Responsible Research and Innovation (RRI) has emerged as a science policy framework that attempts to import broad social values into technological innovation processes whilst supporting institutional decision-making under conditions of uncertainty and ambiguity. When looking at RRI from a ‘principled’ perspective, we consider responsibility and justice to be important cornerstones of the framework. The main aim of this article is to suggest a method of realising these principles through the application of a limited Rawlsian Difference Principle in the (...) distribution of public funds for research and innovation. There are reasons why the world's combined innovative capacity has spewed forth iPhones and space shuttles but not yet managed to produce clean energy or universal access to clean water. (Stilgoe 2013, xii) I derive great optimism from empathy's evolutionary antiquity. It makes it a robust trait that will develop in virtually every human being so that society can count on it and try to foster and grow it. It is a human universal. (de Waal 2009, 209) Responsible Research and Innovation (RRI) has emerged as a science policy framework that attempts to import broad social values into technological innovation processes whilst supporting institutional decision-making under conditions of uncertainty and ambiguity. In this respect, RRI re-focuses technological governance from standard debates on risks to discussions about the ethical stewardship of innovation. This is a radical step in Science & Technology (S&T) policy as it lifts the non-quantifiable concept of values into the driving seat of decision-making. The focus of innovation then goes beyond product considerations to include the processes and – importantly – the purposes of innovation (Owen et al. 2013, 34). Shared public values are seen as the cornerstone of the new RRI framework, while market mechanisms and risk-based regulations are of a secondary order. What are the values that could drive RRI? There are different approaches to the identification of public values. They can be located in democratically agreed processes and commitments (such as European Union treaties and policy statements) or they can be developed organically via public engagement processes. Both approaches have advantages and disadvantages. For instance, although constitutional values can be regarded as democratically legitimate, their application to specific technological fields can be difficult or ambiguous (Schroeder and Rerimassie 2015). On the other hand, public engagement can accurately reflect stakeholder values but is not necessarily free from bias and lobbyist agenda setting. We argue that if RRI is to be more successful in resolving policy dilemmas arising from poorly described and uncertain technological impacts, basic universal principles need to be evoked and applied. When looking at RRI from a ‘principled’ perspective, we consider responsibility and justice to be important cornerstones of the framework. One could describe them in the following manner: Research and innovation should be conducted responsibly. Publicly funded research and innovation should be focused fairly on socially beneficial targets. Research and innovation should promote and not hinder social justice. The main aim of this article is to suggest a method of realising these principles through the application of a limited Rawlsian Difference Principle in the distribution of public funds for research and innovation. This paper is in three parts. The first part discusses the above principles and introduces the Rawlsian Difference Principle. The second part identifies how RRI is currently applied by public funding bodies. The third part discusses the operationalisation of the Rawlsian Difference Principle in responsible funding decisions. (shrink)

According to various accounts, intervention in pediatric decisions is justified either by the best interests standard or by the harm principle. While these principles have various nuances that distinguish them from each other, they are similar in the sense that both focus primarily on the features of parental decisions that justify intervention, rather than on the competency or authority of the parties that intervene. Accounts of these principles effectively suggest that intervention in pediatric decision making is warranted for both (...) physicians and the state under precisely the same circumstances. This essay argues that there are substantial differences in the competencies and authorities of physicians and the state, and that the principles that guide their interventions should also be conceived differently. While both the best interests standard and the harm principle effectively incorporate important aspects of physicians’ ethical obligations, neither adequately reflects the state’s ethical obligations. In contrast to physicians, the state has major obligations of distributive justice and neutrality that should form an integral part of any proposed ethical principles guiding state intervention in pediatric decision making. The differences are illustrated by examining recent cases involving parental refusal of chemotherapy in aboriginal Canadian communities and parental refusal of blood transfusions by Jehovah’s Witnesses. (shrink)

This research attempts to throw light on and show the fundamental similarities and differences between the African and Western ethical conceptions by examining the foundation of ethics and morality in the two systems, using the Golden rule principle in African ethics and Kant’s categorical imperative in Western ethics as tools of comparative analysis. The African indigenous ethics revolves round the “Golden Rule Principle” as the ultimate moral principle. This principle states that “Do (...) unto others what you want them to do unto you”. This principle compares favourably with Immanuel Kant’s whose main thrust is found in his “Categorical Imperative”, with the injunction for us to “Act only on that maxim through which you can at the same time will that it should become a universal law.” The categorical imperative becomes for Kant, the principle of universalizability, which according to Kant, is categorical and must be equally binding on everyone. This idea of Kant, we argue, compares with the “Golden Rule Principle”. Both are rationalistic and social but the limitations of Kant which we hope to point out, make it quite insufficient as the foundation of morality. The Africans’ which is more humanistic describes morality and is better served. The main difference between the two ethical systems lies in the fact that whereas the “golden rule” starts from the self and considers the consequences on the first before others, the universalizability principle on the other hand considers the consequences on others first before self. (shrink)

The purpose of this dissertation is to develop and defend a method of elimination for determining justifiable basic normative ethical principles. The method is developed by considering Books I and X of Aristotle's Nicomachean Ethics and Plato's Meno. The method requires consideration on two different "levels." Aristotle and Plato use regulative endoxic premises as the evaluative criteria of the method. Such premises, which ideally are based upon universal agreement, guide an inquiry of our sort, i.e., determine the elimination or (...) nonelimination of the alternatives. Concerning the second "level," an adequate list of alternative possible solutions should be presented, and some principle or technique should be provided for determining such an adequate list. On the basis of the above premises, alternatives are evaluated in such a way that lack of accordance with any one of the relevant premises--assuming that there is more than one--is sufficient for the elimination of an alternative. The only alternative that is not eliminated by any of the premises provides the solution to the problem. The Aristotle chapter shows how regulative endoxic premises can be used, in an "ideal" sense, for choosing between two or more alternatives that generally accord with the premises. ;Our discussion of Aristotle and Plato shows that they do use this method and illustrates, in some detail, both how the method is used and specific variations of it. Our philosophers use different principles or techniques for determining the plausible alternatives. Aristotle chooses alternatives which are endoxic opinions. Plato uses the opinions of interlocutors, which are often endoxic, but he basically relies on a type of shared or cooperative rational inquiry to determine increasingly more adequate opinions, and, consequently, the plausible opinions that ought to be considered. On this "level," we attempt to show that the Platonic technique is more adequate than the Aristotelian procedure. ;Probably the most controversial feature of our method is the employment of regulative endoxic premises. Our final chapter is concerned with further clarification and defense of these premises. We attempt to show that regulative endoxic premises are different from and more adequate than the more objectionable opinions called conventionally moral opinions. We, then, attempt to provide a justifiable account of the differential value, in our method, in the evidential force of regulative endoxic premises and substantive endoxic opinions, and attempt to determine how adequate regulative endoxic premises relative to a specific inquiry can be identified. We argue that these premises provide the conditions necessary for the possibility of successful inquiry within, what I call, the ordinary ethical standpoint, and that the basic presupposition of this standpoint is an acceptable assumption. ;Two alternatives to our position concerning the defense of regulative endoxic premises are considered: They are intuitively self-evident. They are analytic truths based upon an appeal to ordinary usage. is readily seen to be objectionable. is, apparently, the position of Hare. We argue that Hare's position, which maintains that the probative force of regulative endoxic premises is based upon their analytic nature, is quite debatable, and does not, therefore, provide a viable alternative to our position. We also object to Hare's view of his regulative endoxa, viz., universalizability and prescriptivity. (shrink)

Almost all the existing modern systems of Ethics deal with formal definitions, and at bottom repeat more or less the same thing about them in slightly different words. In this work these are a side issue, and therefore are treated briefly. Their treatment in Section I is based upon the author's theoretical works the Theory of Order and the Theory of Reality, but will be intelligible to those who are not acquainted with those works. The chief concern is moral (...) teaching - that is, the practical element. (shrink)

This article summarizes some of the results of the BIOMED II project “Basic Ethical Principles in European Bioethics and Biolaw” connected to a research project of the Danish Research Councils “Bioethics and Law”. The BIOMED project was based on cooperation between 22 partners in most EU countries. The aim of the project was to identify the ethical principles of respect for autonomy, dignity, integrity and vulnerability as four important ideas or values for a European bioethics and biolaw. The research concluded (...) that the basic ethical principles cannot be understood as universal everlasting ideas or transcendental truths but they rather function reflective guidelines and important values in European culture. The method of the research was conceptual, philosophical analysis of the cultural background of the four values or normative ideas that people use and find important in their existence. Moreover, this was combined with analysis of empirical legal material and policy documents. Also, a number of qualitative interviews with relevant experts were carried out. Another important result of the BIOMED project was the partner's Policy Proposals to the European Commission, the Barcelona Declaration, unique as a philosophical and political agreement between experts in bioethics and biolaw from many different countries. The Policy Proposals are reprinted here at the end of the article. (shrink)

Social workers frequently encounter ethical dilemmas in their daily practice. This paper examines the utility of hierarchies of ethical principles as tools for ethical decision making. Because of limited research on this topic, the degree of agreement on ordering of ethical principles is unknown. This paper presents illustrative data that suggest variability in individual hierarchies and priorities, which may depend on the circumstances of a situation. Recommendations for using hierarchies of ethical principles in social work education and practice are discussed (...) and a detailed example of how different hierarchies may lead to making different decisions is provided. (shrink)

Research that includes non-human animal experimentation is fundamentally a dilemmatic enterprise. Humans use other animals in research to improve life for their own species. Ethical principles are established to deal with this dilemma. But despite this ethical apparatus, people who in one way or another work with animal experimentation have to interpret and understand the principles from their individual points of view. In interviews with members of Swedish animal ethics committees, different views on what the term ethics really (...) means were articulated. For one member, the difficult ethical dilemma of animal experimentation is the lack of enriched cages for mice. For another, the ethical problem lies in regulations restraining research. A third member talks about animals’ right not to be used for human interests. These different views on “ethics” intersect once a month in the animal ethics committee meetings. There is no consensus on what constitutes the ethical problem that the members should be discussing. Therefore, personal views on what ethics means, and hierarchies among committee members, characterise the meetings. But committee traditions and priorities of interpretation as well are important to the decisions. The author discusses how “ethics” becomes situated and what implications this may have for committees’ decisions. (shrink)

Decision-making adhering to the “principle of autonomy" takes place within the wider context of decision-making processes in modern society. Within the medical area, as regards the decision through informed consent, the patient's intention assumes vital importance. The principle of autonomy is derived from the modern thought that the essence of human being is the reason. It becomes difficult, however, to rely on decision-making based on the principle of autonomy when a person’s intention is not clear and the (...) opinions of those who are involved differ from each other. Here, I think that the principle of consensus, which seeks the agreement of those who are concerned, becomes as important as the principle of autonomy. This paper examines the problems of certainty, reliability, andcreativity of medical action through the consideration of the principle of consensus. (shrink)

Principles of Ethics, Rosmini's first great work in the field of moral philosophy, looks to the light of reason as the objective basis of moral action. The subjective foundation of such action is the act of will by which we accept what the light of reason places before us. "Acknowledge what you know for what you know it to be" thus becomes the ultimate, self-evident expression of moral obligation. To acknowledge willingly what in fact we know is the essence (...) of morality. Rosmini's moral theory depends upon a thorough examination of the objective nature of knowledge (already carried out in his New Essay), and on a careful analysis of human volition and freedom. Within the system of truth both the simple, straightforward beauty of moral good in the human person and the duplicity of evil become immediately obvious. It is also clear that willing acceptance of moral imperatives does not diminish, but enhances innate human dignity. Moral law, rational law and natural law indicate a single, inviolable source of obligation present to human nature under different aspects. (shrink)

What kinds of principles of justice should a cosmopolitan support? In recent years some have argued that a cosmopolitan should endorse a Global Difference Principle. It has also been suggested that a cosmopolitan should support a Principle of Global Equality of Opportunity. In this paper I examine how compelling these two suggestions are. I argue against a Global Difference Principle, but for an alternative Needs-Based Minimum Floor Principle (where these are not co-extensive, as I (...) explain). Though I support a negative version of the Global Equality of Opportunity Principle, I argue that a more positive version of the ideal remains elusive. (shrink)

This article examines the inherently ethical nature of resource allocation in policing. Decision-makers must make trade-offs between values such as efficiency vs. equity, individual vs. collective benefit, and adopt principles of distribution which allocate limited resources fairly. While resource allocation in healthcare has been the subject of extensive discussion in both practitioner and academic literature, ethical resource allocation in policing has received almost no attention. We first consider whether approaches used in healthcare settings would be suitable for policing. Whilst there (...) are some high-level similarities in the relevant ethical considerations and processes—such as aiming for efficient and equitable resource deployment—there are also fundamental differences between the two settings, which we argue necessitate a different approach. These differences include: (1) greater diversity and incommensurability of the benefits of policing, (2) more frequent non-linearity in returns on policing investment, (3) greater “ethical divisibility” (permissible scaling down) of programs in policing, (4) a requirement to assess “need” for policing resources at the collective (rather than individual) level, and (5) clearer primacy of equity considerations in policing. Having drawn out the implications of these differences, we sketch some tentative proposals for ethical resource allocation in policing. (shrink)

This paper attempts to provide a broader view into the ethical issues surrounding the field of emergency medicine (EM) research. It starts from defining bioethically relevant features of EM and presents this field in the context of different models of health care provider–patient relationship. The paper also provides a short overview of the “post-Nuremberg” evolution of the main international research ethics guidelines relevant to EM research which demonstrates a tendency of liberalization of research on incapable persons. This tendency culminates (...) with the exceptions to informed consent for EM research which is supposed to be balanced by other research ethics principles, especially a careful rationing of risks and benefits. This finally brings us towards a critical analysis of the minimal risk standard which is one of the main fundamental safeguards in EM research. (shrink)

Monshi and Zieglmayer's case study presents Sri Lankan participants as having views on the privacy of health information that differ radically from those commonly found in Western nations. This article explores 2 questions that their case study raises for the ethical review of research in international settings: First, are allegedly universal ethical principles - of the sort promulgated in the Belmont Report (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1978) - useful in international settings?, (...) and second, how should research oversight bodies address the challenges that arise in international behavioral and social science research? (shrink)

Approaches to clinical ethics dilemmas that rely on basic principles or rules are difficult to apply because of vagueness and conflict among basic values. In response, casuistry rejects the use of basic values, and specification produces a large set of specified rules that are presumably easily applicable. Balancing is a method employed to weigh the relative importance of different and conflicting values in application. We argue against casuistry and specification, claiming that balancing is superior partly because it most clearly (...) exhibits the reasoning behind moral decision-making. Hence, balancing may be most effective in teaching bioethics to medical professionals. (shrink)

The verdicts standard consequentialism gives about what we are obligated to do crucially depend on what theory of value the consequentialist accepts. This makes it hard to say what separates standard consequentialist theories from non-consequentialist theories. This article discusses how we can draw sharp lines separating standard consequentialist theories from other theories and what assumptions about goodness we must make in order to draw these lines. The discussion touches on cases of deontic constraints, cases of deontic options, and cases involved (...) in the so-called "actualism"/"possibilism" debate. What emerges is that there are various interesting patterns relating the different commitments of consequentialism, different principles about obligation and about goodness, and different rules concerning how facts about values determine facts about obligation. (shrink)

It is widely acknowledged that low-income and minority communities in liberal democratic societies suffer a disproportionate burden of environmental hazards. Is “environmental injustice” a necessary feature of liberal societies or is its prevalence due to the failure of existing liberal democracies to live up to liberal principles of justice? One leading version of liberalism, John Rawls’ “justice as fairness,” can be “extended” to accommodate the concerns expressed by advocates of environmental justice. Moreover, Rawlsian environmental justice has some significant advantages over (...) existing conceptions of environmental justice. (shrink)

International human rights law that protects freedom of the press provides a cross-culturally reliable foundation from which to launch a consideration of universal principles in journalism ethics. After examining certain assumptions made by the international law about individuals and about the kind of journalism the law intends to protect, in this article I propose that truthtelling, independence, and freedom with responsibility are universal ethical principles international law envisions for journalists. These principles would undoubtedly be applied differentially in different cultures, (...) but I conclude that the culturally specific ways journalists analyze ethical dilemmas can arise from a common concern for the 3 principles. (shrink)

This article questions the commonly held view that professional ethics is grounded in general ethical principles, in particular, respect for client (or patient) autonomy and beneficence in the treatment of clients (or patients). Although these are admirable as general ethical principles, we argue that there is considerable logical difficulty in applying them to the professional-client relationship. The transition from general principles to professional ethics cannot be made because the intended conclusion applies differently to each of the parties involved, (...) whereas the premise is a general principle that applies equally to both parties. It is widely accepted that professionals are required to recognize that clients or patients possess rights to autonomy that are more than the general rights to personal autonomy accepted in ordinary social life, and that professionals are expected to display beneficence toward their clients that is more than the beneficence expected of anyone in ordinary social life. The comparative component of professional ethics is an intrinsic feature of the professional situation, and thus it cannot be bypassed in working out a proper professional ethics. Thus, we contend, the proper professional treatment of clients or patients has not been explained by appeal to general ethical principles. (shrink)

It has become common in medical ethics to discuss difficult cases in terms of the principles of respect for autonomy, beneficence, nonmaleficence, and justice. These moral concepts or principles serve as maxims that are suggestive of appropriate clinical behavior. Because this language evolved primarily in the acute care setting, I consider whether it is in need of supplementation in order to be useful in the long-term care setting. Through analysis of two typical cases involving residents of long-term care facilities, (...) I argue for the additional principles of candor and responsibility for narrative integrity. (shrink)

This qualitative social scientific study explores professional texts of healthcare ethics to understand the ways in which ethical professionalism in medicine and nursing are culturally constructed in Finland. Two books in ethics, published by Finnish national professional organizations—one for nurses and one for physicians—were analyzed with the method of critical discourse analysis. Codes of ethics for each profession were also scrutinized. Analysis of the texts sought to reveal what is taken for granted in the texts as well (...) as to speculate what appeared to be relegated to the margins of the texts or left entirely invisible. Physicians’ ethics was discovered to emphasize objectivity and strong group membership as a basis for ethical professionalism. The discourses identified in the physicians’ ethics guidebook were universal ethics, reductionism, non-subjectivity, and threat. Nursing ethics was discovered to highlight reflectivity as its central focus. This idea of reflectivity was echoed in the identified discourses: local ethics, enlightenment, and moral agency. The analysis exposes a cultural gap between the ethics discourses of medicine and nursing. More work is needed to bridge ethics discourses in Finland in a way that can support healthcare professionals to find common ground and to foster inclusivity in ethical dialogue. Further development of bioethical practices is suggested as a potential way forward. (shrink)

This paper argues that the function of moral education in the biomedical context should be exactly the same as in a general, philosophical framework: it should not provide ready-to-use kits of moral principles; rather, it must show the history, epistemology and conceptual structure of moral theories that would enable those who have to make decisions to be as informed and as responsible as possible. If this complexity cannot be attained, an incomplete product—i.e. bioethics or bioethical principles—should not be seen as (...) a viable substitute. This theoretical position is subsequently illustrated by a case study involving research ethics committees. It is argued that within these committees, that are carefully formed multidisciplinary bodies, what makes competent decision-making possible is not a bioethical theory, nor even a sound philosophical ethics, but the dynamics of the discussion of a number of experts coming from different disciplines. This multidisciplinary expertise is necessary and sufficient to undertake the challenges of complex decisions in the biomedical context. (shrink)

Moral properties such as being wrong or being obligatory are not brute but based on other kinds of properties, such as being a lie or being promised. Aesthetic properties such as being graceful or being beautiful are similar to moral properties in being based on other kinds of properties, but in the aesthetic cases it may be impossible to specify just what these grounding properties are. Does any single property ground poetic beauty in the way promising grounds obligation to do (...) the promised deed? If aesthetic properties do differ from moral properties in this way, may we conclude that, although ethics is like aesthetics in being a realm of intuitive and perceptual knowledge—or at least intuitive and perceptual sensitivity—it is unlike aesthetics because the latter lacks principles that connect grounding properties with aesthetic properties? Are there any such generalities in aesthetics, or even aesthetic generalities connecting aesthetic properties with other aesthetic properties? If there are, how much like or unlike rules and principles in ethics are they? This paper explores all these questions in the light of examples from the arts, with poetry as the main case study. (shrink)

In celebration of the fortieth anniversary of the publication of Beauchamp and Childress’s Principles of Biomedical Ethics, a review is undertaken to compare the lists of principles in various bioethical theories to determine the extent to which the various lists can be reconciled. Included are the single principle theories of utilitarianism, libertarianism, Hippocratism, and the theories of Pellegrino, Engelhardt, The Belmont Report, Beauchamp and Childress, Ross, Veatch, and Gert. We find theories all offering lists of principles numbering from (...) one to ten. Many of the differences can be reconciled, but some critical differences remain. (shrink)

BackgroundIn order to achieve the goals of the healthcare system, nursing managers are required to comply with ethical principles in decision-making. In complex and challenging healthcare settings, it is shown that the managers’ mere awareness of ethics does not suffice and managers need to be sensitive toward making ethical decisions.AimTo explore nursing managers and their sensitivity toward ethical decision-making by analyzing their related experiences.MethodThe current study has been conducted in Iran in 2017 through a qualitative content analysis approach. Nineteen (...) nurse managers were selected purposefully from different hospitals in Tehran. Data were collected using semi-structured, in-depth, face-to-face interviews, and after transcription, they were analyzed according to the Graneheim and Lundman method.Ethical considerationsThe research was approved by the ethics committee of Tarbiat Modares University, Tehran, Iran. Participants were informed about the purpose of the study and submitted written informed consents regarding their participation. The principle of autonomy, confidentiality, and anonymity was taken into account in data collection.ResultsFifteen subcategories, three categories (assertiveness, commitment, and insight), and one theme of excellent decision-making were the results of data analysis.DiscussionFindings showed that nursing managers’ sensitivity to ethical decision-making allows them to make the best decision by insight, commitment, and assertiveness. Making a morally excellent decision ensures that ethical principles are followed in the healthcare system.ConclusionConsidering that most managers are committed to making ethical decisions, it is required to develop the scope of their insights even further using a professional management and ethical principles training program. Also, by addressing some of the ethical barriers at personal and organizational levels, the assertiveness in managers can be improved, which in turn can facilitate their ethical decision-making. (shrink)

In this much-anticipated book, Jonathan Dancy offers the only available full-scale treatment of particularism in ethics, a view with which he has been associated for twenty years. Dancy now presents particularism as the view that the possibility of moral thought and judgement does not in any way depend on an adequate supply of principles. He grounds this claim on a form of reasons-holism, holding that what is a reason in one case need not be any reason in another, and (...) maintaining that moral reasons are no different in this respect from others. Ethics Without Principles offers detailed treatment and criticism of opposing positions of all sorts, with useful summaries. It also contains three chapters on the nature of what Dancy calls 'contributory' reasons, which, though the topic of much interest at the moment, are not often discussed in anything like the detail given here. And it offers a distinctive form of value-holism to go with the holism of reasons. As Dancy's definitive statement on particularism, the book will be required reading for all those working on moral philosophy and ethical theory. (shrink)

It is widely presumed, at least among typical Western physicians and medical lay persons, that the Hippocratic and the Judeo- Christian traditions in medical ethics are closely connected or at least compatible. We examine the historical, metaethical, and normative relationships between them, and we find virtually no evidence of any historical links prior to the ninth century. In fact, important differences between them are found. The Hippocratic Oath appears to reflect the environment of a Greek mystery cult. It includes (...) a commitment to secrecy and a sense of community alien to Judeo- Christian tradition. Differences between the two traditions on the issues of killing and life prolongation, abortion, surgery, and normative ethical principles including truth-telling, autonomy, and justice are also explored. We conclude that important differences not only exist but also raise serious problems for persons identifying with both traditions. (shrink)

It is commonly thought that moral rules and principles, such as ‘Keep your promises,’ ‘Respect autonomy,’ and ‘Distribute goods according to need ,’ should play an essential role in our moral deliberation. Particularists have challenged this view by arguing that principled guidance leads us to engage in worse decision making because principled guidance is too rigid and it leads individuals to neglect or distort relevant details. However, when we examine empirical literature on the use of rules and principles in other (...) domains, we find that people can learn to use rules discriminately and that rule-based models tend to outperform even expert judgment. I argue that this evidence poses a problem for the moral particularist. If the particularist claims that we should not rely on decision-making rules when making practical decisions and it turns out that these rules help us make better decisions, then the particularists’ prescriptive account is deficient. However, if the particularist claims that we should rely on practical decision-making rules but not on moral rules, she needs to explain how practical rules are different from moral rules and why we should rely on the former but not the latter. (shrink)

John Dewey delivered two sets of related lectures at the University of Chicago in the fall quarter 1895 and the spring quarter 1896. Designed for graduate students, the lectures show the birth of Dewey’s instrumentalist theory of inquiry in its application to ethical and political thinking. From 1891 through 1903, Dewey attempted to develop a revolutionary experimentalist approach to ethical inquiry designed to replace the more traditional ways of moral theorizing that relied on the fixed moral knowledge given in advance (...) of the situations in which they were applied. In the lectures on the logic of ethics, he sets forth and defends the view that the "is" in a moral judgment such as "This is good" is a coordinating factor in an inquiry. Although the subject matter of the lectures is highly technical, its significance is paramount. It provides the key to and opens the door for a theory that preserves the difference between strictly scientific inquiry and moral inquiry even while it provides a "scientific treatment" of the latter. The lectures on political ethics apply Dewey’s theory of inquiry to the logical problems created by three disciplines designated as politics, economics, and ethics, which appear to have separate and antagonistic subject matters. Politics is a quest for political power; economics is based on self-interest; ethical inquiry is about morality. These lectures carry on the experimental theory of inquiry developed in the previous lectures by explaining how the distinction between these subject matters can be developed without the antagonism. These lectures enable us to make much better sense of Dewey’s later works on moral and political topics. (shrink)

The research has three objectives: 1) to study the concept of Heisenberg’s uncertainty principle, 2) to study the concept of reality and knowledge in Buddhist philosophy, and 3) to analyze the concept of Heisenberg’s uncertainty principle in Buddhist philosophical perspective. This is documentary research. In this research, it was found that Heisenberg's uncertainty principle refers to the experiment of thought while studying physical reality on smaller particles than atoms where at the present no theory of Physics can (...) clearly explain such properties. In this respect, the mentioned principle is utilized to predict the pairs of a certain attribute of physics, position, and momentum, for instance. The accuracy of position, however, cannot be precisely yielded in advance by such a principle. In other words, it is impossible to measure the position and momentum of a quantum particle at the same time. In the study of the ultimate reality on the matter in the Buddhist philosophy, it showed that corporeality in nature is conditioned by cause and effect and thereby falling under the three common characteristics: 1) impermanence, 2) state of suffering, and 3) state of non-substantiality. In the study of Heisenberg’s uncertainty principle in the Buddhist philosophical perspective, this research was found that the processes in acquiring certain knowledge of Heisenberg and Buddhist philosophy are by one another in the sense that such knowledge is methodologically acquired through experience, rationality, and intuition because both see the Reality in the same manners, that is, the physical reality is viewed by Heisenberg as the thing that goes under changing state of wave-particle all the times, and the matter is seen by Buddhist philosophy as the impermanence and change depending upon its factors involved and thereby is not-self. However, in the different aspect, on the one hand, Buddhist philosophy utilizes the knowledge on the matter to develop the morality and ethics by which the cessation of suffering could be respectively made, but on the other hand, Heisenberg somehow applies the certain knowledge on physical objects into quantum technology to accommodate the physical comfortability in living life. Suggestions in the application of knowledge gained from this research into benefit were that while Buddhist philosophy can make use of Heisenberg’s uncertainty principle to provide certain help at the time of explanation of three common characteristics being done through the scientific method, science also can utilize knowledge gained from Buddhist philosophy to expand the framework of scientific knowledge which is aimed at studying only the physical objects to be able to study the mental objects through the integration of three epistemological methods as well. (shrink)

John Harris is one of the prominent philosophers and bioethicists of our time. He has published tens of books and hundreds of papers throughout his professional life. This paper aims to take a ‘deep-look’ at Harris' works to argue that it is possible to find some principles of Islamic ethics in Harrisian philosophy, namely in his major works, as well as in his personal life. This may be surprising, or thought of as a ‘big’ and ‘groundless’ claim, since John (...) Harris has nothing to do with any religion in his intellectual works. The major features of Harrisian philosophy could be defined as consequentialism or utilitarianism with liberal overtones. Despite some significant and fundamental differences in the application of principles (ie, abortion, euthanasia), the similarities between the major principles in Harrisian philosophy and Islamic ethics are greater at some points than the similarities between Islamic ethics and some other religious ethics (ie, Christian, Judaism). In this study I compare Harrisian teachings with major Islamic principles on ‘Responsibility’, ‘Side-effects and Double-effects’, ‘Equality’, ‘Vicious choice, guilt and innocence’, ‘Organ transplantation and property rights’ and ‘Advance directives’. (shrink)

This paper addresses the tension between the government policy to increase the number of citizens working in the private sector in the United Arab Emirates and the organizational preference for employing expatriate workers. Currently a dominant construal of the limited success of the policy is that the local workforce, traditionally employed largely in government positions, is unwilling to commit to the perceived greater rigor of the private sector. The author reconceptualizes the issue as one deriving from a principle of (...) corporate financialization in which companies claim the right to optimize their labor costs as much as possible. This paper briefly discusses corporate financialization, overviews the workforce localization program in the United Arab Emirates, termed Emiratization, highlights the reasons cited for its limited success, and argues that this is due to corporate strategy of selecting their workforce according to financial and rights-related criteria. The issue is an ethical one in that a local population, the natural labor force, is marginalized in a national context of immigration laws permitting the large scale importation of cheaper and more compliant foreign labor. (shrink)

Nurse educators, like many of their health care professional colleagues, frequently face moral dilemmas when they identify a student as presenting an unacceptable risk to public safety. In this situation, the statutory requirement of nurse educators to protect the public, under the Health Practitioners Competence Assurance Act , competes with the rights of the student to receive education under the Education Act . Using the different moral voices of justice and care, identified by Gilligan , this moral dilemma is examined (...) within the context of one school of nursing in a New Zealand tertiary education organisation. Overall, the justice voice dominated within the tertiary education organisation. Academic committees, and appeal panels, operating within the educational statutory framework, used democratic processes to reach decisions. The individual committee members, acting as autonomous moral agents, made decisions using universal principles and abstract moral reasoning. The focus was on individual rights, natural justice and due process. Nurse educators articulated both justice and care moral voices. Those with care voices described how they agonised between their duty to protect the public, and their wish to facilitate students, with whom they had built relationships, to succeed. The education management process did not acknowledge the statutory obligations of nurse educators, as registered nurses, or the implications of this within the education context. The moral dilemmas were either ignored, or rendered invisible. As a result of this, nurse educators engaged in various survival strategies, and the broader educational context remained intact and unchallenged. (shrink)

Extraterrestrial Altruism examines a basic assumption of the Search for Extraterrestrial Intelligence (SETI): that extraterrestrials will be transmitting messages to us for our benefit. This question of whether extraterrestrials will be altruistic has become increasingly important in recent years as SETI scientists have begun contemplating transmissions from Earth to make contact. Technological civilizations that transmit signals for the benefit of others, but with no immediate gain for themselves, certainly seem to be altruistic. But does this make biological sense? Should we (...) expect altruism to evolve throughout the cosmos, or is this only wishful thinking? Is it dangerous to send messages to other worlds, as Stephen Hawking has suggested, or might humankind benefit from an exchange with intelligence elsewhere in the galaxy? Would extraterrestrial societies be based on different ethical principles, or would we see commonalities with Earthly notions of morality? Extraterrestrial Altruism explores these and related questions about the motivations of civilizations beyond Earth, providing new insights that are critical for SETI. Chapters are authored by leading scholars from diverse disciplines—anthropology, astronomy, biology, chemistry, computer science, cosmology, engineering, history of science, law, philosophy, psychology, public policy, and sociology. The book is carefully edited by Douglas Vakoch, Director of Interstellar Message Composition at the SETI Institute and professor of clinical psychology at the California Institute of Integral Studies. The Foreword is by Frank Drake. This interdisciplinary book will benefit everybody trying to understand whether evolution and ethics are unique to Earth, or whether they are built into the fabric of the universe. (shrink)

The paper focuses on issues of development dimensions of Medical Law and its ongoing process of standardization and harmonization on one hand, versus the traditionally rooted and available principles of biomedical ethics, on the other. The collision of new legal institutes and the spread of human rights protections is evident. This paper follows the theory and practice of medical ethics and medical law. The theoretical aspect points out medical ethics as one of the sources of medical law. (...) Legal theory makes a distinction between formal and autonomous sources of medical law. Even though ethics is morally much higher, law prevails because it has stronger sanctions and legal power. In its practical aspect, this paper gives examples of different situations of medical decision-making processes. Ethical rules are of the utmost relevance in the domain of confidentiality and options of medical treatment. But, in concrete medical procedures, where legal positions of patients are evidently very significant, law has a more distinct function. Therefore, explaining particular cases from medical malpractice, such as cases of penal, civil or professional liability have an ethical dimension as well. Members of medical professions in Serbia often find these cases unfair. Mostly this is the consequence of ignorance in this kind of medical law and ethics relations. A discussion about practical cases has in that sense a self-learning component, which could be developed to strengthen ethical reasoning and judgment. Clanak stavlja naglasak na razvojnu dimenziju medicinskog prava i pitanja u kojoj meri njegova standardizacija i harmonizacija, na jednoj strani, uticu na primenu tradicionalno ukorenjenih vazecih principa biomedicinske etike, na drugoj. Teorijski aspekt clanka upucuje na medicinsku etiku kao jedan od izvora medicinskog prava koji se smatra autonomnim izvorom. Iako je etika na visoj lestvici, pravo preteze jer ima pravnu snagu element prinude i jacu sankciju za postupanje protivno pravilima. U svom prakticnom aspektu ovaj clanak stavlja naglasak na razlicite situacije pri donosenju medicinskih odluka, gde pravni polozaj onog ko se leci postaje veoma bitan, a pravo tu ima striktno odredjenu funkciju zastite. Zbog toga, objasnjenje posebnih slucajeva pogresne medicinske prakse ima svoj eticki, ali pre svega pravni znacaj, kakvi su slucajevi procesuiranja krivicne, imovinske i staleske odgovornosti. Pripadnici medicinskih profesija u Srbiji cesto smatraju sudske postupke protiv sebe nepravednim. Vecinom je to posledica upravo nepoznavanja odnosa normi medicinskog prava i etickih pravila. Razmatranje slucajeva iz prakse ima i svoju edukativnu komponentu koja na taj nacin unapredjuje eticko promisljanje i osnazuje pravno odlucivanje. (shrink)

_Legitimate Differences_ challenges the usual portrayal of current debates over thorny social issues including abortion, pornography, affirmative action, and surrogate mothering as _moral_ debates. How can it be said that our debates oppose principles of life to those of liberty, principles of liberty to those of equality, principles of equality to those of fairness, and principles of fairness to those of integrity, when we as Americans share all these principles? Debates over such issues are not, Georgia Warnke argues, moral debates (...) over which principles we should adopt. Rather, they are interpretive debates over the meanings of principles we already possess. Warnke traces the structure of these debates with reference to the work of Jane Austen, Hans-Georg Gadamer, Jürgen Habermas, and Bernard Williams. In separate chapters on surrogate mothering, affirmative action, abortion, and pornography she articulates new understandings of the meanings of some of our principles and shows the equal legitimacy of some different interpretations of the meanings of others. Finally, she suggests that the orientation of American public policy ought to be directed less at finding single canonical interpretations of our principles than at accommodating different legitimate understandings of them. The perspective offered by _Legitimate Differences_ should have a significantly beneficial effect on public discussions. (shrink)

In As Free and as Just as Possible: The Theory of Marxian Liberalism, Jeffrey Reiman proposes to develop a theory of “Marxian Liberalism.” ‘Liberalism’ here is defined by the principle that “sane adult human beings should be free in the sense of free from coercion that would block their ability to act on the choices they make.” While the idea of coercion could use some glossing, it is not obvious that poverty, unemployment, racism, and sexism are as such coercive. (...) In this book, it is, very broadly, economic inequality that is the focus, and the argument is that a previously insufficiently appreciated idea that is broadly Marxian shows us that we need a Rawlsian Difference Principle to counteract inherent coercion in the system of free enterprise capitalism. I argue that the book wrongly places the component of labor in the system of economic exchange. We do not as such exchange labor: we exchange services; and because of this there is no normative pull toward his thesis that there is something fundamentally wrong—some people are being unjustly exploited—when several hours of one person’s labor are required to purchase the output of just one of another person’s. Liberalism, I argue, rejects Marxism. (shrink)

Educational gatekeeping functions in psychology serve to assess, remediate, and/or dismiss students and trainees with problematic professional competencies (STPPC). Recently, professional psychology graduate programs have increasingly focused on problems with professional competency, and they have begun to implement formal procedures to intervene with STPPC (Rubin et al., 2007). However, there has been considerably less literature addressing the ethics and ethical considerations of instituting these gatekeeping functions, especially in different stages of education and training in psychology. The American Psychological Association (...) (APA; 2002) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) offers faculty and supervisors ethical principles and obligatory standards that provide guidance about how to implement highly ethical gatekeeping practices. The purpose of this article is to highlight the major ethical issues and dilemmas that faculty and supervisors may face when intervening with STPPC and provide recommendations for ethical gatekeeping practices that are inspired by the APA Ethics Code. (shrink)

Robert Veatch was a notable and prolific author in a variety of areas in philosophy, health care practice, and policy. However, it is evident by the sheer number of case study in ethics books, eighteen editions of case collections in all, that this approach to teaching ethics in the health sciences was especially important to him. A few of these case study collections he wrote alone, but the majority were written with co-authors from nursing, dentistry, pharmacy, allied health, (...) and medicine, drawing on their respective areas of disciplinary expertise and experience as educators. The aim of this article is to focus on the pedagogy and framework Veatch developed to expose students to the rudiments of philosophical ethics so they could understand the conflicts between values, principles, and ethical theories. Authentic clinical cases, he believed, were a useful way to engage students. Putting the two ideas together, Veatch argued the best method of structuring cases is “bootlegging theory in a topical structure” (Veatch, Robert M., Case analysis in ethics instruction. In: Amy Haddad (ed) Teaching and learning strategies in pharmacy ethics, Creighton University, Omaha, 85–97, 1992). Veatch’s rationale for this carefully planned systematic arrangement between case topics and philosophical ethics content are presented. The influence and input of co-authors from different disciplines are explored regarding case development and commentary content. Finally, the impact of these interdisciplinary case study textbooks on ethics instruction in the health sciences is evaluated. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Methodist Morals: Social Principles in the Public Church's Witness by Darryl W. StephensWonchul ShinMethodist Morals: Social Principles in the Public Church's Witness Darryl W. Stephens knoxville: university of tennessee press, 2016. 320 pp. $48.00Darryl W. Stephens's Methodist Morals presents a historical, theological, and ethical analysis of a particular form of social witness in the United Methodist Church (UMC): the Social Principles. Stephens mainly argues that the Social Principles (...) are not only an institutionalized "document" on contemporary social issues but also an "ongoing moral discourse" within a set of democratic, legislative, and participatory practices of the UMC as a "moral community" (6–8). This ongoing moral discourse illustrates the public church as an authentic social witness in the world and the process of moral formation of its members.Stephens's case study of the public church proceeds in three parts. The first part (chapters 1–3) explores the historical development of the Social Principles and examines the distinctive nature and function of it. From its inception, the Social Principles were to function as "middle axioms," a level of ethical deliberation placed between "universal principles and specific policy recommendations" (22). They were intended to promote "dialogue" among different opinions and "conscientious discernment" on social issues (22). The Social Principles' commitment to the dialogue and discernment is further bolstered by representative democratic and legislative procedures in its quadrennial revision at the General Conference.The second part (chapters 4–7) examines the texts and contents of the Social Principles. Through a comparison of the Social Principles to secular human rights documents, Stephens reveals a "deep-seated commitment to human rights" with a theological emphasis on "the universality of God's grace" in the texts of Social Principles (72). On the other hand, Stephens points out a lack of engagement with the broader Methodist social teaching tradition and the undeveloped theological foundations and languages for the commitments in the Social Principles (92–94). Specifically, Stephens calls for developing a "theology of marriage," which has been neglected in the history of Methodist teachings on marriage (140). In addition, Stephens proposes the need of theological guidance for "ecclesial disobedience" as an alternative paradigm for clergy ethics in response to the issue of homosexuality (171–73).In the final part (chapter 8 and the conclusion), Stephens sketches "the public church ecclesiology implied by the Social Principles" (178). He points out the sectarian tendency in the ecclesiologies of Paul Ramsey and Stanley [End Page 205] Hauerwas and argues for a different form of public engagement: the public church is "sometimes distinct from but always part of and partner with the world" (194). In other words, the public church should embrace "the challenges of worldliness," and the Social Principles illustrates "the messiness of genuine moral engagement in life here and now" (197–99).Stephens presents a rich and well-balanced analysis of the UMC Social Principles as a distinctive form of social witness in the public church. Eschewing a biased analysis praising his own denomination's social teaching, Stephens critically points out "the messiness of actual moral meaning-making" in the UMC (3). Chapter 5 highlights his critical evaluation of the Social Principles: the sin of "US-centrism" and the marginalization of the European, African, and Asian UMC bodies (107–9). However, Stephens's critical evaluation could be developed further. As he points out that the US-centrism is about a "perceived hegemony and uniformity of a white, US, middle-class elite," he could also critically address the dominance of a certain racial/ethnic group's perspective within the US context. Some readers might wonder why Stephens does not substantially cover the issue of racism and white privilege that lies at the heart of the US-centrism critiqued in this book.Nevertheless, Methodist Morals has added rich insight into the public church's social witness and its members' moral formation. This book would be a great resource for theological educators in their courses on Christian ethics, public theology, and Methodism.Wonchul ShinEmory UniversityCopyright © 2018 Society of Christian Ethics... (shrink)

OBJECTIVES: To study empirically whether ethical theory (from the mainstream principles-based, virtue-based, and feminist schools) usefully describes the approaches doctors and nurses take in everyday patient care. DESIGN: Ethnographic methods: participant observation and interviews, the transcripts of which were analysed to identify themes in ethical approaches. SETTING: A British old-age psychiatry ward. PARTICIPANTS: The more than 20 doctors and nurses on the ward. RESULTS: Doctors and nurses on the ward differed in their conceptions of the principles of beneficence and respect (...) for patient autonomy. Nurses shared with doctors a commitment to liberal and utilitarian conceptions of these principles, but also placed much greater weight on relationships and character virtues when expressing the same principles. Nurses also emphasised patient autonomy, while doctors were more likely to advocate beneficence, when the two principles conflicted. CONCLUSION: The study indicates that ethical theory can, contrary to the charges of certain critics, be relevant to everyday health care-if it (a) attends to social context and (b) is flexible enough to draw on various schools of theory. (shrink)

Feeding difficulties in older patients who are suffering from dementia present problems with balancing conflicting ethical principles. They have been considered by several writers in recent years, and the views of nursing and care staff have been studied in different contexts. The present study used focus groups to explore the way in which nursing and care staff in a National Health Service trust deal with conflict between ethical principles in this area. Three focus groups were convened, one each from the (...) staff of three wards caring for patients with dementia. Case histories were discussed and transcripts analysed. It emerged that staff were aware of making fine judgements of utility concerning the spectrum of feeding methods available. Informants gave some weight to the principle of autonomy, but sought to balance that against their commitment to care. In explaining their perspectives, informants gave more weight to personal attitudes and trust culture than to professional ethics. (shrink)

Two core questions in pediatric ethics concern when and how physicians are ethically permitted to intervene in parental treatment decisions (intervention principles), and the goals or values that should direct physicians’ and parents’ decisions about the care of children (guidance principles). Lainie Friedman Ross argues in this issue of The Journal of Clinical Ethics that constrained parental autonomy (CPA) simultaneously answers both questions: physicians should intervene when parental treatment preferences fail to protect a child’s basic needs or primary (...) goods, and both physicians and parents should be guided by a commitment to protect a child’s basic needs and primary goods. In contrast, we argue that no principle—neither Ross’s CPA, nor the best interest standard or the harm threshold—can serve as both an intervention principle and a guidance principle. First, there are as many correct intervention principles as there are different kinds of interventions, since different kinds of interventions can be justified under different conditions. Second, physicians and parents have different guidance principles, because the decisions physicians and parents make for a child should be informed by different values and balanced by different (potentially) conflicting commitments. (shrink)

Edited by four leading members of the new generation of medical and healthcare ethicists working in the UK, respected worldwide for their work in medical ethics, Principles of Health Care Ethics, Second Edition_is a standard resource for students, professionals, and academics wishing to understand current and future issues in healthcare ethics. With a distinguished international panel of contributors working at the leading edge of academia, this volume presents a comprehensive guide to the field, with state of the (...) art introductions to the wide range of topics in modern healthcare ethics, from consent to human rights, from utilitarianism to feminism, from the doctor-patient relationship to xenotransplantation. This volume is the Second Edition of the highly successful work edited by Professor Raanan Gillon, Emeritus Professor of Medical Ethics at Imperial College London and former editor of the Journal of Medical Ethics, the leading journal in this field. Developments from the First Edition include:_ The focus on ‘Four Principles Method’ is relaxed to cover more different methods in health care ethics. More material on new medical technologies is included, the coverage of issues on the doctor/patient relationship is expanded, and material on ethics and public health is brought together into a new section. (shrink)

One of the goals of medicine is to improve well-being, in line with the principle of beneficence. Likewise, scientists claim that the goal of human embryonic stem cell research is to find treatments for diseases. In hESC research, stem cells are harvested from a 5-day-old embryo. Surplus embryos from infertility treatments or embryos created for the sole purpose of harvesting stem cells are used in the research, and in the process the embryos get destroyed. The use of human embryos (...) for research purpose raises ethical concern. In this context, the religious leaders play the role to be the moral compass and “reality check” to engage with the public. In Malaysia, the Ministry of Health has outlined the Guidelines for Stem Cell Research and Therapy, reflecting on Islamic principles. Since there has not been much focus on the viewpoints of other faiths in Malaysia, this study attempts to explore the ethical guiding principles deliberated by religious leaders from the Buddhist, Hindu and Catholic traditions and identify if there is a common ground between the mainstream religious views and principles of medical ethics, in relation to hESC research. Eleven religious leaders representing the Buddhist, Hindu and Catholic traditions were interviewed. Interestingly, though reasoning of religious leaders came from different angles, their underlying concerns revolve around the values of “do no harm” and “intention to save lives”. These values are also the key principles in medical ethics. The findings are applied to answer the question as to whether religious and medical guiding principles can co-exist and complement in ethical decision-making, without compromising the values. (shrink)

BackgroundThe coronavirus 2019 pandemic placed unprecedented pressures on healthcare services and magnified ethical dilemmas related to how resources should be allocated. These resources include, among others, personal protective equipment, personnel, life-saving equipment, and vaccines. Decision-makers have therefore sought ethical decision-making tools so that resources are distributed both swiftly and equitably. To support the development of such a decision-making tool, a systematic review of the literature on relevant ethical values and principles was undertaken. The aim of this review was to identify (...) ethical values and principles in the literature which relate to the equitable allocation of resources in response to an acute public health threat, such as a pandemic.MethodsA rapid systematic review was conducted using MEDLINE, EMBASE, Google Scholar, LitCOVID and relevant reference lists. The time period of the search was January 2000 to 6th April 2020, and the search was restricted to human studies. January 2000 was selected as a start date as the aim was to capture ethical values and principles within acute public health threat situations. No restrictions were made with regard to language. Ethical values and principles were extracted and examined thematically.ResultsA total of 1,618 articles were identified. After screening and application of eligibility criteria, 169 papers were included in the thematic synthesis. The most commonly mentioned ethical values and principles were: Equity, reciprocity, transparency, justice, duty to care, liberty, utility, stewardship, trust and proportionality. In some cases, ethical principles were conflicting, for example, Protection of the Public from Harm and Liberty.ConclusionsAllocation of resources in response to acute public health threats is challenging and must be simultaneously guided by many ethical principles and values. Ethical decision-making strategies and the prioritisation of different principles and values needs to be discussed with the public in order to prepare for future public health threats. An evidence-based tool to guide decision-makers in making difficult decisions is required. The equitable allocation of resources in response to an acute public health threat is challenging, and many ethical principles may be applied simultaneously. An evidence-based tool to support difficult decisions would be helpful to guide decision-makers. (shrink)

Advances in neuroscience and other disciplines are producing large-scale brain data consisting of datasets from multiple organisms, disciplines, and jurisdictions in different formats. However, due to the lack of an international data governance framework brain data is currently being produced under various contextual ethical and legal principles which may influence key stakeholders involved in the generation, collection, processing and sharing of brain data thereby raising ethical and legal challenges. In addition, despite the demand for a brain data governance framework that (...) accounts for culture, there is a gap in empirical research and actions to understand how key stakeholders around the world view these issues using neuroscientists who are affected by these ethical and legal principles. Therefore, using the research question how do ethical and legal principles influence data governance in neuroscience? we attempt to understand the perceptions of key actors on the principles, issues and concerns that can arise from brain data research. We carried out interviews with 21 leading international neuroscientists. The analytical insights revealed key ethical and legal principles, areas of convergence, visibility, and the contextual issues and concerns that arise in brain data research around these principles. These issues and concerns circulate around intimately connected areas which include ethics, human rights, regulations, policies and guidelines, and participatory governance. Also, key contextual insights around animal research and ethics were identified. The research identifies key principles, issues, and concerns that need to be addressed in advancing the development of a framework for global brain data governance. By presenting contextual insights from neuroscientists across regions, the study contributes to informing discussions and shaping policies aimed at promoting responsible and ethical practices in brain data research. The research answers the call for a cross cultural study of global brain data governance and the results of the study will assist in understanding the issues and concerns that arise in brain data governance. (shrink)

This study examines the similarities and differences in pre- and post-Sarbanes-Oxley corporate ethics codes and codes of conduct using the framework of structuration theory. Following the passage of the Sarbanes-Oxley (SOX) legislation in 2002 in the United States, publicly traded companies there undertook development and revision of their codes of ethics in response to new regulatory requirements as well as incentives under the U.S. Corporate Sentencing Guidelines, which were also revised as part of the SOX mandates. Questions that (...) remain are whether these new or revised codes are effective means of communicating changed ethical foci and attitudes in organizations. Centering resonance analysis (CRA) is used to identify differences and similarities across time and industries by analyzing word networks of 46 pre- and post-SOX corporate codes of ethics. Analyses focus on content and structure of generated word networks as well as resulting factors that emerged from the texts. Results are interpreted from the structuration perspective that content and structure of codes are constrained and enabled by system structures while they function to produce and reproduce those structures. Results indicate that corporate codes of ethics are formal discourses of ethics, laws, and control. Code structure has changed across time, with an increased emphasis on compliance in post-SOX codes. Implications for research and practice are discussed in light of findings. (shrink)

The article aims at organizing multifaceted discourse on the concept of nondirectiveness in the practice of genetic counseling. The analysis of areas where nondirectiveness was invoked and discussed reveals the problematic confusion of different meanings of the term that often leads to false conclusions about the relations between the professional standards and the practice of genetic counseling. The article offers clear and comprehensive description of different approaches to nondirectiveness and various ideas associated with the term. Normative consequences of various meanings (...) attributed to nondirectiveness are explored. The article concludes by presenting important but unsolved problems regarding both theory (the meaning of nondirectiveness and its operational definition) and practice of genetic counseling (the scope and content of the norm of nondirective counseling). (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might (...) be causing them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. (shrink)