In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 16.4 (2006) 379-396MuseSearchJournalsThis JournalContents[Access article in PDF]Pharmacists and Conscientious Objection *In March 2005, a Wisconsin pharmacist's act of conscience garnered headlines across the United States. After a married woman with four children submitted a prescription for the morning-after pill, the pharmacist, Neil Noesen, not only refused to fill it, but also refused to transfer the prescription to another pharmacist or to return the prescription (...) to the customer. As more such incidents occurred, many states "... decided to consider and enact laws setting the bounds of pharmacists' and other health care workers' professional obligations" (III, Grady 2006, p. 327). Discussions of objector legislation, also referred to as "conscience clauses," "refusal clauses," and "abandonment laws" (III, Appel 2005, p. 279), are not limited to professional ethics, but also draw from philosophical, theological, and legal perspectives. The purpose of this Scope Note is to present a wide variety of viewpoints on the health provider's right to conscience.More than 40 years ago the development of "The Pill" as the first reliable method of birth control not only ushered in a feminist revolution, but also provided a new focus for concerns of conscience for those who were part of the anti-abortion movement based on religious belief in the sanctity of life. Similarly, in the past ten years, worldwide, and seven years (1999) since the emergency contraception "morning after" pill first became available as a prescription item, there has been an upsurge in the number of medical personnel who refuse to prescribe or dispense it on grounds of personal conscience, whether for religious reasons or not. Their actions bring into play issues of power and control for health care personnel and for patients—in this case women, which also raises women's rights issues. Ironically, studies in France, Sweden, and the United Kingdom have shown that emergency contraception does not reduce the abortion rate—it is too infrequently used (II, Glasier 2006).It is important to underline the difference between the "morning-after" pill or "Plan B," which is made up of two progestin pills containing levonorgestrel (a synthetic derivative of the female hormone progesterone), and RU-486 (Mifiprex [End Page 379] or mifipristone with misoprostol). Plan B, if taken within 72 hours post-coitus prevents implantation, and therefore pregnancy, by suppressing the output of luteinizing hormone, the hormone that triggers the ovulation process. Scientists have been unable to determine whether this action could destroy already fertilized eggs, but even if it does, it uses the same mechanism as occurs with the birth-control pill, that was developed some 45 years ago. By contrast, RU-486 acts up to 49 days after implantation by blocking the action of progesterone in order to terminate the pregnancy and as such is an abortifacient (II, US FDA 1).On 24 August 2006, the U.S. Food and Drug Administration announced approval of the Plan B pill for over-the-counter (OTC ) sales (II, US FDA 2). Although this action makes the drug more widely available, it remains to be seen whether pharmacists who are conscientious objectors and who refuse to dispense it also will refuse to provide it OTC.A survey article by Rebecca Dresser (II, 2005, p. 9) succinctly sums up the problem for conscientious objectors: "Because emergency contraception can act to block implantation of a fertilized egg, people who believe in protection of human life after conception find it morally objectionable."When conscientious objections are raised over abortion or birth control services performed, prescribed, or dispensed, they affect not only the health professionals—physicians, pharmacists, nurses, and health technicians—who may object, as well as their colleagues and/or managers, but also the consumers: the female patients who are then forced to reconsider or to seek an alternative supplier, as well as their spouses or partners. Alta Charo (II, 2005, p. 2473) makes the point that the patient needs to have access to a system of counseling and referral "so... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:REDISCOVERING VIRTUE* SERVAIS PINCK.AERS, 0.P. L!universite de Fribourg Fribourg, Switzerland INTRODUCTION: THE DEBATE ABOUT VIRTUE VIRTUE is back. Especially in the United States, a widespread discussion about its role in moral theology has been initiated, a discussion modeled on Aristotle's Ethics, particularly as Aristotle's thought was developed in the Middle Ages by Thomas Aquinas. Accompanying this rediscovery of virtue is a criticism of modern ethical theories. These theories, having (...) broken with Aristotelian tradition, have led to a burgeoning of contradictory systems: a morality of obligation on the Kantian model; utilitarian morality; and a radical critique of morality by Nietzsche. Because of such divergences any discussion between moralists, especially where the foundations and principles of morality are involved, has up to the present seemed doomed to failure.1 •Translated by Sr. Mary Thomas Noble, O.P. 1 The author who has contributed most to this discussion of virtue is undoubtedly Alasdair Macintyre in his three principal books: After Virtue: A Study in Moral Theory (Notre Dame, Ind.: University of Notre Dame Press, 1981; second edition, 1984); Whose Justice? Which Rationality? (Notre Dame, Ind.: University of Notre Dame, 1988); Three Versions of Moral Inquiry: Encyclopedia, Genealogy, and 1radition (Notre Dame, Ind.: University of Notre Dame, 1990). The Italian edition of the last book, Enciclopedia, Genealogia e 1radizione (Milan, 1993), includes a special introduction on Macintyre and a biography. I should also like to mention the article by Martha Nussbaum, "Virtue Revived," Times Literary Supplement 4657 Ouly 3, 1992): 9-11. See also a recent book by Andre Comte-Sponville, Petit traite des grands vertus (Paris: Presses Universitaires de France, 1995). This work is very interesting because it proposes to a wide readership a moral system drawn from Aristotle that is at the same time based entirely on modern philosophy. In my opinion the author unintentionally confirms the thesis of the incompatibility of modern ethical systems of obligation and the 361 362 SERVAIS PINCKAERS, O.P. In view of this ethical pluralism, certain philosophers have undertaken to set up ethical norms through reflection on justice, using the methods of discussion and decision prevalent in our democratic societies. The initiative has been designated as procedural ethics.2 In this rather chaotic situation, other writers have thought a return to Aristotelian ethics opportune-a move that would enable us to reconnect with the long tradition of virtue-based morality represented therein, while bringing it up to date. In fact, the introduction of the concept of virtue offers many opportunities for the shaping of a morality that takes the human person into account. Virtue is a dynamic human quality acquired through education and personal effort. It forms character and assures continuity in action. Furthermore, it is set within the framework of community and a strong tradition, to whose development it contributes. Teaching on virtue would seem to be a good corrective for excessive individualism. This is what the socalled "communitarian" trend has emphasized.3 The debate on virtue has also surfaced within traditional Catholic teaching. Since the first half of this century, under the inspiration of St. Thomas, several authors of moral theology textbooks have undertaken to reorganize special morality on the basis of the virtues rather than the ten commandments, as had been done since the seventeenth century.4 Admittedly, the change Aristotelian construct of the virtues held by Macintyre. With the moderns he rejects a natural foundation for morality, within man, and thus robs the virtues he treats of their deep roots. Virtue is not spontaneous; it remains voluntaristic. 2 To mention a few titles: K. 0. Apel, Transformation der Philosophie, 2 vols. (Frankfurt, 1981); Apel, Ethique de la discussion (Paris, 1994); J.M. Ferry, Philosophie de la communication (Paris, 1994); Jiirgen Habermas, Theorie des kommunikativen Handeln, 2 vols. (Frankfurt, 1981); Habermas, Moralbewusstsein und kommunikativer Handeln (Frankfurt, 1983); John Rawls, A Theory ofJustice (Harvard, 1971). 3 See, for example: J. H. Joder, Jesus et le politique: La radicalite ethique de la croix (Lausanne, 1984); S. Hauerwas, The Peacable Kingdom: A Primer in Christian Ethics (Notre Dame, 1983); W. Reese-Schafer, Was ist Kommunitarismus? (Frankfurt, 1994); Charles Taylor, The Sources ofthe Self: The Making ofthe Modern Identity (Cambridge, Mass., 1989... (shrink)

We present work demonstrating that the nature of an object for our visual system depends on the actions we are programming and on the presence of action relations between stimuli. For example, patients who show visual extinction are more likely to become aware of two objects if the objects fall in appropriate visual locations for a common action. This effect of the action relations between objects is modulated both by the familiarity of the positioning of the objects for action, and (...) by the mere possibility of action (the ‘affordance’) between the objects. In addition, the programming of an action to a part of an object alters the representation of that object, making the ‘part’ into the object selected by the visual system. These results point to object coding being a rather flexible process, affected not only by the perceptual properties of stimuli but also by the relations between these properties and action. We discuss the implications for theories of perception as well as considering why action information, in particular, may be important for perception. (shrink)

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

Teaching competency in bioethics has been a concern of the field since its start. In 1976, The Hastings Center published the first report on the teaching of contemporary bioethics. Graduate programs culminating in an MA or PhD were not needed at the time, concluded the report. “In the future, however,” the report speculated, “the development and/or changing social priorities may at some point allow, or even require, the creation of new academic structures for graduate education in bioethics.” Although that future (...) might be upon us, the creation of a terminal degree in bioethics has its detractors. Scholars have debated whether bioethics is a discipline with its own methods and theoretical grounding, a multidisciplinary field bringing various professional perspectives to bear on particular types of problems, a set of problem-solving skills to resolve moral disagreements, or something else entirely. Whether or not efforts to develop the methods and theory of bioethics have matured to the point that it is now a discipline in the strictest sense, new bioethics training programs have appeared at all postsecondary levels. In this essay, we examine the number and types of U.S. programs and degrees in this growing field. (shrink)

We discuss the difficulty of measuring the perceptual experience of colour, supporting Palmer's assertion that neuropsychological disorders of colour processing can be informative in this respect. We point out that some disorders seem to affect the perceptual experience of colour over and above the perceptual processing of colour, providing direct insights into the neural mechanisms supporting perceptual experience.

Prior work shows that the possibility of action to an object facilitates attentional deployment. We sought to investigate the neural mechanisms underlying this modulation of attention by examining ERPs to target objects that were either congruently or incongruently gripped for their use in the presence of a congruently or incongruently gripped distractor. Participants responded to the presence or absence of a target object matching a preceding action word with a distractor object presented in the opposite location. Participants were faster in (...) responding to congruently gripped targets compared to incongruently gripped targets. There was a reduced N2pc potential when the target was congruently gripped, and the distractor was incongruently gripped compared to the conditions where targets were incongruently gripped or when the distractor, as well as target, was congruently gripped. The N2pc results indicate that target selection is easier when action information is congruent with an object’s use. (shrink)

Community psychologists address social inequalities and problems by employing ecological principles, multiple methodologies, and participatory approaches to empower individuals, organizations, and communities to organize action and systems change. This article aims to contribute to mixed methods literature by presenting three models of mixed methods participatory research across a variety of geographic and sociocultural contexts. The models outline participatory processes and points of qualitative and quantitative data integration. Challenges related to the interplay between participatory approaches and mixed methods studies as well (...) as implications on social science research are discussed. (shrink)

In this article I am concerned with whether it could be morally significant to distinguish between doing something 'in order to bring about an effect' as opposed to 'doing something because we will bring about an effect'. For example, the Doctrine of Double Effect tells us that we should not act in order to bring about evil, but even if this is true is it perhaps permissible to act only because an evil will thus occur? I discuss these questions in (...) connection with a version of the so-called Trolley Problem known as the Loop Case. I also consider how these questions may bear on whether a rational agent must aim at an event which he believes is causally necessary to achieve an end he pursues. (shrink)

In this article I am concerned with whether it could be morally significant to distinguish between doing something 'in order to bring about an effect' as opposed to 'doing something because we will bring about an effect'. For example, the Doctrine of Double Effect tells us that we should not act in order to bring about evil, but even if this is true is it perhaps permissible to act only because an evil will thus occur? I discuss these questions in (...) connection with a version of the so-called Trolley Problem known as the Loop Case. I also consider how these questions may bear on whether a rational agent must aim at an event which he believes is causally necessary to achieve an end he pursues. (shrink)

In one volume, this book brings together a new English translation of Plato's _Meno_, a selection of illuminating articles on themes in the dialogue published between 1965 and 1985 and an introduction setting the _Meno_ in its historical context and opening up the key philosophical issues which the various articles discuss. A glossary is provided which briefly introduces some of the key terms and indicates how they are translated. The _Meno_ is an excellent introduction to Plato and philosophy.

In one volume, this book brings together a new English translation of Plato's _Meno_, a selection of illuminating articles on themes in the dialogue published between 1965 and 1985 and an introduction setting the _Meno_ in its historical context and opening up the key philosophical issues which the various articles discuss. A glossary is provided which briefly introduces some of the key terms and indicates how they are translated. The _Meno_ is an excellent introduction to Plato and philosophy.

In one volume, this book brings together a new English translation of Plato's _Meno_, a selection of illuminating articles on themes in the dialogue published between 1965 and 1985 and an introduction setting the _Meno_ in its historical context and opening up the key philosophical issues which the various articles discuss. A glossary is provided which briefly introduces some of the key terms and indicates how they are translated. The _Meno_ is an excellent introduction to Plato and philosophy.

This book is the result of a three-year study undertaken by a multidisciplinary working party of the Institute of Medical Ethic (UK). The group was chaired by a moral theologian, and its members included biological and ethological scientists, toxicologists, physicians, veterinary surgeons, an expert in alternatives to animal use, officers of animal welfare organizations, a Home Office Inspector, philosophers, and a lawyer. Coming from these different backgrounds, and holding a diversity of moral views, the members produced the agreed report as (...) a result of detailed and rigorous discussions. The book sets out facts about animal experiments and about animal abilities to experience pain, distress and anxiety. There is a detailed examination of the moral claims related to the benefits likely to accrue from animal research, and of strategies for weighing these benefits against the harm caused to animals, in order to decide whether particular research projects ought or ought not to proceed. This leads to consideration of the statutory and non-statutory controls which safeguard standards in such research. The final section explores a variety of philosophical arguments about the use of animals in research, and offers a philosophical justification for the Working Party's more practical conclusions. Written in clear, nontechnical language, this book is accessible to lay people as well as to scientists. It is the first such document to emerge from a meeting of people with such widely differing views on this highly controversial subject, and represents a major contribution towards informing and raising the quality of contemporary debate. The book is unique in drawing together material and ideas never before found in one volume. It will interest a broad spectrum of readers, from ethicists and animal rights advocates to scientific researchers and laboratory administrators, along with general readers concerned about this compelling issue. (shrink)

Our aim in this article is to define the difficulties that clinical ethics services encounter when they are asked to demonstrate the value a clinical ethics service (CES) could and should have for an institution and those it serves. The topic emerged out of numerous related presentations at the Un- Conference hosted by the Cleveland Clinic in August 2018 that identified challenges of articulating the value of clinical ethics work for hospital administrators. After a review these talks, it was apparent (...) that the field of clinical ethics may be at a crisis of sorts due to increased pressure to provide explicit measures to healthcare institutions to concretely demonstrate that CESs make a valuable difference in healthcare delivery. In this article, we grapple with how to satisfy the need for demonstrable value in a field in which metrics alone may not capture the scope of clinical ethics practice. We suggest that capturing the value of a CES has been difficult because the benefits of ethics consultation may be overt or attributable to the CES, but are often hidden due to the systems-level and process-oriented nature of clinical ethics work. Part of the difficulty in demonstrating the value of CESs is capturing and conveying all of the ways the integration of a CES throughout an institution positively affects patients, families, visitors, healthcare professionals, administrators, and the institution itself. Our aim is to (1) elucidate the multifaceted value added by a CES, including value that tends to be hidden and (2) suggest how to demonstrate value to others in a way that is not simplistic or reductionistic. (shrink)