In his major new work, David Boucher surveys the history of thinking about human rights and shows that far from being seen as universal and emancipatory, they have almost always privileged certain groups in relation to others.

For both philosophers and managers, reasoning with ourselves and others can be used both as (1) a way of knowing what is ethical and (2) a way of acting to help ourselves, others and organizations behave ethically. However, for many of us, knowing is frequently not the same as acting. Four areas are addressed: (1) thirteen limitations of ethical reasoning as an action strategy; (2) how a better understanding of these limitations can strengthen ethical reasoning as an action strategy; (3) (...) how an understanding of these limitations can serve as a conceptual foundation for exploring other ethical action strategies; and, (4) implications for experiential learning and teaching. (shrink)

The effects that artificial intelligence (AI) technologies will have on society in the short- and long-term are inherently uncertain. For this reason, many governments are avoiding strict command and control regulations for this technology and instead rely on softer ethics-based approaches. The Russian approach to regulating AI is characterized by the prevalence of unenforceable ethical principles implemented via industry self-regulation. We analyze the emergence of the regulatory regime for AI in Russia to illustrate the limitations of this approach. The (...) article is based on 50 interviews with policymakers, representatives of AI companies, and academics in the country. The findings show that this regulatory regime was formed under the strong influence of Russian big tech companies, which saw an opportunity to avoid regulatory oversight by washing out concrete regulatory measures from the policy. This approach is part of a broader protectionist sanction-proofing strategy for the local IT sector designed by the government, which can be characterized by lifting regulatory barriers for local companies. Unenforceable ethics-based self-regulation is a _regulatory gift_ from the Russian government to the industry. This _gift_ was intentionally designed because the government thought that prioritizing local innovation over consumer protection would benefit the public. However, the _gift_ can also unintentionally undermine the public interest by providing an opportunity for _ethics washing_. (shrink)

This chapter investigates how a reading of Wittgenstein along the lines laid out by Cora Diamond makes room for a novel approach to ethical truth. Following Diamond, I develop the connection between the kinds of elucidatory propositions by means of which we spell out and maintain the shape of our theoretical thinking, such as “‘someone’ is not the name of someone” and “five plus seven equals twelve,” and the kind of propositions by means of which we spell out and maintain (...) the shape of ethical thinking, such as “slavery is unjust.” As Diamond points out in connection with the last example, this is a proposition that we take to be an undeniable truth; for anyone who would attempt to negate it would become unintelligible to us. In this sense this ethical truth spells out the limits of ethical thinking. And yet what counts as coherent thought about such matters tends to shift over time. Indeed the great difficulty of overcoming ethical disagreements has to do with the fact that what is at stake in them is not just the content, but the form and limits of thought. Nonetheless, Diamond proposes that ethical propositions may count as genuine truths. For this to make sense, a middle path between realism and relativism must be found. In order to show how this is possible, and in order to defend Diamond’s view, I propose to approach ethical truth by means of a disjunctivist strategy. On this approach, while we, just as much as our interlocutor, may at times be misled in our ethical thinking, and while we may at times fail to shape our ethical thought in ways that prevent us from gaining clarity on ethical matters, this does not detract from the fact that we may at times be right, and that we may then genuinely possess ethical truth. (shrink)

In this book, James Dunson explores end-of-life ethics including physician-assisted suicide and continuous sedation. He argues that ethical debates currently ignore the experience of the dying patient in an effort to focus on policy creation, and proposes that the dying experience should instead be prioritized and used to inform policy development.

In this book, I consider whether the hypothesis of moral dilemmas undermines ethics' pretensions to objectivity. I argue against the view that moral dilemmas challenge the very possibility of ethical theory, as a practical and theoretical enterprise. By examining Kantian, Intuitionist and Utilitarian arguments about moral dilemmas, I show that no ethical theory is capable of avoiding them. I further argue that an adequate ethical theory should admit dilemmas. Dilemmas do not reveal a logical or normative flaw in the (...) theory that permits them to arise, nor are they necessarily generated by subjective mistakes. Rather, dilemmas are a sign of the deliberative capacity of an agent who operates in non-ideal conditions of rationality and cooperation. The inevitability of moral dilemmas shows that we should reconsider the bounds of deliberation, and the purposes of ethical theory. My argument for the philosophical significance of moral dilemmas rests on the claim that an adequate ethical theory should make sense of moral phenomenology, and that moral phenomenology should to be understood from the perspective of an agent who conceives of herself as an agent. The view of moral dilemmas I advocate does not invite skepticism about ethical theory, but suggests that we redefine its scope and its many practical aims. (shrink)

Cosmopolitanism has become an influential theory in both political and, increasingly, educational discourse. In simple terms cosmopolitanism can be understood as a response to the globalised and diverse world in which we live. Diverse in nature, cosmopolitan ideas come in many forms. The focus here is on what have been termed 'strong' ethical forms of cosmopolitanism; that is, positions which conceptualise moral bonds and obligations as resulting from a shared, common humanity. The view that pupils should be taught that all (...) human beings are equal and, crucially, that this entails a responsibility to take action when human equity is challenged or transgressed, is finding increasing expression within educational literature. The suggestion explored here is that strong forms of ethical cosmopolitanism are limited in ways which seriously restrict their educational worth. In the final section, it is argued that forms of cultural and political cosmopolitanism (which are part of the lived experiences of intra- and supra-national citizenship) are best responded to by developing the requisite virtues in pupils to engage with diverse and dialogic communities. (shrink)

This paper considers how Kierkegaard self-reflexively portrays the tension between the boundary limit of discursive reason and mythic imagination in his classic analysis of Abrahamic faith. Following some reflections on the nature and philosophical implications of that tension, I examine its salient delineation in the Prelude of Fear and Trembling. Through four non-canonical renderings of the biblical Aqedah myth featured in the Prelude, Kierkegaard depicts the limits of ethical reasoning in the drama of Johannes de Silentio’s struggle to figure-forth (...) Abraham’s “movements” in ethically intelligible terms. I conclude that, as dramatized by Kierkegaard, the tension between mythemic figuration and discursively articulated critical reasoning sets in relief one of the formative aporiai of modern Western culture, namely the conflictive interplay of vision and discourse. (shrink)

This paper considers how Kierkegaard self-reflexively portrays the tension between the boundary limit of discursive reason and mythic imagination in his classic analysis of Abrahamic faith. Following some reflections on the nature and philosophical implications of that tension, I examine its salient delineation in the Prelude of Fear and Trembling. Through four non-canonical renderings of the biblical Aqedah myth featured in the Prelude, Kierkegaard depicts the limits of ethical reasoning in the drama of Johannes de Silentio’s struggle to figure-forth (...) Abraham’s “movements” in ethically intelligible terms. I conclude that, as dramatized by Kierkegaard, the tension between mythemic figuration and discursively articulated critical reasoning sets in relief one of the formative aporiai of modern Western culture, namely the conflictive interplay of vision and discourse. (shrink)

Objectives To determine the frequencies and types of limitation of medical treatment performed by physician members of the German Society for Palliative Medicine and to analyse the findings with respect to clinical and ethical aspects of end-of-life practices. Design Cross-sectional postal survey. Setting Data collection via the secretary of the German Society for Palliative Medicine using the German language version of the EURELD survey instrument. Subjects All 1645 physician members of the German Society for Palliative Medicine. Main outcome measures Types (...) and frequencies of limitation of treatment and possible determinants. Results 901 physicians participated in the study (response rate 55.8%). Participants reported limitation of treatment in 69.1% of cases. These decisions most often affected artificial nutrition (19%), chemotherapy (14%), antibiotics (11%) and medication other than antibiotics (11%). In the majority of eligible cases, physicians estimated the life-shortening effect of limitation of treatment to be <7 days. However, estimations differ depending on the medical measures in question. Bivariate statistical analysis indicated that withholding of treatment was performed significantly more frequently for patients aged ≥65 years (p=0.019). In addition, there were significant associations between the incidence of limitation of treatment and the different diseases reported by respondents as the underlying cause of death. Conclusion The findings of this study provide information on the current state of an ethically and clinically challenging aspect of clinical practice and can serve as a starting point for further interdisciplinary research on normative and empirical aspects of treatment decision-making at the end of life. (shrink)

The core of Australia’s response to asylum seekers who arrive in an unauthorised manner has been to detain them in immigration detention centres until they are judged to engage Australia’s protection obligations or, if they do not, until they are returned to their country of origin. For a number of asylum seekers this has resulted in very prolonged detention. This policy has aroused a storm of controversy with very polarised positions being taken by participants in the debate. In particular, the (...) claim has frequently been made (including by this author) that the circumstances and duration of immigration detention cause substantial harm to the mental health of a significant number of detained asylum seekers. A rational debate on the effects of detention has been hampered by the fact that the Australian government has not allowed researchers access to the detention centres in spite of persistent requests for access by professional bodies. This paper is written in response to the following questions posed by the Journal: Is there a case to be made for individuals agreeing to participate in research studies and for the wider population of current and future detainees to be involved in research without informing either the detention provider or the host nation? Is it legitimate for a researcher to engage in potentially deceptive actions in order to obtain access to such detention facilities to undertake research? What ethical framework should underpin such research? Although there is very little guidance in the literature on the ethical conduct of research in settings such as immigration detention centres, a consideration of the ethical implications of carrying out research in the manner raised by these questions leads this author to conclude that such research cannot be ethically justified. Governments must be persuaded to allow, and to provide substantial support for, ethically conducted research on all aspects of detention. There is also a need for the development of an explicit ethical framework for the conduct of research in settings characterised by a very problematic human rights context. (shrink)

By the time of his death in 2003, Bernard Williams was one of the greatest philosophers of his generation. Ethics and the Limits of Philosophy is not only widely acknowledged to be his most important book, but also hailed a contemporary classic of moral philosophy. Presenting a sustained critique of moral theory from Kant onwards, Williams reorients ethical theory towards ‘truth, truthfulness and the meaning of an individual life’. He explores and reflects upon the most difficult problems in (...) contemporary philosophy and identifies new ideas about central issues such as relativism, objectivity and the possibility of ethical knowledge. This edition also includes a new commentary on the text by A.W.Moore and a foreword by Jonathan Lear. (shrink)

Introduction -- Practical reasons and judicial use of force -- Deviating from legal standards -- The legal duties of judges -- The normative classification of legal results -- Reasons to deviate -- Adherence rules -- Obeying adherence rules -- The judicial oath -- Legal duty and political obligation -- Systemic effects -- Agent-relative principles -- Optimal adherence rules -- Guidance rules -- Treating like cases alike -- Implementation -- Theoretical implications -- Conclusion.

The Limits of Cosmopolis addresses the question of how human life is organized: Is it possible to be a «citizen of the world»? Is there a difference between avowing that identity for oneself and morally and ethically making a commitment to others? What are the implications for communication - for a real dialogue of cultures?

Virtue ethics is often understood as a rival to existing consequentialist, deontological, and contractualist views. But some have disputed the position that virtue ethics is a genuine normative ethical rival. This chapter aims to crystallize the nature of this dispute by providing criteria that determine the degree to which a normative ethical theory is complete, and then investigating virtue ethics through the lens of these criteria. In doing so, it’s argued that no existing account of virtue (...) class='Hi'>ethics is a complete normative ethical view that rivals existing consequentialist, deontological, and contractualist views. Moreover, it is argued that one of the most significant challenges facing virtue ethics consists in offering an account of the right-making features of actions, while remaining a distinctively virtue ethical view. (shrink)

With a new foreword by Jonathan Lear 'Remarkably lively and enjoyable…It is a very rich book, containing excellent descriptions of a variety of moral theories, and innumerable and often witty observations on topics encountered on the way.' -_ Times Literary Supplement_ Bernard Williams was one of the greatest philosophers of his generation. Ethics and the Limits of Philosophy is not only widely acknowledged to be his most important book, but also hailed a contemporary classic of moral philosophy. Drawing (...) on the ideas of the Greek philosophers, Williams reorients ethics away from a preoccupation with universal moral theories towards ‘truth, truthfulness and the meaning of an individual life’. He explores and reflects upon the most difficult problems in contemporary philosophy and identifies new ideas about central issues such as relativism, objectivity and the possibility of ethical knowledge. This edition also includes a commentary on the text by A.W.Moore. At the time of his death in 2003, Bernard Williams was hailed by the Times as 'the outstanding moral philosopher of his age.' He taught at the Universities of Cambridge, Berkeley and Oxford and is the author of many influential books, including _Morality; Descartes: The Project of Pure Enquiry_ and _Truth and Truthfulness_. (shrink)

With a new foreword by Jonathan Lear 'Remarkably lively and enjoyable…It is a very rich book, containing excellent descriptions of a variety of moral theories, and innumerable and often witty observations on topics encountered on the way.' -_ Times Literary Supplement_ Bernard Williams was one of the greatest philosophers of his generation. Ethics and the Limits of Philosophy is not only widely acknowledged to be his most important book, but also hailed a contemporary classic of moral philosophy. Drawing (...) on the ideas of the Greek philosophers, Williams reorients ethics away from a preoccupation with universal moral theories towards ‘truth, truthfulness and the meaning of an individual life’. He explores and reflects upon the most difficult problems in contemporary philosophy and identifies new ideas about central issues such as relativism, objectivity and the possibility of ethical knowledge. This edition also includes a commentary on the text by A.W.Moore. At the time of his death in 2003, Bernard Williams was hailed by the Times as 'the outstanding moral philosopher of his age.' He taught at the Universities of Cambridge, Berkeley and Oxford and is the author of many influential books, including _Morality; Descartes: The Project of Pure Enquiry_ and _Truth and Truthfulness_. (shrink)

By the time of his death in 2003, Bernard Williams was one of the greatest philosophers of his generation. Ethics and the Limits of Philosophy is not only widely acknowledged to be his most important book, but also hailed a contemporary classic of moral philosophy. Presenting a sustained critique of moral theory from Kant onwards, Williams reorients ethical theory towards ‘truth, truthfulness and the meaning of an individual life’. He explores and reflects upon the most difficult problems in (...) contemporary philosophy and identifies new ideas about central issues such as relativism, objectivity and the possibility of ethical knowledge. (shrink)

Over the last decade, successive New Zealand governments have instituted social, political and economic changes that have fundamentally challenged nurses’ sense of themselves and their position in society. Major upheavals in the health service have occurred as a result of reforms promoting competition and contestability. This paper deals with the impact of one aspect of the reforms, that of the deregulation of the labour market through the Employment Contracts Act 1991. More specifically, the way in which discussions and decisions regarding (...) the withdrawal of nursing labour are shaped by the language available to those involved are considered. The intersection of ethics and union discourses may exacerbate feelings of ambiguity and confusion in nurses facing strike action. The result can be unnecessary and unproductive division and conflict: among nurses, between employers and employees, between unions, between nurses and the public, and between nursing organizations and the Government. An examination of some of the discourses of strike action may serve as a tool to elucidate the way nurses see themselves and their clients in the context of social change and social action. (shrink)

In discussions of animal ethics, hypothetical scenarios are often used to try to force the clarification of intuitions about the relative value of human and animal life. Tom Regan requests, for example, that we imagine a man and a dog adrift in a lifeboat while Peter Singer explains why the life of one's child ought to be preferred to that of the family dog in the event of a house fire. I argue that such scenarios are not the usefully (...) abstract analytic tools they purport to be, but indirectly reinforce assumptions that are not only anthropocentric, but also tied to racist, sexist and ethnocentric stereotypes. An analysis of some of the cultural and ethical associations of the notion of self-sacrifice proves especially useful in revealing some of the limitations of certain popular Western approaches to animal ethics. (shrink)

In Book I of his Nicomachean Ethics (NE), Aristotle defines happiness, or eudaimonia, in accordance with an argument he makes regarding the distinctive function of human beings. In this paper, I argue that, despite this argument, there are moments in the NE where Aristotle appeals to elements of happiness that don’t follow from the function argument itself. The place of these elements in Aristotle’s account of happiness should, therefore, be a matter of perplexity. For, how can Aristotle appeal to (...) elements of happiness not entailed by his argument for what happiness involves? I will examine two instances that exemplify the sort of appeal to outside elements that I have in mind. The first deals with Aristotle’s reference, in NE, I, 8, to certain goods—ancestry, children, beauty—goods unrelated to man’s function or his fulfillment of it, but nevertheless required for his happiness. The second instance involves pleasure. Aristotle makes various arguments, both in Books I and X of the NE, that tie pleasure to the activity of the soul, and the function argument in turn. However, none of these arguments succeeds in demonstrating that pleasure would necessarily follow from this activity. Taken together then, these two examples demonstrate the extent to which Aristotle’s definition of happiness is more inclusive than his function argument permits. (shrink)

Since its inception as an international requirement to protect patients and healthy volunteers taking part in medical research, informed consent has become the primary consideration in research ethics. Despite the ubiquity of consent, however, scholars have begun to question its adequacy for contemporary biomedical research. This book explores this issue, reviewing the application of consent to genetic research, clinical trials, and research involving vulnerable populations. For example, in genetic research, information obtained from an autonomous research participant may have significant (...) bearing on the interests of family members who have not consented to the study. This casts doubt on the adequacy of consent for such studies. This book also questions the assumptions that informed consent is essential and that it satisfactorily protects the principle of individual autonomy. It reviews recent empirical studies that challenge the possibility of truly informed consent and highlights the extent to which consent is governed by social norms and expectations. It also investigates how consent might be of secondary importance in some circumstances, for example when a research project appears to protect a public or community interest. (shrink)

COVID-19 has created additional challenges in mental health services, including the impact of social distancing measures on care and treatment. For situations where a detention under mental health legislation is required to keep an individual safe, psychiatrists may consider whether to conduct an assessment in person or using video technology. The Mental Health Act 2003 does not stipulate that an assessment has to be conducted in person. Yet, the Code of Practice envisions that detention assessments would be conducted face to (...) face in all circumstances. During the pandemic, the Mental Welfare Commission for Scotland, a statutory body with a duty to promote best practice of the Act, has been asked whether it may be acceptable and indeed preferable for some assessments to be conducted via video technology. Where an assessment is needed to determine if a patient needs to be detained, and where there is a need for social distancing or the need for ‘shielding’, remote assessments may in some circumstances be preferable. In this article, we outline the modification of the Mental Welfare Commission’s previous outright rejection of virtual assessments as the pandemic progressed and discuss the ethical and legal issues the possibility of remote assessments has exposed. We also discuss the limits and when a virtual assessment is not considered ethical. As the pandemic moves from a state of emergency into a ‘new normal’ in psychiatric services during second, or subsequent, waves, the use and place of remote assessments for detention needs to be considered. (shrink)

Over the last decade, successive New Zealand governments have instituted social, political and economic changes that have fundamentally challenged nurses’ sense of themselves and their position in society. Major upheavals in the health service have occurred as a result of reforms promoting competition and contestability. This paper deals with the impact of one aspect of the reforms, that of the deregulation of the labour market through the Employment Contracts Act 1991. More specifically, the way in which discussions and decisions regarding (...) the withdrawal of nursing labour are shaped by the language available to those involved are considered. The intersection of ethics and union discourses may exacerbate feelings of ambiguity and confusion in nurses facing strike action. The result can be unnecessary and unproductive division and conflict: among nurses, between employers and employees, between unions, between nurses and the public, and between nursing organizations and the Government. An examination of some of the discourses of strike action may serve as a tool to elucidate the way nurses see themselves and their clients in the context of social change and social action. (shrink)

I examine the role of tragedy within the ethics of Alasdair MacIntyre and Iris Murdoch. MacIntyre argues for a narrative conception of the self, stressing the need for coherence and intelligibility and for the virtues which promote them. Tragic dilemma presents a successful self with severe frustration but not with destruction of its overall project. Murdoch, on the other hand, holds little hope for the self's coherence, and in fact champions tragic art's capacity for disturbing and even disrupting the (...) self's fantasies of control and coherence. Her virtues correspondingly help the agent to confront the tragic realities of life. I suggest one way to bring these two accounts, of tragedy and the virtues, together: by considering tragic experience in the context of moral pedagogy. (shrink)

This paper interrogates the relation between reciprocity and ethics as it concerns participation in the world of work and organizations. Tracing discussions of business and organizational ethics that concern themselves, respectively, with the ethics of self-interest, the ethics of reciprocity, and the ethics of generosity, we explore the possibility of ethical relations with those who are seen as radically different, and who are divested of anything worth exchanging. To address this we provide a reading of (...) Franz Kafka’s famous novella The Metamorphosis and relate to it as a means to extend our understanding of business and organizational ethics. This story, we demonstrate, yields insight into the unbearable demands of ethics as they relate to reciprocity and generosity. On this basis, we draw conclusions concerning the mutually constitutive ethical limitations of reciprocity and generosity as ethical touchstones for organizational life while simultaneously accepting the seemingly insurmountable difficulties of exceeding those limits. In such a condition, we argue, ethics is not best served by adopting idealistic or moralizing positions regarding generosity but rather by working in the indissoluble tensions between self and other. (shrink)

The re-emergence of virtue ethics (henceforth VE) as both an academic theory and as an approach to applied ethics has contributed to the re-invigoration of ethical debate. It has encouraged reflective consideration of the nature of professionals' commitments to various values that constitute their personal and professional character, both collectively and individually. This paper argues that whilst there may be some value in the re-orientation of applied ethics towards questions of character, it has its limitations, including a (...) tendency to be reduced rather too easily to self-serving ends that ultimately favour dominant social groups. It should therefore be treated with caution by social professionals. (shrink)

Introduction The Odyssey is a poem of paradox. On the one hand, it is the "most teleologi- cal of epics,"' a story of a man's desire, long frustrated but ...

This article explores the links between strategic goals, enterprise risk management, and ethics. We offer a typology of managerial attitudes toward strategic goals and rationality and explore the interaction between strategic and ethical decision making. In so doing, we offer a practical framework for managers to approach ethical dilemmas in the highly complex, volatile, and risky economy that we currently find ourselves in.

The two basic forms of action distinguished in the preceding articles, viz., moral action, where praxis is for praxis sake, and action for a good, where praxis is for the sake of theôria, are found in close relationship to one another in human life. The part they play is rather that of abstract moments in a practical process than that of self-contained and isolable bits of conduct. No philosopher is likely to discount the importance of thus analysing the concrete into (...) its factors before he rectifies the abstraction by showing how they co-operate in actual experience. In any individual biography we can find acts and courses of action in which duty is the dominant motive, and others in which the dominant motive is desire of good. Similarly, when we compare different biographies with one another, some exemplify most strikingly the struggle for righteousness against unruly passion, others the spontaneous aspiration of the soul to attain the goal of its desire. But neither the moral law nor the summum bonum wields an exclusive sovereignty. St. Paul and Luther, in their warfare against carnal desire, drew strength from the ideal vision; nor were St. Bernard or Spinoza, for all their absorption upon union with the divine, strangers to the call of moral obligation. In the lives of ordinary men, the types of conduct are, perhaps, more evenly balanced; yet here also the distinction is discernible. Moreover, it is easy to see how, despite their intrinsic difference, they come to be associated and “by just exchange” to effect a mutual enrichment. (shrink)

The debate over the improvement of moral capacity or moral enhancement through pharmacology has gained momentum in the last decade as a result of advances in neuroscience. These advances have led to the discovery and allowed the alteration of patterns of human behavior, and have permitted direct interventions on the neuronal structure of behavior. In recent years, this analysis has deepened regarding the anthropological foundations of morality and the reasons that would justify the acceptance or rejection of such technology. We (...) present a review of proposals for pharmacological interventions directed directly towards moral enhancement. In addition, we identify the ethical dilemmas that such interventions may generate, as well as the moral assessment of the authors of these studies. There is a moderate consensus on the risks of any intervention on the intimate structure of the human condition, its autonomy and identity, but there are large differences in explaining the reasons for this concern and especially in justifying such interventions. These findings show that it is necessary to investigate the moral assessment of authors and the ethical dimension within the field of pharmacology in order to identify future trends. (shrink)

Conventional wisdom holds that attempts to combine religion and politics will produce unlimited violence. Concepts such as jihad, crusade, and sacrifice need to be rooted out, the story goes, for the sake of more bounded and secular understandings of violence. Ted Smith upends this dominant view, drawing on Walter Benjamin, Giorgio Agamben, and others to trace the ways that seemingly secular politics produce their own forms of violence without limit. He brings this argument to life—and digs deep into the American (...) political imagination—through a string of surprising reflections on John Brown, the nineteenth-century abolitionist who took up arms against the state in the name of a higher law. Smith argues that the key to limiting violence is not its separation from religion, but its reconnection to richer and more critical modes of religious reflection. Only political theology can keep secular politics secular. A historical and theoretical intervention, _Weird John Brown_ is also a constructive theological proposal for rethinking the nature, meaning, and exercise of violence, both human and divine. (shrink)

Codes of medical ethics (codes) are part of a longstanding tradition in which physicians publicly state their core values and commitments to patients, peers, and the public. However, codes are not static. Using the historical evolution of the Canadian Medical Association's Code of Ethics as an illustrative case, we argue that codes are living, socio-historically situated documents that comprise a mix of prescriptive and aspirational content. Reflecting their socio-historical situation, we can expect the upheaval of the COVID-19 pandemic (...) to prompt calls to revise codes. Indeed, Alex John London has argued in favour of specific modifications to the World Medical Association's International Code of Medical Ethics (which has since been revised) in light of moral and scientific failures that occurred during the COVID-19 pandemic. Responding to London, we address the more general question: should codes be modified to reflect lessons drawn from the COVID-19 pandemic or future such upheavals? We caution that codes face limitations as instruments of policy change because they are inherently interpretive and ‘multivocal’, that is, they usually underdetermine or provide more than one answer to the question, ‘What should I do now?’ Nonetheless, as both prescriptive and aspirational documents, codes also serve as tools for reflection and deliberation—collective practices that are necessary to engaging with and addressing the moral and scientific uncertainties inherent to medicine. (shrink)

In biomedical ethics the principle of autonomy is closely connected with the moral and legal claim to informed consent. After World War II and the dramatic misuse of medicine in Nazi Germany, informed consent regulations were expected to help avoid similar misuse in the future, to help overcome the traditional medical paternalism, and to advance the liberty rights of patients and human subjects of research. With the rise of the new field of bioethics in the 1970s, the traditional beneficence-based (...) model of medical ethics shifted in the direction of an individual autonomy model. (shrink)