This paper considers the problems that arise when death, which is a philosophically difficult concept, is incorporated into healthcare metrics, such as the quality-adjusted life year (QALY). These problems relate closely to the debate over euthanasia and assisted suicide because negative QALY scores can be taken to mean that patients would be ‘better off dead’. There is confusion in the literature about the meaning of 0 QALY, which is supposed to act as an ‘anchor’ for the surveyed preferences on which (...) QALYs are based. In the context of the debate over euthanasia, the QALY assumes an ability to make meaningful comparisons between life-states and death. Not only is this assumption questionable, but the ethical debate is much more broad than the question of whether death is preferable to a state of living. QALYs are derived from preferences about health states, so do not necessarily reflect preferences about events (eg, dying) or actions (eg, killing). This paper presents a new kind of problem for the QALY. As it stands, the QALY provides confused and unreliable information when it reports zero or negative values, and faces further problems when it appears to recommend death. This should preclude its use in the debate over euthanasia and assisted suicide. These problems only apply where the QALY involves or seems to involve a comparison between life-states and death, and are not relevant to the more general discussion of the use of QALYs as a tool for comparing the benefits derived from treatment options. (shrink)

John A Barrie; G. H. Bantock as Educational Philosopher, Journal of Philosophy of Education, Volume 24, Issue 1, 30 May 2006, Pages 93–106, https://doi.org/10.1.

The search for “usable” expert systems is leading somemedical researchers to question the appropriate role of these programs. Most current systems assume a limited role for the human user, delegating situated “decision-control” to the machine. As expert systems are only able to replace a narrow range of human intellectual functions, this leaves the programs unable to cope with the “constructivist” nature of human knowledge-use. In returning practical control to the human doctor, some researchers are abandoning focusedproblem-solving in favour of supportiveproblem-analysis. (...) Using ONCOCIN and QMR as examples, this article contrasts these approaches and suggests that the latter avoids many of the difficulties currently facing medical expert systems. (shrink)

Working through Esme Johnson’s case brings to light many of the elements that make for a rich and impactful clinical ethics consultation. The health and well-being of a young person, whether a fami...

This article approaches the question of what musters, or should muster, as global theory for these times through the lens of mediatization. Emergent globalities – states of global (perhaps glocal) becoming – are seen as constituted by world-making practices that are obviously, per­haps paradigmatically, referenced in processes of digital communication within and across borders. This is no hymn to “mere connection”, but a sustained attempt to marry process and consciousness with a proper regard for the vagaries of human interaction with (...) the structures of indifferent technology and indifferent globalities. (shrink)

When I engage in some routine activity, it will usually be the case that I mean or intend the present move to be followed by others. What does meaning the later moves consist in? How do I know, when I come to perform them, that they were what I meant? Problems familiar from Wittgenstein's and Kripke's discussions of linguistic meaning arise here. Normally, I will not think of the later moves. But, even if I do, there are reasons to deny (...) that thinking of them can constitute what it is to mean to perform them. I argue that the problem can be solved, in the case of routine action, by the notion that our behavioural routines are guided by what I callmodest agent memory. It will help explain both how wecan have future moves in mind and how we can be in a position to avow the fact. (shrink)

The purpose of this paper is three-fold. First, to offer fully developed exercises for educators and scholars that could be added immediately to a business ethics course to explore timely ethical issues in an exciting way. Second, to highlight the benefits of incorporating Positive Psychology and a discussion of character strengths into business ethics courses (or courses that include units on ethics or sustainability) to enhance the understanding and practice of ethical decision-making in the business context. Third, to offer a (...) framework other educators could use to create a content-generating and engaging workshop at their discipline-specific conferences. (shrink)

This research illustrates dangers inherent in the gap created when organizations decouple ethics program adoption from implementation. Using a sample of 182 professionals in the pharmaceutical and financial services industries, we examine the relationship between structural decoupling of formal ethics programs and individual-level perceptions and behavior. Findings strongly support the hypothesized relationships between decoupling and organizational members’ legitimacy perceptions of the ethics program, psychological contract breach, organizational cynicism, and unethical behavior.

Book reviewed in this article: The Ethics of War. By Barrie Paskins and Michael Dockrill.

Organizational ethics programs often are created to address tensions in organizational values that have been identified through repeated clinical ethics consultation requests. Clinical ethicists possess some core competencies that are suitable for the leadership of high-quality organizational ethics programs, but they may need to develop new skills to build these programs, such as familiarity with healthcare delivery science, healthcare financing, and quality improvement methodology. To this end, we suggest that clinical ethicists build organizational ethics programs incrementally and via quality improvement (...) projects undertaken in collaboration with senior clinical leaders. Organizational ethics programs often differ from clinical ethics programs in their membership and processes, and likely will require ethicists to forge new partnerships with a wide array of organizational leaders. With attention to the ways that organizational ethics programs differ from clinical ethics programs, and investment in quality improvement methodology and formal institutional needs assessments, clinical ethics leaders can position an organizational ethics program to advocate effectively for visible and compelling alignment of leadership decision making with the values of the organization. (shrink)

This article interrogates the bureaucratization of war, incarnate in the covert lethal drone. Bureaucracies are criticized typically for their complexity, inefficiency, and inflexibility. This article is concerned with their moral indifference. It explores killing, which is so highly administered, so morally remote, and of such scale, that we acknowledge a covert lethal program. This is a bureaucratized program of assassination in contravention of critical human rights. In this article, this program is seen to compromise the advance of global justice. Moreover, (...) the bureaucratization of lethal force is seen to dissolve democratic ideals from within. The bureaucracy isolates the citizens from lethal force applied in their name. People are killed, in the name of the State, but without conspicuous justification, or judicial review, and without informed public debate. This article gives an account of the risk associated with the bureaucratization of the State’s lethal power. Exemplified by the covert drone, this is power with formidable reach. It is power as well, which requires great moral sensitivity. Considering the drone program, this article identifies challenges, which will become more prominent and pressing, as technology advances. (shrink)

" Barry Allen shows what truth has come to mean in the philosophical tradition, what is wrong with many of the ways of conceiving truth, and why philosophers ...

This exploratory study contributes to the literature on disclosing concealable stigmatized identities (CSI) by positing authenticity and identity centrality as antecedents to disclosing body art within a workplace context. We analyze identity centrality and its effect on amplifying or suppressing disclosure and/or fear of disclosure of white‐collar professionals' body art. The research question focuses on whether white‐collar employees believe they can be authentic and disclose body art in the workplace and whether there are adverse career outcomes associated with disclosing body (...) art. Findings suggest authenticity was only related to the degree of disclosure through fear of disclosure, highlighting the role that fear played in the disclosure decision. Identity centrality moderated the relationship between authenticity and fear of disclosure. Both fear of and degree of disclosure were indirectly related to turnover intentions through affective organizational commitment. Given the limited research on body art as a stigma and its disclosure by white‐collar professionals, we believe this study adds to the CSI literature by offering insights into the impact that changing social mores associated with body art may have on the willingness of white‐collar professionals to disclose it. (shrink)

In recent years, there has been a distinct shift in the relationship between science and society. We have moved away from the classic unidirectional “deficit” model (Simis et al. 2016) focused on t...

It appears that there is a conflict of values running through business ethics between profits accruing to shareholders and the cost of entrepreneurial activities on wider stakeholders. In the ethics research literature, the multiplicity of normative ethical stances has resulted in much debate but little in the way of consistent policy proposals. There is, by comparison, an extensive literature in positive economics that attempts to resolve value conflicts similar to those faced by business ethicists. In this paper the adoption of (...) positive welfare statements are advocated and the value judgements implicit in economics are used as the starting point. It is argued that there is merit in expressly stating a set of value judgements to demonstrate the intractable nature of finding a social consensus without a positive social welfare function that explicitly weights the values. This paper reviews the arguments surrounding corporate objectives, particularly with regard to ethical considerations and the profit maximisation orthodoxy. This is discussed within the stakeholder‐stockholder narrative. A range of ethical positions in the management strategy literature are analysed and discussed. It is argued that the values underpinning business ethics research can be conceived of via a function of social welfare (including an ethical ‘auctioneering’ model). The paper concludes by suggesting that all ethical positions can be captured by a Bergson‐type welfare function. (shrink)