This chapter contains sections titled: Note.

During disasters, clinicians may be forced to play dual roles, as both a provider and an allocator of scarce resources. At present, a clear framework to govern resource stewardship at the bedside is lacking. Clinicians who find themselves practicing in this ethical gap between clinical and public health ethics can experience significant moral distress. One provider describes her experience allocating an oxygen tank in the intensive care unit at a hospital in Port-au-Prince, Haiti, immediately following the 2010 earthquake. (...) Using a clinical vignette and reflective narrative she attempts to identify the factors that influenced her allocation decision, opening up the factors for commentary and debate by an ethicist. A better paradigm for the ethical care of patients during disasters is needed to better guide provider choices in the future. (shrink)

We are currently developing a short, online ethics course that attempts to teach students why well-intentioned people act unethically and what students can do to decrease the likelihood that they will find themselves in the middle of an ethical crisis in the future. Most of the well-known case studies in professional ethics textbooks concern ethical failures that do not involve difficult ethical choices. When our students read these case studies, it is not difficult for them to (...) determine what went wrong or what the players in the cases ought to have done. And students don’t need to read Kant or Mill to make these determinations. Importantly, the agents who acted wrongly usually seem to be ethical people. Rarely do cases involve moral monsters. In a similar vein, most cases of research misconduct are cut-and-dry, and most of our students who plagiarize did not enroll in the course intending to plagiarize. Rather, something went wrong. Professional ethics classes neglect to address an important practical question: Why do well-intentioned people find themselves in the middle of ethical crises and how can our students decrease the likelihood that they will find themselves in an ethical crisis in the future? We are developing a course that answers this question. Our course is built around the findings of John Dorris and other situationists. After teaching our students about situationism, we teach them a two-level theory of cognition that may help them avoid acting unethically. (shrink)

Background: Studies have established that negative perceptions of people living with HIV/AIDS exist among nursing students throughout the world, perceptions which can be detrimental to the delivery of high-quality nursing care. Objectives: The purpose of this research was to explore socio-cultural influences on the perceptions of nursing students towards caring for people living with HIV/AIDS. Research design: The study was guided by stigma theory, a qualitative descriptive research approach was adopted. Data collected via semi-structured interviews were thematically analysed. Participants and (...) research context: Participants were 21 international and Australian undergraduate nursing students enrolled in a Bachelor of Nursing programme at an Australian university. Ethical considerations: Ethical approval was granted by the Social and Behavioural Research Ethics Committee at the study university. Participation was entirely voluntary; informed consent was obtained before the study commenced; confidentiality and anonymity were assured. Findings: Three major themes were found: blame, othering and values. Complex and interrelated factors constructed participant perceptions of people living with HIV/AIDS, perceptions underscored by the prevailing culturally construed blame and othering associated with HIV/AIDS. The study found discordance between the negative personal beliefs and perceptions some nursing students have towards people living with HIV/AIDS, and the professional values expected of them as Registered Nurses. Discussion: There was considerable commonality between this and previous studies on how homosexuality and illicit drug use were perceived and stigmatised, correlating with the blame directed towards people living with HIV/AIDS. These perceptions indicated some nursing students potentially risked not fulfilling the ethical and professional obligations the Registered Nurse. Conclusion: Nursing curriculum should be strengthened in relation to comprehending the meaning of being stigmatised by society. Educational institutions need to work towards enhancing strategies that assist nursing students to reconcile any incongruity between their personal beliefs and requisite professional nursing values. (shrink)

Respecting the autonomy of disabled people is an important ethical issue for providers of long-term care. In this influential book, George Agich abandons comfortable abstractions to reveal the concrete threats to personal autonomy in this setting, where ethical conflict, dilemma and tragedy are inescapable. He argues that liberal accounts of autonomy and individual rights are insufficient, and offers an account of autonomy that matches the realities of long-term care. The book therefore offers a framework for carers to develop (...) an ethic of long-term care within the complex environment in which many dependent and aged people find themselves. Previously published as Autonomy and Long-term Care, this revised edition, in paperback for the first time, takes account of recent work and develops the author's views of what autonomy means in the real world. It will have wide appeal among bioethicists and health care professionals. (shrink)

This study examines the accountability of the self among sustainability and humanitarian advocates participating in the World Economic Forum. Drawing from Butler’s (Giving an account of oneself. Fordham University Press, New York, 2005) philosophy, we explore how these individuals narrate their accountability to themselves and others, the contradictions they experience, and how they explain becoming responsible in this context. Our data illustrate the difficulties faced by these individuals in resisting the temptation to condemn themselves for compromising their own (...) values, and/or to condemn others who think and behave differently. Through their humility in relation to their incoherent identities, and their generosity in engaging with others, the participants show their responsibility both to those they advocate for and to other delegates who may have different perspectives. The study illustrates how accountability to and of the self emerges through relations with others, how individuals struggle to resist ethical violence, and how they take up moral responsibility through human interaction. (shrink)

For many years, the actions of Myanmar's military government have provoked domestic discontent and strong condemnation overseas. The government is encouraging tourism in an attempt to legitimize its actions whilst generating valuable foreign currency. However, a number of organizations are urging people to avoid travel to Myanmar and thus prevent the military junta from obtaining the hard currency and global legitimacy it needs to survive. In this article, the ethical arguments for and against tourism in Myanmar are discussed, and (...) for the first time the ethical perceptions of tourists themselves are explored. The study applied the Multidimensional Ethics Scale to a group of 376 Myanmar visitors, finding that respondents were generally in favor of tourism in Myanmar, but were uncomfortable with the ethical implications of their visit. (shrink)

Graduates of the management major at the University of Pittsburgh at Greensburg find employment in a variety of organizations. As future managers with employees from different professions, students expressed an interest in discussing ethics cases in the operations management class. The semester starts with students familiarizing themselves with various professional and corporate codes of ethics. Throughout the semester a number of short ethics’ cases in operations’ areas such as inventory management, scheduling, facility location, and product design are introduced to (...) illustrate ethical issues that a manager and his/her employees might face. Students prepare individual responses before the in-class discussions. The semester ends with a long group ethics case discussion and formal case presentations. In the end-of-semester survey, students responded very favorably to an ethics component in the operations management class. (shrink)

This paper presents an alternative concept of excellence in business, which builds upon the conventional notion of excellence as being in harmony with profit. Although the notion of an enduring harmony (or what we call the convergence thesis) between long-term profit and excellence is favoured by many thinkers, the premise neglects the disruptive force of the autonomous pursuit of excellence in theory and constrains it in practice. Further, autonomous excellence, a key condition of a genuine practice, is structurally weakened by (...) the fact that businesses are heavily reliant on market approval to sustain themselves, irreversibly damaging their status as genuine practices. We argue that the autonomous pursuit of excellence requires not only recognizing but also actively strengthening a contingent relationship between internal and external goods, so that internal goods such as the excellence of the product can achieve maximum autonomy from the pressures of external goods. Such a risk-oriented approach may appear antagonistic to business but finds expression in the insight of key business visionaries such as Steve Jobs and Henry Ford that major technological advancements rarely find themselves in consonance with existing market standards and thus require a courageous break from 'market excellence'. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 349 Pagan Virtue: An Essay in Ethics. By JOHN CASEY. Oxford: Clarendon Press, 1990. Pp. ix + 226. By this philosophical study of the four cardinal virtues, John Casey joins the ever.expanding ranks of those moral theorists who have con· trihuted to the contemporary theory of the virtues. But Casey's hook is set apart from the others both by the exceptionally high quality of his analysis and (...) even more by his thesis that traditional thinking on the virtues is in tension, at least, with fundamental Christian assumptions about the nature of the moral life. For both these reasons, his hook deserves serious attention, especially by those scholars who argue for a special congruity between virtue theory and Christian ethics. Although the title might suggest otherwise, this hook is not primarily a historical study. Rather, Casey uses the traditional schema of the four cardinal virtues (courage, temperance, practical wisdom or prudence, and justice) as the basis for philosophical analysis, which is intended as "a modest rediscovery and (hence) criticism of a tradition which we inherit" (p. viii). Along the way, he draws on a diverse selection of writers, among whom Aquinas as well as Aristotle are prominent. His thesis is that the tradition of the virtues is "worldly," that is, in significant tension with our dominant Christian and Kantian assumptions about morality, in two ways: "[the virtues] include an element of self-regard, and... they rely upon material conditions for their fulfillment" (p. viii). And yet the tradition of the virtues is not simply at odds with our received assumptions about morality. As Casey argues in his brilliant first chapter, "Persons," the Kantian commitment to respect for persons implies that the adventitious qualities that distinguish individuals are far more significant morally than Kant could allow. In the first place, the human qualities that do in fact command our respect include such capacities as intelligence, wit, and even strength. While we may want to distinguish in theory between respect for these sorts of qualities and a purely moral respect for a good will, Casey argues that this sort of distinction is artificial and untrue to our actual judgments. Hence, he concludes, " If there is no adamantine distinction between what characterizes someone purely as a person, and all other advantages and attractive qualities a human being may have, then the way is clearly open for a 'worldly' scheme of values" (p. 9). Secondly, he argues that respect for persons necessarily presupposes some capacities for empathy and emotional response that on Kant's theory must he wholly irrelevant to the moral life (pp. 9-28). Correlatively, he claims that the individual's sense of oneself and 350 BOOK REVIEWS others is mediated through an awareness of one's body and its relation to others' bodies in a way that a Kantian theory cannot readily allow: "We can, then, move naturally from the idea of persons as self-conscious, rational beings, to them as beings with certain emotions and attitudes, and with a certain apprehension of themselves and others mediated through their sense of their own and others' bodies " {p. 43). Finally, he argues that these interlocking human qualities and capacities necessarily entail not only a willingness to acknowledge the claims of others but also a readiness to make certain claims upon others, to set a value on oneself, that is at least in tension with the Christian ideal of self-abnegation (pp. 44-50). I have dwelt at some length on the first chapter of Casey's book because it sets out the main lines of analysis for the subsequent chapters. In the course of developing his main thesis, he offers a number of fascinating analyses of particular questions, including a defense of the unity of the virtues (pp. 67-78), a discussion of the ways in which a virtue can he a bodily quality (pp. 105-113), and an argument that practical wisdom, and therefore moral goodness, may depend in part on the possession of a more than average level of intelligence (pp. 144147 ). At times, the very richness of his analyses can make it difficult to perceive the threads of a coherent argument. But he consistently returns to his... (shrink)

Research integrity and misconduct have recently risen to public attention as policy issues. Concern has arisen about divergence between this policy discourse and the language and concerns of scientists. This interview study, carried out in Denmark with a cohort of highly internationalised natural scientists, explores how researchers talk about integrity and good science. It finds, first, that these scientists were largely unaware of the Danish Code of Conduct for Responsible Conduct of Research and indifferent towards the value of such codes; (...) second, that they presented an image of good science as nuanced and thereby as difficult to manage through abstracted, principle-based codes; and third, that they repeatedly pointed to systemic issues both as triggering misconduct and as ethical problems in and of themselves. Research integrity is framed as a part of wider moves to ‘responsibilise’ science; understood in these terms, resistance to codes of conduct and the representation of integrity as a problem of science as a whole can be seen as a rejection of a neoliberal individualisation of responsibility. (shrink)

Ethical decision-making theories in behavioural ethics management have been developed through the social sciences, psychology, social psychology, and cognitive neurosciences. These theories are either cognitive, non-cognitive or an integration of both. Other scholars have recommended redefining what ethical means through moral philosophy and theology. Buddhism is a religion, a philosophy, a psychology, an ethical system and an art of living. The divine states in Buddhism are virtues that could be developed by anyone regardless of their religion or (...) non-religion through Buddhist meditation. They are so called because they enable individuals to develop ‘God-like qualities’. The theoretical insights of the divine states indicate how to eliminate negative emotions, such as anger, fear, delusion and envy, by cultivating love and compassion towards both the self and others. Accordingly, this paper contributes to EDM by redefining what ethical means through the meanings managers who practise Buddhist meditation assign to divine states in their lived experience of EDM in organisations in Sri Lanka. The sample consisted of 17 Buddhists, 1 Hindu, 1 Muslim and 1 no-religion. Data were collected using semi-structured in-depth interviews and was analysed with IPA. The findings indicated that how the managers made meaning of an ethical decision was influenced by their loving-kindness, compassion, sympathetic joy and equanimity. The findings also indicated that the managers justified the reasons for their decisions subsequently through the benefits to themselves as well as their employees. Accordingly, this study supports the view that EDM is an integrated approach. (shrink)

Twenty-four children (aged 5 months to 18 years) who were admitted to a university hospital were observed for a total of 135 hours with the aim of describing their degree of participation in decisions concerning their own care. Grading of their participation was made by using a 5-point scale. An assessment was also made of what was considered as optimal participation in each situation. The results indicate that children are not always allowed to participate in decision making to the extent (...) that is considered optimal. In no case was it judged that a child participated in or was forced to make a decision that was too difficult for the child. The interactions between children, parents and staff were also described in connection with discussions and decision-making processes. This showed that parents do not always support their children in difficult situations and that health care staff often inform children about what is going to happen without presenting alternatives or asking for their views. Staff may, however, find themselves facing an ethical conflict in deciding between supporting a child’s view or following hospital routine. It is of great importance that children are looked upon as potentially autonomous individuals and that staff members realize that one of their core duties is to facilitate children’s participation in decision making concerning their health care. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:ICONOCLASM in the OLD AND NEW TESTAMENTS Peter Goldman Westminster State College ofSalt Lake City Acentral problem for any monotheistic religion is distinguishing worship of the one true God from idolatry in all its forms. René Girard's pioneering interpretation ofthe Judeo-Christian scriptures clarifies this distinction by recourse to an ethical conception ofthe sacrificial: False religion or idolatry is essentially sacrificial, while the Judeo-Christian tradition opposes the sacrificial in (...) all its myriad forms. As Girard explains, the Passion narrative makes clear that the sacrificial or scapegoat victim, Christ, is innocent. The violence inflicted upon Christ is human, not divine. The Gospels thus reveal the violence that hides behind the sacred. Religious practices that further sacrificial violence are idolatrous, worshiping violence in the guise ofthe sacred.1 The ethical simplicity of the Girardian distinction between true faith and idolatry is complicated, however, by the issue of representation. According to the Old Testament, the one true God cannot be represented by images or figures of any kind, while idols typically take figurai form. From a biblical perspective, therefore, the question ofform is central to an understanding of idolatry. The Old Testament ban on images has never been investigated from a Girardian perspective. In this essay I apply Rene Girard's anthropological insights to the subject oficonoclasm in the Old and New Testaments. More specifically I address the second command-ment, the famous ban on "graven images," and the problem of representing God. From the per- ' For a fuller treatment ofGirard's interpretation ofChristianity in relation to the sacrificial, see his Things Hidden since the Foundation ofthe World 84Peter Goldman spective ofGirard's "fundamental anthropology" there are two basic issues in this regard. The first is the ethical function of the ban on images; how does the second commandment function ethically to preserve the human community in the Bible? Second, is the ban on images sacrificial as understood in Girardian terms? Or is it anti-sacrificial and therefore ethically progressive? The second commandment reads: "Thou shalt not make unto thee any graven image, or any likeness of any thing that is in heaven above, or that is in the earth beneath, or that is in the water under the earth : Thou shalt not bow down thyself to them, nor serve them: for I the Lord thy God am a jealous God" (KJV, Exod. 20.4-5). At first glance, this commandment might appear as an expression ofthe most primitive form ofreligious taboo. A specific cultural activity is arbitrarily forbidden under threat of punishment. The taboo on images, unlike the law against murder for example, has no obvious moral dimension. Images of any kind must be violently expelled —sacrificed, as it were—for no immediate reason. According to the second commandment, any attempt to represent God or his creation by images is a profane violation of his "jealous" nature; the second commandment therefore often finds expression in the violent destruction ofsocalled idolatrous images. Acts oficonoclasm directed againstthe images of foreign gods are quite common in the Old Testament. Nevertheless, I argue here thatthe second commandment is in practical terms ethically progressive and anti-sacrificial. It actually questions and underminesthe whole sacred-profane dichotomy. Indeed, the ban on images is ultimately a secularizing influence crucial for the development of modernity. I also address the Christian acceptance of divine images, which has often been understood as a reversal of the Judaic ban on figurai representations. In the interpretation of iconoclasm that I am proposing here, however, the image ofChrist on the cross can be seen as a logical development of the second commandment rather than its contradiction. I. The second commandment in context In the Old Testament, the giving of the second commandment is associated with the Exodus from Egypt and the Hebrew rejection of Egyptian religion and culture. In Herbert Schneidau's book Sacred Discontent, he argues persuasively that Hebrew monotheism is first of all a reaction against pagan polytheism. Schneidau writes, "The JudeoChristian tradition defines itselfas opposed to a pagan world which it sees Iconoclasm in the Old and New Testaments85 as essentialIy mythological"(12). Further, "TheHebrews habitually defined themselves negatively, by their differences from their neighbors" (51). Schneidau explains: We find... (shrink)

Excerpt from A Study in the Ethics of the Early Romantic School in Germany It is very probable that any writer or group of writers will be subjected to the pen of the critic, whether they abound in deficiencies or not. But, should the ethics of the individual or group diverge somewhat from the line drawn by society, there is no limit to the untold severity of merciless criticism, no element of defense in the many comments. Still it must be (...) remembered that no one can calculate the depth of a body of water by merely scanning the surface: nor can anyone fully realize the profundity of any situation by viewing it superficially. In other words, it is absolutely necessary that the critic resort to detailed investigation. He must go below the surface to solve the complicated problems which may be presented. Thereby he will acquaint himself with the factors that mould the pattern for the times. Then again, the average human being does or says as he or she sees fit, and can very often furnish justifiable reasons therefor. Everyone reserves for oneself the privileged right of personal opinion and belief. But herein lies a decisive difference. Some people are lovers of the truth, and therefore speak candidly and act openly; others are prone to lose courage and try to hide behind a transparent veil of false modesty. Those, who can be included within this latter category, are only reticent and untrue to themselves, simply because they are in the majority. If the proportion be reversed, they would be more than glad to feel the relief from the pressure removed. But those poor unfortunates, who are forced by their nature and spurred on by their immediate environment to be outspoken, become down-trodden social outcasts. If we ask ourselves why this is so, the answer is: primarily because they are in the minority, as all persecuted classes are. No credit or encouragement is given them for their originality. Yet they are as determined as ever in their aim, and proceed with the innovations that are criteria for their own development. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

When a child is hospitalized, the parents find themselves in an unfamiliar environment and their parental role changes. They are in a stressful and often anxiety-filled situation and it may be difficult for them to participate in decisions. The purpose of this study was to examine the extent to which parents participate in decisions during the course of events when their child is hospitalized. Thirty-five parents of 24 children (aged 5 months to 18 years) were followed by mobile observation (...) during their child’s hospitalization in a paediatric department in Sweden. Three researchers analysed field notes in three steps, using manifest and latent coding. In step 1, 119 situations that included a decision process were identified. In step 2, the situations were assessed according to a five-level scale concerning how the parents’ wishes, desires or values had been respected. In step 3, each situation was scrutinized with respect to factors influencing the extent of the parents’ participation. The results showed that parents have varying ability to be involved in decision making. Professionals need to communicate more openly with them in order to identify and satisfy their needs because some parents are unwilling or incapable of expressing them. (shrink)

Socially assistive devices such as care robots or companions have been advocated as a promising tool in elderly care in Western healthcare systems. Ethical debates indicate various challenges. An important part of the ethical evaluation is to understand how users interact with these devices and how interaction influences users’ perceptions and their ability to express themselves. In this review, we report and critically appraise findings of non-comparative empirical studies with regard to these effects from an ethical (...) perspective.Electronic databases and other sources were queried using a comprehensive search strategy generating 9851 records. Studies were screened independently by two authors. Methodological quality of studies was assessed. For 22 reports on 21 datasets using a non-comparative design a narrative synthesis was performed.Data shows positive findings in regard to attitudes and emotional reactions of users. Varying perception of a social relation and social presence are the most commonly observed traits of interaction. Users struggle with understanding technical complexities while functionality of the devices is limited. This leads to a behavioral alignment of users towards the requirements of the devices to be able to make use of them.This evidence adds to three important ethical debates on the use of socially assistive devices in healthcare in regard to (1) reliability of existing empirical evidence to inform normative judgements, (2) ethical significance of the social presence of devices and (3) user autonomy in regard to behavioral alignment. (shrink)

Software systems play an ever more important role in our lives and software engineers and their companies find themselves in a position where they are held responsible for ethical issues that may arise. In this paper, we try to disentangle ethical considerations that can be performed at the level of the software engineer from those that belong in the wider domain of business ethics. The handling of ethical problems that fall into the responsibility of the engineer (...) has traditionally been addressed by the publication of Codes of Ethics and Conduct. We argue that these Codes are barely able to provide normative orientation in software development. The main contribution of this paper is, thus, to analyze the normative features of Codes of Ethics in software engineering and to explicate how their value-based approach might prevent their usefulness from a normative perspective. Codes of Conduct cannot replace ethical deliberation because they do not and cannot offer guidance because of their underdetermined nature. This lack of orientation, we argue, triggers reactive behavior such as “cherry-picking,” “risk of indifference,” “ex-post orientation,” and the “desire to rely on gut feeling.” In the light of this, we propose to implement ethical deliberation within software development teams as a way out. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 42.1 (2004) 105-107 [Access article in PDF] Richard H. Popkin. The History of Scepticism: From Savonarola to Bayle. Revised and Expanded Edition. New York: Oxford University Press, 2003. Pp. xxiv + 415. Cloth, $74.00. Paper, $24.95. Richard Popkin tells the story that once a long time ago when he asked a question at a conference that made reference to late-eighteenth-century skeptics like Maimon (...) and Platner, Myles Burnyeat turned to the audience and asked, "Does anyone else read these people that Popkin reads?" The answer, by the time we get to this, the fourth edition of a book that first appeared in 1960, is that lots of people are reading the people that Popkin reads. Now [End Page 105] Myles Burnyeat is quoted on the cover of this volume for graciously saying "I regard it as one of the seminal books in the history of ideas." In one of the three Festschriften that have been published in Popkin's honor, David Katz even reports that some of those who work in areas Popkin pioneered refer to themselves as "Popkinites" (James E. Force and David S. Katz, eds., Everything Connects [Leiden and Boston: Brill, 1999], ix).Popkin was also founding editor of this journal, and his name has been footnoted in numerous articles over the years, so it will not be unknown to many. But readers will want to know what is new in this latest version of the classic work. For openers, it is roughly fifty percent longer, now 18 chapters instead of the 12 chapters of the last version. The original book was subtitled "From Erasmus to Descartes" and the later California edition subtitle became "From Erasmus to Spinoza." This edition pushes the envelope in both directions: back to Savonarola and forward to Pierre Bayle.The Savonarola connection comes from the unlikely discovery that the famous monk collected manuscripts of Sextus Empiricus and was planning to have them translated as tools for use against pagan philosophy and in favor of revealed religion. This brings out one of Popkin's favorite points: that what we think of as philosophical skepticism was part and parcel of religious debate early on. Among other new findings in this edition, Popkin finds clues that Leone Ebreo (Judah Abravanel) may have helped Gianfrancesco Pico read anti-Aristotelian Hebrew texts. Jews could use this sort of skepticism against the dogmatic Christians who tried to refute them.The religious connection is fundamental throughout the text. In his new introduction, Popkin admits that "I am more in sympathy with those who used the sceptical and fideist views of the nouveaux pyrrhoniens for religious rather than secular purposes" (p. xxiii). He has developed this sympathy into research on millenarianism in volumes such as Popkin and David S. Katz, Messianic Revolution: Radical Religious Politics to the End of the Second Millennium (New York: Hill and Wang, 1998) and Popkin, et al., eds., Millenarianism and Messianism in Early Modern European Culture, 4 vols. (Dordrecht: Kluwer, 2001).Other new materials follow the discussion of Descartes with a chapter on Henry More, Pascal, and the Quietists and another one on Hobbes's political and practical answer to skepticism. There are new chapters on Wilkins, Boyle, and Glanvill of the Royal Society, and on late seventeenth-century metaphysics. New material on Simon Foucher and Pierre-Daniel Huet is followed by the concluding chapter on Pierre Bayle as a "super sceptic."The book has never been uncontroversial. Although they could follow the skeptical undercutting of the Bible in Spinoza, many scholars could not see how the master of the geometrical method in ethics could be anything but a dogmatist in the final analysis. (Popkin has an answer.) The same doubt will now apply to the treatment of Pierre Bayle in this version. To Popkin, as we have seen, Bayle is a "super sceptic" who "carried scepticism to its ultimate extreme" (300); to Gianluca Mori (Bayle philosophe, Paris: Champion, 1999) and others, he is a dogmatic philosophical atheist as well as moral rigorist. To his credit... (shrink)

American businesses, their leaders, and the business schools that developed these leaders find themselves under public scrutiny. As a result, business programs have placed increased emphasis on developing and implementing curriculum to address business ethics, which presents practitioners with the issue of how to define, measure, and evaluate business ethics curriculum. The purpose of this study was to examine the business ethics curriculum in AACSB-accredited business schools in the U.S. A framework for defining and examining the curriculum was developed (...) using Lattuca and Stark’s (2009) Academic Plan, and other variables from the literature relevant to the business ethics curriculum were examined. The results indicated that the current business ethics curriculum in most business schools has all of the academic plan elements: an ethics-related learning goal; content in a variety of subjects and at a variety of levels; a sequence that has been applied to it; learners’ needs addressed; appropriate and even innovative learning processes; the necessary resources including faculty; assurance of learning at the program level; and has been adjusted an average of 2.6 times in the last five years. Commonly, business ethics is integrated throughout the business curriculum in addition to having an ethics class available, whether elective or required. Faculty generally create and support an ethical culture and the program’s efforts to include business ethics in the curriculum. (shrink)

The Covid-19 pandemic broke on a world whose grip on epistemic trust was already in disarray. The first months of the pandemic saw many governments publicly performing reliance on epidemiological and modelling expertise in order to signal that data would be the basis for justifying whatever population-level measures of control were judged necessary. But comprehensive data has not become available, and instead scientists, policymakers and the public find themselves in a situation where policy inputs determine the data available and (...) vice versa. This essay asks how we can live with what Amoore has termed ‘post-Cartesian doubt’ in situations of existential risk, and what kind of approach to science and data can answer the moral and human demands of a situation such as the Covid-19 pandemic. I suggest that science and policy could be able to control the pandemic better by addressing the sources of uncertainty and missing data not as gaps in the information landscape, but as individuals who are likely to be members of less-visible and less powerful groups including low-wage workers, the elderly, migrants, prisoners and others. This would shift both data use and policy toward an ethics of care, an embodied approach which asks what people need and how they behave in relation to each other, rather than how to manage population-level behaviour. This approach, I argue, is more appropriate for pandemic response than a utilitarian calculation of how many people each country should expect to lose as a result of the disease. (shrink)

Philosophy is often understood in terms of public benefit as being synonymous with its application to other domains of public life such as politics, economics, education etc. The question I would like to raise is of an altogether different nature—namely, it is the question of whether philosophy can be seen as having any public or social value per se, before there is any further thought of application or usage. In particular, it is the question of whether it contains anything universally (...) significant, something that could make it of interest to anyone as seen in the context of one’s personal evolution. And in order to answer that question, first we have to find out what philosophy is to the philosophers themselves and how it benefits them. (shrink)

Educators find themselves in the midst of arising tide of urban school reform marked byevermore centrally designed and monitoredsystems of accountability. In response to thislooming high-stakes gaze of surveillance, thisessay offers an ethics of educationalleadership predicated upon taking up thechallenge of creatively and courageouslyauthoring one's ethical self. It seeks tocontribute to mapping an ethical terrain whichcan support the production of pedagogicalpractices, initiatives, and agendas asdistinctive, bold responses to theproliferation of one-dimensional,technicist-driven efforts which narrowlycalculate and assess student learning, (...) teacherwork, school effectiveness, and which offeranemic, foreclosed readings of a possiblefuture. My claim is that a consideration ofFoucault's ethics draws us closer torecognizing what such a project would mean andask of the educator as leader. (shrink)

In this article I try to show in what sense Emmanuel Levinas’ ‘ethics as first philosophy’ moves our ethical thinking away from what has been called ‘centrist ethics’. Proceeding via depictions of the structure of Levinasian ethics and including references to examples as well as to some empirical research, I try to argue that human beings always already find themselves within an ethical universe, a space of meaning. Critically engaging with the writings of David Gunkel and Lucas (...) Introna, I try to argue that these thinkers, rather than clarifying, distort our ethical understanding of how we stand in relation to artefacts. Drawing a distinction between how pervasive our ethical relationship to other human beings, and living animals, is and how the nature of artefacts is tied to us, I conclude by indicating that the aspiration to give artefacts an ethical face suggests a fantasy to avoid ethical responsibility and generates what I call a ‘compensatory logic’. (shrink)

A methodology for using philosophy to guide teaching preparation and practice. In Teaching from an Ethical Center, Cara E. Furman proposes a process for bringing philosophical inquiry into teacher education and adopting it as a centering tool to enrich teaching practice and help teachers act justly. Under Furman's thoughtful guidance, both experienced and preservice teachers will find that engagement with philosophy can be a useful means of clarifying for themselves the educational ethics, values, and pedagogy that guide their (...) work. Using firsthand accounts, recommended resources, and thought exercises, Furman prompts readers to explore the many benefits for both educators and their students of the act of reading and making sense of philosophical texts and thinking philosophically through daily dilemmas. Furman encourages teachers to engage in philosophical reflection as part of their professional preparation as well as their in-classroom practice. She illustrates how the focus on core values that emerges from this practice can be applied to everyday teaching dilemmas such as student behavior concerns and conflict management. Offering tips for adapting activities to different audiences, she shows how student participation in such inquiry supports hermeneutics, cultivates student voice, and helps build a culture of trust and interdependence through classroom collaboration. Filled with practical wisdom, this insightful work advances philosophical inquiry as a foundation for an inclusive education. Furman's tools and methods offer continuous opportunities for reflection and affirmation, enhancing educators' ability to adapt to new challenges and, when necessary, to resist. (shrink)

The paper describes a two week course that has been offered as a special study module to intermediate level undergraduate medical students at Dundee University Medical School for the past five years. The course requires students to research the various aspects of ethical dilemmas that they have identified themselves, and to “teach” these issues to their colleagues in a short PowerPoint presentation as well as to prepare an extended 3000 word essay discussion. The course specifically asks students not (...) to disclose their own ethical positions, as these are probably still in formation and the objective is to promote critical thinking capacity in ethical and moral issues as a prelude to the development of practical skills in dealing with clinical problems. The course is easy to resource for the school and has received universally high evaluations from the students since its inception. (shrink)

Incidental findings and secondary findings, being results that are unrelated to the diagnostic question, are the subject of an important debate in the practice of clinical genomic medicine. Arguments for reporting these results or not doing so typically relate to the principles of autonomy, non-maleficence and beneficence. However, these principles frequently conflict and are insufficient by themselves to come to a conclusion. This study investigates empirically how ethical principles are considered when actually reporting IFs or SFs and how (...) value conflicts are weighed. A qualitative focus group study has been undertaken, including a multidisciplinary group of professionals from Belgian centres for medical genetics. The data were analysed thematically. All eight Belgian centres participated in this study. Ethical values were frequently referred to for disclosure policies on IFs and SFs. Participants invoked respect for patient autonomy to support the disclosure of IFs and opt-out options for IFs and SFs, non-maleficence for the professional delineation of reportable IFs and opt-out options for IFs and SFs and beneficence for the mandatory reporting of actionable IFs, the delineation of reportable IFs and a current decline of actively pursued SFs. Professional assumptions about patients’ genetic literacy were an important factor in the weighing of values. In line with the traditional bioethical discourse, the mandatory reporting of actionable IFs might be interpreted as a “technological, soft paternalism”. Restricting patients’ choices might be acceptable, but then its motives should be valid and its beneficent outcomes highly plausible. Hence, the presuppositions of technological, soft paternalism - patients’ inability to make informed decisions, normative rationality, the efficacy of beneficent outcomes and the delineated spectrum of beneficence - should be approached critically. Moreover, distributive justice should be considered an important value in the delineation of the current scope of the ethical debate on IFs and SFs. This study of guiding values may stimulate the debate on the ethical grounds for a solid policy on IFs and SFs internationally. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:358 BOOK REVIEWS ing and his arguments seem more tentative and relativistic than those offered in his previously published works (Truth and Other Enigmas, 1978; The Interpretation of Frege's Phuosophy, 1981, etc.). Yet he uses his mastery of powerful logical techniques in order to support the chosen positions. This fact might give great satisfaction to a logician, hut the metaphysician may he somewhat disappointed by the meager results attained, (...) though Dummett himself modestly restricts his goals to those of forming only " a base camp for an assault on the metaphysical peaks...". One may also wonder whether Dummett remained faithful to his methodological requirement of the priority of meaningtheory with regard to logic and metaphysics. Doesn't Dummett's acceptance of intuitionistic logic (with its rejection of the principle of bivalence) dictate his preference for a certain meaning-theory, and not the other way around? To distill and extract metaphysical beliefs and insights which are contained (perhaps tacitly) in the working of our language is undoubtedly a legitimate goal of any philosophical enterprise. But our ambitions go beyond this goal: we are reaching after reality itself, not just after our opinions about reality and their semantical elucidation. In this respect Dummett's programmatic conception of metaphysics may face serious difficulties in attempts to climb the ahovementioned metaphysical peaks. On the other hand, is any metaphysical program exempt from such difficulties? The hook is beautifully printed; Harvard University Press has done an excellent job! The Index, which combines names and subjects, is a hit too economical, omitting certain references (for example, important remarks on God's omniscience on pp. 75-76). AUGUSTIN RISKA Saint John's University New York, New York Ethical Practice in Clinical Medicine. By WILLIAM J. ELLOS. New York: Routledge, 1990. Pp. 190. Medical ethics is an integral part of the science and art of medicine. Rather than being a set of norms or regulations added from external sources, such as the legal norms regulating the medicare program, the norms and maxims of medical ethics are integral elements of medicine arising from the relationship between physician and patient. In one way or another, most philosophers of ethics and medicine would agree with the foregoing statements. But once the role of ethics in medicine has BOOK REVIEWS 359 been established, a serious difficulty arises: What method should he used to define and delineate ethical norms for particular cases? More to the point, how should one go about solving problems in medical ethics? Father William Ellos, S.J., is concerned with resolving the difficulty of method in medical ethics. He seeks to develop and explain a method in medical ethics that will be both clinical and pragmatic. Joining with other specialists in the field, he opts for a virtue-centered approach to solving issues in medical ethics, as opposed to a rulecentered duty-based approach. While not rejecting the ethical method featuring the principles of autonomy, beneficence, and justice derived from W. D. Ross (an approach favored by so many contemporary scholars in the field of medical ethics), he does maintain that these principles are greatly overworked as well as simplistic. He proposes virtue-centered reasoning as a better method of ethical endeavor, especially attuned to the complexity and problematics of clinical ethics. In developing the notion of virtue·centered ethics, Ellos considers the contributions of the past and present thinkers to this method of ethical decision making. Hence, Plato, Aristotle, Thomas, the Scottish Enlightenment Philosophers, and American Pragmatists are the main sources of his reflections upon virtue ethics. Ellos finds a culmination of virtue ethics in the present-day tendency of many consultants in medical ethics to classify themselves as casuists, indicating that they are eclectic and pragmatic in their efforts to solve clinical cases. In the course of the historical and analytical sections of this work, Ellos demonstrates not only a wide acquaintance with classical and contemporary authors but also an ability to discern continuity of thought among these well.known philosophers and theologians. Especially significant is his recognition of the too often neglected contemporary authors Collen Clements and Roger Sider, whose accurate indictment of the principle of autonomy as interpreted by present-day medical ethicists restores the... (shrink)

Background: Nursing students on clinical placements as part of their professional training are routinely faced with situations involving ethical conflicts. The initial act of perceiving a situation as causing an ethical dilemma is the result of both the students’ personal values, drawn from their culture and families, and of the professional knowledge and values that they have acquired through training and experience. Objectives: Nursing students’ experiences on clinical placements in primary care settings were investigated in order to identify (...) situations that they perceived as involving ethical conflict and describe the elements they took into consideration during their decision-making processes in these situations. Methods: The research design was qualitative descriptive case study. Around 50 students from three different intakes to a nursing degree answered a questionnaire and discussed it in focus groups. Ethical considerations: The study was designed in accordance with the principles guiding research with human beings and was approved by the Human Research Ethics Committee. Results: Synthesised into two principal axes: (a) ethical conflicts in primary care, linked with the domains of working processes, professional nursing ethics and human and social rights and (b) students’ decision-making processes – realisation, reflection and intervention. Conclusion: The student nurses saw themselves both as actors and spectators in situations involving ethical problems and demanding moral deliberation, demonstrating the ability to base their arguments soundly. They tended to emphasise the possibilities offered by dialogue and that different ethical values must be respected to find fair solutions to ethical problems. (shrink)

The role of the business leader is key to develop the culture of an enterprise. To exemplify its importance in the national and globalcontext, the Muslim author from Indonesia points with admiration to Konosuke Matsushita, founder of Matsushita Electric Corporation, who already in the 1930s set up the seven ethical principles for healthy business growth, which also are commended by the Islamic imperative. Due to the current dynamic business environment, Muslims find themselves confronted with serious dilemmas and need (...) guidance from a clearly developed Islamic business ethics. For this purpose the author offers, first, the essentials of such an ethics: the utmost importance of all sort of productive work and the distribution of wealth in society; the vocation of trade; the fundamental principles of freedom and justice for business conduct; the prescription of certain manners such as leniency, service-motive, and consciousness of Allah; and mutual consultation. He, then, presents his personal view on leadership in business. It involves three basic ingredients: an inspiring vision of high and achievable standards; a value system based on the principles of freedom and justice and promoting fairness, business integrity, and efficiency; and courage to face tough decisions while putting one’s complete trust in Allah. (shrink)

This paper presents a review of 100 empirical papers studying corporate codes of ethics in business organizations from the time period mid-2005 until mid-2016, following approximately an 11-year time period after the previous review of the literature. The reviewed papers are broadly categorized as content-oriented, output-oriented, or transformation-oriented. The review sheds light on empirical focus, context, questions addressed, methods, findings and theory. The findings are discussed in terms of the three categories as well as the aggregate, stock of empirical CCE (...) studies in comparison with previous reviews, answering the question “where are we now?” Content and output studies still stand for the majority of the studies, whereas the transformation studies are fewer. Within these areas, two new trends are found to have emerged: discursive analyses and a focus on labor conditions. The review finds that the content of CCEs is still predominantly self-defensive, that CCEs are insufficient in themselves in terms of protecting workers’ rights, that CCEs are likely to encounter tensions when implemented across national and organizational boundaries, and that while perception of CCEs is generally positive, CCEs may lead to both positive and negative outcomes. Based on these findings, potential areas for further exploration in the area of CCE research are suggested. (shrink)

This article analyzes the contribution Christian ethics might be able to make to the ethical debate on policy and caregiving in health and social care in the United Kingdom. The article deals particularly with the concepts of solidarity and subsidiarity which are essential in Christian social ethics and health care ethics, and which may be relevant for the ethical debate on health and social caregiving in the United Kingdom. An important argument in the article is that utilitarian and (...) market-driven policies in the National Health Service (NHS) and the social care system have marginalized the position of the elderly and have seriously impoverished the quality of care for the elderly. The neglect of the elderly and other vulnerable groups is also the result of widespread consumerist attitudes among patients and of libertarian models of noninterference which are affirmed by a public ethos of self-sufficiency and counter-dependency. Those who need care dare not make their need known to others and ask for help, while simultaneously those who could help are so intimidated by the public affirmation of privacy and negative rights that they do not dare to offer help except if this is explicitly demanded. This distant and standoffish attitude is in an important way responsible for the fact that the voice of those in need is altogether lost to the public forum. Christian ethics puts much emphasis on responsibility and solidarity with the needy other but is not able to have much impact on the delivery of care in a secularized society and health care system like the NHS. Nonetheless, Christianity still has a powerful and respected voice, by speaking up for those who cannot speak for themselves, such as the elderly and the handicapped. Christians can find allies in the ethics of care and other relational approaches in health care ethics in order to combat libertarianism, consumerism, and utilitarianism. (shrink)

The aim of this study was to describe Tanzanian nurses' meaning of and experiences with ethical dilemmas and workplace distress in different care settings. An open question guide was used and the study focused on the answers that 29 registered nurses supplied. The theme, `Tanzanian registered nurses' invisible and visible expressions about existential conditions in care', emerged from several subthemes as: suffering from (1) workplace distress; (2) ethical dilemmas; (3) trying to maintaining good quality nursing care; (4) lack (...) of respect, appreciation and influence; and (5) a heavy workload that did not prevent registered nurses from struggling for better care for their patients. The analysis shows that, on a daily basis, nurses find themselves working on the edge of life and death, while they have few opportunities for doing anything about this situation. Nurses need professional guidance to gain insight and be able to reflect on their situations, so that they do not become overloaded with ethical dilemmas and workplace distress. (shrink)

Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...) by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics consultants. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self-reported quality outcome measures. Despite these limitations, to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly, our findings shed light on ways this checklist can be used to improve ethics consultation, including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. (shrink)

Background: Ethically difficult situations are frequently encountered by healthcare professionals. Moral case deliberation is one form of clinical ethics support, which has the goal to support staff to manage ethical difficulties. However, little is known which difficult situations healthcare teams need to discuss. Aim: To explore which kinds of ethically difficult situations interprofessional healthcare teams raise during moral case deliberation. Research design: A series of 70 moral case deliberation sessions were audio-recorded in 10 Swedish workplaces. A descriptive, qualitative approach (...) was applied, using thematic content analysis. Ethical considerations: An advisory statement specifying no objections to the study was provided from an Ethical Review Board, and consent to be recorded was assumed by virtue of participation in the moral case deliberation. Findings: Three themes emerged: powerlessness over managing difficult interactions with patients and next-of-kin, unease over unsafe and unequal care, and uncertainty over who should have power over care decisions. The powerlessness comprised feelings of insufficiency, difficulties to respond or manage patient’s/next-of-kin’s emotional needs or emotional outbursts and discouragement over motivating patients not taking responsibility for themselves. They could be uncertain over the patient’s autonomy, who should have power over life and death, disclosing the truth or how much power next-of-kin should have. Discussion: The findings suggest that the nature of the ethically difficult situations brought to moral case deliberations contained more relational-oriented ethics than principle-based ethics, were permeated by emotions and the uncertainties were pervaded by power aspects between stakeholders. Conclusion: MCD can be useful in understanding the connection between ethical issues and emotions from a team perspective. (shrink)

A framework is presented for studying ethical conduct in public accounting practice. Four levels of analysis are distinguished: individual, local office, multi-office firm and professional institute. Several propositions are derived from the framework and discussed: (1) The effects of ethical vs. unethical behavior on an accountant's prospects for advancement are asymmetrical in nature; (2) the way individuals perceive or frame the decision problem at hand will make an ethical response more or less likely; (3) the economic incentives (...) present in competitive markets influence the work goals of firms and offices, and lead to ethical dilemmas for individuals; and (4) initiatives at the firm or institute level aimed at compliance with professional ethical standards will by themselves have little effect on individual ethical behavior. Research into ethical behavior of practitioners will capture self-conscious and biased responses unless it is designed so as to permit indirect observation and recording of spontaneous comments. To assure valid research findings, practitioners should be interviewed and their motives assessed indirectly. A longitudinal approach is recommended, beginning with students who are choosing an accounting career. Two types of questions for use in these interviews are described. (shrink)

The relationship between stress and unethical behaviour amongst non-tenured research staff in academia is a relatively unexplored phenomenon. The research reported herein was therefore carried out with the aim of exploring the relationship between stress, the socio-organisational factors which contribute to it, job satisfaction, perceptions of job instability, and the occurrence of unethical behaviour in research. 793 Italian researchers participated in the research—all of whom were working on fixed-term contracts—after being individually requested to complete an online questionnaire. The data indicate (...) that unethical behaviours occur with alarming frequency. The stress level reported is quite high, as is the level of perceived job insecurity, both of which impact upon levels of job satisfaction. Perceived stress levels also seem to play a role in the commission of unethical behaviours, but this relationship is irrelevant when one considers the role of social and organisational factors that are known to induce it. Indeed, it seems that there are various socio-organisational determinants of stress that have an obvious direct negative influence on the commission of unethical behaviours more than the stress level per se. This research paints a worrying picture in relation to the psycho-physical state of non-tenured researchers as a result of the working conditions in which they find themselves in Italian universities. (shrink)

Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In (...) a moral case deliberation, the participants are invited to place themselves in the position of the case presenter and to investigate their own emotions in the situation. It is about critically assessing the facts in the case that cause the emotion and the related (moral) thoughts that accompany the emotion. It is also about finding the right emotion in a given situation and finding the right balance in dealing with that emotion. These steps in the moral inquiry give rise to group learning. It is a process of becoming open towards the perspectives of others, leading to new insights into what is an appropriate emotion in the specific situation. We show how this approach works in moral case deliberation. A physician presents a situation in which he is faced with a pregnant woman who is about to deliver multiple extremely premature infants at the threshold of viability. The moral deliberation of the case and the emotions therein leads to the participants’ conclusion that “compassion” is a more adequate emotion than “sadness”. The emotion “sadness” is pointed towards the tragedy that is happening to the woman. The emotion “compassion” is pointed towards the woman; it combines consideration and professional responsibility. Through the shift towards compassion, participants experienced more creativity and freedom to deal with the sad situation and to support the woman. The paper ends with an analysis and reflection on the deliberation process. In the conclusion we argue for more attention to emotions in clinical ethics support and offer some directions for doing this in the right way. (shrink)

Richard Rorty is famous, maybe even infamous, for his philosophical nonchalance. His groundbreaking work not only rejects all theories of truth but also dismisses modern epistemology and its preoccupation with knowledge and representation. At the same time, the celebrated pragmatist believed there could be no universally valid answers to moral questions, which led him to a complex view of religion rarely expressed in his writings. In this posthumous publication, Rorty, a strict secularist, finds in the pragmatic thought of John Dewey, (...) John Stuart Mill, William James, and George Santayana, among others, a political imagination shared by religious traditions. His intent is not to promote belief over nonbelief or to blur the distinction between religious and public domains. Rorty seeks only to locate patterns of similarity and difference so an ethics of decency and a politics of solidarity can rise. He particularly responds to Pope Benedict XVI and his campaign against the relativist vision. Whether holding theologians, metaphysicians, or political ideologues to account, Rorty remains steadfast in his opposition to absolute uniformity and its exploitation of political strength. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:324 BOOK REVIEWS Reading in Communion: Scripture & Ethics in Christian Life. By STEPHEN E. FowL & L. GREGORY JONES. Series: Biblical Foundations in Theology. Grand Rapids: Wm. B. Eerdmans Pub. Co., 1991. Pp. ix + 166. $13.95 (paper). This book represents the collaborative attempt of a biblical scholar and an ethicist to determine the precise sense in which scriptural texts can be taken as normative for the Christian (...) moral life. The collabora· tion is a fruitful one, its results illuminating not only the problem of method in ethics, but issues of biblical hermeneutics as well. This re· sult is not serendipitous; for the authors, the question of how one ought to live the Christian life and the question of how one ought to interpret Scripture are inextricably linked. Indeed, perhaps it would be more accurate to suggest that, on the account that Fowl and Jones supply, these are different formulations of the very same question. There is no rigid demarcation here between the hermeneutical and the ethical realm, no rigorous sorting out of issues appropriate to each field of inquiry. The authors make good on their introductory promise "to write a single text " rather than simply to generate a series of " alternating perspectives " (p. 3). In the very first chapter of the book, certain typical, even dominant, ways of construing the relationship between Scripture and ethics are briefly reviewed and then rejected. Ethics is commonly perceived as being primarily "concerned with right actions and decisions," the authors contend, while the Bible is viewed as a moral guide for the " particular decisions made by isolated individuals " (p. 5). In contrast, Fowl and Jones argue that " Scripture is primarily addressed not to individuals but to specific communities called into being by God " (p. 8). Moreover, our ethical deliberations ought not to be focused on particular decisions and the formulation of moral principles that bear on those decisions, but rather, on " issues of character and the formation of character in and through socially-embodied traditions" (p. 9). The consequences of such a general position are carefully and sen· sitively explored in this first and in subsequent chapters. The authors reject the assumption that one such consequence must be the conclusion that moral behavior is not, after all, ruled behavior, that one cannot formulate and articulate the principles that govern much of what we do. Their position entails the conclusion, rather, that such principles cannot be meaningfully detached from the communally embodied traditions that engender them. Indeed, they have meaning at all only in· sofar as the individuals describing, interpreting and employing these BOOK REVIEWS 325 principles possess the peculiar habits and beliefs characteristic of the :members of a specific community. In the analysis of any given moral situation, then, the discussion of principles will necessarily presuppose.a discussion of character, of the sorts of persons involved in the situation, their moral beliefs and capabilities. It is important to note that this discussion will often take a narrative form, precisely because the delineation of character is most readily accomplished by telling stories about persons, about their communities, their politics and practices, their interests and aspirations. Thus, moral capabilities are formed in " the friendships and prac-.tices " that constitute communal life. In asserting this, the authors defend an important but not terribly controversial claim. What is especially intriguing and insightful about their account, however, is the reIated claim that moral capabilities are also hermeneutical capabilities, that some of the patterns and habits of action acquired by living in a·Community also function as habits of interpretation. "Well-formed·character," Fowl and Jones explain, is crucial not only to "Christians'.ability to live faithfully in the various contexts within which they find themselves," but also to their " ability to read, speak and perform the word of the Lord " (p. 85). Moral virtue is, on their account, a kind of interpretive skill. (If not identical, character and interpretive skill.are, at the very least, formed in the same process, inextricably linked ;together as aspects of "practical wisdom." See page 31.) This result is especially meaningful once it becomes clear that the authors are employing a usefully broadened concept of " interpreta· tion." To interpret a scriptural text can and often... (shrink)

Our understanding of the complexity of the oral biome and of the role of the various constituent bacteria in the aetiology of dental disease is growing. Probiotics and their relationship with prebiotics, as well as other microbiome‐based interventions, could be useful in preventing and treating dental disease and in promoting oral health. However, given the promise and early stage of this treatment approach, there are also a number of ethical, social and regulatory issues associated with innovative probiotic therapy. In (...) this article, a brief update is given on contemporary theories of the aetiology and management of the two commonest dental diseases, and on the roles of pre‐ and probiotics and oral biome transplant in the management of these diseases. The focus is primarily on four core issues: informed consent, risk–benefit assessment, how to determine suitable healthy donors, and commercialization and regulation. We discuss the safety and benefits of oral probiotics, not only concerning the products and quality control during their manufacture, but also regarding the depth of public knowledge about this topic. We point out that the requirement of listing ingredients honestly might be insufficient, and that the prevalent rhetoric of ‘natural’ and ‘organic’ as well as some health claims in the translational, innovative probiotic industry and markets are themselves misleading and should be carefully scrutinized. Finally, we suggest an ethical imperative to find a balance between scientific research and industry, and public health in the regulation of probiotics. (shrink)

This article considers two questions: Do democratic states have the right to deport non-citizens present or residing on their territory? And, if so, what principles should guide deportation in democratic states? The overall objective is to offer an account of what deportation should look like in a liberal democratic state. I begin by situating the practice of deportation in larger discussions of the extent of state discretion in controlling both borders and membership; here, I will argue that potential deportees occupy (...) an awkward middle space, i.e. it is not clear whether they should be treated according to the principles that regulate discretion at the border or discretion in admitting migrants to membership. I then consider more deeply whether deportation can be rendered non-arbitrary, or whether it is bound to remain unjustly applied; where it cannot be rendered non-arbitrary, it must be rejected, or so I shall argue. To be non-arbitrary, the practice of deportation must meet three criteria: a publicity criterion, a justification criterion, and a collective interest criterion. In the final section of the article, I disentangle deportation into its component parts – I distinguish just cause for deportation from just action in deportation – and consider how the criteria that stem from a commitment to non-arbitrariness constrain its application to non-citizen residents. The consequence of requiring deportation to be applied, if at all, in a non-arbitrary way is that there will certainly be cases where liberal democracies find themselves unable to deport those who might otherwise be thought eligible for deportation. Ultimately, I conclude that deportation from liberal democratic states can be fair only in a small number of cases. (shrink)

Military ethics seeks to provide practical guidance for the resolution of real ethical problems associated with the conduct of military operations. In doing so, it must reflect how actual persons give and take-up reasons when deliberating what actions to take. The Just War Tradition, for example, provides deontological and consequentialist considerations soldiers should take up when considering how to conduct operations. Sometimes, unfortunately, soldiers may find themselves in tragic situations where principles and consequences provide no clear guidance. To (...) fill that gap, a full account of military ethics requires an account of virtue, which focuses more on the agent than the act and can provide resources necessary to avoid, or failing that, resolve, otherwise unresolvable ethical dilemmas that can arise during military operations. This point does not mean virtue ethics supersedes or assimilates other ethical approaches. Rather it means that in the context of a process aimed at establishing reflective equilibrium, it provides important beliefs, judgments, and ways of thinking about applied ethics that are critical not just to building a robust, maximally coherent equilibrium but also to maintain it. These resources are especially critical when one is faced with the kind of tragic situations soldiers confront in war. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Josiah Royce on RaceIssues in ContextJacquelyn Ann K. KegleyAll philosophy, whether or not we want to admit it, is done in a context, filtered through lenses that are personal, intellectual, historical, cultural, social, and political. Thus to fairly treat and fully understand Royce's views on race, we must set a situational framework. First, Royce's 1906 article entitled "Race Questions and Prejudices" is the lead piece in a collection that (...) implements his philosophy of loyalty. It applies his principle of loyalty to what he considers one of the most significant social/political issues of his time—the race question. As we discuss Royce and race issues, the philosophy of loyalty must be in the background as a point of reference. Indeed, Royce tells us that he will address the various questions in his article "Race Questions and Prejudices" by calling attention to "a few principles which seem to me to be serviceable to any one who wants to look at race questions fairly and humanely" (6).Secondly, except for W. E. B. DuBois and Jane Addams, no other major figure associated with pragmatic philosophy substantially addressed issues of race and racism in their written work, nor did anyone so early in the twentieth century as did Royce. DuBois's The Souls of Black Folk, which came out in 1903, immediately preceded Royce's article. Jane Addams briefly touched on race issues in her 1915 Democracy and Social Ethics. Alain Locke, who sought to study with Royce at Harvard but could not because of Royce's premature death, gave his "Lectures on the Theory and Practice of Race" in 1915, but they were published posthumously. John Dewey's "Race Prejudice and Friction" appeared in 1922. There is an absence of treatment of race issues in George Herbert Mead, Charles Sanders Peirce, and Alfred North Whitehead. Thus Shannon Sullivan and I agree that Royce stands out in the history of classical American philosophy in taking an antiracist focus on race questions when very few philosophers—especially white male philosophers—took scholarly time to think about these issues.1 [End Page 1]Another important context for Royce's article is the political climate of the time. Royce identifies the era as one in which there were "more ways and places in which men find themselves in the presence of alien races with whom they have to live in the same social order" (4). It was a time of "white anxiety." In 1905, Theodore Roosevelt gave his famous "On American Motherhood" speech in which he warned of white "race suicide" if white families continued to reproduce at a slower rate than other races. Thus, Royce was speaking and writing against racism in a time of anti-immigration and proimperialism sentiment due to white anxiety in the United States about the possible decline of global white supremacy. It is in this setting that Royce highlights the color line as a significant problem.Royce states the problem as follows:This is the problem of dealing with the men who seem to us somehow very widely different from ourselves in physical constitution, in temperament, in all their deeper nature, so that we are temped to think of them as natural strangers to our souls, while nevertheless we find that they are stubbornly there in our world and that they are men as much determined to live as we are, and are men who, in turn, find us as incomprehensible as we find them.(5)With increased contact among different populations, the age-old problem of how to deal with people who seem different from one's own group intensifies. There will be, says Royce, numerous questions including those of superiority-inferiority, power and sovereignty, and a new assessment of the ways in which these "different" people might be helpful or perilous to one's own group interests. Royce notes that one cannot assume an automatic answer. He asks, "Is it a ‘yellow peril,' or a ‘black peril,' or perhaps after all, is it not rather some form of ‘white peril' which threatens the future of humanity in this day of great struggles and of complex issues?" (6). With the question posed in this... (shrink)

This is a study involving three HIV clinics in the Canadian provinces of Newfoundland and Labrador, and Manitoba. We sought to identify ethical issues involving health care providers and clinic clients in these settings, and to gain an understanding of how different ethical issues are managed by these groups. We used an institutional ethnographic method to investigate ethical issues in HIV clinics. Our researcher conducted in-depth semi-structured interviews, compiled participant observation notes, and studied health records in order (...) to document ethical issues in the clinics, and to understand how health care providers and clinic clients manage and resolve these issues. We found that health care providers and clinic clients have developed work processes for managing ethical issues of various types: conflicts between client-autonomy and public health priorities, difficulties associated with the criminalization of nondisclosure of HIV positive status, challenges with non-adherence to HIV treatment, the protection of confidentiality, barriers to treatment access, and negative social determinants of health and well-being. Some ethical issues resulted from structural disadvantages experienced by clinic clients. The most striking findings in our study were the negative social determinants of health and well-being experienced by some clinic clients – such as experiences of violence and trauma, poverty, racism, colonization, homelessness, and other factors affecting well-being such as problematic substance use. These negative determinants were at the root of other ethical issues, and are themselves of ethical concern. (shrink)

Ethics support staff help others to deal with moral challenges. However, they themselves can also experience moral challenges such as issues regarding (breaching) confidentiality when practicing ethics support. Currently there is no insight in these confidentiality issues and also no professional guidance for dealing with them. To gain insight into moral challenges related to Moral Case Deliberation (MCD), we studied a) beliefs and experiences of MCD facilitators regarding breaching confidentiality, b) considerations for (not) breaching confidentiality, and c) needs for (...) an ethics support tool. Data collection consisted of qualitative research methods: six semi-structured interviews; analyses of a) two recorded MCD sessions, and b) a focus group with MCD facilitators. Findings: MCD facilitators mention different conceptions and interpretations of confidentiality and various moral challenges. Questions concerning confidentiality ultimately cause reflections on roles and responsibilities of facilitators. Needs for ethics support vary from seeking advice to procedural and sometimes normative guidance for MCD facilitators. Education for MCD facilitators should focus on developing a concrete tool that stimulates awareness and reflection(skills). (shrink)

It is difficult to talk about ethics in Australia these days, because the different metamoral languages make it difficult for people to communicate on moral matters; there are no generally accepted criteria for assessing the meaning and truth of moral propositions; and witness talks larger in these matters than theoretical expertise, and the ideals that favour the acceptance of credible role models are no longer generally accepted. We should not assume that we can say anything meaningful about business ethics. One (...) reason for this arises from the Australian experience of the ''80s: the fruits of a profound cynicism are now with us, as prominent figures find themselves in court to defend their actions, and seem amazed that they are accused of doing anything wrong at all. We may want to stop something like this from happening again, but if the language of business ethics meant nothing to these people, how can we hope that it will mean much to us, or to future generations? A second reason arises from the nature of ethics itself. Business ethics, after all, does not exist in a vacuum; its language will not mean much to people who do not agree on what they mean whenever they talk about right and wrong. Some people, for example, measure the rightness or wrongness of actions in terms of their consequences; for others, on the other hand, some actions are wrong, no mater what the consequences. How are they to talk to each other? What is at issue here is what ethical propositions mean, and how one can measure their truth. And there is another reason. As Socrates pointed out long ago, ethics is not a theoretical science, which can be taught and learnt as dispassionately as mathematics. It is practical, and so engages teacher and pupil in an entirely different way: one cannot say one thing, and do another. When you have read a journal like this, will you necessarily be a better person or a more honest businessman/woman? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Medical Ethics in a Time of De-CommunizationRobert Baker (bio)Ethics is often treated as a matter of ethereal principles abstracted from the particulars of time and place. A natural correlate of this approach is the attempt to measure actual codes of ethics in terms of basic principles. Such an exercise can be illuminating, but it can also obscure the circumstances that make a particular codification of morality a meaningful response (...) to specific historic circumstances. This is particularly true of the codes of medical ethics beginning to emerge from the post-Communist societies of Eastern Europe, which are, perhaps, best understood as artifacts of an era, rather than as expressions of abstract principles.The era in question is post-Communist. It is an era informed by a reaction to decades of Communism, which, of course, was more than an economic system or even an ideology; it was a form of life that permeated every aspect of civil society—advertising, art, literature, music. Medicine was not exempt. I recall entering an oncology ward in East Berlin and finding the patients seated around a large table making posters. Wondering whether this was a form of art therapy, I asked the head nurse what the patients were doing. She replied: it is "Party time—the portion of each week every citizen donates to the people and the Party." I looked again at the posters and saw that they honored Karl Marx on the 100th anniversary of his death: "1883-1983, The Struggle Goes On." The Party, the struggle, the people, were everywhere, and they penetrated and informed daily life even for terminal patients on a cancer ward.The interweaving of Communist practices into the warp and woof of daily life has profound implications for the post-Communist era. It means that East Europeans cannot simply rebuild; they must unweave Communist thought patterns—what might be called the ideostructure of Communism—from the fabric of their lives through a deliberate process of deCommunization. What remains after de-Communization depends upon [End Page 363] the historical relationship each country had with Communism. In Russia, removing Communist ideostructure sets the conceptual calendar back to 1918. For the Czechs, the calendar advances to the 1930s, leaving them with thought patterns that are Western, industrial, and democratic. In the rest of Eastern Europe the conceptual clock also tends to turn back to the 1930s, but at that time the conceptual frameworks were nationalist, anti-Western, and frequently fascist, or even Nazi.In Poland the situation is different. World War II opened with the Nazi invasion of the country—which Hitler (later joined by Stalin) subsequently occupied. After the war, the Soviet army controlled the country, which became a captive player in the Soviet sphere of influence (aptly denominated, "the Warsaw Pact"). Poland's pre-Communist thought patterns are nationalist, West-leaning, accepting of parliamentary structures, but also of authoritarian government. They are also Catholic.Catholicism to Poles is not merely a religion, it is a posture of opposition to their German (Nazi, antichristian) and Russian (Orthodox or atheist) occupiers. I toured Polish hospitals several times during the Communist period —always accompanied by one or more "tour guides." (Westerners were not allowed to roam Communist countries unescorted.) Almost all of my guides wore little pins adorned with the face of Lenin (not the hammer and sickle—a symbol of Soviet occupation). Most doctors and nurses, however, adorned themselves with Catholic icons—typically a crucifix. Their conspicuously displayed crosses symbolized less their embrace of Catholicism than their rejection of Communism. Catholicism, in the Polish context, was thus an affirmation of individual and national independence.De-Communizing Polish Medical Ethics: The Abortion ControversyIn Poland, de-Communization was initiated through a series of negotiations between Lech Walensa's Solidarity and the Communist Government. The Polish Code of Medical Ethics is an indirect consequence of these negotiations, which stipulated the dissolution of Communist medical organizations. They were to be replaced by a Polish Medical Chamber—a type of quasi-governmental body, common in Eastern Europe, which combines the functions of a governmental licensing agency with those of a national medical association. Medical chambers also set standards of professional conduct and (unlike... (shrink)

Does hindsight knowledge make research seem more ethical and predictable? In line with the notion of hindsight bias, students in 3 experiments knowing the outcome of an animal experiment judged the results as more foreseeable and ethical relative to students who did not know the outcome. Via self to other comparisons, students evaluate themselves more favorably compared to a peer but exhibited hindsight bias in doing so. Uniquely, the findings reveal the possibility that students deem themselves (...) to be more skeptical and objective than their peers. Implications for teaching animal ethics and for Institutional Review Boards are discussed. (shrink)

This paper will examine the concepts of integrity and moral residue as they relate to nursing practice in the current health care environment. I will begin with my definition and conception of ethical practice, and, based on that, will go on to argue for the importance of recognizing that nurses often find themselves in the position of compromising their moral integrity in order to maintain their self‐survival in the hospital or health care environment. I will argue that moral (...) integrity is necessary to a moral life, and is relational in nature. When integrity is threatened, the result is moral distress, moral residue, and in some cases, abandonment of the profession. The solution will require more than teaching bioethics to nursing students and nurses. It will require changes in the health care environment, organizational culture and the education of nurses, with an emphasis on building a moral community as an environment in which to practise ethically. (shrink)