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)

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)

Volume 20, Issue 2, February 2020, Page 51-53.

Barrie Falk; X*—Having What We Want, Proceedings of the Aristotelian Society, Volume 91, Issue 1, 1 June 1991, Pages 171–186, https://doi.org/10.1093/aristoteli.

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...

Plotinus can be regarded as the greatest Greek philosopher of late Antiquity, and as the father of Neoplatonism. His Enneads are now recognised as seminal works in the development of Western thought. This book is the only detailed scholarly commentary available on this part of Plotinus' work, and should be invaluable to all scholars interested in ancient philosophy and early Christian theology. All Greek in the commentary is translated.

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)

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 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.

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...

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

Summary The paper reports the results of a longitudinal case study conducted in Australia and New Zealand. The study compares the reading and comprehension age of children in their fifth and sixth years in school. Reading and comprehension ages of 121 children who had Reading Recovery intervention at age 6 were compared with those of a Comparison group of 121 children, drawn from the same classes who, at age 6 years, had been better performers in literacy. Reading and comprehension assessment (...) was conducted with the use of the Neale Analysis of Reading and analysed by means of a t?test. Results show that the mean reading age of ex?Reading Recovery children was nearly 12 months superior to that of the Comparison group and that the mean comprehension age was nearly 13 months superior at very highly significant levels. The results strongly suggest that Reading Recovery tuition at age 6 years enabled the 121 ex?Reading Recovery children to make greater progress in literacy than children in the Comparison group. (shrink)

This project investigates critical issues and events related to Trek Therapeutics experience as a public benefit corporation. We will present and discuss how Trek differentiates itself in an industry where the attention is on high prices supporting high investor returns. Trek’s benefit corporation status helped it garner favorable attention in some respects, but has also presented challenges, particularly when it comes to attracting new capital.

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)

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)

In light of growing concerns in the public and recent mandates from business program accrediting bodies and curricular task forces, the importance of teaching ethical topics in information systems programs is discussed. Innovative strategies used for teaching the application of ethical criteria to common situations are reviewed. Results of a survey of information systems faculty members in the US are presented and are compared to previous studies that related primarily to computer science and software engineering programs. Insight is provided into (...) the topics, techniques, degree of coverage, and assessment techniques currently used when teaching ethics in computing-related programs. Key concerns and future work is also outlined. (shrink)

The extant literature on discourse comprehension distinguishes between two types of texts: narrative and expository. Narrative discourse tells readers a story by giving them an account of events; the narration informs and/or persuades the readership by using textual elements such as theme, plot, and characters. Expository discourse explains or informs the readership by using concepts and techniques such as definition, sequence, categorization, and cause-effect relations. The present study is based on two experiments. In Experiment 1, we compared the two discourse (...) types to examine if college students would be better at extracting the meanings of novel words from one of the two types of discourse structure than from the other. The findings indicated that participants were significantly better at inferring the meaning of novel words from narrative compared to expository discourse. In Experiment 2, we examined the number of situation models that a reader is required to mentally construct, as a possible characteristic that influences the difficulty of learning new word meaning within narrative discourse. Contrary to intuition, fewer novel words were learned in a single-situation, as opposed to a multi-situation model condition, suggesting that the additional inferencing needed to construct multiple models also promotes word learning. Results are discussed with respect to how the structure of written discourse can facilitate word learning in a reader’s native language. Implications for education and assessment are also discussed. (shrink)