Background Nurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses’ experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral distress, moral injury, moral outrage, and moral courage. We re-analyzed ethics-related findings in light of refined definitions of ethics concepts. Research aim To analyze frontline U.S. nurses’ experiences of ethics during the COVID-19 pandemic. Research design Qualitative analysis using a directed content (...) methodology. Participants and research context The study included 43 nurses from three major metropolitan academic medical centers and one community hospital in the northeastern, mid-Atlantic, midwestern, and western United States. Ethical considerations Participant privacy and data confidentiality were addressed. Findings Moral dilemmas arose from many situations, most frequently related to balancing safety and patient care. Moral uncertainty commonly arose from lacking health information or evidence about options. Moral distress occurred when nurses knew the right thing to do, but were prevented from doing so, including with end-of-life issues. Moral injury (accompanied by suffering, shame, or guilt) occurred after doing, seeing, or experiencing wrongdoing, often involving authority figures. Nurses expressed moral outrage at events and people within and outside healthcare. Despite difficult ethical situations, some nurses exemplified moral courage, sometimes by resisting policies they perceived as preventing compassionate care, guided by thinking about what was best for patients. Discussion This content analysis of ethics-related subthemes revealed conceptual characteristics and clarified distinctions with corresponding exemplars. Conceptual clarity may inform responses and interventions to address ethical quandaries in nursing practice. Conclusions Ethics education in nursing must address the moral dilemmas of pandemics, disasters, and other crises. Nurses need time and resources to heal from trying to provide the best care when no ideal option was available. (shrink)

In this paper, the theory and practice of therapeutic touch (TT) is scrutinized from a number of perspectives. Firstly, the alleged close relationship between TT and Martha Rogers’ Science of Unitary Human Beings is evaluated. Secondly, the employment of the language of modern physics in Rogers’ theory and TT is critically examined. The authors then review the research literature on TT's efficacy, completing their critique by discussing the ethical issues involved in the practice of TT. As each of the perspectives (...) considered reveals some concerns, the paper concludes that TT is a questionable intervention, underpinned by a very weak theoretical, clinical and research base. (shrink)

This symposium includes twelve narratives from individuals or groups who have worked to help the sick and injured receive healthcare during armed conflict. Four commentaries on these narratives are also included, authored by experts and scholars in the fields of bioethics, human rights, sexual violence in armed conflict, the forced displacement of civilians, and policy development for resource constrained healthcare. The goal of this symposium is to call attention to the the difficulties and ethical dilemmas of providing healthcare during violent (...) armed conflict. (shrink)

A connection has long been made between music and moral education. Recent discussions have focused on concerns that certain lyrics can lead to acceptance of violence, suicide, inappropriate views of women, and other unethical behaviour. Debate over whether such connections exist at least illustrates that popular songs engage listeners with ethical issues; this arises from the unique blend of emotional and cognitive reactions to music. And while the emotional side of ethics has received less attention than other aspects of ethics, (...) it is important and music can be a powerful and unique tool to introduce the emotional aspects of ethics. Music appeals to almost everyone. Throughout history songs have rallied people to action and drawn people into deeper reflection. Music engages our emotions, our imagination and our intellect. Students already spend many hours listening to songs, some of which address ethical issues; it is thus an ideal pedagogic aid in teaching subjects like ethics. This article will discuss how carefully selected songs can encourage thoughtful reflection and critical thinking about ethical issues: a number of specific examples will be described, along with a discussion of the general practicalities of using popular songs in teaching ethics and a demonstration of how students learn to listen critically and actively reflect on the ethical messages they receive. The enjoyment of music helps to engage students with ethics and its relevance for their lives and careers. This article aims to share some of the excitement and enthusiasm that popular songs have brought to my teaching of ethics. (shrink)

This Open Access Book is the first to examine disasters from a multidisciplinary perspective. Justification of actions in the face of disasters requires recourse both to conceptual analysis and ethical traditions. Part 1 of the book contains chapters on how disasters are conceptualized in different academic disciplines relevant to disasters. Part 2 has chapters on how ethical issues that arise in relation to disasters can be addressed from a number of fundamental normative approaches in moral and political philosophy. This book (...) sets the stage for more focused normative debates given that no one book can be completely comprehensive. Providing analysis of core concepts, and with real-world relevance, this book should be of interest to disaster scholars and researchers, those working in ethics and political philosophy, as well as policy makers, humanitarian actors and intergovernmental organizations.. (shrink)

Moral theory has generally focused on resolving ethical dilemmas by identifying ethically sound options. Whether the focus is on consequences, duties, principles or virtues, ethical cases are often approached in ways that assume morally sound solutions can be found and followed. Such ‘ideal morality’ assumes that moral goodness is always possible, leaving people confident they have done the right thing. Such an approach becomes inadequate in disaster settings where any good solution is often difficult to see. This paper examines recent (...) work on nonideal moral theory as a useful model for disaster bioethics. This approach views moral dilemmas as situations where no choice is ideal and every option involves some element of unavoidable wrongdoing. Rather than straining for ideal answers, this approach acknowledges that sometimes the lesser of two evils is the best that can be done. Such situations inevitably lead to feelings of regret or guilt, commonly encountered in discussions of disaster bioethics. This paper explores the practical implications of nonideal approaches for disaster responders working in tragic situations. (shrink)

Diagnostic self-testing devices are being developed for many illnesses, chronic diseases and infections. These will be used in hospitals, at point-of-care facilities and at home. Designed to allow earlier detection of diseases, self-testing diagnostic devices may improve disease prevention, slow the progression of disease and facilitate better treatment outcomes. These devices have the potential to benefit both the individual and society by enabling individuals to take a more proactive role in the maintenance of their health and by helping society improve (...) health and reduce health costs. However, the full implications of future home-based diagnostic technology for individuals and society remain unclear due to their novelty. We argue that the development of diagnostic tools, especially for home use, will heighten a number of ethical challenges. This paper will explore some of the ethical implications of home-based self-testing diagnostic devices for the autonomous and relational dimensions of the person. This will be facilitated by examining the impact of diagnostic devices for individual autonomy, for the delivery of accurate diagnosis and for the personal significance of the information for the user. The latter will be examined using Charles Taylor's view of personhood and his emphasis on human agency and interpretation. While the ethical issues are not necessarily new, the development of home-based self-testing diagnostic devices will make issues regarding autonomy, accuracy of information and personal significance more and more demanding. This will be the case particularly when an individual's autonomous choices come into conflict with the person's relational responsibilities. (shrink)

Background The justification for Nazi programs involving involuntary euthanasia, forced sterilisation, eugenics and human experimentation were strongly influenced by views about human dignity. The historical development of these views should be examined today because discussions of human worth and value are integral to medical ethics and bioethics. We should learn lessons from how human dignity came to be so distorted to avoid repetition of similar distortions. Discussion Social Darwinism was foremost amongst the philosophies impacting views of human dignity in the (...) decades leading up to Nazi power in Germany. Charles Darwin's evolutionary theory was quickly applied to human beings and social structure. The term 'survival of the fittest' was coined and seen to be applicable to humans. Belief in the inherent dignity of all humans was rejected by social Darwinists. Influential authors of the day proclaimed that an individual's worth and value were to be determined functionally and materialistically. The popularity of such views ideologically prepared German doctors and nurses to accept Nazi social policies promoting survival of only the fittest humans. A historical survey reveals five general presuppositions that strongly impacted medical ethics in the Nazi era. These same five beliefs are being promoted in different ways in contemporary bioethical discourse. Ethical controversies surrounding human embryos revolve around determinations of their moral status. Economic pressures force individuals and societies to examine whether some people's lives are no longer worth living. Human dignity is again being seen as a relative trait found in certain humans, not something inherent. These views strongly impact what is taken to be acceptable within medical ethics. Summary Five beliefs central to social Darwinism will be examined in light of their influence on current discussions in medical ethics and bioethics. Acceptance of these during the Nazi era proved destructive to many humans. Their widespread acceptance today would similarly lead to much human death and suffering. A different ethic in needed which views human dignity as inherent to all human individuals. (shrink)

This book provides a current analysis of the legal and ethical challenges in preparing for and responding to chemical, biological, radiological, nuclear and explosive crises. From past events like the Chernobyl nuclear incident in Russia or the Bhopal chemical calamity in India, to the more recent tsunami and nuclear accident in Japan or the Ebola crisis in Africa, and with the on-going threat of bioterrorism, the need to be ready to respond to CBRNE crises is uncontroversial. What is controversial is (...) whether we are on a path that adequately prepares us for the next event. The ethical and legal scholars in this volume hold that much work remains to be done and offer this book to stimulate further reflection and dialogue around CBRNE crises. This is an indispensable book for both students and scholars of bioethics, international law, public health, as well as for regulators and administrators developing policy and legislation related to public health planning and emergency responses. (shrink)

This paper aims to critique the phenomenon of advanced patient autonomy and choice in healthcare within the specific context of self-testing devices. A growing number of self-testing medical devices are currently available for home use. The premise underpinning many of these devices is that they assist individuals to be more autonomous in the assessment and management of their health. Increased patient autonomy is assumed to be a good thing. We take issue with this assumption and argue that self-testing provides a (...) specific example how increased patient autonomy and choice within healthcare might not best serve the patient population. We propose that current interpretations of autonomy in healthcare are based on negative accounts of liberty to the detriment of a more relational understanding. We also propose that Kantian philosophy is often applied to the healthcare arena in an inappropriate manner. We draw on the philosophical literature and examples from the self-testing process to support these claims. We conclude by offering an alternative account of autonomy based on the interrelated concepts of relationality, care and responsibility. (shrink)

Research ethics is an integral part of research, especially that involving human subjects. However, concerns have been expressed that research ethics has come to be seen as a procedural concern focused on a few well-established ethical issues that researchers need to address to obtain ethical approval to begin their research. While such prospective review of research is important, we argue that it is not sufficient to address all aspects of research ethics. We propose retrospective review as an important complement to (...) prospective review. We offer two arguments to support our claim that prospective review is insufficient. First, as currently practiced, research ethics has become for some a ‘tick box’ exercise to get over the ‘hurdle’ of ethics approval. This fails to capture much of what is important in ethics and does not promote careful reflection on the ethical issues involved. Second, the current approach tends to be rules-based and we argue that research ethics should go beyond this to develop people’s capacity to be sensitive to the relevant moral features of their research, their ethical decision-making skills and their integrity. Retrospective review of a project’s ethical issues, and how they were addressed, could help to achieve those aims better. We believe that a broad range of stakeholders should be involved in such retrospective review, including representatives of ethics committees, participating communities and those involved in the research. All stakeholders could then learn from others’ perspectives and experiences. An open and transparent assessment of research could help to promote trust and understanding between stakeholders, as well as identifying areas of agreement and disagreement and how these can be built upon or addressed. Retrospective review also has the potential to promote critical reflection on ethics and help to develop ethical sensitivity and integrity within the research team. Demonstrating this would take empirical evidence and we suggest that any such initiatives should be accompanied by research into their effectiveness. Our article concludes with a discussion of some possible objections to our proposal, and an invitation to further debate and discussion. (shrink)

Conducting research during or in the aftermath of disasters poses many specific practical and ethical challenges. This is particularly the case with research involving human subjects. The extraordinary circumstances of research conducted in disaster settings require appropriate regulations to ensure the protection of human participants. The goal of this study is to systematically and qualitatively review the existing ethical guidelines for disaster research by using the constant comparative method. We performed a systematic qualitative review of disaster research ethics guidelines to (...) collect and compare existing regulations. Guidelines were identified by a three-tiered search strategy: 1) searching databases, 2) an Internet search, and 3) a search of the references in the included documents from the first two searches. We used the constant comparative method for analysis of included guidelines. Fourteen full text guidelines were included for analysis. The included guidelines covered the period 2000-2014. Qualitative analysis of the included guidelines revealed two core themes: vulnerability and research ethics committee review. Within each of the two core themes, various categories and subcategories were identified. Some concepts and terms identified in analyzed guidelines are used in an inconsistent manner and applied in different contexts. Conceptual clarity is needed in this area as well as empirical evidence to support the statements and requirements included in analyzed guidelines. (shrink)

ABSTRACTDiagnostic self‐testing devices are being developed for many illnesses, chronic diseases and infections. These will be used in hospitals, at point‐of‐care facilities and at home. Designed to allow earlier detection of diseases, self‐testing diagnostic devices may improve disease prevention, slow the progression of disease and facilitate better treatment outcomes. These devices have the potential to benefit both the individual and society by enabling individuals to take a more proactive role in the maintenance of their health and by helping society improve (...) health and reduce health costs. However, the full implications of future home‐based diagnostic technology for individuals and society remain unclear due to their novelty.We argue that the development of diagnostic tools, especially for home use, will heighten a number of ethical challenges. This paper will explore some of the ethical implications of home‐based self‐testing diagnostic devices for the autonomous and relational dimensions of the person. This will be facilitated by examining the impact of diagnostic devices for individual autonomy, for the delivery of accurate diagnosis and for the personal significance of the information for the user. The latter will be examined using Charles Taylor's view of personhood and his emphasis on human agency and interpretation.While the ethical issues are not necessarily new, the development of home‐based self‐testing diagnostic devices will make issues regarding autonomy, accuracy of information and personal significance more and more demanding. This will be the case particularly when an individual's autonomous choices come into conflict with the person's relational responsibilities. (shrink)

Ambient assisted living technologies can provide assistance and support to persons with dementia. They might allow them the possibility of living at home for longer whilst maintaining their comfort and security as well as offering a way towards reducing the huge economic and personal costs forecast as the incidence of dementia increases worldwide over coming decades. However, the development, introduction and use of AAL technologies also trigger serious ethical issues. This paper is a systematic literature review of the on-going scholarly (...) debate about these issues. More specifically, we look at the ethical issues involved in research and development, clinical experimentation, and clinical application of AAL technologies for people with dementia and related stakeholders. In the discussion we focus on: the value of the goals of AAL technologies, the special vulnerability of persons with dementia in their private homes, the complex question of informed consent for the usage of AAL technologies. (shrink)

Disasters and public health emergencies raise a variety of ethical dilemmas, often including those that require balancing the best interests of individuals against those of groups or communities. The on-going COVID-19 pandemic provides examples of these ethical conflicts, as do other recent outbreaks. Decisions and actions in this context must address different ethical issues, ranging from those directly related to autonomy, consent, privacy and confidentiality to those related to interventions and technologies, such as efficacy, effectiveness, safety and fair access. This (...) paper aims to identify ethical conflicts with complex resolutions involving aspects related to values, rights and needs of individuals and the collective, and to suggest how such challenges could lead to more positive experiences and outcomes when confronted in future emergencies. (shrink)

The humanitarian sector continually faces organizational and operational challenges to respond to the needs of populations affected by war, disaster, displacement, and health emergencies. With the goal of improving the effectiveness and efficiency of response efforts, humanitarian innovation initiatives seek to develop, test, and scale a variety of novel and adapted practices, products, and systems. The innovation process raises important ethical considerations, such as appropriately engaging crisis-affected populations in defining problems and identifying potential solutions, mitigating risks, ensuring accountability, sharing benefits (...) fairly, and managing expectations. This paper aims to contribute to knowledge and practice regarding humanitarian innovation ethics and presents two components related to a value-sensitive approach to humanitarian innovation. First is a mapping of how ethical concepts are mobilized in values statements that have been produced by a diverse set of organizations involved in humanitarian innovation. Analyzing these documents, we identified six primary values (do-no-harm, autonomy, justice, accountability, sustainability, and inclusivity) around which we grouped 12 secondary values and 10 associated concepts. Second are two proposed activities that teams engaged in humanitarian innovation can employ to foreground values as they develop and refine their project’s design, and to anticipate and plan for challenges in enacting these values across the phases of their project. A deliberate and tangible approach to engaging with values within humanitarian innovation design can help to ground humanitarian innovation in ethical commitments by increasing shared understanding amongst team members, promoting attentiveness to values across the stages of innovation, and fostering capacities to anticipate and respond to ethically challenging situations. (shrink)

Disaster Bioethics: Normative Issues When Nothing Is Normal, edited by Dónal P. O’Mathúna, Bert Gordijn, and Mike Clarke, is reviewed. This volume is the second in a series addressing public health ethics and is comprised of 13 chapters contributed by individual authors and divided into two sections. Although this is not a monumental work, it is one of importance. It asks more questions than it answers, which is fitting in an emerging discipline. It will serve to shape and focus future (...) research and debate. Not all contributions are of equal import, but each has something to contribute to the discussion. (shrink)

The OT and the NT have each one apocalyptic book: Daniel and Revelation. Both books consist of richly imaginative visions of the final triumph of God over the forces of evil—a theme and a genre of religious writing which enjoyed popularity in the inter-testimental period and was particularly consoling to devout Jews in times of persecution: Dn during the Seleucid persecution which culminated in the profanation of the Temple in 167 BC, and Rev during the persecution of Domitian circa AD (...) 95. The very name indicates the drawing back of the veil from the secret design of God for the triumph of His Kingdom; but not everything is clearly revealed, and the history of the interpretations of Rev is as complicated as it is unrewarding. Nevertheless the main themes stand out: the Church and its struggle against Satan, and Christ whom God has appointed Judge to condemn the enemies of His people. (shrink)

Intersectionality theory explores the special sorts of disadvantage that arise as the result of occupying multiple disadvantaged demographic categories. One significant methodological problem for the quantitative study of intersectionality is the difficulty of acquiring data sets large enough to produce significant results when one is looking for intersectional effects. For this reason, we argue, simulation methods may be particularly useful to this branch of theorizing because they can generate precise predictions and causal dependencies in a relatively cheap way, and can (...) thus guide future empirical work. We illustrate this point through models which show that intersectional oppression can arise under conditions where social groups are disadvantaged in the emergence of bargaining norms. As we show, intersectional disadvantage can arise even when actors from all social categories are completely identical in terms of preferences and abilities. The conditions necessary to derive such disadvantage are relatively minimal. And when actors behave in ways that reflect stronger intersectional identities, the potential for disadvantage increases. (shrink)

Cooperation in evil or wrongdoing is one of the most perplexing areas in bioethics, both for those working in the field and those seeking their advice. The papers collected in this book are written by philosophers, theologians and lawyers who have studied these problems and / or by those who have faced these problems in their own work in law, healthcare and research, and political campaigning. The volume includes both general treatments of the subject of cooperation and conscientious objection, and (...) more specific treatments of topics such as voting to improve unjust laws, research on fetal / embryonic cells, and care of suicidal patients. The book is offered as a guide to a field which is both of academic interest and of personal concern to those who face cooperation problems in their own life and work. Contributors include: Bishop Donal Murray, Bishop Anthony Fisher OP, Jane Adolphe, Mike Delany, John Finnis, Luke Gormally, Colin Harte, Cathleen Kaveny, Richard Myers, Charlie O'Donnell, Alexander Pruss, Neil Scolding and Helen Watt. (shrink)

Books Reviewed in this Article: Introduction to the Critical Study of the Text of the Hebrew Bible. By J. Weingreen. Pp.vii, 103, Oxford, Clarendon Press; New York, Oxford University Press, 1982, £5.50. The Archaeology of the Land of Israel. By Yohanan Aharoni. Pp.xx, 344, Philadelphia, The Westminster Press, 1982, $27.50, $18.95 ; London, SCM Press, 1982, £12.50. A Commentary on the Gospel of Mark. By Terence J. Keegan. Pp.183, New York, Paulist Press, and Leominster, Fowler Wright Books, 1981, £4.45. The (...) Panorama of Luke: An Introduction to the Gospel of Luke and the Acts of the Apostles. By Neil Richardson. Pp.116, London, Epworth Press, 1982, £3.95. The Synoptic Gospels: An Introduction. By Keith F. Nickle. Pp.119, London SCM Press, 1982, £5.50. What is a Gospel? By Nicholas King. Pp.132, Leigh‐on‐Sea, Kevin Mayhew, 1982, £3.00. The Women Around Jesus: Reflections on Authentic Personhood. By Elisabeth Moltmann‐Wendel, translated by J. Bowden. Pp.xii, 148, London, SCM Press, 1982, £3.95. Paul and Paulinism: Essays in honour of C.K. Barrett. Edited by M.D. Hooker and S.G. Wilson. Pp.xxvii, 404, London, SPCK, 1982, £25.00. Divine Revelation and the Limits of Historical Criticism. By William J. Abraham. Pp.222, Oxford, Oxford University Press, 1982, £15.00. The Social Teaching of Vatican II. By Rodger Charles with Drostan Maclaren. Pp.xxvi, 569, San Francisco, Ignatius Press; Oxford, Plater Publications, 1982, £12.75. Option for the Poor: A Hundred Years of Vatican Social Teaching. By Donal Dorr. Pp.viii, 328, New York, Orbis Books; Dublin, Gill & Macmillan, 1983, £7.95. The Kindness that Kills. Edited by Digby Anderson. Pp.xii, 170, London SPCK, 1984, £3.95. Communism in the Bible. By José Porfiro Miranda. Pp.x, 86, London, SCM Press Ltd. 1982, £3.50. Why I am still a Catholic. Edited by Robert Nowell. Pp.157, London, Collins, 1982, £4.95. Does God Answer Prayer? By Peter Baelz. Pp.55, London, Darton, Longman and Todd, 1982, £1.95. A Cry for Mercy. By Henri J.M. Nouwen. Pp.175, Dublin, Gill and Macmillan, 1982, £3.50. The Living Reminder. By Henri J.M. Nouwen. Pp.80, Dublin, Gill and Macmillan, 1982, £2.95. Making All Things New. By Henri J.M. Nouwen. Pp.95, Dublin, Gill and Macmillan, 1982. £2.95. Picturing God. By Norman Pittenger. Pp.x, 147, London, SCM Press, 1982, £4.50. Christotherapy II, The Fasting and Feasting Heart. By Bernard J. Tyrrell. Pp.xiii, 337, New York, Paulist Press, 1982, £6.70. With Respect: A Doctor's Response to a Healing Pope. By Frank Lake. Pp.xxiii, 327, London, Darton, Longman and Todd, 1982, £6.95. Euthanasia and Clinical Practice: Trends, Principles and Alternatives: The Report of a Working Party. Pp.viii, 88, London, The Linacre Centre, 1982, £2.75. Essays in Religion and Morality. By William James. Pp.xxviii, 345, Cambridge, Harvard University Press, 1982, £17.50. Freud and Jung: Conflicts of Interpretation. By Robert Steele. Pp.vii, 390, London, Routledge and Kegan Paul, 1982, £14.95. Archetype: A Natural History of the Self. By Anthony Stevens. Pp.xi, 324, London, Routledge and Kegan Paul, 1982, £12.50. The Seeing Eye: Hermeneutical Phenomenology in the Study of Religion. By Walter L. Brenneman Jr. and Stanley O. Yarian, in association with Alan M. Olson. Pp.xii, 177, University Park and London, The Pennsylvania State University Press, 1982, £8.10. Contemporary Philosophy of Religion. Edited by S.M. Cahn and D. Schatz. Pp.x, 310, Oxford University Press, 1982, £6.95. Beyond Empiricism: Philosophy of Science in Sociology. By Andrew Tudor. Pp.xii, 213, London, Routledge & Kegan Paul, 1982, £4.95. Philosophy and Human Geography: An Introduction to Contemporary Approaches. By R.J. Johnston. Pp.viii, 152, London, Edward Arnold, 1982, £5.50. The Literate Revolution in Greece and its Cultural Consequences. By Eric A. Havelock. pp.viii, 362, Princeton, Princeton University Press, 1982, £17.70, £6.30. The Philosophy of Robert Grosseteste. By James McEvoy. Pp.xviii, 560, Oxford, Clarendon Press, 1982, £35.00. Kant's Life and Thought. By Ernst Cassirer, translated by James Haden, introduction by Stephan Körner. Pp.xxiii, 429, New Haven, Yale University Press, 1981, £17.50. Kant's Theory of Form: An Essay on the Critique of Pure Reason. By Robert B. Pippin. Pp.xii, 247, New Haven and London, Yale University Press, 1982, £16.50. The Basic Problems of Phenomenology. By Martin Heidegger, translated by Albert Hofstadter. Pp.xxxi, 396, Bloomington, Indiana, Indiana University Press, 1982, £16.50. In the Active Voice By Mary Douglas. Pp.xi, 306, London, Routledge and Kegan Paul, 1982, £9.75. Structural Sociology. Edited by Ino Rossi. Pp.xiv, 363, New York, Columbia University Presss, 1982, £45.50. A Vanquished Hope: The Movement for Church Renewal in Russia, 1905–1906. By J.W. Cunningham. Pp.384, Crestwood, St Vladimir's Seminary Press, 1981, £7.95. Christians in Ulster 1968–1980. By Eric Gallagher and Stanley Worrall. P.241, Oxford University Press, 1982, £10.00. Scotland and the Papacy. By John Cooney. Pp.126, Edinburgh, Paul Harris, 1982, £8.95, £4.95. Scotia Pontificia. Edited by Robert Somerville. Pp.xiii, 177, Oxford, Clarendon Press: Oxford University Press, 1982, £25.00. (shrink)

This article challenges the individualism and neutrality of modern moral conscience. It looks to the history of the concept to excavate an older tradition that takes conscience to be social and morally responsive, while arguing that dominant contemporary justifications of conscience in terms of integrity are inadequate without reintroducing these social and moral traits. This prompts a rethinking of the nature and value of conscience: first, by demonstrating that a morally-responsive conscience is neither a contradiction in terms nor a political (...) absurdity; second, by suggesting how a morally-responsive conscience can be informed by the social world without being a mere proxy for social power or moribund tradition. (shrink)

Book reviewed in this article: Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church. By Stanley Hauerwas.

Appeals to nature are ubiquitous in Epicurean ethics and politics. The foundation of Epicurean ethics is its claim that pleasure is the sole intrinsic good and pain the sole intrinsic evil, and this is supposedly shown by the behavior of infants who have not yet been corrupted, "when nature's judgement is pure and whole." Central to their recommendations about how to attain pleasure is their division between types of desires: the natural and necessary ones, the natural but non-necessary ones, and (...) the vain and empty ones. Elsewhere, the Epicureans talk about the "natural goods" of political power and fame, and they contrast "natural wealth" with wealth as "defined by empty opinion." Finally, in their politics, Epicurus claims that the "the justice of nature is a pledge of reciprocal usefulness, [i.e.,] neither to harm one another nor to be harmed." This paper explores two questions regarding these various appeals to nature. The first is: what is it for these things to be natural, i.e., what notion of "natural" or "nature" is at play here? (Furthermore, is there a single notion being used across these appeals, and if not, how are they related?) The second is: what normative work does a thing's being natural do? That is, what reason, if any, does a desire's being natural give me for pursuing the object of that desire and trying to fulfill that desire, as opposed to not doing so and trying to eliminate it, and similarly for the other appeals to nature? (shrink)

Given its centrality to the intellectual thought processes through which the great structures of logic, nature, and spirit are unfolded it is clear that mediation is vital to the very possibility of Hegel’s encyclopaedic philosophy. Yet Hegel gives little specific explanation of the concept of mediation. Surprisingly, it has been the subject of even less attention by scholars of Hegel. Nevertheless it is casually used in discussions of Hegel and post- Hegelian philosophy as though its meaning were simple and straightforward. (...) In these discussions mediation is the thesis that meanings are not atomic in that the independence of something is inseparable from its relation to something else. Hence being is mediated by nothing, the particular by the universal, the individual by society. But does Hegel ever explain mediation in a way which justifies such use of the concept? The same easy employment of mediation is found in Theodor Adorno whose works are replete with the use of this concept and, indeed, acknowledgements of its Hegelian origin. But the concept of mediation in Adorno’s negative dialectic is operative in an entirely different context from that of Hegel. How, it might be asked, can a concept be so adaptable? I want to argue that mediation is, in fact, an equivocal term which in both Hegel and Adorno covers a variety of entirely different conceptual relations. Furthermore, as propounded by both Hegel and Adorno it lacks the rigour which could allow the particular conclusions which the concept allegedly facilitates. (shrink)

The first part of this paper looks into the question of Lucretius’ philosophical sources and whether he draws almost exclusively from Epicurus himself or also from later Epicurean texts. I argue that such debates are inconclusive and likely will remain so, even if additional Epicurean texts are discovered, and that even if we were able to ascertain Lucretius’ philosophical sources, doing so would add little to our understanding of the De Rerum Natura. The second part of the paper turns to (...) a consideration of what Lucretius does with his philosophical sources. The arguments within the De Rerum Natura are not original. Nonetheless, the way Lucretius presents these arguments establishes him as a distinctive philosopher. Lucretius deploys non-argumentative methods of persuasion such as appealing to emotions, redeploying powerful cultural tropes, and ridicule. These methods of persuasion do not undercut or displace reasoned argumentation. Instead, they complement it. Lucretius’ use of these methods is rooted in his understanding of human psychology, that we have been culturally conditioned to have empty desires, false beliefs, and destructive emotions, ones that are often subconscious. Effective persuasion must take into account the biases, stereotypes, and other psychological factors that hinder people from accepting Epicurus’ healing gospel. (shrink)

This chapter provides an outline of consent in the history of medical ethics. In doing so, it ranges over attitudes towards consent in medicine in ancient Greece, medieval Europe and the Middle East, as well as the history of Western law and medical ethics from the early modern period onwards. It considers the relationship between consent and both the disclosure of information to patients and the need to indemnify physicians, while attempting to avoid an anachronistic projection of concern with patient (...) autonomy too far back into the historical record. The chapter also includes a survey of the development of the social and intellectual infrastructure that underpins modern medical consent. It concludes with a brief discussion of possible future directions for ethical approaches to medical consent and competence that would depart from the models that arose in the twentieth-century. (shrink)

Both in antiquity and ever since the Renaissance Lucretius' De Rerum Natura has been admired – and condemned – for its startling poetry, its evangelical faith in materialist causation, and its seductive advocacy of the Epicurean good life. Approaches to Lucretius assembles an international team of classicists and philosophers to take stock of a range of critical approaches to which this influential poem has given rise and which in turn have shaped its interpretation, including textual criticism, the text's strategies for (...) engaging the reader with its author and his message, the 'atomology' that posits a correlation of the letters of the poem with the atoms of the universe, the literary and philosophical intertexts that mediate the poem, and the political and ideological questions that it raises. Thirteen essays take up a variety of positions within these traditions of interpretation, innovating within them and advancing beyond them in new directions. (shrink)

This chapter develops a civic republican approach to disability justice. It begins by articulating a republican account of liberty as nondomination before showing how such domination can shape the relationships of people with disabilities. This leads to a consideration of whether disability justice can be defined in terms of maximizing or sufficient nondomination. Instead, the chapter provides a civic framework within which republican disability justice can be understood, encompassing both the absence of oppressive relationships and the presence of capabilities of (...) special egalitarian concern. It also considers some specific normative implications of a republican account of disability justice—doubting the suitability of contestatory democracy but pointing toward the merits of self-education and universal basic income. Finally, the objection that this republican approach to disability justice unreasonably denigrates dependence is rebutted. (shrink)

This article draws upon the civic republican tradition to offer new conceptual resources for the normative assessment of mental capacity law. The republican conception of liberty as non-domination is used to identify ways in which such laws generate arbitrary power that can underpin relationships of servility and insecurity. It also shows how non-domination provides a basis for critiquing legal tests of decision-making that rely upon ‘diagnostic’ rather than ‘functional’ criteria. In response, two main civic republican strategies are recommended for securing (...) freedom in the context of the legal regulation of psychological disability: self-authorisation techniques and participatory shaping of power. The result is a series of proposals for the reform of decisional capacity law, including a transition towards purely functional assessment of decisional capacity, surer legal footing for advanced care planning, and greater control over the design and administration of decision-making capacity laws by those with psychological disabilities. (shrink)

In this paper I argue that the development of cubism by Picasso and Braque at the beginning of the twentieth century can be illuminated by consideration of long-running philosophical debates concerning perceptual realism, in particular by Locke’s distinction between primary and secondary properties, and Kant’s empirical realism. Daniel-Henry Kahnweiler, Picasso’s dealer and early authority on cubism, interpreted Picasso and Braque as Kantian in their approach. I reject his influential interpretation, but propose a more plausible, Kantian reading of cubism.

Discursive accounts of the body have been prominent recently. While acknowledging the usefulness of these, the author, drawing upon specific philosophers of the body and a wide range of other theorists, focuses attention on the experiencing body which she refers to as 'creatural existence’. Thinking in terms of the creatural, she argues, can better situate human beings in their environment, thus emphasizing a kind of 'ecological notion of subjectivity’, in which place-based existence is understood anew. The educational implications of focusing (...) on what bodies 'do' and not so much in terms of how they are socially inscribed, presents them as practico-sensory totalities which should perhaps be seen as systems rather than an as mere organisms or entities. Such an articulation of creatural existence emphasizes animality, and in so doing reminds us of the centrality of the senses in all knowing and doing, including crucially, in relation to those practices which we have understood as 'work'. Multi-sensorial education is a major sub-theme of the book and the author argues persuasively for this by means of a critical analysis of the ocularcentrism that is characteristic of contemporary culture. (shrink)

Augustine asserted that demons have material bodies, while Aquinas denied demonic corporeality, upholding that demons are separated, incorporeal, intelligible substances. Augustine’s conception of demons as composite substances possessing an immaterial soul and an aerial body is insufficient, in Thomas’s view, to account for certain empirical phenomena observed in demoniacs. However, Thomas, while providing more detailed accounts of demonic possession according to his development of Aristotelian psychology, does not avail of this demonic incorporeal eminence when analysing demonic attacks: demonic agency is (...) still confined to the material body. Aquinas’s account of demonic possession need not, on the face of it, require an immaterial cause. In his renouncement of the strong Christian tradition affirming demonic corporeality, Aquinas either conflates the need for a demonic agent with a requirement for a super corporeal one, or subordinates his demonology and angelology to a deeper, more fundamental Dionysian metaphysical principle of creative diffusion to which these adhere in a secondary way. (shrink)

This essay is concerned with the question of what kind of economic system would be needed in order to realize Rawls’s principles of social justice. Hitherto, debates about ‘property-owning democracy’ and ‘liberal socialism’ have been overly schematic, in various respects, and have therefore missed some of the most important issues regarding the relationships between social justice and economic institutions and systems. What is at stake between broadly capitalist or socialist economic systems is not in fact a simple choice in a (...) single dimension, but rather a range of choices across a range of different dimensions. This essay, then, has a dual objective: first, it aims to provide a richer account of this normative territory, while showing how issues of economic democracy, decommodification and the limits of markets, and the role of democratic economic planning, all raise questions of justice that are not well captured by focusing only on questions of ownership. Second, it aims to show how the case for democratic socialism can be developed from Rawlsian foundations, in a way that is sensitive to the normative affinities between Rawlsian liberal egalitarianism and democratic socialism, and which attends carefully to the different kinds of institutional elements which a stable, just, and democratic society would require. Taking these aims together, the hope is that we can move onward to a richer debate about the ways in which the realization of democratic socialist institutions may be seen as a requirement of social justice. (shrink)

Communication is complicated, and so is the ethics of communication. We communicate about innumerable topics, to varied audiences, using a gamut of technologies. The ethics of communication, therefore, has to address a wide range of technical, ethical and epistemic requirements. In this book, Onora O'Neill shows how digital technologies have made communication more demanding: they can support communication with huge numbers of distant and dispersed recipients; they can amplify or suppress selected content; and they can target or ignore selected audiences. (...) Often this is done anonymously, making it harder for readers and listeners, viewers and browsers, to assess which claims are true or false, reliable or misleading, flaky or fake. So how can we empower users to assess and evaluate digital communication, so that they can tell which standards it meets and which it flouts? That is the challenge which this book explores. (shrink)

G. A. Cohen has argued that there is a surprising truth in conservatism—namely, that there is a reason for some valuable things to be preserved, even if they could be replaced with other, more valuable things. This conservative thesis is motivated, Cohen suggests, by our judgments about a range of hypothetical cases. After reconstructing Cohen's conservative thesis, I argue that the relevant judgments about these cases do not favor the conservative thesis over standard, nonconservative axiological views. But I then argue (...) that there is a Mirrored Histories case that is such that, if one shares Cohen's conservative attitude, judgments about this case favor Cohen's conservative thesis over a wide range of non-conservative axiological views. Reflection on this case also suggests a different explanation of apparently conservative judgments that merits consideration in its own right. (shrink)

Heidegger's thinking in the decades following the publication of Being and Time is often deemed irreconcilable with that work. Critics contrast the notion of "resoluteness" in Being and Time with Heidegger's post-war account of "releasement" in an attempt to establish a discrepancy between the allegedly voluntarist humanism of his early work and the supposedly 'anti-humanist' thinking of his later work. By contrast, Mahon O'Brien argues for the structural and thematic coherence of Heidegger's movement from authenticity to the search for an (...) authentic free relation to the world - as captured by the term "releasement". By demonstrating the structural and thematic unity of Heidegger's thought in its entirety, O'Brien paves the way for a more measured and philosophically grounded understanding of the issues at stake in the Heidegger controversy. (shrink)