One of the areas of concern raised by cross-border reproductive travel regards the treatment of women who are solicited to provide their ova or surrogacy services to foreign consumers. This is particularly troublesome in the context of developing countries where endemic poverty and low standards for both medical care and informed consent may place these women at risk of exploitation and harm. We explore two contrasting proposals for policy development regarding the industry, both of which seek to promote ethical outcomes (...) and social justice: While one proposal advocates efforts to minimize cross-border demand for female reproductive resources through the pursuit of national self-sufficiency, the other defends cross-border trade as a means for meeting the needs of vulnerable groups. Despite the conflicting objectives of the proposed strategies, the paper identifies common values and points of agreement between the two, including the importance of regulations to safeguard those providing ova or surrogacy services. (shrink)

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To incorporate medical ethics into clinical practice, it must first be understood and valued by health care professionals. The recognition of this principle led to an expanding and continuing educational effort by the ethics committee of the Vancouver General Hospital. This paper reviews this venture, including some pitfalls and failures, as well as successes. Although we began with consultants, it quickly became apparent that education in medical ethics must reach all health care professionals—and medical students as well. Our greatest successes (...) came in the formative years of a medical career (ie, in medical school and residency training programmes), but other efforts were not wasted, particularly among nurses and other health care professionals.Although this is a personal review of the experience in one institution, the lessons learnt in Vancouver are applicable to the further development of medical ethics in the UK. (shrink)

Taking a fresh view on Wittgenstein's apparent ethical skepticism, many contributions to this volume explore the reach of what can be said in ethical terms, while others provide critical discussions of what is being said in various fields of applied ethics and political philosophy under real-world power relations. This volume collects invited contributions from the 35th International Wittgenstein Symposium 2012 in Kirchberg am Wechsel, Austria.

Due to the enormous disparity of power in the child welfare professional-client relationship, a high level of trust is necessary for this relationship to achieve its intended benefits, including protecting, caring for, terminating parental rights to, and finding appropriate adoptive homes for, abused and neglected children. This paper first defines conflicts of interest as necessarily including the exercise of judgment, and then argues that contractual relationships between private child welfare agencies and public departments of child welfare often betray their fiduciary (...) responsibilities through conflicts of interest inherent in these contracts, particularly as regarding incentives for and against finding permanent homes for abused and neglected children. Finally, I propose an evidence-based strategy to ameliorate conflicts of interest when making permanent placement decisions for foster children. (shrink)

Why do we watch and like horror films? Despite a century of horror film-making and en-tertainment, little research has examined the human motivation to watch fictional horror and how horror film influences individuals’ behavioural, cognitive and emotional re-sponses. This review provides the first synthesis of the empirical literature on the psy-chology of horror film using multi-disciplinary research from psychology, psychotherapy, communication studies, development studies, clinical psychology, and media studies. The paper considers the motivations for people’s decision to watch horror, why (...) people enjoy horror, how individual differences influence responses to, and preference for, hor-ror film, how exposure to horror film changes behaviour, how horror film is designed to achieve its effects, why we fear and why we fear specific classes of stimuli, and how lik-ing for horror develops during childhood and adolescence. The literature suggests that (1) low empathy and fearfulness are associated with more enjoyment and desire to watch horror film but that specific dimensions of empathy are better predictors of people’s re-sponses than are others; (2) there is a positive relationship between sensation-seeking and horror enjoyment/preference but this relationship is not consistent; (3) men and boys prefer to watch, enjoy and seek our horror more than do women and girls; (4) women are more prone to disgust sensitivity or anxiety than are men and this may mediate the sex difference in the enjoyment of horror; (5) younger children are afraid of symbolic stimuli whereas older children become afraid of concrete or realistic stimuli; (6) in terms of coping with horror, physical coping strategies are more successful in younger children; priming with information about the feared object reduces fear and increases children’s enjoyment of frightening television and film. A number of limitations in the literature are identified, including the multifarious range of horror stimuli used in studies, disparities in methods, small sample sizes, and a lack of research on cross-cultural differences and similarities. Ideas for future research are explored. (shrink)

The right to teach at university is a distinctive philosophical and legal conundrum but a largely unexplored question. Drawing on Humboltdian principles, the legitimacy of the university teacher stems from their continuing engagement in research rather than possession of academic and teaching qualifications alone. This means that the right to teach needs to be understood as a privilege and implies that it is always provisional, requiring an ongoing commitment to research. Yet, massification of higher education systems internationally has led to (...) the disaggregation of the academic profession with teaching-only positions now increasingly common. University teachers employed to both teach and research face a narrowing set of performative expectations with respect to how ‘research-active’ is defined. This paper challenges these contemporary understandings and, drawing on historical evidence, argues that a broader definition of research and scholarship needs to underpin the basis of the right to teach. (shrink)

As coronavirus disease 2019 made its way across the world in 2019, health systems began to develop guidelines to allocate what was expected to be a scarcity of medical resources. Considerable attention was given to triaging intensive care resources such as ventilators. While there was general agreement among bioethicists and policymakers that it may be permissible to withhold life-sustaining interventions from patients with poor prognoses in order to make them available to patients with better prognoses, there was disagreement about the (...) permissibility of withdrawing such interventions for this purpose. Some maintained that the doctrine of double effect (DDE) revealed the intrinsic wrongness of such acts of reallocation. This article argues that so long as there is transparency and effective ongoing communication, the DDE may permit the discontinuation of life-sustaining interventions from patients who may still benefit from them in order to make them available to patients with more favorable prognoses. (shrink)

In the case of an intellectually disabled patient, the attending physician was restricted from writing a Do-Not-Resuscitate (DNR) order. Although the rationale for this restriction was to protect the patient from an inappropriate quality of life judgment, it resulted in a worse death than the patient would have experienced had he not been disabled. Such restrictions that are intended to protect intellectually disabled patients may violate their right to equal treatment and to a dignified death.

Terms such as ‘cultural competence’ and ‘transcultural nursing’ have comfortably taken their place in the lexicon of health care. Their high profile is a reflection of the diversity of western societies and health care’s commitment to provide care that is responsive to the values and beliefs of all who require treatment. However, the relationship between cultural competence and familiar ethical concepts such as patient autonomy has been an uneasy one. This article explores the moral foundations of cultural competence, ultimately locating (...) them in patient autonomy and patient good. The discussion of patient good raises questions about the moral relevance of a value’s rootedness in a particular culture. I argue that the moral justification for honoring cultural values has more to do with the fact that patients are strongly committed to them than it does with their cultural rootedness. Finally, I suggest an organizational approach to cultural competence that emphasizes overall organizational preparedness. (shrink)