Duty of candour legislation was introduced in Scotland in 2018. However, literature and experience of duty of candour when applied to infection control incidents/outbreaks is scarce. We describe clinician and parental perspectives with regard to duty of candour and communication during a significant infection control incident in a haemato-oncology ward of a children’s hospital. Based on the learning from this incident, we make recommendations for duty of candour and communication to patients and (...) families during future infection control incidents. These include the need to consider a crisis management approach, the importance of not underestimating psychological harm in incidents of a prolonged duration and embedding the existing legislation pertaining to the rights of the child. (shrink)

ContentTruth-telling is an integral part of medical practice in many parts of the world. However, recent public inquiries, including the Francis Inquiry reveal that a duty of candour in practise, are at times compromised. Consequently, the duty of candour became a statutory requirement in England. This study aimed to explore clinicians’ perspectives of the implications of the legislation for medical ethics education, as raising standards to improve patient safety remains an international concern.MethodsOne-to-one interviews with clinical educators (...) from various specialties who contribute to the MBChB programme at the authors’ university. Once data saturation had been assessed, transcripts were analysed using a thematic approach by the following concurrent activities: data reduction and coding into themes. Example quotations are used to illustrate that key themes are grounded in the data.ResultsEleven clinical educators were interviewed; three general practitioners, six physicians and two surgeons. Thematic... (shrink)

Sale of Sperm, Health Records, Minimally Conscious States, and Duties of Candour Content Type Journal Article Category Recent Developments Pages 7-14 DOI 10.1007/s11673-011-9347-6 Authors Cameron Stewart, Centre for Health Governance, Law and Ethics, Sydney Law School, University of Sydney, Sydney, NSW, Australia 2006 Bernadette Richards, Law School, University of Adelaide, Adelaide, SA, Australia 5005 Richard Huxtable, Centre for Ethics in Medicine, University of Bristol, Bristol, BS8 1TH UK Bill Madden, School of Law, University of Western Sydney, Sydney, NSW, Australia (...) Tina Cockburn, School of Law, Queensland University of Technology, Brisbane, QLD, Australia Journal Journal of Bioethical Inquiry Online ISSN 1872-4353 Print ISSN 1176-7529 Journal Volume Volume 9 Journal Issue Volume 9, Number 1. (shrink)

Dr Bawa-Garba, a senior paediatric trainee who had been involved in the care of a child who died shortly after admission to hospital, was convicted of gross negligence manslaughter and subsequently erased from the medical register. We argue that criminalisation of doctors in this way is fraught with ethical tensions at levels of individual blameworthiness, systemic failures, professionalism, patient safety and at the interface of the regulator and doctor. The current response to alleged manslaughter during clinical care is not fit (...) for purpose because of its narrow focus on criminalisation and punishment of individual doctors. The justice system fails to take into account systemic issues in a sufficiently proper and informed way particularly in respect of human factors involved in decision-making. It is easier to convict individual doctors for gross negligence manslaughter than it is to effect legal accountability upon organisations. If educational reflections are used to apportion blame, then this could impact detrimentally on honesty and the duty of candour, with negative implications for patient safety. Regulatory processes should not be deployed without consideration of context. There is an urgent need for a fresh and open evaluation of professional and societal expectations from the regulator that should include positive action as well as those that are proportionately punitive. Justice and patient safety would be served better by more sophisticated contextualisation through an approach that balances accountability in healthcare with failures that can occur within complex systems, and by working to a radical shift towards a just culture. (shrink)

This article critically evaluates the Medicines and Healthcare products Regulatory Agency’s announcement, in March 2008, that GlaxoSmithKline would not face prosecution for deliberately withholding trial data, which revealed not only that Seroxat was ineffective at treating childhood depression but also that it increased the risk of suicidal behaviour in this patient group. The decision not to prosecute followed a four and a half year investigation and was taken on the grounds that the law at the relevant time was insufficiently clear. (...) This article assesses the existence of significant gaps in the duty of candour which had been assumed to exist between drugs companies and the regulator, and reflects upon what this episode tells us about the robustness, or otherwise, of the UK’s regulation of medicines. (shrink)

Now in its sixth edition, this highly popular text covers the range of ethical issues affecting nurses and other healthcare professionals. Authors Simon Robinson and Owen Doody take a holistic and practical approach, focused in the dialogue of ethical decision making and how this connects professional, leadership and governance ethics in the modern healthcare environment. This focuses on the responsibility of professionals and leaders, and the importance of shared responsibility in the practice of healthcare. With a foreword by the eminent (...) medical ethicist Alastair Campbell, the revised edition includes contemporary topics, such as the duty of candour, recent cases, such as the Mid Staffs scandal, and ethical perspectives on vulnerable groups, such as; persons with intellectual/learning disability, dementia and those with an enduring mental illness. It builds on professional identity and personal development as part of ongoing learning, individual and organizational, and provides interactive ways that helps the reader to develop reflective ethical practice. This text aims to enable ethical engagement with the ever changing healthcare environment, and is a must-have for anyone serious about ethics in healthcare. Holistic and practice relevant approach New perspectives on vulnerable groups, such as persons with intellectual/learning disability, dementia and those with an enduring mental illness Descriptive as well as normative ethical theory Promoting dialogue and engagement with practice, practitioners, patients and families Development of professional ethical skills Connecting professional ethics to leadership, governance and social ethics Highly accessible format Case studies/Scenarios presented within chapters and pause for thought exercises to promote dialogue and engagement? Suitable for pre/post registration nurses, students, health care professionals. (shrink)

In this paper we question whether the concept of "genetic privacy" is a contradiction in terms. And, if so, whether the implications of such a conclusion, inevitably impact on how society comes to perceive privacy and responsibility generally. Current law and ethical discourse place a high value on self-determination and the rights of individuals. In the medical sphere, the recognition of patient "rights" has resulted in health professionals being given clear duties of candour and frankness. Dilemmas arise, however, when (...) patients decline to know relevant information or, knowing it, refuse to share it with others who may also need to know. This paper considers the notions of interconnectedness and responsibility to others which are brought to the fore in the genetic sphere and which challenge the primacy afforded to personal autonomy. It also explores the extent to which an individual's perceived moral obligations can or should be enforced. (shrink)

The National Health Service (NHS) has, for over four decades, been beset with numerous ‘scandals’ relating to poor patient care across several diverse clinical contexts. Ensuing inquiries proceed as though each scandal is unique, with recommendations highlighting the need for more staff training, a change of culture within the NHS based upon a ‘duty of candour’, and proposed criminal sanctions for employees believed to breach good patient care. However, mistakes reoccur and failings in patient safety continue. While inquiries (...) describe _what_ went awry in each case, questions of _how_ and _why_ such failures came to be remain unanswered. Psychology has a role in answering these questions. Applying psychological theory can guide an understanding of the _causes_ that lead to catastrophic failures in healthcare settings. Indeed, what is often neglected in inquiries is the role of human behaviour in contributing to these failures. Drawing upon behavioural, social and cognitive theories, a psychological analysis of key factors, typically present in clinical contexts where serious failures of care occur, is presented. Applying theory and models from the field of psychology can guide further understanding of the precipitants to poor care. (shrink)

Modern health care rhetoric promotes choice and individual patient rights as dominant values. Yet we also accept that in any regime constrained by finite resources, difficult choices between patients are inevitable. How can we balance rights to liberty, on the one hand, with equity in the allocation of scarce resources on the other? For example, the duty of health authorities to allocate resources is a duty owed to the community as a whole, rather than to specific individuals. Macro-duties (...) of this nature are founded on the notion of equity and fairness amongst individuals rather than personal liberty. They presume that if hard choices have to be made, they will be resolved according to fair and consistent principles which treat equal cases equally, and unequal cases unequally.In this paper, we argue for greater clarity and candour in the health care rights debate. With this in mind, we discuss (1) private and public rights, (2) negative and positive rights, (3) procedural and substantive rights, (4) sustainable health care rights and (5) the New Zealand booking system for prioritising access to elective services. This system aims to consider: individual need and ability to benefit alongside the resources made available to elective health services in an attempt to give the principles of equity practical effect. We describe a continuum on which the merits of those, sometimes competing, values—liberty and equity—can be evaluated and assessed. (shrink)

This contribution asks how to approach the question of whether the European Union should – replacing or supplementing member states – also be a locus of social justice‐based duties to provide welfare state services. The contribution scrutinizes two important theories of global justice (cosmopolitan and relational theories) and finds that their normative assumptions hinder them from adequately addressing this question. A new theory is proposed, inspired by Immanuel Kant's political philosophy. The core idea is that social justice requires public authorities (...) to protect citizens against private forms of coercion; and that the level (national, European, global) at which such authority needs to be exercised depends on which arrangement best protects citizens' rights to independence. The paper outlines several duties of global justice to give specificity to this general principle, and then applies them to the case of integrating European welfare states. (shrink)

The relationship between memory and history, which has preoccupied historiography and the philosophy of history since the middle of the nineteenth century, took a particular course in France at the end of the millennium. The forms this relationship took in this particular context have been the subject of heated debate around whether the reconstruction of the past should bear the sign of a moral imperative or, on the contrary, it should be kept away from any moral conditioning. To address this (...) question and underline its particular relevance to the present, I will revisit a significant debate, based around Paul Ricoeur’s interpretation of the duty of memory developed in his book Memory, History, Forgetting. I will do this by means of a three-step approach. First, a short introduction will provide several guidelines for understanding the issues at stake in the debate in which Ricoeur was caught and explanations regarding the significance of the main notions around which the discussions took place, i.e., the duty and work of memory. Second, I will identify how historical debates, political decisions and civic concerns about the past gradually coagulated into two different “camps” in France during the 1980s and 1990s, i.e., the advocates of memory against those of history, foreshadowing the emergence of a historiographical crisis, the stakes of which I will analyse in detail. Finally, I will show how Ricoeur’s solution to this debate, i.e., an incomplete dialectic between the duty and the work of memory, developed on the horizon of justice, continues to have relevance for the present, being an innovative form of “defatalizing” the past. (shrink)

Many social practices treat citizens with cognitive disabilities differently from their nondisabled peers. Does John Rawls's theory of justice imply that we have different duties of justice to citizens whenever they are labeled with cognitive disabilities? Some theorists have claimed that the needs of the cognitively disabled do not raise issues of justice for Rawls. I claim that it is premature to reject Rawlsian contractualism. Rawlsians should regard all citizens as moral persons provided they have the potential for developing the (...) two moral powers. I claim that every citizen requires specific Enabling Conditions to develop and exercise the two moral powers. Structuring basic social institutions to deny some citizens the Enabling Conditions is unjust because it blocks their developmental pathways toward becoming fully cooperating members of society. Hence, we have a duty of justice to provide citizens labeled with cognitive disabilities with the Enabling Conditions they require until they become fully cooperating members of society. (shrink)

In the course of attacking the idea that the concept of the duty of care can be dispensed with and replaced by a view of negligence that deals only with fault and causation, critics have revived the notion that there are many duties of care. This article argues that the idea of many duties of care is unworkable, but that there is no need to revive such an idea to avoid falling into the view that the whole concept of (...) the duty of care can be discarded. It argues instead for a unified view of the duty of care as a single duty. It also argues for a new analysis of negligence, facilitated by the one-duty view, which does see fault as central to negligence but which, instead of discarding duty, sees arguments about duty as about whether the defendant should be permitted to act unreasonably. The article defends the one-duty view and the new analysis of negligence against the relational view of negligence and against charges that it is motivated by a desire for unity between English and French law, that it would be incompatible with the conventional economic analysis of tort law (in the course of which it suggests an economic analysis of the duty of care), and that, unlike the no-duty view or the many-duties view, it fails to articulate a coherent view of the relationship between freedom and community. (shrink)

Displaying her intellectual and literary abilities from a young age, 'Mrs Taylor of Ongar' enjoyed writing all her life. She had eleven children, of whom six survived to adulthood. Her published works began with advice books for her own daughters, produced when increasing deafness made ordinary conversation difficult for her. This book, published in 1818, follows her earlier works for young women with a guide to conduct and 'reciprocal duties' within the family. Stern warnings and cautionary tales are given to (...) show the importance of duty to and respect for parents by children, but the parental duties of care in rearing and especially in education are emphasised. Early discipline, lovingly applied, is seen as the key to successful parenting, and its absence is deemed disastrous. Like Ann Taylor's Practical Hints to Young Females, the book offers fascinating insights into the middle-class ideal of domestic happiness. (shrink)

Background Escalating levels of obesity place enormous and growing demands on Health care provision in the (U.K.) United Kingdom. Resources are limited with increasing and competing demands upon them. Ethical considerations underpin clinical decision making generally, but there is limited evidence regarding the relationship between these variables particularly in terms of treating individuals with obesity. Research aim To investigate the views of National Health Service (NHS) clinicians on navigating the ethical challenges and decision making associated with obesity management in adults (...) with chronic illness. Research design A cross-sectional, multi-site survey distributed electronically. Participants A consensus sample of nurses, doctors, dietitians and final year students in two NHS Trusts and two Universities. Ethical considerations Ethical and governance approvals obtained from a National Ethics Committee (11NIR035), two universities and two teaching hospitals. Results Of the total ( n = 395) participants, the majority were nurses (48%), female (79%) and qualified clinicians (59%). Participants strongly considered the individual to have primary responsibility for a healthy weight and an obligation to attempt to maintain that healthy weight if they wish to access NHS care. Yet two thirds would not withhold treatment for patients with obesity. Discussion While clinicians were clear about patient responsibility and obligations, the majority prioritised their duty of care and would not invoke a utilitarian approach to decision making. This may reflect awareness of obesity as a multi-faceted entity, with responsibility for support and management shared amongst society in general. Conclusions The attitudes of this sample of clinicians complemented the concept of the health service as being built on a principle of community, with each treated according to their need. However limited resources challenge the concept of needs-based decisions consequently societal engagement is necessary to agree a pragmatic way forward. (shrink)

Kant is well known for claiming that we can never really know our true moral disposition. He is less well known for claiming that the injunction "Know Yourself" is the basis of all self-regarding duties. Taken together, these two claims seem contradictory. My aim in this paper is to show how they can be reconciled. I first address the question of whether the duty of self-knowledge is logically coherent (§1). I then examine some of the practical problems surrounding the (...) duty, notably, self-deception (§2). Finding none of Kant's solutions to the problem of self-deception satisfactory, I conclude by defending a Kantian account of self-knowledge based on his theory of conscience (§3). (shrink)

A challenge to Kant’s less known duty of self-knowledge comes from his own firm view that it is impossible to know oneself. This paper resolves this problem by considering the duty of self-knowledge as involving the pursuit of knowledge of oneself as one appears in the empirical world. First, I argue that, although Kant places severe restrictions on the possibility of knowing oneself as one is, he admits the possibility of knowing oneself as one appears using methods from (...) empirical anthropology. Second, I show that empirical knowledge of oneself is fairly reliable and is, in fact, considered as morally significant from Kant’s moral anthropological perspective. Taking these points together, I conclude that Kant’s duty of self-knowledge exclusively entails the pursuit of empirical self-knowledge. (shrink)

There is a surprising absence of systematic theological reflection on what the church’s response to refugees should be and how its response relates to wider debates on the duty of care to refugees. This article situates theological concerns within wider philosophical debate on what the duty of care to refugees consists of. The first section critically reviews the debate on how liberal democracies should respond to refugees. The second section, following Georgio Agamben’s characterisation of refugees as ‘bare life’, (...) argues that refugees unveil a deep contradiction in contemporary patterns of political sovereignty. It closes by arguing that while a theological account of political authority points to some roads beyond the crisis, the first task of the church is to properly order its own duty of care to refugees. The last section consists of an exegesis of the second clause of the Lord’s Prayer as a way of giving an account of what such care involves. (shrink)

The rules governing impaired transfers are widely thought to lie at the core of unjust enrichment law. This essay defends two propositions about these rules. First, there is no duty, in the common law, to make restitution of benefits obtained as the result of an impaired transfer . Rather than imposing duties to make restitution, or indeed duties of any kind, the rules governing impaired transfers impose only liabilities, in particular liabilities to judicial rulings. The only legal consequence of (...) a mistaken payment is that the recipient is liable to be judicially ordered to repay a sum of money equal to the payment. Second, it matters that the law governing impaired transfers imposes only liabilities, and not duties, because, inter alia, explaining and justifying liabilities is different from explaining and justifying duties. In particular, certain well-known objections to attempts to explain impaired transfer law can be avoided once it is recognized that this law is concerned exclusively with liabilities. In summary, then, this essay argues that the distinction between duty-imposing and liability-imposing rules has important implications for understanding the foundations of the law governing impaired transfers. (shrink)

The passing of the French law that prohibits face coverings, such as the Islamic burqa, in public places ignited a complex philosophical and legal debate. Participants in the debate have typically focused on the boundaries between individual and religious liberties, on the one hand, and state-imposed limitations on public behaviors, on the other. The author of this paper wishes to introduce a change in perspective by concentrating instead on the duties immigrants have to the citizens of the countries that host (...) them. The author finds that, under certain circumstances, immigrants may have a moral duty to conform to the ethical preferences of the communities they have come to live and interact with. (shrink)

I argue that agents can have duties to cooperate with one another if this increases their combined efficiency and/or efficacy in addressing ongoing collective moral problems. I call these duties cooperative duties of efficiency and efficacy. I focus particularly on collective agents and how agents ought to reason and act in the face of global moral problems. After setting out my account, I argue that a subset of cooperative duties of efficiency and efficacy of collective agents are duties of justice (...) in virtue of the roles these agents have taken up. (shrink)

Vaccine hesitancy or refusal has been one of the major obstacles to herd immunity against Covid-19 in high-income countries and one of the causes for the emergence of variants. The refusal of people who are eligible for vaccination to receive vaccination creates an ethical dilemma between the duty of healthcare professionals (HCPs) to care for patients and their right to be taken care of. This paper argues for an extended social contract between patients and society wherein vaccination against Covid-19 (...) is conceived as essential for the protection of the right of healthcare providers to be taken care of. Thus, a duty of care is only valid when those who can receive vaccination actually receive it. Whenever that is not the case, the continuing functioning of HCPs can only be perceived as supererogatory and not obligatory. (shrink)

In NX v. Cabrini Medical Center, New York's highest court overruled a divided Appellate Division and held that, as a matter of law, a jury could find a hospital negligent for its failure to protect a patient from sexual assault. The court refused, however, to adopt a higher standard of tort liability for health-care providers who treat incapacitated patients.

Patient’s duties are a topical but little researched area in nursing ethics. However, patient’s duties are closely connected to nursing practice in terms of autonomy, the best purpose of care and rethinking from the patient’s perspective. This article is a metasynthesis (N = 11 original articles) of patient’s duties, aimed to create a tentative model. In this article, a tentative model called ‘right-based duties of a patient’ was constructed. With its aid, a coherent structure of patient’s duties within different roles (...) and objects of a patient can be defined. In addition, the ethical basis, prerequisites, outcomes and risks of patient’s duties can be named. In conclusion, so-called right-based duties of a patient constitute the basic argument. Patient’s duties are not unambiguous for all patients, and the global perspective to duties has been challenged. However, due to both conceptual and practical reasons, rethinking of patient’s duties is needed. (shrink)

The view that innocent beneficiaries of injustice bear special duties to victims of injustice has recently come under attack. Luck egalitarian theorists have argued that thought experiments focusing on the way innocent beneficiaries should distribute the benefits they’ve received provide evidence against this view. The apparent special duties of innocent beneficiaries, they hold, are wholly reducible to general duties to compensate people for bad brute luck. In this paper we provide empirical evidence in defense of the view that innocent beneficiaries (...) have genuine special duties to victims of injustice. Through a series of four experiments, we show that judgments about the kinds of cases that luck egalitarian critics have provided do not undermine but rather support this view. We also explore a number of other questions that theorists working in this area have yet to discuss and provide suggestions for further research on the moral significance of benefiting from injustice. (shrink)

We address the issue of whether, why and under what conditions, quarantine and isolation are morally justified, with a particular focus on measures implemented in the developing world. We argue that the benefits of quarantine and isolation justify some level of coercion or compulsion by the state, but that the state should be able to provide the strongest justification possible for implementing such measures. While a constrained form of consequentialism might provide a justification for such public health interventions, we argue (...) that a stronger justification is provided by a principle of State Enforced Easy Rescue: a state may permissibly compel individuals to engage in activities that entail a small cost to them but a large benefit to others, because individuals have a moral duty of easy rescue to engage in those activities. The principle of State Enforced Easy Rescue gives rise to an Obligation Enforcement Requirement: the state should create the conditions such that submitting to coercive or compulsive measures becomes a fundamental moral duty of individuals, i.e. a duty of easy rescue. When the state can create such conditions, it has the strongest justification possible for implementing coercive or compulsive measures, because individuals have a moral duty to temporarily relinquish the rights that such measures would infringe. Our argument has significant implications for how public health emergencies in the developing world should be tackled. Where isolation and quarantine measures are necessary, states or the international community have a moral obligation to provide certain benefits to those quarantined or isolated. (shrink)

Journal of Social Philosophy, EarlyView.

Is there a moral requirement to assist wild animals suffering due to natural causes? According to the laissez-faire intuition, although we may have special duties to assist wild animals, there are no general requirements to care for them. If this view is right, then our positive duties toward wild animals can be only special, grounded in special circumstances. In this article I present the contribution argument which employs the thought that the receipt of benefits from wild animals is one such (...) kind of special circumstance. If this argument is correct, then the circle of moral agents required to assist some wild animals is significantly widened. (shrink)

This is a time of change in American healthcare. Market forces are restructuring local delivery systems around competing managed care networks. Many leading proposals for healthcare reform intend a reshaping of the national healthcare marketplace itself. Periods of change create an opportunity to reassess traditional values and practices. Such reassessments can be used to help insure that current innovations and proposed reforms preserve and strengthen the best in the traditions of medicine. A legitimate focus of concern in the medical and (...) medical ethics community has been the effect of these delivery system changes on the physician-patient relationship. For example, will the future American healthcare system support and encourage compassion by physicians? Suppose it does not. Would something of significant moral value have been lost? More pointedly, would a system that undervalued or frustrated physician compassion be incompatible with the moral obligations of physicians? In order to address these questions, we examine the meaning of compassion and the role it should play in the physician-patient relationship. We argue that compassion is a duty of all physicians. Because this is so, we believe that changes in the healthcare system must be judged, in part, by how well they protect and encourage compassionate conduct by physicians. (shrink)

Conjoined with the claim that there is a moral right to privacy, each of the major contemporary accounts of privacy implies a duty of ignorance for those against whom the right is held. In this paper I consider and respond to a compelling argument that challenges these accounts (or the claim about a right to privacy) in the light of this implication. A crucial premise of the argument is that we cannot ever be morally obligated to become ignorant of (...) information we currently know. The plausibility of this premise, I suggest, derives from the thought that there are no epistemically ways in which we can cause ourselves to become ignorant of what we already know. Drawing on some recent work in the epistemology and psychology of self-deception and forgetting, I seek to undermine this thought, and thus provide a defense against the challenging argument, by arguing that there are indeed such ways. (shrink)

Scholars who favor shareholder primacy usually claim either that managers should not fulfill corporate duties of beneficence or that, if they are required to fulfill them, they do so by going against their obligations to shareholders. Distinguishing between structurally different types of duties of beneficence and recognizing the full force of the normative demands imposed on managers reveal that this view needs to be qualified. Although it is correct to think that managers, when acting on behalf of shareholders, are not (...) required to fulfill wide duties of charity, they are nevertheless required to fulfill a variety of narrow duties of beneficence. What is more, the obligation to fulfill these duties arises precisely because they are acting on behalf of shareholders. As such, this article 1) refines our understanding of the duties of corporate beneficence and 2) helps to identify which duties of beneficence are imposed on managers when they are acting on behalf of shareholders. (shrink)

In discussing the normative implications of the doctor-patient relationship, medical ethics has mostly focused on the duties of doctors to their patients. This focus neglects an important normative dimension of the doctorpatient- relationship, namely the duties of patients to doctors. Only few authors have discussed the content and ground of the moral duties of patients, and each of these accounts are wanting in some way. This paper discusses patients’ duties and argues that patients have a relationship-dependent obligation to cooperate with (...) the doctor, because doctors have a morally justified interest in fulfilling their moral role obligations as doctors, and by not cooperating, patients make it more difficult for doctors to fulfill their moral obligations. In some cases, failing to cooperate might even create an avoidable moral dilemma for the doctor. (shrink)

This article argues that congregations should be seen as grassroots public moral agents, on the ground working to bring what they discern as God's preferred future into being. Deliberations among congregations of all social backgrounds are a way of doing ethics "polycentrically," without a dominant center. Because cultural and social boundaries are permeable and people in various social groups can imaginatively enter the worlds of people unlike themselves, they can engage those perspectives morally on an equal footing. The essay addresses (...) ethicists' participation in congregations' moral deliberation and action, and concludes with a plea for theological ethicists to consider congregations in their work. (shrink)

One of the principal aims of Kant’s Metaphysics of Morals, especially of the Doctrine of Virtue, is to present a taxonomy of our duties as human beings. The basic division of duties is between juridical duties and ethical duties, which determines the division of the Metaphysics of Morals into the Doctrine of Right and the Doctrine of Virtue. Juridical duties are duties that may be coercively enforced from outside the agent, as by the civil or criminal laws, or other social (...) pressures. Ethical duties must not be externally enforced (to do so violates the right of the person coerced). Instead, the subject herself, through her own reason and the feelings and motives arising a priori from her rational capacities -- the feelings of respect, conscience, moral feeling and love of other human beings, must constrain herself to follow them (MS 6:399-404).1 Among ethical duties, the fundamental division is between duties to oneself and duties to others. Within each of these two main divisions of ethical duty, there is a further division between duties that are strictly owed, requiring specific actions or omissions, and whose violation incurs moral blame, and duties that are wide or meritorious, the specific actions not strictly owed, but deserving of moral credit or merit. Kant treats these latter as ‘duties’ (eschewing any category such as ‘supererogation’) because the actions in question are conceived as fit objects of self-constraint – things we can make ourselves do through the exercise of reason and the moral feelings arising from the application of practical reason to our faculty of desire. Regarding duties to oneself, this division is between ‘perfect’ and ‘imperfect’ duty; regarding duties to others, the strict or narrow... (shrink)

Individuals who demonstrate organizational citizenship behavior (OCB) contribute to their organization’s ability to create wealth, but they also owe their organizations a complex set of ethical duties. Although, the academic literature has begun to address the ethical duties owed by organizational leaders to organizational citizens, very little has been written about the duties owed by those who practice OCB to their organizations. In this article, we identify an array of ethical duties owed by those who engage in extra-role behavior and (...) describe those duties in context with personality theory. We suggest that employees who understand the complex nature of OCB and the associated duties they owe to others are more likely to reach their potential and make greater contributions within their organizations. (shrink)

It is uncontroversial that our engagement with artworks is constrained by obligations; most commonly, these consist in obligations to other persons, such as artists, audiences, and owners of artworks. A more controversial claim is that we have genuine obligations to artworks themselves. I defend a qualified version of this claim. However, I argue that such obligations do not derive from the supposed moral rights of artworks – for no such rights exist. Rather, I argue that these obligations are instances of (...) duties of love: obligations that one incurs in virtue of loving some object, be it a person or, in this case, an artwork. (shrink)

This paper investigates board judgment in response to management led buyouts (MLBs). Board response is suggested to be guided by the business judgment rule and its dual duties of care and loyalty. The duty of loyalty is seen to be evolving into a specification of fair dealing. With this trend, the current interpretation of the business judgment rule emphasizes the role of care and relies on the market to insure fairness. Possible failures in the MLB market which limit its (...) effectiveness in assuring fairness are discussed. Recommendations to counteract these failures are suggested. (shrink)

In his paper ‘The truth behind conscientious objection’ Nir Ben-Moshe develops a new approach aimed at justifying conscientious objection (CO) without relying on respect of moral integrity of the conscientious objector or tolerance towards her moral views.1 According to Ben-Moshe, the problem with justifications of CO based on moral integrity and tolerance is that ‘truth of conscience’s claims is irrelevant to their justification’. He argues, to the contrary, that whether the claims of the conscientious objector are true or false makes (...) a difference in assessing whether their objection is justifiable or not. He goes on explaining that someone’s CO can be justified if it can be proved that ‘conscience can express true moral claims’. Ben-Moshe then proceeds to explain how one can determine true moral claims. He develops an account of conscience that is modelled on that of Adam Smith. In particular, he uses the idea of the ‘impartial spectator’ to show how a true claim of conscience can emerge after careful thinking from the point of view of an impartial perspective. So, if the healthcare practitioner wants to object to a certain medical procedure after considering the issue at hand from the moral standpoint of such impartial spectator, then her claims of conscience are true (or …. (shrink)

Background: The theoretical framework of Jϋrgen Habermas suggests that effective communication requires competent participants with an objective attitude that complies with the rules and worlds designated as objective, social and subjective. This situation determines communicative action, which stimulates the search for mutual understanding and results in a process of interaction that promotes self-determination. Objectives: In this study, the discharge letters of patients with myocardial infarction were explored regarding the provision of information. The patient’s right to information and the duty (...) of informing were analysed according to the perspective of Jϋrgen Habermas. Research design: This was a cross-sectional analysis (from a broader longitudinal study) of all discharge letters that were directly related to nursing interventions regarding the provision of information to 106 patients. In this major study, the difficulties faced by patients who experienced a myocardial infarction and the changes in their lifestyles were analysed based on the type of information received. Ethical considerations: The hospital Ethics Committee approved the study, which complied with ethical principles and required informed consent. Findings: In the nursing letters, interventions related to the provision of information were conducted at an average of 3.59 interventions per patient. For 8.5% of the patients, however, no interventions related to the provision of information were performed. The most common area of information during hospitalisation was related to the management of signs and symptoms and applied to 90.6% patients. Discussion: The nursing interventions did not cover patient education, transition processes or awareness of the disease. Thus, the right to information can be questioned. Conclusion: Information is a right, and communication is extremely important. Health professionals should be aware of this importance regarding both care management and the satisfaction guarantee. The sharing of information by health professionals based on their competency is essential for patients to exercise their right to self-determination and decision-making. (shrink)

Artificial intelligence-driven technology increasingly shapes work practices and, accordingly, employees’ opportunities for meaningful work (MW). In our paper, we identify five dimensions of MW: pursuing a purpose, social relationships, exercising skills and self-development, autonomy, self-esteem and recognition. Because MW is an important good, lacking opportunities for MW is a serious disadvantage. Therefore, we need to know to what extent employers have a duty to provide this good to their employees. We hold that employers have a duty of beneficence (...) to design for opportunities for MW when implementing AI-technology in the workplace. We argue that this duty of beneficence is supported by the three major ethical theories, namely, Kantian ethics, consequentialism, and virtue ethics. We defend this duty against two objections, including the view that it is incompatible with the shareholder theory of the firm. We then employ the five dimensions of MW as our analytical lens to investigate how AI-based technological innovation in logistic warehouses has an impact, both positively and negatively, on MW, and illustrate that design for MW is feasible. We further support this practical feasibility with the help of insights from organizational psychology. We end by discussing how AI-based technology has an impact both on meaningful work (often seen as an aspirational goal) and decent work (generally seen as a matter of justice). Accordingly, ethical reflection on meaningful and decent work should become more integrated to do justice to how AI-technology inevitably shapes both simultaneously. (shrink)