While such epistemic rules as 'If you perceive that X, you ought to believe that X' and 'If you have outstanding testimony that X, you ought to believe that X' seem to be getting at important truths, it is easy to think of cases in which they come into conflict. To avoid classifying such cases as dilemmas, one can hold either that epistemic rules have built-in unless-clauses listing the circumstances under which they don't apply, or, alternatively, that epistemic rules are (...) contributory. This paper explores both responses from a formal perspective, drawing on a simple defeasible logic framework. (shrink)

There are at least two different aspects of our rational evaluation of agents’ doxastic attitudes. First, we evaluate these attitudes according to whether they are supported by one’s evidence (substantive rationality). Second, we evaluate these attitudes according to how well they cohere with one another (structural rationality). In previous work, I’ve argued that substantive and structural rationality really are distinct, sui generis, kinds of rationality – call this view ‘dualism’, as opposed to ‘monism’, about rationality – by arguing that the (...) requirements of substantive and structural rationality can come into conflict. In this paper, I push the dialectic on this issue forward in two main ways. First, I argue that the most promising ways of resisting the diagnosis of my cases as conflicts still end up undermining monism in different ways. Second, supposing for the sake of argument that we should understand the cases as conflicts, I address the question of what we should do when such conflicts arise. I argue that, at least in a prominent kind of conflict case, the coherence requirements take precedence over the evidential requirements. (shrink)

The 6th Consensus Statement on Concussion in Sport is authored by the Concussion in Sport Group (CiSG) and intends to provide evidence-based recommendations on concussion management for the welfare of sports participants. However, the authors of the Consensus Statement have declared many competing links to third-party groups. While the declaration of an author’s competing interests is now a widely accepted practice within academic publishing aimed at greater transparency and research integrity, it is not a measure to remove the potential influence (...) of third-party links. In the case of the Consensus Statement, this leaves uncertainty about how the potential sources of third-party bias declared by individual members of the CiSG may have influenced the CiSG’s interpretation of the existing state of evidence on concussion management and impacted the content of the recommendations contained with the Consensus Statement. Openly declaring third-party links falls short of securing trustworthiness in the Consensus Statement recommendations since it leaves end-users of the Consensus Statement with the task of interpreting the impact(s) of these competing interests with little information to guide them. This is because the authors themselves offer neither explanation nor guidance concerning potential bias arising from the competing interests that they have declared, which impinges upon the ability of readers to evaluate the trustworthiness of the content. The status quo could be improved by excluding researchers who have conflicts of interest. Nevertheless, if authors with competing interests are permitted to be part of the CiSG (as is the status quo), then I propose a novel option for increasing transparency that would require authors of the Consensus Statements to provide a reflexive explanation, not simply a declaration, of their competing interests. (shrink)

Statements containing epistemic modals (e.g., “by spring 2023 most European countries may have the Covid-19 pandemic under control”) are common expressions of epistemic uncertainty. In this paper, previous published findings (Knobe & Yalcin, 2014; Khoo & Phillips, 2018) on the opposition between Contextualism and Relativism for epistemic modals are re-examined. It is found that these findings contain a substantial degree of individual variation. To investigate whether participants differ in their interpretation of epistemic modals, an experiment with multiple phases and sessions (...) is used to classify participants according to the three semantic theories of Relativism, Contextualism, and Objectivism. Through this study, some of the first empirical evidence for the kind of truth-value shifts postulated by semantic Relativism is presented. It is furthermore found that participants’ disagreement judgments match their truth evaluations and that participants are capable of distinguishing between truth and justification. In a second experimental session, it is investigated whether participants thus classified follow the norm of retraction which Relativism uses to account for argumentation with epistemic modals. Here the results are less favorable for Relativism. In a second experiment, these results are replicated and the normative beliefs of participants concerning the norm of retraction are investigated following work on measuring norms by Bicchieri (2017). Again, it is found that on average participants show no strong preferences concerning the norm of retraction for epistemic modals. Yet, it was found that participants who had committed to Objectivism and had training in logics applied the norm of retraction to might-statements. These results present a substantial challenge to the account of argumentation with epistemic modals presented in MacFarlane (2014), as discussed. Keywords: Epistemic Modals, Relativism, Norm Conflicts, Retraction, Semantics, Truth Conditions, Argumentation. (shrink)

Anyone who has ever found herself or himself at odds with a boss, a board, a committee, a pastor, family member - or with any other institutional setting of which she or he my be a part - will find this book full of help and insight and wisdom. Conflicting Agendas is an invaluable guide to sorting out the complexities of individual moral existence in an increasingly complex and complicated world.

Conflicts of interest pose special problems for the professions. Even the appearance of a conflict of interest can undermine essential trust between professional and public. This volume is a comprehensive and accessible guide to the ramifications and problems associated with important issue. It contains fifteen new essays by noted scholars and covers topics in law, medicine, journalism, engineering, financial services, and others.

Practical conflicts pervade human life. Agents have many different desires, goals, and commitments, all of which can come into conflict with each other. How can practical reasoning help to resolve these practical conflicts? In this collection of essays a distinguished roster of philosophers analyse the diverse forms of practical conflict. Their aim is to establish an understanding of the sources of these conflicts, to investigate the challenge they pose to an adequate conception of practical reasoning, and to assess the degree (...) to which that challenge can be met. These essays will serve as a major resource for students of philosophy but will also interest students and professionals in related fields of the social sciences such as psychology, political science, sociology and economics. (shrink)

The evolution of altruism in human societies has been intensively investigated in social and natural sciences. A widely acknowledged recent idea is the “parochial altruism model,” which suggests that inter- group hostility and intragroup altruism can coevolve through lethal intergroup conflicts. The current article critically examines this idea by reviewing research relevant to intergroup conflicts in human evolutionary history from evolutionary biology, psychology, cultural anthropology, and archaeology. After a brief intro- duction, section 2 illustrates the mathematical model of parochial altruism (...) and some critiques of the model and its interpretation, primarily from an evolutionary biology point of view. Section 3 delves into the archaeological evidence of prehistoric intergroup conflicts in the Japanese archipelago’s Jomon and Yayoi periods, Europe’s Mesolithic period, and North America’s Pacific period as counter examples of the paro- chial altruism model. In section 4, the ethnographies of intergroup relationships and conflicts reveal that intergroup relationships in many ethnic groups are not as simple as the assumption in the mathematical model of parochial altruism. In section 5, we outline psychological research on intergroup conflicts which suggest that intergroup hostility and ingroup altruism are not necessarily correlated. In conclusion, we argue that the assumption and parameter settings of the parochial altruism model are inconsistent with empirical data. (shrink)

In this thesis, I present an account of the development of early Greek epistemology, according to which Protagoras' measure doctrine, and his argument from conflicting appearances, was the starting point for work on perception and knowledge by Plato in the Theaetetus, Aristotle in Metaphysics IV and Democritus. In Chapter One, I argue against the assumption that Protagoras' Aletheia contained a philosophical theory. It was probably not a treatise, but a virtuoso show-piece, with the aim of "knocking down" views according to (...) which truth is only known by gods, and, with difficulty, by privileged humans--namely, philosophers. For this, it need not have contained more than some well-chosen examples of perceptual and value beliefs, and arguments that one cannot decide which are true. In Chapter Two, I argue that Democritus should be seen as Protagoras' heir. Democritus argued Protagoras' general claim is self-refuting, but thought he was right about perceptual appearances. In Confirmations, he defended the senses, attributing to them knowledge and "power of proof." However, his theory led to an ancestor of the primary/secondary quality distinction, and this threatened to undermine the theory itself because of implications--that one can only know how things appear and not how things are by nature--which were later taken up in Pyrrhonist skepticism. In Chapter Three, I present a reading of the Secret Doctrine in Plato's Theaetetus as a defense and diagnosis of Protagoras' claim, in particular, an explanation of the global relativization which Protagoras' claim seems to recommend. This reading is meant to avoid the well-known difficulties concerning the prevailing interpretation of Protagoras' "Secret Doctrine" as a flux doctrine. I also argue that Plato developed the Secret Doctrine with Democritus in mind. In Chapter Four, I argue that Plato's "self-refutation argument" is aimed at relativism, but not relativism about truth. The latter, which Aristotle dismisses as eristical, is a position Protagoras can take, but Plato's argument works against it as well. In Chapter Five, I examine why Aristotle seems to treat Protagoras in Metaphysics IV as being committed to a denial of the principle of non-contradiction. (shrink)

One of the popular albeit controversial ideas in the last century of moral philosophy is that what we ought to do is explained by our reasons. And one of the central features of reasons that accounts for their popularity among normative theorists is that they can conflict. But I argue that the fact that reasons conflict actually also poses two closely related problems for this popular idea in moral philosophy. The first problem is a generalization of a problem in deontic (...) logic concerning the existence of conflicting obligations. The second problem arises from a tension between the fact that reasons can conflict and a model of how reasons explain ‘ought’s that has been widely accepted. Having presented each of these problems, I develop a unified solution to them that is informed by results in both ethics and deontic logic. An important implication of this solution is that we must distinguish between derivative and nonderivative reasons and revise our conception how it is that reasons explain ‘ought’s. (shrink)

Conflict zone entrepreneurs—local entrepreneurs running small businesses in conflict settings—have paradoxical impacts on stability: holding the ability both to foster peace but also to enhance conflict. Prior scholarly work has been unable to explain this divergence, as existing entrepreneurial indicators do not account for fundamental peacebuilding elements. In response, the article consolidates divergent fields of study, applies paradox theory to analyze underlying tensions in the field, and reframes entrepreneurship through a peacebuilding lens based on intergroup inclusivity and value-creating business practices. (...) Using several cases, this article shows how entrepreneurial activity in conflict zones can foster sustainable peace, limited peace, or conflict, arguing that entrepreneurship based on value-creating and inclusive practices can result in pro-peace outcomes. The article offers policy recommendations for local governments and the humanitarian sector seeking to use entrepreneurship in conflict zones to promote peace. (shrink)

For many epistemologists, and for many philosophers more broadly, it is axiomatic that rationality requires you to take the doxastic attitudes that your evidence supports. Yet there is also another current in our talk about rationality. On this usage, rationality is a matter of the right kind of coherence between one's mental attitudes. Surprisingly little work in epistemology is explicitly devoted to answering the question of how these two currents of talk are related. But many implicitly assume that evidence -responsiveness (...) guarantees coherence, so that the rational impermissibility of incoherence will just fall out of the putative requirement to take the attitudes that one's evidence supports, and so that coherence requirements do not need to be theorized in their own right, apart from evidential reasons. In this paper, I argue that this is a mistake, since coherence and evidence -responsiveness can in fact come into conflict. More specifically, I argue that in cases of misleading higher-order evidence, there can be a conflict between believing what one's evidence supports and satisfying a requirement that I call “inter-level coherence ”. This illustrates why coherence requirements and evidential reasons must be separated and theorized separately. (shrink)

Role conflict occurs when a job possesses inconsistent expectations incongruent with individual beliefs, a situation that precipitates considerable frustration and other negative work outcomes. Increasing interest in processes that reduce role conflict is, therefore, witnessed. With the help of information collected from a large sample of individuals employed at an education-based healthcare institution, this study identified several factors that might decrease role conflict, namely mindfulness and organizational ethics. In particular, the results indicated that mindfulness was associated with decreased role conflict, (...) and that perceived ethical values and a shared ethics code were associated with decreased role conflict and increased mindfulness. Despite the study's limitations, these findings imply that companies might better manage role conflict through the development of mindfulness and organizational ethics. (shrink)

Two groups of agents, G1 and G2, face a *moral conflict* if G1 has a moral obligation and G2 has a moral obligation, such that these obligations cannot both be fulfilled. We study moral conflicts using a multi-agent deontic logic devised to represent reasoning about sentences like "In the interest of group F of agents, group G of agents ought to see to it that phi". We provide a formal language and a consequentialist semantics. An illustration of our semantics with (...) an analysis of the Prisoner’s Dilemma follows. Next, necessary and sufficient conditions are given for (1) the possibility that a single group of agents faces a moral conflict, for (2) the possibility that two groups of agents face a moral conflict within a single moral code, and for (3) the possibility that two groups of agents face a moral conflict. (shrink)

This paper considers the relation between the sources of normativity, reasons, and normative conflicts. It argues that common views about how normative reasons relate to their sources have important consequences for how we can understand putative normative conflicts.

In the sacrificial moral dilemma task, participants have to morally judge an action that saves several lives at the cost of killing one person. According to the dual process corrective model of moral judgment suggested by Greene and collaborators (2001; 2004; 2008), cognitive control is necessary to override the intuitive, deontological force of the norm against killing and endorse the utilitarian perspective. However, a conflict model has been proposed more recently to account for part of the evidence in favor of (...) dual process models in moral and social decision making. In this model, conflict, moral responses and reaction times arise from the interplay between individually variable motivational factors and objective parameters intrinsic to the choices offered. To further explore this model in the moral dilemma task, we confronted three different samples with a set of dilemmas representing an objective gradient of utilitarian pull, and collected data on moral judgment and on conflict in a 4-point scale. Collapsing all cases along the gradient, participants in each sample felt less conflicted on average when they gave extreme responses (1 or 4 in the UR scale). They felt less conflicted on average when responding to either the low- or the high-pull cases. The correlation between utilitarian responses and conflict was positive in the low-pull and negative in the high-pull cases. This pattern of data suggests that moral responses to sacrificial dilemmas are driven by decision conflict, which in turn depends on the interplay between an objective gradient of utilitarian pull and the moral motivations which regulate individual responsiveness to this gradient. (shrink)

One hypothesis concerning the human dorsal anterior cingulate cortex (ACC) is that it functions, in part, to signal the occurrence of conflicts in information processing, thereby triggering compensatory adjustments in cognitive control. Since this idea was first proposed, a great deal of relevant empirical evidence has accrued. This evidence has largely corroborated the conflict-monitoring hypothesis, and some very recent work has provided striking new support for the theory. At the same time, other findings have posed specific challenges, especially concerning the (...) way the theory addresses the processing of errors. Recent research has also begun to shed light on the larger function of the ACC, suggesting some new possibilities concerning how conflict monitoring might fit into the cingulate's overall role in cognition and action. (shrink)

This study examines the extent to which scientific and biomedical journals have adopted conflict of interest (COI) policies for authors, and whether the adoption and content of such policies leads to the publishing of authors’ financial interest disclosure statements by such journals. In particular, it reports the results of a survey of journal editors about their practices regarding COI disclosures. About 16 percent of 1396 highly ranked scientific and biomedical journals had COI policies in effect during 1997. Less than 1 (...) percent of the articles published during that year in the journals with COI policies contained any disclosures of author personal financial interests while nearly 66 percent of the journals had zero disclosures of author personal financial interests. Nearly three fourths of journal editors surveyed usually publish author disclosure statements suggesting that low rates of personal financial disclosures are either a result of low rates of author financial interest in the subject matter of their publications or poor compliance by authors to the journals’ COI policies. (shrink)

Research on implicit conflict detection suggests that people are sensitive to violations of logical principles. When they make reasoning errors, their epistemic radar presumably detects an anomaly....

This paper looks at conflicts of interest in the not-for-profit sector. It examines the nature of conflicts of interest and why they are of ethical concern, and then focuses on the way not-for-profit organisations are especially prone to and vulnerable to conflict-of-interest scandals. Conflicts of interest corrode trust; and stakeholder trust (particularly from donors) is the lifeblood of most charities. We focus on some specific challenges faced by charitable organisations providing funding for scientific (usually medical) research, and examine a case (...) study involving such an organisation. One of the principal problems for charities of this kind is that they often distribute their funds within a relatively small research community (defined by the boundaries of a small region, like an American state or Spanish Autonomous region, or a small country), and it often proves difficult to find high-level researchers within the jurisdiction to adjudicate impartially the research grants. We suggest and recommend options appropriate for our case study and for many other organisations in similar situations. (shrink)

Eriksson thinks that moral disagreements are intuitively faulty whereas disagreements about taste are intuitively faultless. He attempts to account for this difference by arguing, first, that moral judgements and taste judgements differ with regard to the presence of a disposition to challenge conflicting judgements and, second, that the intuition that a judgement is mistaken consists in the disposition to challenge it. In this article, I focus on the reasons given to support the first claim and argue that they are not (...) sufficient. First, I assess the thesis that a taste judgement is only contingently connected with a disposition to challenge conflicting judgements. Second, I focus on the claim that a moral judgement is in part a disposition to challenge conflicting judgements. In both cases, I argue that the reasons given fail to disclose any substantial difference between the two domains. (shrink)

US citizens perceive their society to be one of the most diverse and religiously tolerant in the world today. Yet seemingly intractable religious intolerance and moral conflict abound throughout contemporary US public life - from abortion law battles, same-sex marriage, post-9/11 Islamophobia, public school curriculum controversies, to moral and religious dimensions of the Black Lives Matter and Occupy Wall Street movements, and Tea Party populism. Healthy Conflict in Contemporary American Society develops an approach to democratic discourse and coalition-building across deep (...) moral and religious divisions. Drawing on conflict transformation in peace studies, recent American pragmatist thought, and models of agonistic democracy, Jason Springs argues that, in circumstances riven with conflict between strong religious identities and deep moral and political commitments, productive engagement may depend on thinking creatively about how to constructively utilize conflict and intolerance. The result is an approach oriented by the recognition of conflict as a constituent and life-giving feature of social and political relationships. (shrink)

An area where conflicts of interest can take place in Estonia is in the conduct of clinical trials. The paper lists the main areas where such conflicts of interest can occur. The author also briefly discusses Estonia’s current position with regard to regulating genetic information and the commencement of the Estonian Genome Project.

The thesis contains my early work arguing against evidentialism for reasons for belief (chapter 1), my early argument that rationality is not normative (chapter 2), an argument that rationality is not responding reasons, at least understood in one way (chapter 2), a general discussion of how normative conflicts might (appear to) arise in many different ways (chapter 3), a discussion of how to weigh pragmatic and evidential reasons for belief (chapter 4), and a discussion of the general structure of normativity (...) and its ramifications for understanding putative normative conflicts (chapter 4). At a more general level, the thesis aims to explore how putative normative conflicts might arise and whether they are genuine conflicts or only apparent. It also offers a defence of the view that there are genuine state-given reasons for propositional attitudes, including pragmatic reasons for belief. (shrink)

The growing commercialization of science has raised concerns about financial conflicts of interest (COIs). Evidence suggests that such conflicts threaten the integrity of research and the well-being of research participants. Trying to minimize these negative effects, federal agencies, academic institutions, and publishers have developed conflict-of-interest policies. Among such policies, recommendations or requirements to disclose financial COIs to potential research participants and patients have become commonplace. Here, I argue that disclosing conflicts of interest to potential research participants fails to achieve the (...) weighty moral goals that presumably ground such policies. This is so either because disclosure is simply a wrong means for achieving some of the goals in question or because, although disclosure could be an appropriate means for some of those goals, the way in which it is implemented prevents fulfillment of the desirable moral aim. (shrink)

Background Ethical conflict is a problem with negative consequences, which can compromise the quality and ethical standards of the nursing profession and it is a source of stress for health care practitioners’, especially for nurses. Objectives The main aim of this study was to analyze Spanish critical care nurses’ level of exposure to ethical conflict and its association with sociodemographic, occupational, and COVID-19–related variables. Research Design, Participants, and Research context: This was a quantitative cross-sectional descriptive study conducted among 117 nurses (...) working in critical care units. Data collection tools were sociodemographic, occupational, and COVID-19–related questionnaires and previously validated Spanish version of Ethical Conflict in Nursing Questionnaire-Critical Care Version. Ethical Considerations We obtained permission from the Ethics Committee and participants' informed consent. Findings Data indicates a moderate level of exposure to ethical conflicts. The most frequent ethical conflicts were related to situations about "treatment and clinical procedures." The most intensity of ethical conflicts was related to situations about "treatment and clinical procedures" and "dynamics of the service and working environment." No statistical significance was identified between the socio-demographic variables and level of exposure to ethical conflicts. However, for critical care nurses working in ICU, nurses with perceived worked stress had a higher level of exposure to ethical conflicts. Likewise, critical care nurses whose family/friends were infected with COVID-19 had a higher level of exposure. Conclusions Critical care nurses experience a moderate level of exposure to ethical conflicts which is consistent with the results of previous studies. A deeper understanding of ethical conflicts in conflictive situations allows recognition of the situations that occur in everyday clinical practice, identification of the ethical conflicts, and facilitation of the nurses working in the challenging clinical situation. (shrink)

The last years have seen a surge of scandals in financial intermediation. This article argues that the agency structure inherent to most forms of financial intermediation gives rise to conflicts of interest. Though this does not excuse scandalous behavior it points out market imperfections. There are four types of conflicts of interest: personal-individual, personal-organizational, impersonal-individual, and finally, impersonal-organizational conflicts. Analyzing recent scandals we find that all four types of conflicts of interest prevail in financial intermediation.

The heart of the matter -- The evolution of the French medicine -- Coping with physicians' conflicts of interest in France -- The rise of a protected medical market : the United States before 1950 -- The commercial transformation : the United States, 1950-1980 -- The logic of medical markets : the United States, 1980 to the present -- Coping with physicians' conflicts of interest in the United States -- The evolution of Japanese medicine -- Coping with physicians' conflicts of (...) interest in Japan -- Reforms -- Professionalism reconsidered. (shrink)

Advances in assisted reproductive technologies can give rise to several ethical challenges. One of these challenges occurs when the reproductive desires of two individuals become incompatible and conflict. To address such conflicts, it is important to unbundle different aspects of (non)parenthood and to recognize the corresponding reproductive rights. This article starts on the premise that the six reproductive rights—the right (not) to be a gestational, genetic, and social parent—are negative rights that do not entail a right to assistance. Since terminating (...) or continuing a pregnancy is a form of assistance, the right (not) to be a gestational parent should enjoy primacy in conflicts. However, while refusing assistance may hinder the reproductive project of another person, “prior assistance” does not entitle someone to violate a reproductive right. Therefore, our analysis provides reasons to argue that someone has a right to unilaterally use cryopreserved embryos or continue the development of an entity in an extracorporeal gestative environment (i.e., ectogestation). Although this could lead to a violation of the right not to be a genetic parent, it does not necessarily entail a violation of the right not to be a social parent. (shrink)

Clinical ethics records offer bioethics researchers a rich source of cases that clinicians have identified as ethically complex. In this paper, we suggest that clinical ethics records can be used to point to types of cases that lack attention in the current bioethics literature, identifying new areas in need of more detailed bioethical work. We conducted an analysis of the clinical ethics records of one paediatric hospital in Australia, focusing specifically on conflicts between parents and health professionals about a child’s (...) medical treatment. We identified, analysed, and compared cases of this type from the clinical ethics records with cases of this type discussed in bioethics journals. While the cases from journals tended to describe situations involving imminent risk to the child’s life, a significant proportion of the clinical ethics records cases involved different stakes for the child involved. These included distress, poorer functional outcome, poorer psychosocial outcome, or increased risk of surgical complications. Our analysis suggests that one type of case that warrants more detailed ethics research is parental refusal of recommended treatment, where the refusal does not endanger the child’s life but rather some other aspect of the child’s well-being. (shrink)

Background:Ethical conflict is a barrier to decision-making process and is a problem derived from ethical responsibilities that nurses assume with care. Intensive care unit nurses are potentially exposed to this phenomenon. A deep study of the phenomenon can help prevent and treat it.Objectives:This study was aimed at determining the frequency, degree, level of exposure, and type of ethical conflict among nurses working in the intensive care units.Research design:This was a descriptive cross-sectional research.Participants and research context:In total, 382 nurses working in (...) the intensive care units in Iranian hospitals were selected using the random sampling method. Data were collected using the Ethical Conflict in Nursing Questionnaire-Critical Care Version (Persian version).Ethical considerations:This study was approved by the Medical Research Ethics Committee. Ethical considerations such as completing the informed consent form, ensuring confidentiality of information, and voluntary participation were observed.Findings:The results showed that the average level of exposure to ethical conflict was 164.39 ± 79.06. The most frequent conflict was related to “using resources despite believing in its futility,” with the frequency of at least once a week or a month (68.6%, n = 262). The most conflictive situation was violation of privacy (76.9%, n = 294). However, the level of exposure to ethical conflict according to the theoretical model followed was the situation of “working with incompetent staff.” The most frequently observed type of conflict was moral dilemma.Conclusion:The moderate level of exposure to ethical conflict was consistent with the results of previous studies. However, the frequency, degree, and type of ethical conflict were different compared to the results of other studies. Recognizing ethical conflict among intensive care unit nurses can be useful as it allows to consolidate those measures that favor low levels of ethical conflict, design appropriate strategies to prevent ethical conflicts, and improve the nursing work environment. (shrink)

Conflicts of interest are common and exist in academia, government, and many industries, including pharmaceutical development. Medical journal editors and others have recently criticized “the pharmaceutical industry,” citing concerns over investigator access to data, approaches to analysis of clinical trial data, and publication practices. Merck & Co., Inc. is a global, research-driven pharmaceutical company that discovers, develops, manufactures, and markets a broad range of human and animal health products, directly and through its joint ventures. Although part of its mission is (...) to provide a superior rate of return to its investors, Merck does not believe this creates an irreconcilable conflict of interest, particularly in activities concerning clinical drug development. We employ rigorous scientific methods to design, conduct, analyze, and report results of clinical trials in the development of innovative drugs and vaccines, with a focus on meeting unmet medical needs and with an ethic that puts the interests of the patient first. This article describes Merck’s approaches to potential conflicts of interest in drug development, particularly with regard to clinical trials. We believe that proprietary interests of the Company can be respected while observing objectivity and transparency in communicating clinical research results. The standards for the review of manuscripts reporting such trials for peer-reviewed publication should be the same, whether they are from Merck or elsewhere. (shrink)

Given the current climate of political division and global conflict it is not surprising that there has been an increasing interest in how we ought to respond to perceived wrongdoing, both personal and political. In this volume, top scholars from around the world contribute all new original essays on the ethics of forgiveness, revenge, and punishment. -/- This book draws on both historical and contemporary debates in order to answer important questions about the nature of forgiveness, the power of apology, (...) the relationship between punishment and revenge, the path to reconciliation, the morality of blame, and the role of forgiveness in political conflict. -/- Chapter 16 is available open access . (shrink)

Conflict of interest has been a leading issue in the Canadian legal profession over the last three decades, and it shows no sign of abating. No other issue has so consistently and dramatically dominated both the practice of law and its regulation in Canada. This article describes the conceptual and political battles that have been fought over conflicts of interest in Canada during this time. These battles reveal deeper ontological divisions about the practice of law in Canada. The clash over (...) conflicts of interest exposes competing conceptions of what it means to be a lawyer in Canada in the twenty-first century and how the legal profession should be governed. The conflicts of interest debate increasingly centres on the duty of loyalty owed by lawyers to their clients. (shrink)

Our society has long sanctioned, at least tacitly, a degree of conflict of interest in medical practice and clinical research as an unavoidable consequence of the different interests of the physician or clinical investigator, the patient or clinical research subject, third party payers or research sponsors, the government, and society as a whole, to name a few. In the past, resolution of these conflicts has been left to the conscience of the individual physician or clinical investigator and to professional organizations. (...) The public is no longer willing to allow health care providers to wholly govern their own conflicts of interest for several reasons. These include: new forms of health care financing and delivery that provide innovative and lucrative opportunities for physician or insurer enrichment at patient expense; the increased importance of commercial research support as peer-reviewed governmental research support has decreased; evidence that physicians and clinical investigators too frequently resolve conflicts of interest in their own favor; and a general societal mistrust of authority. This volume represents a multidisciplinary effort, drawing from philosophy, medicine, law, economics and public policy to identify and categorize conflicts of interest in medical practice and clinical research, and, where possible, to offer a mechanism for resolving them. Part I addresses conflicts of interest from a theoretical perspective, offering basic concepts and analytical frameworks. The second part discusses two topics prominent in current health care policy debates--self-referral and financial incentives to limit care. Part III examines conflicts of interest generated by pharmaceutical industry involvement in clinical practice and research. The final section deals with conflicts of interest in clinical research in several contexts, including institutional reviews boards, clinical trials, Cooperative Research and Development Agreements between government and private researchers, brokerage of research subjects by Contract Research Organizations, and cost-effectiveness studies. (shrink)

Context Conflicts over treatment decisions have been linked to physicians' emotional states. Objective To measure the prevalence of emotional exhaustion and conflicts over treatment decisions among US obstetrician/gynaecologists (ob/gyns), and to examine the relationship between the two and the physician characteristics that predict each. Methods Mailed survey of a stratified random sample of 1800 US ob/gyn physicians. Criterion variables were levels of emotional exhaustion and frequency of conflict with colleagues and patients. Predictors included physicians' religious characteristics and self-perceived empathy. Results (...) Response rate among eligible physicians was 66% (1154/1760). 36% of ob/gyns reported high levels of emotional exhaustion, and majorities reported conflict with colleagues (59%) and patients (61%). Those reporting conflict were much more likely to report emotional exhaustion (58% vs 29% who never conflict, OR, 95% CI 2.8, 1.6 to 4.8 for conflict with colleagues; 55% versus 26%, OR, 95% CI 2.2, 1.4 to 3.5 for conflict with patients). Physicians with lower self-perceived empathy were more likely to report physician-patient conflicts (65% vs 58% with higher empathy, OR, 95% CI 1.4, 1.0 to 1.9), as were female ob/gyns (66% vs 57% of males, OR, 95% CI 1.5, 1.1 to 2.0). Foreign-born physicians were less likely to report such conflicts (47% vs 64% of US born, OR, 95% CI 0.5, 0.4 to 0.8). Physicians' religious characteristics were not significantly associated with reporting conflict. Conclusions Conflicts over treatment decisions are associated with physicians' empathy, gender, immigration history and level of emotional exhaustion. With respect to the latter, conflict in the clinical encounter may represent an overlooked source or sign of burnout among ob/gyns. (shrink)

It is in the interest of the totalitarian state that subjects not think for themselves, much less confer about their thinking. Writing under the hostile watch of the Prussian censorship, Immanuel Kant dared to argue the need for open argument, in the university if nowhere else. In this heroic criticism of repression, first published in 1798, he anticipated the crises that endanger the free expression of ideas in the name of national policy. Composed of three sections written at different times, (...) The Conflict of the Faculties dwells on the eternal combat between the "lower" faculty of philosophy, which is answerable only to individual reason, and the faculties of theology, law, and medicine, which get "higher" precedence in the world of affairs and whose teachings and practices are of interest to the government. Kant makes clear, for example, the close alliance between the theological faculty and the government that sanctions its teachings and can resort to force and censorship. All the more vital and precious, then, the faculty of philosophy, which encourages independent thought before action. The first section, "The Conflict of the Philosophy Faculty with the Theology Faculty," is essentially a vindication of the right of the philosophical faculty to freedom of expression. In the other sections the philosopher takes a long and penetrating look at medicine and law, the one preserving the physical "temple" and the other regulating its actions. (shrink)

Since at least the 1960s, deontic logicians and ethicists have worried about whether there can be normative systems that allow conflicting obligations. Surprisingly, however, little direct attention has been paid to questions about how we may reason with conflicting obligations. In this paper, I present a problem for making sense of reasoning with conflicting obligations and argue that no deontic logic can solve this problem. I then develop an account of reasoning based on the popular idea in ethics that reasons (...) explain obligations and show that it solves this problem. (shrink)

As earthquakes expose geological faults, so mental conflict reveals tendencies to rupture within the mind. Dissension is rife not only between people but also within them, for each of us is subject to a contrariety of desires, beliefs, motivations, aspirations. What image are we to form of ourselves that might best enable us to accept the reality of discord, or achieve the ideal of harmony? Greek philosophers offer us a variety of pictures and structures intended to capture the actual and (...) the possible either within a reason that fails to be resolute, or within a split soul that houses a play of forces. Reflection upon them alerts us to the elusiveness at once of mental reality, and of the understanding by which we hope to capture and transform it. Studying in turn the treatments of _Mental Conflict_ in Socrates, Plato, Aristotle and the Stoics, A.W. Price demonstrates how the arguments of the Greeks are still relevant to philosophical discussion today. (shrink)

One hundred and three participants solved conflict and non-conflict versions of four reasoning tasks using a two-response procedure: a base rate task, a causal reasoning task, a denominator neglect task, and a categorical syllogisms task. Participants were asked to give their first, intuitive answer, to make a Feeling of Rightness judgment, and then were given as much time as needed to rethink their answer. They also completed a standardized measure of IQ and the actively open-minded thinking questionnaire. The FORs of (...) both high- and low-capacity reasoners were responsive to conflict, such that FORs were lower for conflict relative to non-conflict problems. Consistent with the quantity hypothesis, high-capacity reasoners made a greater distinction between conflict and non-conflict items on measures of Type 2 thinking, namely, rethinking time and probability of changing answers. In contrast to the quality hypothesis, however, this rethinking time did not advantage the ability of the high-capacity group to produce normative answers, except for the base rate task. Indeed, we observed that the correlation between capacity and the probability of normative answers emerged at the initial response, rather than after rethinking. (shrink)

Financial relationships in academic research can create institutional conflicts of interest because the financial interests of the institution or institutional officials may inappropriately influence decision-making. Strategies for dealing with institutional COIs include establishing institutional COI committees that involve the board of trustees in conflict review and management, developing policies that shield institutional decisions from inappropriate influences, and establishing private foundations that are independent of the institution to own stock and intellectual property and to provide capital to start-up companies.

Moral conflicts over medical treatment that are the result of differences in fundamental moral commitments of the stakeholders, including religiously grounded commitments, can present difficult challenges for clinical ethics consultants. This article begins with a case example that poses such a conflict, then examines how consultants might use different approaches to clinical ethics consultation in an effort to facilitate the resolution of conflicts of this kind. Among the approaches considered are the authoritarian approach, the pure consensus approach, and the ethics (...) facilitation approach described in the Core Competencies for Healthcare Ethics Consultation report of the American Society for Bioethics and Humanities, as well as a patient advocate approach, a clinician advocate approach, and an institutional advocate approach. The article identifies clear limitations to each of these approaches. An analysis of the introductory case illustrates those limitations, and the article concludes that deep-seated conflicts of this kind may reveal inescapable limits of current approaches to clinical ethics consultation. (shrink)

Mill’s socialism and democratic theory have led some scholars to accuse him of trying to eliminate conflict from political life. Whereas Graeme Duncan has averred that Mill’s socialism aims to institute a completely harmonious society, James Fitzjames Stephen has contended that Millian democracy sought to evacuate conflict from political discussion. This article reconstructs both critiques and argues they are imprecise. Even if disputes motivated by redistribution of material goods would no longer exist in an egalitarian society, conflicts driven by resentment (...) over social reputation would keep the flame of conflict burning in a Millian socialist community. Moreover, a close reading of Considerations on Representative Government shows that Mill knew that no amount of political discussion is able to make conflicting opinions disappear. According to him, conflict is unavoidable in democratic politics because citizens analyse political issues from different social perspectives. Mill’s goal was not to eliminate conflict, but rather to regulate it in such a way as to bring about its attendant benefits, namely, progress and self-development. (shrink)

With an interest in origins, it is proposed that conflict within the group can be taken as a natural focus for exploring the evolutionary development of human moral communities. Morality today involves social control but also the management of conflicts within the group. It is hypothesized that early manifestations of morality involved the identification and collective suppression of behaviours likely to cause such conflict. By triangulation the mutual ancestor of humans and the two Pan species lived in pronounced social dominance (...) hierarchies, and made largely individualized efforts to damp conflict within the group, exhibiting consolation, reconciliation, and active pacifying intervention behaviour. It is particularly the active interventions that can be linked with social control as we know it. It is proposed that when this process became collectivized, and when language permitted the definition and tracking of proscribed behaviour, full-blown morality was on its way. Because early humans lived in egalitarian bands, a likely candidate for the first behaviour to be labelled as morally deviant is not the incest taboo but bullying behaviour, of the type that egalitarian humans today universally proscribe and suppress. (shrink)

As the debate over how to manage or discourage physicians? financial conflicts of interest with the drug and medical device industries has become more heated, critics have questioned or dismissed the concept of ?conflict of interest? itself. A satisfactory definition relates conflict of interest to concerns about maintaining social trust and distinguishes between breaches of ethical duty and temptations to breach duty. Numerous objections to such a definition have been offered, none of which prevails on further analysis. Those concerned about (...) conflicts of interest have contributed to misunderstandings, however, by failing to demonstrate when social arrangements leading to temptations to breach duties are in themselves morally blameworthy. Clarifying ?conflict of interest? is important if we are eventually going to develop productive modes of engagement between medicine and for-profit industry that avoid the serious ethical pitfalls now in evidence. (shrink)

Scientific communication takes place at two registers: first, interactions with colleagues in close proximity—members of a network, school of thought or circle; second, depersonalised transactions among a potentially unlimited number of scholars can be involved (e.g., author and readers). The interference between the two registers in the process of peer review produces a drift toward conflict of interest. Three particular cases of peer review are differentiated: journal submissions, grant applications and applications for tenure. The current conflict of interest policies do (...) not cover all these areas. Furthermore, they have a number of flaws, which involves an excessive reliance on scholars’ personal integrity. Conflicts of interest could be managed more efficiently if several elements and rules of the judicial process were accepted in science. The analysis relies on both primary and secondary data with a particular focus on Canada. (shrink)

This collection explores the subject of conflicts of interest. It investigates how to manage conflicts of interest, how they can affect well-meaning professionals, and how they can limit the effectiveness of corporate boards, undermine professional ethics, and corrupt expert opinion. Legal and policy responses are considered, some of which (e.g., disclosure) are shown to backfire and even fail. The results offer a sobering prognosis for professional ethics and for anyone who relies on professionals who have conflicts of interest. The contributors (...) are leading authorities on the subject in the fields of law, medicine, management, public policy, and psychology. The nuances of the problems posedby conflicts of interest will be highlighted for readers in an effort to demonstrate the manyways that structuring incentives can affect decision making and organizations' financial well-being. (shrink)

Background: Working as an ambulance nurse involves facing ethically problematic situations with multi-dimensional suffering, requiring the ability to create a trustful relationship. This entails a need to be clinically trained in order to identify ethical conflicts. Aim: To describe ethical conflicts in patient relationships as experienced by ambulance nursing students during clinical studies. Research design: An exploratory and interpretative design was used to inductively analyse textual data from examinations in clinical placement courses. Participants: The 69 participants attended a 1-year educational (...) programme for ambulance nurses at a Swedish university. Ethical consideration: The research was conducted in accordance with the Declaration of Helsinki. Participants gave voluntary informed consent for this study. Findings: The students encountered ethical conflicts in patient relationships when they had inadequate access to the patient’s narrative. Doubts regarding patient autonomy were due to uncertainty regarding the patient’s decision-making ability, which forced students to handle patient autonomy. Conflicting assessments of the patient’s best interest added to the conflicts and also meant a disruption in patient focus. The absence of trustful relationships reinforced the ethical conflicts, together with an inadequacy in meeting different needs, which limited the possibility of providing proper care. Discussion: Contextual circumstances add complexity to ethical conflicts regarding patient autonomy, dependency and the patient’s best interest. Students felt they were fluctuating between paternalism and letting the patient choose, and were challenged by considerations regarding the patient’s communication and decision-making ability, the views of third parties, and the need for prioritisation. Conclusion: The essence of the patient relationship is a struggle to preserve autonomy while focusing on the patient’s best interest. Hence, there is a need for education and training that promotes ethical knowledge and ethical reflection focusing on the core nursing and caring values of trust and autonomy, particularly in situations that affect the patient’s decision-making ability. (shrink)