many of the people they treated or represented. In renewing debates over the importance of advance directives, the appropriate role of artificial hydration and nutrition, and the (...) responsibilities of family members, the case also became one of history's most extensively litigated health care disputes. The Case of Terri Schiavo assembles a team of first-hand participants and content experts to provide thoughtful and nuanced analyses. In addition to a comprehensive overview, the book includes contributions by Ms. Schiavo's guardian ad litem, a neurologist and lawyer who participated in the case, and scholars who examine issues related to litigation, faith, gender, and disability. The volume also includes a powerful dissent from the views of many scholars in the bioethics community. The book is intended for students, health care professionals, policy makers, and other in search of carefully reasoned analyses of the case that will shape our view of death and end-of-life medical care for decades. (shrink)

On the grounds of the libertarian ethics presented by Murray N. Rothbard, the state is an institution which acts against individuals and whole societies. The state steals money from its citizens (taxes), stands in the way of free market development and controls the economy, thus hindering entrepreneurship. Besides that, the state – through its rules and regulations – limits every man's right to make moral choices. The state is an immoral institution, therefore its citizens have the right to refuse (...) to pay taxes, follow orders, and even – in some circumstances – corrupt civil servants. In this paper we analyse Rothbard’s ethics and look into the arguments of critics of libertarian thought. Practical social and economic solutions that emerge from Rothbard’s point of view are also considered. (shrink)

ABSTRACT Do physicians and nurses have an obligation to treat patients who are HIV‐positive? Although an initial review of the possible sources of such an obligation yields equivocal results, a closer examination reveals a clear obligation to treat. The current risk of job‐caused HIV‐infection is not sufficient to warrant a refusal to treat. This is so because there exist rationally justified, general social, as well as specific peer expectations, that health care professionals treat HIV‐positive patients. (...) These expectations impose moral obligations on doctors and nurses. Moreover there is no sound libertarian argument entitling doctors and nurses to refuse to treat HIV‐positive patients. A morally appropriate identification with his or her role would disincline a health care professional to refuse treatment to an HIV‐positive patient. The likely source of such refusal is occupational alienation and an irrational reaction to AIDS symbolism. (shrink)

In Morality and Ethics of War, which includes a foreword by Major General Susan Coyle, ethicist Deane-Peter Baker goes beyond existing treatments of military ethics to address a fundamental problem: the yawning gap that exists between the diverse moral frameworks defining personal identity in a multicultural society on the one hand, and the professional military ethic on the other. Baker argues that overcoming this chasm is essential to minimising the ethical risks that can lead to operational and strategic (...) failure for military forces engaged in today's complex conflict environment. He contends that spanning the gap is vital in preventing moral injury from befalling the nation's uniformed servants. Drawing on a revised account of what he calls 'the Just War Continuum', Baker develops a bridging framework that combines conceptual clarity and rigour with insights from cutting edge psychological research and creates a practical means for military leaders to negotiate the moral chasm in military affairs. (shrink)

This article examines one kind of conscientious refusal: the refusal of healthcare professionals to treat sexual dysfunction in individuals with a history of sexual offending. According to what I call the orthodoxy, such refusal is invariably impermissible, whereas at least one other kind of conscientious refusal—refusal to offer abortion services—is not. I seek to put pressure on the orthodoxy by (1) motivating the view that either both kinds of conscientious refusal are permissible or (...) neither is, and (2) critiquing two attempts to buttress it. (shrink)

A practical approach to ethics -- The doctor-patient relationship -- Consent, choice, and refusal : adults with capacity -- Treating adults who lack capacity -- Treating children and young people -- Confidentiality -- Management of health records --Prescribing and administering medication.

Recent reports in Australia have suggested that some medical practitioners are refusing to treat children who have not been vaccinated, a practice that has been observed in the USA and parts of Europe for some years. This behaviour, if it is indeed occurring in Australia, has not been supported by the Australian Medical Association, although there is broad support for medical practitioners in general having the right to conscientious objection. This paper examines the ethical underpinnings of conscientious objection (...) and whether the right to conscientious objection can be applied to the refusal to treat unvaccinated children. The implications of such a decision will also be discussed, to assess whether refusal to treat unvaccinated children is ethically justifiable. The best interests of both existing and new patients are crucially important in a doctor’s practice, and the tension between these two groups of patients are contemplated in the arguments below. It is argued that on balance, the refusal to treat unvaccinated children constitutes unjustified discrimination. (shrink)

Interest in Aristotelianism and in virtue ethics has been growing for half a century but as yet the strengths of the study of Aristotelian ethics in politics have not been matched in economics. This ground-breaking text fills that gap. Challenging the premises of neoclassical economic theory, the contributors take issue with neoclassicism’s foundational separation of values from facts, with its treatment of preferences as given, and with its consequent refusal to reason about final ends. Contributions critically engage with aspects (...) of corporate capitalism, managerial power and neoliberal economic policy, and reflect on the recent financial crisis from the point of view of Aristotelian virtue ethics. Containing a new chapter by Alasdair MacIntyre, and deploying his arguments and conceptual scheme throughout, the book critically analyses the theoretical presuppositions and institutional reality of modern capitalism. (shrink)

The sphere of disability can be treated nowadays from different perspectives that answer to multidimensional of this embodied reality. In this context, a privileged area of reflection is constituted by ethics and, inside of this, as this text propose, the prism of the reciprocal recognition. To achieve this, this present article is structured in two parts. The first, regarding to the understanding of disability from different models. The second, according to the recognition perspective approach of Honneth, and its link with (...) the disability, presents the three stages of recognition with their corresponding ways of disdain. Finally, a series of reflections are exposed regarding the necessity to accomplish a group of demands that transcend civil and political prerogatives, as well as public ones. (shrink)

In this paper, the results of a pilot interview study with 19 subjects participating in an EEG-based non-invasive brain–computer interface (BCI) research study on stroke rehabilitation and assistive technology and of a survey among 17 BCI professionals are presented and discussed in the light of ethical, legal, and social issues in research with human subjects. Most of the users were content with study participation and felt well informed. Negative aspects reported include the long and cumbersome preparation procedure, discomfort with (...) the cap and the wet electrodes, problems concerning BCI control, and strains during the training sessions. In addition, some users reflected on issues concerning system security. When asked for morally problematic issues in this field of non-invasive BCI research, the BCI professionals stressed the need for correct information transfer, the obligation to avoid unrealistic expectations in study participants, the selection of study participants, benefits and strains of participation, BCI illiteracy, the possibility of detrimental brain modifications induced by BCI use, and problems that may arise at the end of the trials. Furthermore, privacy issues were raised. Based on the results obtained, psychosocial and ethical aspects of EEG-based non-invasive BCI research are discussed and possible implications for future research addressed. (shrink)

Raimo Tuomela’s we-mode groups are partly characterized by norms. Some norms may be characteristic of all we-mode groups like the norm restricting a member’s right to leave the group. Some think that this aspect of Tuomela’s theory has implausible ethical implications concerning the rights and autonomy of members in we-mode groups. That worry vanishes, I argue, on a plausible interpretation of Tuomela’s notion of social normativity and a reasonable precisification of the notion of autonomy in this context. On the (...) other hand, Tuomela’s general silence on the nature of moral normativity makes it unclear how his distinction between social and moral normativity should be drawn more precisely. Is this a difference in kind, or merely a difference in the scope or social basis of the norms in question? I find this worth exploring with the aid of resources available within a broadly Tuomelian framework. Like Jeremy Koons (2019), I believe that Tuomela’s framework could be used to refine Wilfrid Sellars theory of ethical judgments as expressions of we-intentions. My preferred interpretation of Tuomela differs from Koons’ though, and so does the resulting reconstruction of Sellars, which is more Humean than Kantian. (shrink)

Wrongdoing and the Moral Emotions provides an account of how we might effectively address wrongdoing given challenges to the legitimacy of anger and retribution that arise from ethical considerations and from concerns about free will. The issue is introduced in Chapter 1. Chapter 2 asks how we might conceive of blame without retribution, and proposes an account of blame as moral protest, whose function is to secure forward-looking goals such as the moral reform of the wrongdoer (...) and reconciliation in relationships. Chapter 3 considers whether it's possible to justify effectively dealing those who pose dangerous threats if they do not deserve to be harmed, and contends that wrongfully posing a threat is the core condition for the legitimacy of defensive harming. Chapter 4 provides an account of how to treat criminals without a retributive justification for punishment, and argues for an account in which the right of self-defense provides justification for measures such as preventative detention. Chapter 5 considers how we might forgive if wrongdoers don't basically deserve the pain of being resented, which forgiveness would then renounce, and proposes that forgiveness be conceived instead as renunciation of the stance of moral protest. Chapter 6 considers how personal relationships might function without retributive anger having a role in responding to wrongdoing, and contends that the stance of moral protest, supplemented with non-retributive emotions, is sufficient. Chapter 7 surveys the options for theistic and atheistic attitudes regarding the fate of humanity in a deterministic universe, and defends an impartial hope for humanity. (shrink)

Lapses in the ethical behavior of individuals can seriously and permanently affect the moral health of an organization. In Organizations and Ethical Individualism, Kolenda's edited volume, this complex problem is treated from a multi-dimensional, interdisciplinary approach; each author considers organizational life from his own professional perspective while maintaining the focus on ethical individualism. This format allows for wide-angled coverage and will thus be useful to a broad range of readers: professionals and students of philosophy, professional ethics, (...) business ethics, social psychology and the sociology of values will all find this an informative and valuable source. (shrink)

Healthcare systems around the world are struggling to maintain a sufficient workforce to provide adequate care during the COVID-19 pandemic. Staffing problems have been exacerbated by healthcare workers refusing to work out of concern for their families. I sketch a deontological framework for assessing when it is morally permissible for HCWs to abstain from work to protect their families from infection and when it is a dereliction of duty to patients. I argue that it is morally permissible for HCWs to (...) abstain from work when their duty to treat is outweighed by the combined risks and burdens of that work. For HCWs who live with their families, the obligation to protect one’s family from infection contributes significantly to those burdens. There are, however, a range of complicating factors including the strength of duty to treat which varies according to the HCW’s role, the vulnerability of family members to the disease, the willingness of family members to risk infection and the resources available to the HCW to protect their family. In many cases, HCWs in ‘frontline’ roles with a weak duty to treat and families at home will be morally permitted to abstain from work given the risks posed by COVID-19; therefore, society should provide additional incentives to maintain sufficient staff in these roles. (shrink)

The importance of the collective management of immaterial resources is a key variable in the valorisation of products in a post-industrial economy. The purpose of this paper is to analyse how, in post-industrial economies, it is possible to devise alternative forms of mediation between producers and consumers, such as organic farmers' markets, to curb the appropriation of rent by transnational and/or local business elites from the value created by immaterial resources. More specifically, we analyse those aspects of the collective management (...) of ethical values that, in the case of organic farmers' markets, can be a strategic source of competitive advantage for local producers. In this paper, the Ecomercado de Granada is studied as an example of mediation between production and consumption in a post-industrial economy. (shrink)

Collaborative economy emerged as a response to the need of people to exchange, produce and share in a more humane and cooperative manner. However, the growth of collaborative economy organizations and the terminological confusion have led to debates about their possible effects, both positive and negative. In this study, we have created a guideline that can be used to evaluate the contribution of organizations considered within collaborative economy to common good. We used the conceptualization of common good, which, from its (...) Aristotelian-Thomist philosophy, was developed by the personalist-humanist perspective of management. Our analysis leads us to conclude that the evaluation of the contribution of any organization to the common good must take into account how the participants develop their virtues, the creation of the community and its impact on the common good of society. At the end of the article, we present the aspects that society must take into account regarding collaborative economy. Firstly, society, in general, must approach collaborative economy as a tool that must complement others in the search for solutions to economic and social problems and, secondly, the governance of the platform-network is essential to foster organizational models that favour the common good. (shrink)

He addresses three main issues: first, the historical means by which economics has consciously surrendered its original association with ethical categories and criteria; second, the need to articulate the appropriate thoughtforms and vocabulary of ethical theory; and third, the illustration of areas in economics where ethical awareness is desirable and should be allowed to exert influence.

Is it ethical to treat a death row inmate only to stabilize him or her for eventual execution? What happens when a military provider receives highly sensitive intelligence from a client?

One of the most important aspects of our lives is the conception which we have of ourselves. For the way in which we view ourselves fundamentally affects how we interact among others and, most importantly perhaps, how we think others should treat us. For instance, one will not expect others to regard one as having a high mathematical acumen if one. realizes that one's mathematical skills are very minimal. Of course, persons may be mistaken in their assessment of themselves. (...) And it is not clear, at least to me, that we are for the most part morally justified in trying to get persons to have an accurate assessment of themselves, especially in the case of those whose mistaken assessment of themselves is in their favor. To deal someone a severe blow to their self-esteem comes very close to being cruel. Yet, it is very difficult to tell someone that he is not as good as he thinks he is without dealing such a blow to his self-esteem. Again, one will not expect others to regard one as a talented artist if one realizes that one is not. And so on. What is more, not every person can rightly take him-or herself to be talented in this or that area. And given that this is so, what inevitably follows is that the self-esteem of some will be lower than the self-esteem of others, and rightly so.See note 7 above.But if I have argued soundly in this essay, we have seen that there is a respect in which no person rightly thinks less of him-or herself vis à vis any other person. For each person, it has been shown, is deserving of fair treatment in virtue of the fact that he or she is a person. I have called the sense of worth which corresponds with having this conviction self-respect. Whatever a person's abilities are, whatever a person's moral character is like, he should not lose sight of the fact that he is deserving of fair treatment in any case. The social institutions of a society are fairly arranged, I have argued, when they are conducive to persons having this conviction.Little has been said on the connection between morality and our self-concept. And if anything, I have only touched the surface of what needs to be said. I should like to acknowledge the recent appearance of Stephen L. Darwall's important essay “Two Kinds of Respect,” Ethics, Vol. 88 (1977), although I have not been able to take into account the differences between his views and mine. (shrink)

As the world population is growing and government directives tell us to consume more fatty acids, the demand for fish is increasing. Due to declines in wild fish populations, we have come to rely more and more on aquaculture. Despite rapid expansion of aquaculture, this sector is still in a relatively early developmental stage. This means that this sector can still be steered in a favorable direction, which requires discussion about sustainability. If we want to avoid similar problems to the (...) ones we have experienced with livestock farming, we need to generate knowledge of the biology, profitability, environmental aspects, consumer awareness, and product appreciation of particular fish species. However, the discussion about a sustainable aquaculture also raises the question how we should treat fish. This moral question is regularly addressed as a problem of applied ethics with a focus on tailoring ethical principles to practical questions. In this article we do not deny the importance of the practical accounts, but we start from the fundamental question whether and why fish matter in our moral deliberations, i.e., from the discussion on moral status. We elaborate the distinction between moral considerability and moral significance in order to show both the importance and the limitations of the discussion about moral status for practical problems in aquaculture. We illustrate these points with a case-study about the farming of a specific fish species, the African catfish. (shrink)

Ritual circumcision of infant boys is controversial in Norway, as in many other countries. The procedure became a part of Norwegian public health services in 2015. A new law opened for conscientious objection to the procedure. We have studied physicians’ refusals to perform ritual circumcision as an issue of professional ethics. Qualitative interview study with 10 urologists who refused to perform ritual circumcision from six Norwegian public hospitals. Interviews were recorded and transcribed, then analysed with systematic text condensation, a qualitative (...) analysis framework. The physicians are unanimous in grounding their opposition to the procedure in professional standards and norms, based on fundamental tenets of professional ethics. While there is homogeneity in the group when it comes to this reasoning, there are significant variations as to how deeply the matter touches the urologists on a personal level. About half of them connect their stance to their personal integrity, and state that performing the procedure would go against their conscience and lead to pangs of conscience. It is argued that professional moral norms sometimes might become more or less ‘integrated’ in the professional’s core moral values and moral identity. If this is the case, then the distinction between conscience-based and professional refusals to certain healthcare services cannot be drawn as sharply as it has been. (shrink)

The main purpose of the paper is to examine the question as to whether self-sacrifice is intrinsic to moral action. The conclusion is that though some moral deeds can be free of appreciable self-sacrifice, most of the time some degree of self-sacrifice is called for. The necessity is not conceptual but built into the lives of most people. The paper is especially interested in a person's refusal to go along with or actively cooperate with wrongdoing, even when (...) there is some risk; and positively giving assistance to those who are oppressed or persecuted, and again when there is some risk. Abstaining from violating the rights and entitlements of others is not enough to be moral, indispensable as it is. An important issue is what degree of self-sacrifice is called for, which, when not risked or endured, allows us to think that immorality has been committed. I follow the standard practice of distinguishing between moral heroism and moral obligation. Moral heroism is exemplified by Socrates who at risk to his life refused to cooperate with the unjust command of the Thirty to seize an innocent man and hand him over for execution. The paper holds that one's basic rights set the limits to the extent of self-sacrifice that one can be obliged to risk or endure. The first part of the paper is devoted to Socrates and to the way in which his moral heroism is not a model for the moral person's action, but rather an inspiration to think hard about what self-sacrifice is demanded, short of his. I locate in the golden rule, the precept that urges us "always to treat others as you would like them to treat you" , the best single moral precept. The second part of the paper is on the golden rule. But the precept must be revised somewhat in accordance with the limits on self-sacrifice set by the preservation of one's basic rights. The consequences of the golden rule for political involvement is also discussed. The paper also looks at self-denial, especially as it is taught by Jesus in the Sermon on the Mount. Self-denial in its most extreme form counsels martyrdom or passive non-resistance and even cooperation with one's oppression. Thus, extreme self-denial is perhaps not a moral phenomenon at all, though in its less extreme forms, it is one of the best aspects of civilized life. There are undeniable affinities between self-sacrifice and self-denial. (shrink)

This thesis studies some philosophical and ethical issues that economic design raises. Chapter 1 gives an overview of economic design and argues that a crossfertilisation between philosophy and economic design is possible and insightful for both sides. Chapter 2 examines the implications of mechanism design for theories of rationality. I show that non-classical theories, such as constrained maximization and team reasoning, are at odds with the constraint of incentive compatibility. This poses a problem for non-classical theories, which proponents of (...) these theories have not addressed to date. Chapter 3 proposes a general epistemology of economic engineering, which is motivated by a novel case study, viz. the reform of a matching market for medical practitioners. My account makes use of causal graphs to explain how models allow encoding counterfactual information about how market outcomes change if the design of the market changes. The second part of the thesis examines ethical issues. In Chapter 4, I apply tools from matching theory to gain insights into the distribution of refugees, such as among countries of the European Union. There is an ethical trade-off between the fairness of matchings and their efficiency, and I argue that in this context, fairness is the morally weightier criterion. Chapter 5 deals with the ethics of kidney exchange. Against critics, I give two arguments for the implementation of kidney exchange programmes. The first argument is that they are instrumental in meeting a moral obligation, namely to donate effectively. The second is that kidney exchange may increase the motivation for altruistic donations, because the donation of one kidney may trigger > 1 life savings. The final chapter identifies questions for future research and it closes with some thoughts about the future trajectory of economic design. (shrink)

The main purpose of the paper is to examine the question as to whether self-sacrifice is intrinsic to moral action. The conclusion is that though some moral deeds can be free of appreciable self-sacrifice, most of the time some degree of self-sacrifice is called for. The necessity is not conceptual but built into the lives of most people. The paper is especially interested in a person's refusal to go along with or actively cooperate with wrongdoing, even when (...) there is some risk; and positively giving assistance to those who are oppressed or persecuted, and again when there is some risk. Abstaining from violating the rights and entitlements of others is not enough to be moral, indispensable as it is. An important issue is what degree of self-sacrifice is called for, which, when not risked or endured, allows us to think that immorality has been committed. I follow the standard practice of distinguishing between moral heroism and moral obligation. Moral heroism is exemplified by Socrates who at risk to his life refused to cooperate with the unjust command of the Thirty to seize an innocent man and hand him over for execution. The paper holds that one's basic rights set the limits to the extent of self-sacrifice that one can be obliged to risk or endure. The first part of the paper is devoted to Socrates and to the way in which his moral heroism is not a model for the moral person's action, but rather an inspiration to think hard about what self-sacrifice is demanded, short of his. I locate in the golden rule, the precept that urges us "always to treat others as you would like them to treat you", the best single moral precept. The second part of the paper is on the golden rule. But the precept must be revised somewhat in accordance with the limits on self-sacrifice set by the preservation of one's basic rights. The consequences of the golden rule for political involvement is also discussed. The paper also looks at self-denial, especially as it is taught by Jesus in the Sermon on the Mount. Self-denial in its most extreme form counsels martyrdom or passive non-resistance and even cooperation with one's oppression. Thus, extreme self-denial is perhaps not a moral phenomenon at all, though in its less extreme forms, it is one of the best aspects of civilized life. There are undeniable affinities between self-sacrifice and self-denial. (shrink)

Institutionalized and internalized, competence intersubjectivity contain many user-illusions and an imaginary or manifest image of reality, including of themselves (Dennett and Sellars),. This can be contrasted we a comprehension or comprehensive, understanding intersubjectivity. It is possible and perhaps even necessary to transform or replace the competence intersubjectivity to a comprehension or understanding (scientific, Dennett and Sellars) image of reality and themselves.Ethics and morality and studies of ethics and morality deal with the reality of competence intersubjectivity (by means of socio-cultural practices (...) that are derived from, based on an created by means of this restrictive, misleading, unreal, illusory, unrealistic intersubjectivity and the life-worlds associated with it) and human life-worlds constituted on the basis of and in terms of this intersubjectivity. This is why I am a nihilist, a libertarian, at least a minarchist or rather an anarchist and epistemologically a sceptic. Kant’s things in themselves are similar to Dennett and Searle’s notions of manifest and scientific image. With my addition that we are socialized and internalize the competent, know how to do it, institutionalized manifest, everyday intersubjectivity, instead of the comprehension, insights and understanding knowing that, scientific intersubjectivity of all scientific disciplines. This piece can be read as independent as comments on meta-ethics, or it can be read as a chapter in my Book ‘Intersubjectivity (continued)’, or it can be read as an introduction to my thoughts on philosophy and more specifically Intersubjectivity as – Determining the nature of philosophy Determining the nature of the subject-matter of philosophy, sociology, social psychology, aspects of cognitive sciences, ethics, epistemology, etc, Determining the nature of philosophical methodology and approaches. (shrink)

This book introduces major philosophical theories and issues in the context of the contemporary debate about the so-called culture wars in American society. It is designed to make these theories come alive as they are related to these vital contemporary concerns and to provide a framework within which to assess the ongoing debate about the future direction of Western culture. As a book in ethical theory, it is designed to provide the framework for clear and comprehensive thinking about our (...) cultural development. Classical ethical positions like cultural relativism, emotivism, egoism, hedonism, utilitarianism and theorists like Kant are introduced and assessed. The contemporary theorists John Rawls and Alasdair MacIntyre are given extensive treatment and made accessible to the introductory student in philosophy. Culture War and Ethical Theory exhibits a non-ptolemical tone as it relates these theories, for heuristic purposes, to the contrasting perspective of fundamentalism and secular humanism. These two viewpoints are treated fairly without pretense of thorough exposition. They were chosen because they set the contemporary debate in stark relief. Thus, they assist the reader in understanding the relationship of philosophical reflection to commonly held perspectives. (shrink)

Summary The author of the paper studies the ethical views of Matthias Bel expressed in his Preface to Johann Arndt's treatise and in Davidian-Solomonian Ethics, which contain a critique of false Christianity and ancient (especially Aristotle's) ethics. Bel refuses any philosophical ethics based on human nature, since man, in his very essence, is sinful and vicious. This leads to the general moral downfall of the young and mankind. He only recognises ethics whose source and the highest good is (...) God. He accepts ancient ethics as long as it is useful for achieving Christian moral values. Bel was a vociferous critic of the morality of the time; he adopted a highly negative stance towards the Jews and Gypsies living in the then Historical Hungary. The author considers Matthias Bel a confident, or enthusiastic, Pietist in the early period of his life and work; later, he rates him as a moderate Pietist. (shrink)

The book has two aims. First, to examine the extent and significance of the connection between Hume's aesthetics and his moral philosophy; and, second, to consider how, in light of the connection, his moral philosophy answers central questions in ethics. The first aim is realized in chapters 1-4. Chapter 1 examines Hume's essay "Of the Standard of Taste" to understand his search for a "standard" and how this affects the scope of his aesthetics. Chapter 2 establishes that he (...) treats beauty in nature and art and moral beauty as similar in kind, and applies the conclusions about his aesthetics to his moral thought. Chapter 3 solves a puzzle to which this gives rise, namely, how individuals both accept general standards that they also contravene in the course of aesthetic and moral activity. Chapter 4 takes up the normative aspect of Hume's approach by understanding moral character through his view of moral beauty. The second aim of the book is realized in chapters 5-7 by entertaining three objections against Hume's moral philosophy. First, if morality is an immediate reaction to the beauty of vice and the deformity of virtue, why is perfect virtue not the general condition of every human individual? Second, if morality consists of sentiments that arise in the subject, how can moral judgments be objective and claim universal validity? And third, if one can talk of "general standards" governing conduct, how does one account for the diversity of moral systems and their change over time? The first is answered by showing that like good taste in aesthetics, 'right taste' in morals requires that the sentiments are educated; the second, by arguing against the view that Hume is a subjectivist and a relativist, and the third, by showing that his approach contains a view of progress left untouched by any personal prejudices Hume himself might harbor. The book concludes in chapter 7 by showing how Hume's view of philosophy affects the scope of any normative ethics. (shrink)

The 14 chapters in _Ethics at the End of Life: New Issues and Arguments_, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters—written (...) by a team of experts—survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section. TABLE OF CONTENTS John K. Davis, "Introduction" Geoffrey Scarre, "Is it possible to be better off dead?" Taylor W. Cyr, "How Does Death Harm the Deceased?" Benjamin Mitchell-Yellin, "The Significance of an Afterlife" Jens Johansson, "The Severity of Death" John K. Davis, "Defining Death" James Stacey Taylor, "Autonomy, Competence, and End of Life" Eric Vogelstein, "Deciding for the Incompetent" Paul T. Menzel, "Change of Mind: An Issue for Advance Directives" Nancy S. Jecker, "Medical Futility and Respect for Patient Autonomy" Paul T. Menzel, "Refusing Lifesaving Medical Treatment and Food and Water by Mouth" Thomas S. Huddle, "Suicide, Physician-Assisted Suicide, the Doing-Allowing Distinction and Double Effect" Michael Cholbi, "Grief and End of Life Surrogate Decision-making" Bruce Jennings, "Solidarity near the End of Life: The Promise of Relational Decision-making in the Care of the Dying" Colin Farrelly, "Justice and the Aging of the Human Species". (shrink)

The 14 chapters in _Ethics at the End of Life: New Issues and Arguments_, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters—written (...) by a team of experts—survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section. TABLE OF CONTENTS John K. Davis, "Introduction" Geoffrey Scarre, "Is it possible to be better off dead?" Taylor W. Cyr, "How Does Death Harm the Deceased?" Benjamin Mitchell-Yellin, "The Significance of an Afterlife" Jens Johansson, "The Severity of Death" John K. Davis, "Defining Death" James Stacey Taylor, "Autonomy, Competence, and End of Life" Eric Vogelstein, "Deciding for the Incompetent" Paul T. Menzel, "Change of Mind: An Issue for Advance Directives" Nancy S. Jecker, "Medical Futility and Respect for Patient Autonomy" Paul T. Menzel, "Refusing Lifesaving Medical Treatment and Food and Water by Mouth" Thomas S. Huddle, "Suicide, Physician-Assisted Suicide, the Doing-Allowing Distinction and Double Effect" Michael Cholbi, "Grief and End of Life Surrogate Decision-making" Bruce Jennings, "Solidarity near the End of Life: The Promise of Relational Decision-making in the Care of the Dying" Colin Farrelly, "Justice and the Aging of the Human Species". (shrink)

The 14 chapters in Ethics at the End of Life: New Issues and Arguments, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters--written (...) by a team of experts--survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section. TABLE OF CONTENTS John K. Davis, "Introduction" Geoffrey Scarre, "Is it possible to be better off dead?" Taylor W. Cyr, "How Does Death Harm the Deceased?" Benjamin Mitchell-Yellin, "The Significance of an Afterlife" Jens Johansson, "The Severity of Death" John K. Davis, "Defining Death" James Stacey Taylor, "Autonomy, Competence, and End of Life" Eric Vogelstein, "Deciding for the Incompetent" Paul T. Menzel, "Change of Mind: An Issue for Advance Directives" Nancy S. Jecker, "Medical Futility and Respect for Patient Autonomy" Paul T. Menzel, "Refusing Lifesaving Medical Treatment and Food and Water by Mouth" Thomas S. Huddle, "Suicide, Physician-Assisted Suicide, the Doing-Allowing Distinction and Double Effect" Michael Cholbi, "Grief and End of Life Surrogate Decision-making" Bruce Jennings, "Solidarity near the End of Life: The Promise of Relational Decision-making in the Care of the Dying" Colin Farrelly, "Justice and the Aging of the Human Species". (shrink)

BackgroundMoral dilemmas have arisen concerning whether physicians and other providers should treat patients who have declined COVID vaccination and are now sick with this disease. Several ethicists have argued that clinicians have obligations to treat such patients, yet providing care to these patients has distressed clinicians, who have at times declined to do so. Critical questions thus emerge regarding how best to proceed.Main bodyProviders face moral tensions: whether to place the benefits to an unvaccinated patient over their (...) duties to protect themselves and their families, staff and other patients, and goals of working collaboratively with patients. Clinicians’ duties to treat such patients arguably outweigh claims otherwise, but these obligations are creating moral conflict and distress for providers. Moral distress has been associated with burnout, post-traumatic stress disorder, and interpersonal and work difficulties. Given ongoing vaccine refusals, these problems are unlikely to disappear in the foreseeable future. Society has obligations to address this moral distress due to principles of reciprocity, and implicit social contracts, as part of which physicians risk their lives in caring for patients for the good of society as a whole. Responses are thus urgently needed at several levels: by hospitals, medical schools, professional societies, governments, media, providers and patients. Medical training on professionalism should address these stresses, probing why doctors have duties to treat these patients, but also how moral conflicts can ensue, and how best to address these tensions. Governments and institutions should thus alter relevant policies and devote more resources to addressing clinicians’ psychological strains. Institutions should also improve organizational culture. Public health organizations and the media described clinicians, earlier in the pandemic, as heroes, committed to treating COVID patients. This narrative should now be changed to highlight the strains that unvaccinated patients cause—endangering hospital staff and others.ConclusionsUnvaccinated COVID patients should receive care, but multi-level strategies, involving enhanced policies, education and practice are vital to alleviate ensuing moral distress, and thus aid these clinicians and their patients. Ethical arguments that providers must treat these patients have not considered these obligations’ effects on clinicians, but should do so. (shrink)

Part intellectual autobiography and part exposition of complex yet contemporary economic ideas, this lively conversation with renowned scholar and public intellectual Kenneth J. Arrow focuses on economics and politics in light of history, current events, and philosophy as well. Reminding readers that economics is about redistribution and thus about how we treat each other, Arrow shows that the intersection of economics and ethics is of concern not just to economists but for the public more broadly. With a foreword by (...) Amartya Sen, this book highlights the belief that government can be a powerful force for good, and is particularly relevant in the current political climate and to the lay reader as well as the economist. (shrink)