Autonomy and responsibility are interrelated concepts crucial to the moral analysis of professional persons, organizations and institutions, and for the purpose of this paper, I focus on the persons, organizations, and institution of journalism. My paper’s thesis hinges on the notion that the confluence of the concepts of autonomy and responsibility creates a natural conceptual foundation for understanding moral praise and blame. Though in moral philosophy this notion has long been accepted, it has not yet been carefully applied to the (...) practice of journalism. Applying these concepts to journalism, I will argue, is crucial for accurately determining moral praise and blame, as it adds a structure to evaluating ethical behavior in a way that has not yet been put forward. (shrink)

Has the renewal of interest in the ostensible agency of living beings signaled an advance from a merely heuristic Kantian sense of purposiveness to an unequivocally, empirically grounded research program or are there as yet hidden tensions or contradictions in, for example, the organizational autonomy approach to natural agency? Can normativity be found to be immanent in nature but only beginning with the living cell or must a thoroughgoing naturalism find the seeds of normativity immanent throughout abiotic as well as (...) biotic nature? Beginning with a brief exposition of Kant´s influential treatment and recommendation for how to methodologically combine what he took to be the inevitable epistemological limit to explaining the origins of ostensible biotic purposefulness with the legitimate intentions of scientific research and explanation, this essay will critically engage with three recent essays that attempt to grapple with the preceding questions. Having putatively raised questions about the consistency and adequacy of each of the individual positions, the essay will attempt to move synthetically, drawing upon aspects of all three contributions, in the direction of a “cooperativity theoretic” approach to incipient natural normativity and agency. (shrink)

On what basis should we judge whether a parent’s medical decision for their child is morally acceptable? In a recent article, Johan Bester attempts to answer this question by defending a version of the Best Interest Standard for parental decision making. The purpose of this paper is to identify a number of problems faced by Bester’s version of BIS and to suggest ways to redress these problems. Accordingly, we intend to advance the project of formulating a method for guiding parents’ (...) medical decision making for their children. We argue that Bester’s standard fails to accommodate the autonomy of the child and that his criteria for assessing the reasonableness of the parents’ argument for their decision is too weak. We conclude that properly addressing these worries renders his test otiose and that it ought to be replaced with the three commonly held principles of bioethics—the principles of autonomy, beneficence, non-maleficence—and a standard of reasonableness. (shrink)

Beauchamp and Childress have performed a great service by strengthening the principle of respect for the patient's autonomy against the paternalism that dominated medicine until at least the 1970s. Nevertheless, we think that the concept of autonomy should be elaborated further. We suggest such an elaboration built on recent developments within the neurosciences and the free will debate. The reason for this suggestion is at least twofold: First, Beauchamp and Childress neglect some important elements of autonomy. Second, neuroscience itself needs (...) a conceptual apparatus to deal with the neural basis of autonomy for diagnostic purposes. This desideratum is actually increasing because modern therapy options can considerably influence the neural basis of autonomy itself.Sabine MNeuroScienceAndNorms: Ethical and Legal Aspects of Norms in Neuroimaging at Bonn University Hospital, Germany. Her main research interests are in neuroethics. She is coauthor of three German books about neuroethics and bioethics.Henrik Walter, M.D., Ph.D., is Full Professor of Medical Psychology at the University of Bonn, Germany, and vice-director of the Department of Psychiatry and Psychotherapy at the University Clinic of Bonn. He is author of Neurophilosophy of Free Will and editor of the book From Neuroethics to Neurolaw?. His research fields are biological psychiatry, cognitive neuroscience, neuroimaging, neurophilosophy, and neuroethics. (shrink)

In the practice of medicine there has long been a conflict between patient management and respect for patient autonomy. In recent years this conflict has taken on a new form as patient management has increasingly been shifted from physicians to insurers, employers, and health care bureaucracies. The consequence has been a diminshment of both physician and patient autonomy and a parallel diminishment of medical record confidentiality. Although the new managers pay lip service to the rights of patients to confidentiality of (...) their records, in fact they advocate very liberal medical records access policies. They argue that a wide range of parties has a need to know the contents of individually identifiable medical records in order to control costs, promote quality of care, and undertake research in the public interest. Broad interpretations of the need to know, however, are at odds with strict interpretations of the right to confidentiality. Strict confidentiality policies require that, with few exceptions, patient consent be obtained whenever a patient's record is used outside the treatment context. The traditional criterion for overriding the consent requirement has been that without the override some harm would directly result. This rule is now challenged by the claim that patients have a duty to make their records available for a wide range of research and public health purposes. The longstanding tension between physician responsibility for patient welfare and respect for patient autonomy is being replaced by a debatable requirement that both physician and patient autonomy be subordinated to the goals of data collection and analysis. (shrink)

According to both contemporary intuitions and scholarly opinion, autonomy is something specifically modern. It is certainly taken to be incompatible with religions like Islam and Judaism, if these are invested with political power. Both religions are seen as centered on a divine Law (sharî'a, viz., torah) which prescribes what we may and may not do, promising reward for obedience and threatening punishment for disobedience. Not we, but God makes the rules. This picture is in important ways misleading. There is, I (...) argue, a substantive intellectual tradition, going back to Plato's Laws, which takes the purpose of a theocracy—a community governed by God through the intermediary of a divine Law—to be promoting rational autonomy, conceived as (1) the ability to rationally determine what is in one's best interest and (2) having the motivation to live accordingly.Among the most important representatives of this intellectual tradition are medieval Muslim and Jewish philosophers. (shrink)

“That the imagination should be both free and yet of itself conformable to law, that is, that it should carry autonomy with it, is a contradiction.” So Kant writes to express as a paradox the epistemological problem that the feeling on which an aesthetic judgment is based must be free of the constraint provided by determinate concepts, for otherwise there will be no reason why it should be pleasurable, yet must also be subject to some kind of rule, for otherwise (...) the claim of universal validity which this judgment asserts will be irrational. And so understood, the remark is entirely rhetorical, for it is the express purpose of Kant’s main argument in the Critique of Aesthetic Judgment to show that this conception of the judgment of taste is coherent rather than contradictory. But taken from its intended context, the remark need not be rhetorical, for it can be seen as an expression of competing demands for aesthetic integrity, or demands for individual freedom and social agreement in the creation and reception of art which, unlike the two epistemological constraints on aesthetic judgment, cannot be simultaneously satisfied but which instead introduce a permanent source of instability into the history of art and taste. Indeed, it is even fitting that Kant’s remark has to be taken out of context to be given this interpretation, for although Kant lays the theoretical basis for such a picture of art history he also tries to suppress its consequence and to avert the destruction of the eighteenth-century ideal of aesthetic stability which is its inevitable outcome. (shrink)

I argue that religious elementary schools whose pedagogical methods satisfy the principle of rational authority have distinctive advantages over secular elementary schools for the purpose of laying the foundations for ethical autonomy in the children of religious parents. Insights from developmental psychology bolster the argument from conceptual analysis. Before children have the cognitive capacities to engage in authentically autonomous reflection, their long-run interest in developing autonomy is best served by developing their understanding of and provisional identity within their primary culture (...) and by encouraging a limited form of ethical reasoning within the framework provided by that secure cultural identity. (shrink)

Psychologists and neuroscientists often struggle to integrate findings in their respective domains, a problem due partly to implicitly and explicitly held philosophical positions on issues of reduction and autonomy across these domains. The present article reviews how reduction and autonomy have been used in philosophical arguments regarding how macro-scale findings relate to micro-scale findings across various scientific disciplines. The present article demonstrates how macro findings are indispensable to explanations of phenomena of interest by (a) providing information regarding higher levels of (...) organization in mechanisms, (b) including information not contained within certain micro explanations that (c) provides more general and stable causal explanations relative to micro explanations in certain situations. The purpose of presenting these analyses and recommendations is to disabuse psychologists and neuroscientists of pervasive assumptions that psychology is reducible to biology and that lower level phenomena (molecular) should be prioritized as somehow more explanatory than higher level phenomena (behavioral). The article concludes with 3 hypothetical scenarios from clinical psychology and psychiatry illustrating this critique and providing a pragmatic approach to clarify the relative roles, and importance, of biological and psychological data in service of general and stable explanations that are tailored to the kind of intervention desired. (shrink)

Behavioural techniques or ‘nudges’ can be used for various purposes. In this paper, we shift the focus from government nudges to nudges used by for-profit market agents. We argue that potential worries about nudges circumventing the deliberative capacities or diminishing the control of targeted agents are greater when it comes to market nudges, given that these (1) are not constrained by the principles that regulate government nudges (mildness, sensitivity to people’s interests and public justifiability) and (2) are often ‘stacked’ (...) – they come in great numbers that overwhelm agents. In addition, we respond to possible objections and derive several policy suggestions. (shrink)

In modern law medical paternalism no longer rules. Respect for patient autonomy is now a fundamental principle of both medical law and bioethics. As a result of these developments, and cases such as Rees v Darlington Memorial NHS Trust and Chester v Afshar, there have been suggestions that the law of clinical negligence should be developed so as to recognise diminished autonomy as a form of actionable damage in this area of tort law. Yet in order for the tort of (...) negligence to recognise this new interest, it is first necessary to determine how autonomy should be understood in this context. The purpose of this article is to shed light on this issue and arrive at a suitable definition of the concept. After outlining the different theories of autonomy it is argued that the traditional liberal (current desire) definition is the most philosophically and legally coherent. (shrink)

The purpose of this paper is to analyse the concept of 'best interest' in order to give nurses, who use it to justify their actions, a clear picture of what this means, and to identify the skills needed for doing so. The process for concept analysis developed by Walker and Avant was used in the analysis of data generated from the literature. Themes were identified from which the defining attributes, antecedents and consequences emerged. The congruence of the findings with current (...) values in nursing, such as promotion of patient autonomy, and the nurse as advocate, are discussed, together with the underpinning ethics theory. The skills needed for nursing practice are identified and recommendations for nurse education are made. (shrink)

Many philosophers, past and present, have attempted to eradicate the notion of sovereignty. The most interesting and most ambitious attempt to do so, comes from those philosophers who claim that sovereignty is in principle incompatible with the rule of law. The purpose of this paper is to repel this latter attack. In order to do so, I investigate the analogy between sovereignty and individual autonomy. The resulting conception of sovereignty, ‘sovereignty as autonomy’, shows that sovereignty and the rule of law (...) are utterly compatible. At the same time, this conception conserves what I believe to be the normative core of our modern notion of sovereignty: when speaking of sovereignty, we invoke the perspective from which a political community can consciously understand itself as an autonomous agent. (shrink)

It has recently been asserted that legislative moves to consider plants as ethical subjects are philosophically foolish because plants lack autonomy. While by no means the sole basis or driving criterion for moral behavior, it is possible to directly challenge skeptical attitudes by constructing a human-plant ethics centered on fundamental notions of autonomy. Autonomous beings are agents who rule themselves, principally for their own purposes. A considerable body of evidence in the plant sciences is increasingly recognizing the capacity of plants (...) to assess, perceive, and act on their environment. The primary purpose of their doing so is to generate the conditions for their own flourishing. With these plant purposes in mind, it is evidentially inappropriate to treat plants purely as instruments. In this age of environmental crisis, knowledge of plant intelligence and autonomy opens up a new debate on respecting and promoting the well-being of the plants that make life on Earth possible. (shrink)

Galston's study of liberalism sets out to establish the autonomy of liberal political thinking from older, more traditional concepts of the good. The author attempts to anchor his discussion in the liberal political theories of Locke and Kant and in a critical assessment of democratic socialists Ronald Dworkin, Judith Shklar, John Rawls, Bruce Ackerman, and Michael Walzer. Though the book is cluttered with name references, the strongest presences may be those that are unannounced. Galston's object brings to mind the postmodernist (...) quest for a nonfoundationalist philosophy. Like nonfoundationalist ethical thinkers, Galston is looking for an immanentist interpretation of the good, which rests on self-enclosed and self-referring premises about the relative value of human actions. Individual self-realization, mutual respect of persons, and government by consent, are all concepts upon which his analysis turns. Another undisclosed point of reference for this book is Hans Blumenberg's Über die Legitimität der Neuzeit, a seminal exposition of the moral and intellectual autonomy of the modern age. Like Blumenberg, Galston is intent on showing that modernity, here identified with liberal society, can stand on its own philosophical feet. Those feet are individualistic but also fortified by utilitarian and neo-Kantian components, without the acknowledged admixture of preliberal legacies. Galston takes the need for a purely liberal ethic for a liberal society so seriously that he contends with radical democrat Jurgen Habermas for not taking it seriously enough. Unlike Galston, Habermas insists that democratic pluralism requires core values that do not derive entirely from liberalism. Significantly, neither thinker bothers to make much of a distinction between welfare state democrats and classical liberals. Economic collectivism is not seen as incompatible with the principle of individuality, providing the collectivist arrangements can be linked to individual interest. (shrink)

In this new study of Rousseau, Levine presents a Kantian reading of the Social Contract. By attempting to reveal Rousseau’s anticipation of such Kantian themes as moral right and obligation the author’s purpose has been "to produce a Kantian reading of The Social Contract, a reading that emphasizes the many respects in which Rousseau anticipates Kant and motivates his investigations in moral philosophy". This purported similarity has been noted previously by thinkers such as Hegel and Cassirer. The book also develops (...) the theme that the solution to the conflict between moral autonomy and political authority is the main issue in The Social Contract. Because Rousseau apparently "grasped his conflict better than either Hobbes or Locke" he was able to anticipate Marx’s critique of the contractarian tradition. Consequently, Rousseau’s political philosophy underlies the "deep structure" of contemporary mentality, and continues to dominate our own sense of self, society, and being-in-the-world. While the main issues in Kant’s moral philosophy—autonomy/heteronomy, person/thing, rule of reason/heteronomous irrationalism—are present in ovo in Rousseau, the author warns us of crucial differences between the two thinkers, for example, in Kant the notion of our being forced to our own freedom is absent. But both thinkers share the belief that any conception of the state’s function as merely external coercion or coordination is sub-rational. Also, Kant’s conception of moral autonomy located in the de jure kingdom of political ends is anticipated in Rousseau’s attempt to direct society to the norm of the general will as its legitimate political end. In sum, Levine’s book, while drawing from the previous work of Althusser, avoids the usual Marxist concept manipulation, and gives us an interesting addition to Rousseau scholarship.—H.N.T. (shrink)

The theory of biological autonomy provides a naturalized characterization of agency, understood as a general biological phenomenon that extends beyond the domain of intentionality and causation by mental states. Agency refers to the capacity of autonomous living beings (roughly speaking: organisms) to purposively and functionally control the interactions with the environment, and to adaptively modulate their own self-determining organization and behavior so as to maintain their own existence, construed as their intrinsic telos. We mention some crucial strengths of the autonomist (...) conception of agency, and some interesting challenges that it faces. Among the latter, we focus on the intertwined relationships between agency and evolution, as well as on the transition between agency and cognition. (shrink)

Houston, Texas, is a major U.S. city with, like many, a growing aging population. The purpose of this study and ultimate book chapter is to explore the views and perceptions of long-term care (LTC) residents, family members and health care providers. Individuals primarily in independent living and group residential settings were interviewed and studied. Questions emphasized the concepts of personal autonomy, dignity, quality and location of care and decision making. Although a small sample of participants were involved, consistency was noted. (...) Keeping the elderly in caring and loving home situations (theirs or family) was most preferred. Personal choice and independence were emphasized by residents, but family members needed to act as advocates. We also noted that the legal system emphasizes family control over individual decision making as competency declines with aging. Optimal personal decision making in the residents' best interest also became more difficult with loss of individual mental capacity. (shrink)

Using Michel Foucault’s conception of pervasive power, the purpose of this chapter is to analyse the contemporary paradigm of online surveillance from a philosophical perspective by unpacking the power dynamics involved in online surveillance, ultimately arguing, with McKenzie Wark, that there is an asymmetry of power that puts individual persons at risk. I then turn to Martin Heidegger’s notion of Gelassenheit as a helpful way to think through what an intentional stance towards online surveillance might look like that does not (...) escape the paradigm but is at least conscious of its influence. Finally, I utilise Immanuel Kant’s ethics and political philosophy to provide recommendations as to the appropriate ethical relationships that should exist between individual persons, governments, and corporations, ultimately arguing that respect for personal autonomy – that is, the right to choose our lives in accordance with our interests – must be at the forefront of conversations regarding the ethics of online surveillance. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Joanne Wood LORDJIM AND THE CONSEQUENCES OF KANTIAN AUTONOMY Autonomy IS the fundamental principle of Kantian ethics. This is so because his moral system is based on the crucial idea that nothing in the world can be called "good without qualification except a good will."1 Thus a good will is good in and of itself, without regard to any possible end. For such a will, morality is categorical, for (...) only with such an imperative can moral laws be said to be laws ofcomplete freedom, and willed without regard to any other interest. Thus autonomy is a necessary condition for a good will, because any heteronomous worth a will could achieve would by definition be conditional, and would therefore violate Kant's notion of the unconditional worth of a good will. However, it is precisely this notion of the absolute worth a good will merits on its own that would seem to bear looking into: there is something intuitively wrong with Kant's assertion that even if"it should happen that, by a particularly unfortunate fate or by the niggardly provision of a stepmotherly nature, this will should be wholly lacking in power to accomplish its purpose," it would still "sparkle like a jewel in its own right, as something that had its full worth in itselP (p. 10). The idea implied in this passage, that a good will could exist somehow apart from the world and any effects achieved therein, is problematic to say the least. How could such a will be known? The metaphor ofa "sparklingjewel" is striking, but flawed: ajewel exists in the world, for all eyes to see if they know where to look, whereas a good will exists in the hearts of men. It is for this reason thatJoseph Conrad's LordJim is a fitting supplement to understanding the implications of a Kantian view of morality, for the central concern of the novel is the moral ambiguity that results from our common obscurity ofvision into ourselves and those around us. Given this 57 58Philosophy and Literature ambiguity, which Kant recognizes when he says, "even the strictest examination can never lead us entirely behind the secret incentives, for, when moral worth is in question, it is not a matter of actions which one sees but ofdieir inner principles which one does not see" (p. 23). It seems then irresponsible still to maintain that the worth ofa good will is independent of the way of the world. Since it is evident that if results or other empirical factors are invalid tojudge intentions, then the only judge capable of assessing in advance what maxim is being acted upon is the moral agent; morality becomes a matter of strictly individual conscience or reason. The moral agent thus becomes romanticized, a lone figure needing no other guidance than that which his or her own reason can provide in order to lead a truly good life. LordJim challenges just such a conception of individualist or self-sufficient morality. Due to the essential ambiguity ofwhatjim himselfis, the novel is an extremely difficult one to read. This is further complicated by the fact that, after the first four chapters, the reader is never given an impersonal view ofJim, but instead Marlow's painstaking efforts to fit together the puzzle ofJim's character: "I don't pretend I understood him. The views he let me have of himself were like those glimpses through the shifting rents in a thick fog— bits of vivid and vanishing detail, giving no connected idea of the general aspect of a country... they were no good for purposes of orientation."2 Given this cloud of uncertainty, Jim remains an enigma from beginning to end. The reader is treated to various judgments ofhim during this time from a wide range of viewpoints which Marlow perhaps pursues in an effort to shed some light on the subject, but which nonetheless leave us in darkness because they all omit one factor or another. There is no Authority in this book. The facts ofJim's case are relatively straightforward: it is the interpretation of what lies behind them, ofJim's "inner principles," which is extraordinarily complex. Jim is working as first mate on... (shrink)

For the purpose of advancing the feminist commitment to inclusion and nonliberal articulations of pluralism, in this essay I conceptualize the Native account of individual autonomy that itself evolves from a commitment to pluralism. I demonstrate that Native individual autonomy is concurrently strong and feminist in nature—what I call “radical-cum-relational.” That is, Native autonomy is more radical than the traditional liberal conception and is simultaneously grounded in relationality, which is the basis of much of feminist ethics. I demonstrate that the (...) Native conception of autonomy is radical and promotes the highest degree of individual self-determination and independence qua individuality and particularity. Yet this radical self-determination depends on intense social interdependency. The grounding metaphysics and epistemology of the Native framework are conceived entirely in terms of ethical relationships between and responsibilities to other individuals, animals, and the Earth. That is, no part of the Native paradigm can be understood outside of the ethical connections persons have by virtue of their primary position as community members. It is by situating radical autonomy against a background of ethical social interdependence, together with thebackground condition of gender equality of Native practices, that the radical construal of Native individual freedom is feminist. To shore up and illustrate the connection between Native autonomy and feminism, I argue that an identification between the Native social practice of gifting and feminist reciprocity can be made, specifically Iris Marion Young’s notion of asymmetrical reciprocity. Finally, I argue that this connection avoids the problem of incommensurability and so is theoretically possible, responsible, and fits the criterion of respectfulness also at the foundation of the Native framework. Broadly speaking, the problem of incommensurability is concerned with theorists’ inability to recognize foundational incompatibilities between paradigms and their forced attempts to mergethem, often at the price of ignoring inconsistencies, inaccuracies, and contradictions that result from impossible translations and conversions. Historically and to the present day, Western philosophy has been egregiously guilty of distorting Native theories and practices. In this essay I argue that since translation takes place at the level of praxis rather than at the level of language, my argument circumvents problems that arise from failed attempts to map cultural concepts onto others that do not share similar foundations. (shrink)

There is a lot of material in this book, and Duff handles most of it very well. It is unfortunate that he felt the need to tie his discussion of serious philosophical questions in the criminal law to larger overarching questions of philosophy. It is possible that current conceptions of intentional action implicate dualism (or Dualism), I suppose, but that would be a book-length discussion all of its own. It would begin with a careful discussion of just what dualism is, (...) and would track down the various ways in which particular substantive positions on intentional action rule out alternatives to dualism. Such a work might be interesting indeed. It would be interesting, for example, to see a discussion of a type of conceptual dualism that I suspect Duff would find congenial: a dualism that insisted upon the autonomy of purposive notions and rejected the causal analysis of intentional action. Would that sort of dualism make any difference at all for the criminal law? It might, and it might not. But in any event that is not what we find in this book, which, for all of its healthy enthusiasm for the place of philosophy in the law shows an excessive tolerance for makeweight arguments about the great questions. (shrink)

A growing literature addresses the ethical implications of electronic surveillance at work, frequently assigning ethical priority to values such as the right to privacy. This paper suggests that, in practice, the issues are sociologically more complex than some accounts suggest. This is because many workplace electronic technologies not designed or deployed for surveillance purposes nevertheless embody surveillance capacity. This capacity may not be immediately obvious to participants or lend itself to simple deployment. Moreover, because of their primary functions, such systems (...) embody a range of other features which are potentially beneficial for those utilising them. As a result, more complex ethical dilemmas emerge as different desired goods compete for priority in the decision-making of individuals and groups. From a sociological point of view this raises interesting questions about the way ethical dilemmas arise in the context of the ongoing social relationships of work. The paper explores these issues using data from a study of the development and implementation of a computerised instructional package in a maternity setting. This medical setting illustrates clearly how seeking to assign ethical priority to a particular concern, such as the right to privacy, cannot but oversimplify the real day to day dilemmas encountered by participants. At the same time,the example of the instructional package demonstrates that it is difficult to predict in advance what ethical issues will be raised by technologies that almost always turn out to have a range of capabilities beyond those envisaged in their original design specification. (shrink)

The purpose of this dissertation is to identify some of the most pressing problems in the dominant contemporary approach to research ethics, and to devise an alternative approach that avoids these problems. I contend that the fundamental ethical values invoked in human research are often appealed to in contradictory or ambiguous ways, or in ways that do not adequately capture or do not show an adequate understanding of the specific ethical concerns of human research. One significant problem in this domain (...) is that values for ethical research are often unreflectively imported from medical therapy, producing ill-suited guidelines that cannot capture the different ethical situations that arise in the context of research. Furthermore, ethical guidelines in this area are often not developed with a sufficient understanding of the deep philosophical issues that they invoke. I suggest that we can address these problems through examining the fundamental ethical concerns of research on a philosophical level. This method will reveal severe problems with the approach to two of the ethical values underlying research; beneficence and respect for autonomy (or respect for persons). Once the nature of these problems has been revealed, and with reference to ethical problems that typically arise in the domain of research, I construct a coherent philosophical foundation for research ethics, which both avoids these deep-seated problems and better captures the ethical issues that arise in the domain of human research. I argue that we need to radically depart from the values of beneficence and autonomy/respect for persons as they are currently understood in the guidelines. We need an idea of beneficence that is clearly distinct from that which is used in the therapeutic medical context from which this notion is currently drawn. I also contend that we need to move away from autonomy as a central value in research ethics. I posit an alternative choice-based approach to informed consent which is concerned both with respecting agents’ freedom of choice, and also with their wellbeing, as providing a good means of protecting and promoting the interests of the individual research subject. Although these two imperatives are often thought to clash on a fundamental level, I will show that, in research ethics, they can be reconciled with minimal conflict. Though this represents a departure from the ethics of medical therapy, this approach is far more suited to the context of research. This theoretical basis for informed consent can help to clarify the ethical problems that are specific to this domain and provide us with relevant ethical guidance in research ethics. (shrink)

The initial purpose of this study is to provide an empirical validation of Victor and Cullen’s ethical-climate model (1987, Frederick (ed.), Research in Corporate Social Performance and Policy, Vol. 9, pp. 51–71; 1988, Administrative Science Quarterly 33, 101–125; 1990, Frederick and Preston (eds.), Business Ethics: Research Issues and Empirical Studies (JAI Press Inc., Greenwich, Connecticut), pp. 77–97). Testing the model on a sample of Danish firms, this study demonstrates that the empirical model as suggested by Victor and Cullen is much (...) stronger than suggested by previous research. Based on a confirmatory factor model, the results of this study suggest a revised ethical structure. Especially a sixth dimension – own interest – is separated from the original instrumental dimension. Further, this study suggests that the ethical-climate model can be enhanced with the dimension of autonomy deriving from Koys and DeCotiis’ (1991, Human Relations 44(3), 265–285.) dimensional psychological climate instrument. (shrink)

Purpose. The paper considers the fear of social alienation of love. It is within the limits of psychoanalytic epistemology, the analysis of which will be presented in the article, the tendencies to monotony and universal solutions with an emphasis on ensuring the objectivity of the problem of gender alienation, to be more exact, the fear of love, which causes the gender process, are viewed most reliably. In view of the above the purpose of the paper is to investigate the conceptual (...) contradictions associated with the reconstruction of basic measurements of the fear of alienation of love within different ideological approaches; to reveal the most significant contradictions that manifest themselves in the differences between secular and religious frames; to determine a philosophical and fundamental foundation for the types of fear: metaphysical, transcendental and social, which to some extent have influenced the development of a gender tradition. The paper investigates the fear of alienation of love, not as an instinct or psychological experience, or as a social factor, but as a correlation between the functional types of fear and the peculiarities of social and cultural processes, and it acts as a dependence of the European societies on the various functional forms of fear of love that influence the processes of social transformations. Theoretical basis. The authors determine that in the gender approach the subject, who is cognized, has specific desires and interests. The process of cognation is local, contextual, in which physiologically and spiritually the fear of alienation of love is closely linked to the conditions of existence of people, with the arrangement of social and individual life. In modern civilization, true love with some exceptions, is fleeting. It is now hindered by the burdens of life, and ideological settings, which go only from the "I", and not from the common "I and You", contributing to frustration and alienation. Originality. The emphasis is placed on the fact that the fear of alienation of love, as a way of identifying the essential characteristics of "I", acts as an existential, which concentrates on the sense-life range of problems. The range of problem in a single topic is in the "point I", surrounded by gender boundaries, it contains as a condition for its manifestation the personality distancing – free or forced consolidation and assertion of the autonomy of the individual. Alienation of love as an existential admits in the register of the intimate, intentional for self-perception, internal state to organize and identify with the "authentic I". Conclusions. The article establishes that gender identity under the conditions of modern socio-psychological crisis is associated with forming a special "picture of fear, anxiety, loneliness" as a part of that internal and external world, generated by alienation from society. The fear of alienated love acts as the essential existential of human being, which is a necessary existential condition of the existential tension that occurs as an antipode and a characteristic of courage, asceticism, and the "beginning of wisdom". The considered phenomenon of the fear of alienation of love is interpreted as the result of the ontological and gender alienation of a person who has lost a sense of security and plunged into a continuous interindividual rivalry. (shrink)

The purpose of this study was to understand the perceptions of highly skilled and less skilled volleyball players about the influences that parents, coaches, and peers had on their sport development and performance achievement. Highly skilled (n= 30) and less skilled (n= 30) volleyball players participated in semi-structured retrospective interviews to explain how parents, coaches and peers may have influenced their sport participation. Data was analyzed through a process of content analysis. Results indicated that parents, coaches, and peers had an (...) important influence in player's sport development but differing according to players' expertise level. Concerning to parental influences, tangible support during the early years of development was mentioned by all players. However, parents' level of involvement and parenting styles revealed interesting differences between highly skilled and less skilled players. Highly skilled players perceived a moderate parental involvement and an autonomy-supportive parenting style, while less skilled players referred a excessive parental involvement in players' sport participation. Coaches influences showed to have some similarities in the early years with all players mentioning coaches as caring and recognizing their value as an athlete. However, highly skilled players described a different training environment characterized by a demanding coach, individualized instruction, and specific goal setting. Regarding peers' influence, all players recognized that friends were not only one of the main reasons to start playing volleyball, but also an important source of support to remain engaged and staying motivated to do sport. Highly skilled players, however, mentioned the importance of teammates' positive push and critiques during practice for enhancing their motivation, team cohesion and friendship. They also highlighted the importance of friends outside of sport in the later years of their career by acting as an escape from all the pressure that emerged from volleyball training and competition demands. Overall, these findings highlight different social influences according to the players' expertise level suggesting the need to examine more extensively the nature of significant others' support on athlete and talent development. (shrink)

In this paper I attempt to show that the doctrine of informed consent, as practiced in the relationships between physicians and patients, often does not fulfill its main purpose, i.e., it does not safeguard the interests, rights, and dignity of patients. This happens because of clinicians' skepticism about the existence of the right to informed consent, patients' disinclination to make decisions, the current nature of health care, and the absence of clear guidelines about implementing informed consent. In the context (...) of this paper informed consent refers to the principle of respect for autonomy. (shrink)

What I call ‘the standard view’ claims that IRBs should not regard financial payment as a benefit to subjects for the purpose of risk/benefit assessment. Although the standard view is universally accepted, there is little defense of that view in the canonical documents of research ethics or the scholarly literature. This paper claims that insofar as IRBs should be concerned with the interests and autonomy of research subjects, they should reject the standard view and adopt ‘the incorporation view.’ The (...) incorporation view is more consistent with the underlying soft-paternalist justification for risk-benefit assessment and demonstrates respect for the autonomy of prospective subjects. Adoption of the standard view precludes protocols that advance the interests of subjects, investigators, and society. After considering several objections to the argument, I consider several arguments for the standard view that do not appeal to the interests and autonomy of research subjects. (shrink)

The “best interests of the patient” standard—a complex balance between the principles of beneficence and autonomy—is the driving force of ethical clinical care. Clinicians’ fear of litigation is a challenge to that ethical paradigm. But is it ever ethically appropriate for clinicians to undertake a procedure with the primary goal of protecting themselves from potential legal action? Complicating that question is the fact that tort liability is adjudicated based on what most clinicians are doing, not the scientific basis of (...) whether they should be doing it in the first place. In a court of law, clinicians are generally judged based on the “reasonably prudent” standard: what a reasonably prudent practitioner in a similar situation would do. But this legal standard can have the effect of shifting the medical standard of care—enabling astandard‐of‐care sprawlwhere actions undertaken for the primary purpose of avoiding liability reset the standard of care against which clinicians will be adjudicated. While this problem has been recognized in the legal literature, neither current ethical models of care nor legal theory offer workable solutions.One of the best examples of the conflict between evidence‐based medicine and common clinical practice is the use of electronic fetal monitoring. Despite strong evidence and professional guidelines that argue against the use of EFM for healthy pregnancies, the practice persists. One of the main reasons for this is often assumed to be physicians’ concerns about liability. (shrink)

Within the Western tradition we can find important and interesting philosophical differences between the continental European and the Anglo-American ethical and political outlooks towards biotechnology. The Anglo-American attitude appears based on naturalistic and empiricist views, while continental European viewpoints are built on idealistic liberal humanism. A Northern European view integrates both of the above-mentioned liberal traditions. The main problem is that although these different outlooks can be said to be liberal in their common promotion of equality, autonomy, and individual rights, (...) they still tend to conflict. I purpose to explicate the main differences of these liberalisms and to analyze how they affect the ethical views towards biotechnology in the Western world. Secondly, I will search for the shared values involved in these approaches in order to find common ground for open discussion on the ethical problems involved in biotechnological development. (shrink)

This article provides a donor-focused analysis of how transnational reproductive donation intersects with issues central to bodily autonomy of surrogates and egg donors from the global South. Little is known about the autonomy of surrogates and egg donors, especially among those from the global South. This article addresses this gap by examining two key issues on surrogacy and egg donation—conflict of interest and recruitment market. With these issues, this paper presents contexts of the reproductive body as a space of contestation (...) for autonomy. Analysis reveals that bodily autonomy is not an absolute entitlement available for surrogates and egg donors from the global South. Having bodily autonomy is a privileged disposition rather than a universal liberty for reproductive donors. The discussions in this work encourage further examination to understand the multi-layered experiences of reproductive donors from the global South, towards deeper interrogation of the processes of reproductive industry. (shrink)

OBJECTIVES: The subject of patient self-determination in health care has gained broad interest because of the increasing number of incompetent patients. In an attempt to solve the problems related to doctors' decision making in such circumstances, advance directives have been developed. The purpose of this study was to examine relationships between public attitudes towards patient autonomy and advance directives. SUBJECTS AND MAIN OUTCOME MEASURES: A stratified random sample of 600 adults in northern Sweden was surveyed by a questionnaire with a (...) response rate of 78.2%. The subjects were asked about their wish for control of their health care, their concerns about health care, their treatment preferences in a life-threatening situation (both reversible and irreversible), and their attitudes towards the application of advance directives. RESULTS: Numerous relationships between various aspects of self-determination in health care (desire for control, fears of over-treatment, and choice of treatment level) in general and advance directives, in particular, were found. Those who wanted to have a say in their health care (about 94%) also mainly supported the use of an advance directive. CONCLUSIONS: The fact that almost 30% of the respondents were undecided concerning their personal use of advance directives points to a lack of knowledge and to the necessity of education of the public on these issues. (shrink)

After a wave of breakthroughs in image‐based medical diagnostics and risk prediction models, machine learning (ML) has turned into a normal science. However, prominent researchers are claiming that another paradigm shift in medical ML is imminent—due to most recent staggering successes of large language models—from single‐purpose applications toward generalist models, driven by natural language. This article investigates the implications of this paradigm shift for the ethical debate. Focusing on issues like trust, transparency, threats of patient autonomy, responsibility issues in the (...) collaboration of clinicians and ML models, fairness, and privacy, it will be argued that the main problems will be continuous with the current debate. However, due to functioning of large language models, the complexity of all these problems increases. In addition, the article discusses some profound challenges for the clinical evaluation of large language models and threats to the reproducibility and replicability of studies about large language models in medicine due to corporate interests. (shrink)

Having indicated my own enthusiasm for the project, I must hasten to add that it is precisely the explicit philosophical concern of existential psychoanalysis which constitutes its greatest vulnerability. No matter how strong one's interest in metaphysics may be and, hence, his initial sympathy with the metaphysical component in existential psychoanalysis, if one is critical and honest he cannot long avoid the question: what will be the results for psychoanalysis as a science? Two considerations are bound to give the philosopher (...) pause: Modern experimental science deliberately and willfully cut itself free from metaphysical speculation; up to the point where it failed to take this step, its progress was minimal. There are, I think, obvious dangers involved in empirical science either becoming too explicitly metaphysical or attempting to adapt itself to an antecedently available metaphysical system. I do not mean to suggest that metaphysics has not or cannot contribute to natural science, but only to underscore the fact that natural science has attained at least a relative autonomy. The physicist develops his own metaphysics to serve his own purposes and there is good reason to believe that he is well advised in doing so. (shrink)

Compared with data that is initially collected for research purposes, the mandatory authorization of a government database for secondary use deserves greater scrutiny because it consists of information that is collected initially for administrative purposes. Using the case of Taiwan’s National Health Insurance (NHI) Database as an example, this paper analyzes the ethical issues that emerge when the research participants are “participated” in studies without their consent, according to the current policy. The proponents of secondary use for research purposes maintain (...) that the authorized use of the NHI Database is necessary for public interests, while the opponents argue that the potential lack of democratic accountability and the infringement on people’s rights to privacy and information autonomy is unwarranted. Drawing on the solidarity‐based approach, this paper proposes a temporal solution as a possible reform direction for better ethical justification of the secondary use of the NHI Database. (shrink)

Rawls offers three arguments for the priority of liberty in Theory, two of which share a common error: the belief that once we have shown the instrumental value of the basic liberties for some essential purpose (e.g., securing self-respect), we have automatically shown the reason for their lexical priority. The third argument, however, does not share this error and can be reconstructed along Kantian lines: beginning with the Kantian conception of autonomy endorsed by Rawls in section 40 of Theory, we (...) can explain our highest-order interest in rationality, justify the lexical priority of all basic liberties, and reinterpret Rawls’ threshold condition for the application of the priority of liberty. Perhaps unsurprisingly, this Kantian reconstruction will not work within the radically different framework of Political Liberalism. (shrink)

The purpose of this paper is as follows. First, we can see the ethical problems of biotechnology and characteristic of BT-ICT convergence products in the era of BT-ICT convergence centered on the paradigm shift from IT industry to ICT industry and 4th industrial revolution. Second, as the issue of biotechnology ethics in the era of BT-ICT convergence, we can see the main areas of interest and issues of bioethics, the ethical development process of clinical ethics related to bioethics, and new (...) ethical issues in the era of BT-ICT convergence. Third, the principles and ethics of bioethics - the principles of bioethics of Hood’s P4 Medicine, Robert Merton's CUDOS, M. F. Atiyah’s Responsibility, David B. Resnik - reveal the ethics and social responsibilities that biotechnologists need as professionals. Fourth, as biotechnologists, autonomy and social responsibility of professionalism, and moral literacy and ethical personality to be possessed by biotechnologists. (shrink)

Rawls offers three arguments for the priority of liberty in Theory, two of which share a common error: the belief that once we have shown the instrumental value of the basic liberties for some essential purpose (e.g., securing self-respect), we have automatically shown the reason for their lexical priority. The third argument, however, does not share this error and can be reconstructed along Kantian lines: beginning with the Kantian conception of autonomy endorsed by Rawls in section 40 of Theory, we (...) can explain our highest-order interest in rationality, justify the lexical priority of all basic liberties, and reinterpret Rawls’ threshold condition for the application of the priority of liberty. Perhaps unsurprisingly, this Kantian reconstruction will not work within the radically different framework of Political Liberalism. (shrink)

My purpose is to examine two of the foundations of medical ethics: the principle of autonomy and the concept of the human. I also investigate the extent to which health technology makes autonomy and humanness possible. I begin by underlining Illich's point that the same health technology designed to promote health and autonomy also is pathogenic. I proceed to analyse the Kantian concept of autonomy, a concept which is closely associated with health and which continues to determine current ethical thinking. (...) In so doing, I uncover an unexpected ontological function of health technology, a function described in Heidegger's work on technology. Based on this discovery, I suggest that calls for Kantian autonomy may often be self-defeating or even sometimes harmful. I conclude by calling for continued ethical vigilance, but also for a questioning of the hitherto virtually unquestionable concepts of ethics and humanness which may themselves play a role in our era's greatest problems. (shrink)

This article explores traditional views of advance care planning in the broader context of advance personal planning, which also accounts for legal and financial matters. Criticisms of existing processes are noted, while the significance of interprofessional collaboration is highlighted. Reframing the purpose of advance personal planning as planning for the rest of life, rather than the end-of-life, and adopting a more holistic perspective informed by theory may help individuals to view advance personal planning as a routine, preventative exercise that safeguards (...) their autonomy and well-being. Both lawyers and healthcare providers have an important role to play in reframing the purpose of advance personal planning. This revised approach is underpinned by the unification of two separate theoretical lenses: Preventive Law Theory and Therapeutic Jurisprudence. This combination enhances our understanding of what it means for people to truly achieve “the good result” (Holtz 2017) when planning ahead for their future legal, financial, health, and personal interests. Preventive Law Theory encourages an ongoing, collaborative relationship between lawyers and their clients, or healthcare providers and their patients, while Therapeutic Jurisprudence ensures an ethical approach to advance personal planning that accounts for all aspects of the individual’s well-being, including consideration of vulnerability, autonomy, and empowerment. (shrink)

This issue of the Journal of Medical Ethics features a special symposium on ‘elective ventilation’ . EV ) was originally described in the 1990s by doctors working in Exeter in the UK.1 At that time there was concern about the large shortfall in organs for transplantation. Patients could become organ donors if they were diagnosed as being brain dead, but this only ever occurred in patients on breathing machines in intensive care who developed signs of brainstem failure. Doctors wondered if (...) there were patients dying outside intensive care who, if they were ventilated, could become brain dead and hence eligible to donate their organs. They embarked on a process of identifying patients who were dying who would not normally be taken to intensive care because their prognosis was judged to be too poor, and then ‘electing’ to insert breathing tubes when they stopped breathing.1 With the consent of family members the patients were supported in intensive care until they were diagnosed as having signs of brain death, or until the family and doctors together judged that this was unlikely to occur.1 The Exeter team saw a 50% increase in their numbers of organs for transplantation.Box 1 Definition of elective ventilation Elective ventilation is the provision to a patient of intensive medical treatment with the sole purpose of facilitating organ donation, in the absence of an expected medical benefit.EV was a controversial practice at the time. There were a number of papers written from points of view defending2 ,3 and criticising it.4 A Department of Health guideline in 1994 concluded that EV was not in the best interests of patients and was therefore unlawful5; subsequently, the practice effectively ceased.2 However, debate about EV has not …. (shrink)

This volume, designed to bring together new analyses of moral skepticism, consists of papers by Professors William Frankena, Marcus Singer and Antony Flew and a long introduction by the editor which describes the central issues and discusses each of the papers. In his paper, "The Principles of Morality," Frankena contends that underlying many of our ordinary moral expressions is the implicit belief in an absolute moral action-guide, i.e., an action-guide which all those who are fully rational within the moral point (...) of view would acknowledge. Although Frankena does not discuss in this paper the crucial and perplexing problems of whether all those taking the moral point of view must accept the same principles and whether there is an irreducible plurality of moral points of view, he does discuss at length H. D. Aiken’s rejection of moral absolutism in favor of moral autonomy and the differences between his theory and R. Firth’s Ideal Observer Theory. In "Moral Skepticism," Singer carefully defines his topic and classifies its major variants, three of which—personal subjectivism, social subjectivism and emotivism—he criticizes in detail. Although Singer does not present new arguments against the various forms of moral skepticism, he provides the valuable service of organizing clearly and stating precisely the major difficulties. The concluding paper by Flew, "Must Morality Pay? or What Socrates Should Have Said to Thrasymachus," seems out of place in this collection since it neither defends an absolute position nor attacks a variety of skepticism. Flew argues that Socrates’ attempt to prove that the life of justice is always in one’s interest is misguided, since, in the real world, morality often demands that an individual sacrifice his good for the good of others. What Socrates should have argued, according to Flew, is that the choice of the moral life rather than the prudent one cannot be deemed to be either rational or irrational because for such a choice, the issue of rationality arises only in connection with the coherence of our plans and purposes or the internal consistency of our preferences.—M. G. (shrink)

: Autonomous driving systems promise important changes for future of transport, primarily through the reduction of road accidents. However, ethical concerns, in particular, two central issues, will be key to their successful development. First, situations of risk that involve inevitable harm to passengers and/or bystanders, in which some individuals must be sacrificed for the benefit of others. Secondly, and identification responsible parties and liabilities in the event of an accident. Our work addresses the first of these ethical problems. We are (...) interested in investigating how humans respond to critical situations and what reactions they consider to be morally right or at least preferable to others. Our experimental approach relies on the trolley dilemma and knowledge gained from previous research on this. More specifically, our main purpose was to test the difference between what human drivers actually decide to do in an emergency situations whilst driving a realistic simulator and the moral choices they make when they pause to consider what they would do in the same situation and to better understand why these choices may differs. Keywords: Self-driving Cars; Trolley Problem; Moral Choices; Moral Responsibility; Virtual Reality Dilemmi morali nelle automobili a guida autonoma Riassunto: I sistemi di guida autonomi promettono importanti cambiamenti per il futuro dei trasporti, principalmente attraverso la riduzione degli incidenti stradali. Tuttavia, vi sono preoccupazioni etiche, in particolare due questioni centrali, fondamentali per il loro sviluppo. In primo luogo, le situazioni di rischio che comportano inevitabili danni ai passeggeri e/o ai pedoni, ovvero situazioni in cui alcune persone devono essere sacrificate a beneficio di altri. In secondo luogo, l’identificazione delle parti responsabili in caso di incidente. Il nostro lavoro affronta il primo di questi problemi etici. Siamo interessati a studiare come gli umani rispondono a situazioni critiche e quali reazioni considerano moralmente giuste o almeno preferibili. Il nostro approccio sperimentale si basa sul trolley problem e sulle conoscenze acquisite da precedenti ricerche su questo ambito. Più specificamente, il nostro scopo principale è quello di testare la differenza tra ciò che i conducenti umani decidono effettivamente di fare in una situazione di emergenza, mentre guidano un simulatore realistico, e le scelte morali che compiono se posti nella stessa situazione e hanno la possibilità di decidere senza limiti di tempo. Lo scopo è inoltre comprendere come e perché queste scelte possono differire. Parole chiave: Automobili a guida autonoma; Trolley problem; Scelte morali; Responsabilità morale, Realtà virtuale. (shrink)

"Is higher education a right, or a privilege? This author argues that all citizens in a free and open society should have an unconditional right to higher education. Such an education should be costless for the individual and open to everyone regardless of talent. A readiness and willingness to learn should be the only qualification. It should offer opportunities that benefit citizens with different interests and goals in life. And it should aim, as its foundational moral purpose, to help (...) citizens from all walks of life live better, freer lives. Using concepts and ideas from liberal political philosophy the author argues that access to educational goods and services is something to which all citizens have a right over a full life. Such goods, it is argued, play a key role in helping citizens realize self-determined goals. Higher education should therefore be understood a basic social institution responsible for ensuring that all citizens can access such 'autonomy-supporting' goods. The book examines the implication of this justification of the right to higher education for questions of educational justice, political authority, distributive justice, civic education, and personal autonomy"--. (shrink)

The “best interests of the patient” standard—a complex balance between the principles of beneficence and autonomy—is the driving force of ethical clinical care. Clinicians’ fear of litigation is a challenge to that ethical paradigm. But is it ever ethically appropriate for clinicians to undertake a procedure with the primary goal of protecting themselves from potential legal action? Complicating that question is the fact that tort liability is adjudicated based on what most clinicians are doing, not the scientific basis of (...) whether they should be doing it in the first place. In a court of law, clinicians are generally judged based on the “reasonably prudent” standard: what a reasonably prudent practitioner in a similar situation would do. But this legal standard can have the effect of shifting the medical standard of care—enabling a standard-of-care sprawl where actions undertaken for the primary purpose of avoiding liability reset the standard of care against which clinicians will be adjudicated. While this problem has been recognized in the legal literature, neither current ethical models of care nor legal theory offer workable solutions. One of the best examples of the conflict between evidence-based medicine and common clinical practice is the use of electronic fetal monitoring. Despite strong evidence and professional guidelines that argue against the use of EFM for healthy pregnancies, the practice persists. One of the main reasons for this is often assumed to be physicians’ concerns about liability. (shrink)

Brain-Computer Interface is a set of technologies that are of increasing interest to researchers. BCI has been proposed as assistive technology for individuals who are non-communicative or paralyzed, such as those with amyotrophic lateral sclerosis or spinal cord injury. The technology has also been suggested for enhancement and entertainment uses, and there are companies currently marketing BCI devices for those purposes as well as health-related purposes. The unprecedented direct connection created by BCI between human brains and computer hardware raises various (...) ethical, social, and legal challenges that merit further examination and discussion. To identify and characterize the key issues associated with BCI use, we performed a scoping review of biomedical ethics literature, analyzing the ethics concerns cited across multiple disciplines, including philosophy and medicine. Based on this investigation, we report that BCI research and its potential translation to therapeutic intervention generate significant ethical, legal, and social concerns, notably with regards to personhood, stigma, autonomy, privacy, research ethics, safety, responsibility, and justice. Our review of the literature determined, furthermore, that while these issues have been enumerated extensively, few concrete recommendations have been expressed. We conclude that future research should focus on remedying a lack of practical solutions to the ethical challenges of BCI, alongside the collection of empirical data on the perspectives of the public, BCI users, and BCI researchers. (shrink)

In this chapter we argue that the four principles of medical ethics -- beneficence, non-maleficence, respect for autonomy and justice (Beauchamp & Childress, 2001; Gillon, 1985), a new Family Interest Principle (introduced below) and a consideration of ‘capacity’ provide a reasoned practice guide for work with mothers experiencing health problems, focussing here on mental health when a parent is a patient. Our concern is the relationship of the clinician with a parent and through the parent their child. Ethics of service (...) provision or services planning (e.g. Culyer, 2001; McLachlan, 2005; see also Newbigging and Paul, chapter xxx), or the provision of other services (e.g. education, child protection) although intensely relevant to this area are not addressed in this chapter nor will we deal with the complex aspects of medical ethics relating to the treatment of children (Baines, 2008). We use the term ‘parent’ to refer to any adult person who fulfils a substantive parental role with a child. Defining what counts as a family will in certain circumstances be contentious. There are diverse patterns of family arrangements that may be influenced by cultural, political economic and temporal factors. For the purposes of our discussion, we define a family in terms of its role in childrearing, as a group of at least one adult and at least one child, living together in long term relationships on an ongoing basis with vested interest in the well being of each of the family members. (shrink)

Two major philosophical movements have sought to fundamentally rethink the relationship between humans and their environment(s): environmental ethics and enactivism. Surprisingly, they virtually never refer to or seek inspiration from each other. The goal of this analysis is to bridge the gap. Our main purpose, then, is to address, from the enactivist angle, the conceptual backbone of environmental ethics, namely the concept of intrinsic value. We argue that intrinsic value does indeed exist, yet its "intrinsicality" does not boil down to (...) being independent of the interests and needs of humans. Rather, it is brought forth by what we callshared enactionof an axiological domain. The latter is built upon such core posits of enactivism as autonomy, enaction, participatory sense-making as well as the most recent concept of loving as knowing proposed by Hanne De Jaegher. (shrink)

Many healthy volunteers choose to take part in Alzheimer’s disease prevention studies because they want to know whether they will develop dementia—and what they can do to reduce their risk—and are therefore interested in learning the results of AD biomarker tests. Proponents of AD biomarker disclosure often refer to the personal utility of AD biomarkers, claiming that research participants will be able to use AD biomarker information for personal purposes, such as planning ahead or making important life decisions. In this (...) paper, the claim that AD biomarkers have personal utility for asymptomatic individuals is critically assessed. It demonstrates that in the absence of clinical validity, AD biomarkers cannot have personal utility and do not serve research participants’ autonomy. Over the next few years, many research groups will be confronted with participants’ preferences to learn the results of AD biomarker tests. When researchers choose to make results available upon explicit request, they should ensure adequate information provision and education, notably on the uncertain clinical significance of AD biomarker information. Routine disclosure of AD biomarkers to cognitively unimpaired individuals in research settings cannot be justified with an appeal to the personal utility of AD biomarker information. (shrink)