Pain medication is one of the responses to the mercy argument that utilitarian ethicists use for justifying active euthanasia on the grounds of prevention of cruelty and appeal to beneficence. The researcher reinforces the significance of pain medication in meeting this challenge and considers it the most preferred response among various other responses. It is because of its realism and effectiveness. In exploring the mechanism and considerations related to pain medication, the researcher briefly touches the Catholic ethical position on the (...) issue, a position that cannot be ignored in the development of contemporary bioethics. The researcher particularly deliberates on the contemporary Islamic discourse on the issue; by furthering the debate in line with the Islamic legal maxims and general guidance from the primary sources of Islamic law and ethics. The resolution on the issue is sought by synthesizing the views and legal maxims (al-Qawaid al-Fiqhiyyah) on the issue, which in conclusion provide justification for pain medication by considerably regarding pain as necessity and pressing need. However, such resolution allows pain medication to the limit and proportion that removes the pain and prohibits overdosing the patient with medication that may directly cause the death. (shrink)

Non-medical or Social egg freezing (oocyte cryopreservation) is currently a controversial topic in Islam, with contradictory fatwas being issued in different Muslim countries. While Islamic authorities in Egypt permit the procedure, fatwas issued in Malaysia have banned single Muslim women from freezing their unfertilized eggs (vitrified oocytes) to be used later in marriage. The underlying principles of the Malaysian fatwas are that (i) sperm and egg cells produced before marriage, should not be used during marriage to conceive a child; (...) (ii) extraction of mature egg cells from single women being unacceptable; and (iii) fertility preservation in anticipation of late marriage is a conjecture that has not yet occurred. Ovarian tissue freezing can potentially be a more Shariah-compliant alternative to social egg freezing, because once the frozen ovarian cortical tissue sections have been re-transplanted back into the woman, mature egg cells can readily be produced, collected, and fertilized by the husband’s sperm only during the period of marriage contract (′akd al-nikāḥ). Unlike accidental mix-ups with frozen eggs, muddling of lineage (nasab) would be automatically avoided in ovarian tissue freezing due to immunological rejection. However, upon critical analysis based on Qawā’id Fiqhiyyah (Islamic Legal Maxims), Maqāṣid-al-Shariah (Higher Objectives of Islamic Law), and Maslaḥah-Mafsadah (benefits versus harmful effects on society), elective ovarian tissue freezing by healthy single women for social reasons would likely be a highly contentious and controversial issue within Muslim communities that may conflict with conservative social-religious norms. This thus needs further debate among Islamic jurists in dialogue with medical doctors and biomedical scientists. (shrink)

PurposeThe paper aims to introduce the Islamic “legal system of Shari'ah laws and ethics” and its process of resolving ethical quandaries as applied in the field of information ethics.Design/methodology/approachThe paper first introduces some of the intricacy of the Islamic Shari'ah laws and ethics and then to reason its applicability in the field of IE, a scenario is discussed to illustrate how Islamic legal maxims maybe implemented to arrive at a moral judgment.FindingsThe discussed scenario shows glimpses (...) of the Shari'ah laws and reasoning processes of the Islamic ethical methodology for deriving moral judgment as used in the Muslim world to bring benefits and repel harms. The system respects both collective and individual's perspectives and can be conceived as being a synthesis between deontological, consequentialist and virtue ethics theories.Practical implicationsThe paper is sufficient to give the reader a feel for its potential to encourage further research in the area of resolving ethical issues, specifically for those who are calling for universal ethical theories to avoid moral imperialism.Originality/valueEthical researchers have gone back in history as far as Aristotle and Descartes to address ethical issues arising from the development and application of information and computer technologies. One area of ethics rarely touched by ethical theorists is the religious laws and ethics of Islam. The paper introduces Islam and its sources of knowledge, which are the foundation for a large set of legal maxims used to govern ethical decisions. (shrink)

Catholic ethical teaching has increasingly relied on a concept of the common good for making and evaluating social decisions. The authors have argued that the common good is a maximal and ideal concept about which people and communities differ fundamentally. In practice, it does not resolve moral and social disagreements. The concept of the common harm is preferable because it is a minimal standard that can be more clearly identified and agreed for individuals and society, providing a basis for legislative (...) and social action. Bioethics and public health both have strong roots in doing no harm and preventing harm to both individuals and communities in society. The authors argue that the application of the concept of the common harm from these disciplines into wider use in the health professions and public policy would be beneficial. National Catholic Bioethics Quarterly 14.3 : 449–455. (shrink)

Polygyny, the marriage of a man with more than one woman at the same time is a well-known practiced in human history. Islamic law accepts the institution of polygyny as a substitute provision if it fulfills the certain conditions and reasons, -and limited the maximum number of wives to four. Although polygyny is mubah (permissible) in Islamic law, it is not an absolute right that every man can use arbitrarily. Thus in Islamic law, the legitimacy of polygyny (...) has been attributed to the presence of two basic conditions: the observance of justice among co-wives and providing maintnance. However, the observance of these conditions that is left to the mercy of men leads to the exploitation of the right for practicing to polygyny and victimization of the first spouse. Therefore, inserting some restrictions for using this right has come to the agenda from time to time in Islamic legal history. The first legal arrangements concerning the restriction of the polygyny (taaddud al-zawjāt) in the history of Islamic law were indirectly made with the Family Law Decree of 1917 which was prepared in the last periods of the Ottoman Empire. Among the late Islamic jurists, the issue of the limitation of polygyny by public authority in Islamic law continues to be discussed. The civil laws of contemporary Muslim countries contain different regulations on the issue. In this article, the restriction of polygyny by the public authority in Islamic family law will be focused on.Summary: Polygyny, the marriage of a man with more than one woman at the same time is a well-known practiced in human history. Islamic law accepts the institution of polygyny as a substitute provision if it fulfills the certain conditions and reasons, and limited the maximum number of wives to four. Thus, relevant verses in the Qur’an (al-Nisa 4/3, 129) and the Prophet’s own practice (al-Ahzab 33/50, 51, 59 al-Tahrim 66 / 3-5) show that it is legitimate for a man to marry more than one woman (up to four) at the same time in Islamic law. Although polygyny is legally permissible (mubah) in Islamic law it is not an absolute right that every man can arbitrarily use. Thus in Islamic law, the legitimacy of polygyny has been attributed to the presence of two basic conditions: the observance of justice among co-wives and providing maintenance. On the other hand, there may be some exceptional circumstances permitting polygyny in Islamic law. For example, when female population is much more than male in the society and when a, woman is can not fulfill her family duties due to her cureless illness, polygyny is permitted in Islamic law.As it can be understood from the explanations above, polygyny in Islamic law is not a general and mandatory provision that should be applied by every man who has legal capacity to marry. On the contrary, it is an exceptional provision that is justified if there are certain conditions and justifications. According to this; polygyny is a moral and legal institution that is made up of mutual consent based on individual and social conditions and needs in Islamic law. Therefore, men do not have to marry a second woman on their current wives, as well as women have the right to say “no” to marry a married man as a second wife.When the conditions and rationales indicated in the relevant verses and doctrine are evaluated together, it can be said that in order to be able to legitimize the polygyny in Islamic law, there must be three basic conditions:(1) Observing justice among spouses, (2) Having sufficient financial power to provide maintenance for spouses, (3) Existence of individual or social need or necessity.Therefore, in order to prevent the exploitation of polygyny, which is justified under certain conditions and justifications in Islamic law, the above-mentioned conditions must be fulfilled. Otherwise, polygyny can cause some problems, unrest and injustice for individual, family and society. Hence, in the presence of certain conditions and justifications, polygyny accepted in Islamic law as a moral and legal institution aiming the elimination of individual and social arbitration.Although the legitimacy of polygyny in Islamic law depends on the existence of certain conditions and special circumstances, it is a known fact that they are not always observed in practice. It can be said that the right of polygyny is a subject of abuse in practice. Therefore, the limitation of polygyny by the public authority has come to the fore in Islamic legal history. Today, control of the public authority and inserting some restrictions of polygyny continue to be discussed among the Islamic jurists. In the past, it is possible to say that the control of the exercising of this right has been done relatively by society (social environment). However, nowadays, since the society cannot perform the control mechanism, it is brought up by the state (public authority) on behalf of the society.Among the contemporary Islamic jurists regarding the supervision or limitation of polygyny by the public authority; there are two approaches: “those who accept” and “those who do not accept” such restrictions.Islamic jurists, who accept that public authority is allowed to intervene in polygyny, grounded their views on two perspectives: The first is that the polygyny is legally permissible and the public authority has the authority to limit the permissible (mubah) in Islamic law. The second is that polygyny is restricted with the conditions in the Qur’anic verses such as “husband’s observation supervision of justice among his wives” and “having the power for ensuring the livelihood (nafaqa) of his wives” and it is more appropriate for the benefit of society and the purpose of the legislator (Shari’) to be subject to the control of the public authority whether these conditions are present or not. Islamic jurists, who do not agree that the public authority has the right to intervene in polygyny grounded their views on two perspectives as well: First, polygyny is a legitimate right mentioned in the verses in Islamic law and there is no definite proof that this can be prohibited or restricted by the public authority. Secondly, it is contrary to the verses to prohibit or limit the right that the Qur’an makes legitimate (free).Thus, it is possible to say that the opinion which accepts that the public authority has to limit polygyny is more accurate in terms today’s social conditions. Namely, polygyny is linked to two basic conditions: ”husband’s observance of justice among his wives and having the power to provide maintenance for his wives. Therefore, supervision of the public authority on checking the existence of these conditions is more appropriate for the purpose of the legislator (Shari legitimizing polygyny and social benefit.In fact, the Ottoman Family Law Decree of 1917 indirectly limited the right of the husband to marry more than one woman, giving the woman right to stipulate a condition in her marriage contract that her husband not to marry a second woman. In the 1924 Draft of Family Law Decree, which was prepared after the repeal of the Family Law Decree of 1917, but not enacted, it was proposed that the application of polygyny should be presented to the approval judge.In today’-s Muslim countries, there are three different practices: namely “completely prohibiting polygyny”, ”releasing polygyny” and “giving the court the right to monitor the existence of necessary conditions “. In countries such as Morocco, Algeria, Iraq, Syria, Indonesia, Malaysia (and Pakistan), the validity of polygyny depends on the permission and supervision of the judiciary. Some of these countries which have accepted judicial review have given the judicial control for the requirement of justice, some of them the conditions of justice and maintenance some of them for the conditions of justice, maintenance and a legitimate justification.In sum, in accordance with the provisions of the relevant verses, polygyny in Islamic law is legitimately permissible (mubah). However, the public authority has the right and authority to limit the mubah in Islamic law in the case of the elimination of damage and the necessity of the public interest. On the other hand, the public authority has the right and authority to enact the law in Islamic law by preferring one of the existing ijtihads that meet the needs of the society and conforms to the conditions of the age.According to this, when the public authority made a statutory regulation that links the use of right of polygyny to the permission of the judge, this regulation is binding on society.Therefore, in the event of such a legal arrangement, it is possible for the public authority to allow the men who comply with the conditions and not to allow the ones who are not to comply with the conditions after conducting the necessary investigation. As a matter of fact, now Family Laws of many Muslim countries now include such legal arrangements. It is also worth mentioning here that there may be a necessity for a man to marry more than one woman (up to four) at the same time in terms of social benefits, when the population of male and female in a society is excessively disproportionate. In such circumstances, it is also possible that the public authority encourages, or even mandates, the marriage of men who have fulfilled the conditions to more than one woman. (shrink)

Artificial womb technology for extracorporeal gestation of human offspring (ectogenesis or ectogestation) has profound ethical, sociological and religious implications for Muslim communities. In this article we examine the usage of the technology through the lens of Islamic ethico-legal frameworks specifically the legal maxims (al-Qawaid al-Fiqhiyyah) and higher objectives of Islamic law (Maqaṣid al-Shariah). Our analysis suggests that its application may be contingently permissible (halal) in situations of dire need such as sustaining life and development of extremely (...) premature newborns, for advancing fetal medicine and avoiding maternal co-morbidities during fetal treatment, and for enabling motherhood for women without functional wombs, or who face grave medical risks in pregnancy. However, its application may be proscribed (haram) for enabling healthy women to avoid pregnancy and childbirth, or to achieve parenthood equity. Specification of these views to particular policy, legal contexts and Fatwa will require multidisciplinary Shariah-based bioethical deliberations between jurists, policymakers, and scientists. (shrink)

Muslims living in England are living in a predicament. On the onehand, they have to face the reality that the laws governing the family institutionare secular in nature. This poses a threat to their identity and freedom ofreligion. On the other hand, they are commanded by Islam to settle theirdisputes according to its laws and principles. However, this is unrealistic,simply due to the fact that the only recognized legal system in England isthe English Law. To circumvent this situation, certain (...) Muslim scholars andcommunities have established quasi-judicial courts, acting in the capacity ofmediators, counsellors, arbitrators and even judges, in order to settle maritaldisputes. These courts, known as Shariah councils, provide a modern approachto alternative dispute resolution, whereby Muslim families and individualscan have their disputes resolved amicably. It was also set up as a response forMuslims to adapt to life under the English secular laws in which they live in,that do not afford them the right of having a Sharʑah-based institution. Onesuch Shariah council offering a modern approach to settling marital disputesamicably is the Islamic Council of Europe. The researcher conducted anin-depth interview with the said council and was able to collect a couple ofarbitrational cases and analysed them in order to give a better understandinginto its inner workings, its structural set-up and operation. Hence, this paperaims to critically and juristically analyse them from an Islamic legal maximperspective while taking the Muslim minority context into consideration. (shrink)

Advances in genomics have led to calls for developing population-based preventive genomic sequencing programs with the goal of identifying genetic health risks in adults without known risk factors. One critical issue for minimizing the harms and maximizing the benefits of PGS is determining the kind and degree of control individuals should have over the generation, use, and handling of their genomic information. In this article we examine whether PGS programs should offer individuals the opportunity to selectively opt out of the (...) sequencing or analysis of specific genomic conditions or whether PGS should be implemented using an all-or-nothing panel approach. We conclude that any responsible scale-up of PGS will require a menu approach that may seem impractical to some, but that draws its justification from a rich mix of normative, legal, and practical considerations. (shrink)

Adolescent sexuality is one of the most important reproductive health issues that confronts healthcare professionals with moral dilemmas and legal issues. In this study, we aim to justify the at-risk adolescents’ regulations on access to key reproductive health services (KRHSs) based on principles of Islamic biomedical ethics and jurisprudence. Despite the illegitimacy and prohibition of sexuality for both girls and boys in Islamic communities, in this study, using 5 principles or universal rules of purpose; certainty, no-harm; necessity; (...) and custom, we argue that first, applying these principles in the context of the no-harm principle can provide the best interests of at-risk adolescents; second, it is permissible to provide KRHSs to these adolescents with their own assent, as long as necessary, only with the intention of preventing or reducing harm. In this framework, while preventing harm, it tries to provide the best interests of at-risk adolescent. Thus, the principle of no-harm requires that the government, by designating the responsibility to healthcare professionals, protects at-risk adolescents from harm, and obliges these professionals to choose and implement the option that best suits adolescents’ interests. (shrink)

Subsequent to the crystallization of the legal schools, Muslim jurists felt the need to consolidate the massive corpus of legal opinion in order to aid students and practitioners of the law. The result was legal maxims, concise theoretical statements that captured the objectives of the Sharia. An example is al-ḍarar yuzāl, which is based on the hadith lā ḍarar wa-lā ḍirār. This article analyzes the role of legal maxims in Yūsuf al-Qaraḍāwī’s jurisprudence and fatwas, as found (...) in his numerous books and articles. Its preliminary assumption is that Qaraḍāwī uses legal maxims to control and systematize the use of considerations of public welfare, especially in the field of “the jurisprudence of reality”. Because this fiqh deals mainly with political topics on which there are hardly any guidelines in scripture, and stems therefore from mostly nontextual benefits, it is an area vulnerable to undisciplined use of utilitarian considerations by jurists. Legal maxims then come in handy when weighing the relevant benefit and harm related to each topic. (shrink)

Nowadays, genetically modified foods find application in many sectors from livestock to health and especially in agriculture. From Islamic law perspective, the critical point is to know whether the modern biotechnology is properly used in genetically modified food production and whether these products are suitable for human health and whether all production stages are halal. Another important point is the uncertainty that may arise during the production and whether the precaution can be taken. The Islamic law methodology is (...) of great importance in understanding and resolving the above issues in line with religious values and scientific data together. This paper outlines how the Islamic law methodology can be applied to the issues of genetically modified goods in an interdisciplinary framework, by combining the pillars of Islam and scientific knowledge, and thus promoting what is morally, legally and economically beneficial for halal nutrition and life, for all humanity, Muslims and non-Muslims. We reach the conclusion that there are no definitive provisions set by Islamic law about these issues but they can be resolved within the scope of maslahah and maqasid, which is to achieve the righteous and eliminate the harmful. (shrink)

Formulations of Mill's principle of utility are examined, and it is shown that Mill did not recognize a moral obligation to maximize the good, as is often assumed. His was neither a maximizing act nor rule utilitarianism. It was a distinctive minimizing utilitarianism which morally obligates us only to abstain from inflicting harm, to prevent harm, to provide for others minimal essentials of well being (to which rights correspond), and to be occasionally charitable or benevolent.

Ignorant speech, which spreads falsehoods about people and policies, is pervasive in public discourse. A popular response to this problem recommends countering ignorant speech with more speech, rather than legal regulations. However, Mary Kate McGowan has influentially argued that this ‘counterspeech’ response is flawed, as it overlooks the asymmetric pliability of conversational norms: the phenomenon whereby some conversational norms are easier to enact than subsequently to reverse. After demonstrating that this conversational ‘stickiness’ is an even broader concern for counterspeech (...) than McGowan suggests—it applies not just to oppressive or hateful speech, but also to ordinary policy-related misinformation—I argue that a more sophisticated account of counterspeech can nevertheless overcome it. First, the stickiness objection overlooks the distinction between ‘negative’ and ‘positive’ counterspeech. Instead of directly negating a distorted proposition, positive counterspeech affirms a correct proposition that is inconsistent with the falsehoods at hand. This, I contend, allows it to counter ignorant speech without triggering the properties that render it sticky. Second, the stickiness objection presupposes an unrefined conception of counterspeech’s temporality. Counterspeech should be understood as a diachronic process, which not only follows, but also pre-empts, ignorant utterances. Drawing on speech-act theories of silencing, I argue that pre-emptive counterspeech can condition the conversational context so as to prevent subsequent ignorant utterances from enacting sticky conversational norms. Thus, this theoretically-refined conception of counterspeech helps appreciate how verbal responses might overcome the stickiness of conversational norms; and, in doing so, it reveals that this stickiness need not provide reasons to prefer legal remedies to counterspeech. (shrink)

Faced with hate speech, oppressed groups can use their own speech to respond to their verbal oppressors. This “counterspeech,” however, sometimes itself takes on a hateful form. This paper explores the moral standing of such “hateful counterspeech.” Is there a fundamental moral asymmetry between hateful counterspeech, and the hateful utterances of dominant or oppressive groups? Or are claims that such an asymmetry exists indefensible? I argue for an intermediate position. There _is_ a key moral asymmetry between these two forms of (...) speech. But, this asymmetry notwithstanding, hateful counterspeech is capable of enacting serious harms—and so, contrary to what many legal theorists have argued, it is in principle an appropriate object of legal regulation. I begin by considering the central argument for thinking that hateful counterspeech is not seriously troubling. This argument holds that oppressed groups lack authority—and, by extension, “speaker power.” Yet this argument, I suggest, sits in tension with the fact that low-status members of dominant groups can, through their utterances, seriously harm members of oppressed groups. Philosophers of language have developed sophisticated arguments to explain this last phenomenon: they have argued that speaker power is relativised to particular jurisdictions; that it can be acquired dynamically in local settings; and that it is socially dispersed. I argue that, in light of these arguments, it appears that hateful counterspeech, too, can generate serious harms. Nevertheless, I show that this conclusion is compatible with recognising a crucial moral asymmetry between hateful counterspeech and the hate speech of oppressors. (shrink)

: In Islamic inheritance law, although in different ratios, the shares of male and female siblings are already determined. The testator has no right to deprive the inheritors of inheritance. However, in today’s Islamic countries, it is well known that some testators deprive the inheritors of inheritance fully or partially through various ways such as donation, last will, and fictitious. Last will, as a legal term, means that a person transfers his\her property complimentarily to person\persons who have (...) the right to inherit originally or legally, provided that it is valid after death. In Islamic law, principally, making a last will to foreigners is regarded as a legitimate act. However, today, as it was in the past, the right of last will is being misused in causing harm to the inheritors and depriving them of the inheritance. For this reason, in Islamic law, there have been taken some precautions to prevent any possible misuse of the last will right in order to protect the rights of the inheritors and third persons. These precautions are as follow: The last will that is made is restricted to one third of the total amount; It is prohibited to make last will to the inheritors; There have been laid down some formal conditions for proving a last will; It is prohibited to make a last will with the intention of harming the inheritors, even if it is one third and less than one third. Summary: In Islamic inheritance law, although in different ratios, the shares of male and female siblings are already determined. The testator has no right to deprive the inheritors of inheritance. However, in today’s Islamic countries, it is well known that some testators deprive the inheritors of inheritance fully or partially through various ways such as donation, last will and fictitious. Therefore, some precautions have been taken in Islamic law in order to protect the right of the inheritors to inheritance. One of these precautions is to impose some restrictions on the legal acts of the testator who has an intention of depriving his\her inheritors fully or partially of the inheritance, misusing his\her right oflast will. The last will, as a legal term, means that a person transfers his\her property complimentarily to person\persons who have the right to the inheritance originally or legally, provided that it is valid after death. The last will is a legal procedure which is regarded as legitimate in all societies and legal systems. All legal systems that accept the legitimacy of the last will set out some regulations and restrictions on the use of the last will to protect the rights of individuals and public order. In Islamic law, the last will is also regarded as a legitimate regulation in order to meet people's earthly needs and to be a means of solidarity and getting reward in hereafter. However, in today's Islamic countries, the right of last will is being misused in causing harm to the inheritors and depriving them of the inheritance. In Islamic law, the precautions that have been taken to prevent any possible misuse of the last will right in order to protect the rights of the inheritors and third persons are as follow: The last will that is made is restricted to one third of the total amount The Prophet Muhammad visited Sa'd b. Abu Vakkas due to his illness in the year in which the Last Pilgrimage was being performed. Sa'd b. Abu Vakkas had no children other than a daughter. That is why he told the Prophet that he wanted to make a last will according to which the two third of his property shall be given to the foreigners. Thereupon, the Prophet Muhammad told him that he could only give one third of his property maximum. The Prophet Muhammad explained the reason why as follows: “It is better to leave your inheritors as wealthy than to leave them as needy people.” ; Muwatta, “Wasiyyāt”, 3; Tirmīzī, “Wasāyā”, 1, Abū Dāvūd, “Wasāyā”, 2; Nasāī, “Wasāyā”, 3; Bayhakī, “Wasāyā”, 5.). The Muslim jurists who regard this event as a proof have arrived at the consensus that the Muslims can only give one third of their property to foreigners by means of the last willIt is prohibited to make last will to the inheritors The Prophet Muhammad said, "Allah surely gives every right. There is no will to inheritors.” The Muslim jurists who regard this saying as a proof have arrived at the consensus that the last will to inheritors cannot not be made. There have been laid down some formal conditions for proving a last will Since a last will is a process that is upon death, there might be some disagreement between the inheritors and those who are a last will made to after the death of testator. For this reason, the last will shall be proven so that any possible dispute would be prevented. In the classical Islamic Law, it is emphasized that the last will should be oral, written or by any means of signs that might express oneself well, and the last will shall be made in the presence of the witnesses as a matter of principle. However, in my opinion, following the verses that require the last will to be made before the witnesses, placing the last will on record through an official procedure is much more suitable in regard to the purpose of the Shari’ and the spirit of Islam. Indeed, in the Islamic countries, the Family Law Codes are subject to the legal dispute that a case cannot be open if a last will is not been made in accordance with the law. It is prohibited to make a last will with the intention of harming the inheritors, even if it is one third and less than one third. In Islamic law, the last will made to foreigners is limited to one third of the property of the testator. Nevertheless, still there is a possibility of misusing this right against the inheritors with the intention of depriving them of the inheritance even if it is one third and less than one third. However, the verse which lay down the condition "the will made without harming the inheritors" indicates that the last will is legitimate only with the intention of not harming the inheritors, even if it is less than one third. Therefore, the last will made to foreigners with the intention of harming the inheritors, as it is contrary to the purpose of the law maker, can be restricted by the public authority. No doubt, the most important of the above-mentioned precautions is to restrict a testator's right of the last will to one third of the property when it is a foreigner to whom he is willing to give from his property, and the remaining two third is left to the inheritors. That is why in Islamic law, this two-third share, which is legally guaranteed and will be passed on to the inheritors, is called "reserved share". In principle, except for some exceptions, the testator has no authority to give from the "reserved share." Although in Islamic law, theoretically, the two-third share called "reserved share" is legally secured, nowadays, the testators are misusing their right of the last will. Therefore, the question “is it possible for the public authority, in Islamic law, to restrict a person’s essentially legitimate right of making last will in a case of misuse?” is quite important concerning our subject matter. It has been accepted as a basic principle that the acts in the category of "mubah" in Islamic law are to be taken without violating the rights of others and harming the public. Accordingly, it is possible for the public authority to restrict the acts that are taken in contradiction to the purpose of Shari and the interest of others. From this point of view, the use of the right of the last will in Islamic law is not absolute and unrestricted. Therefore, in the case of harming to the inheritors, it is possible that the right to be restricted by the public authority. As a result, the last will right, in Islamic law, is restricted in four different ways in favour of the inheritors as briefly summarized above. (shrink)

If you slide far enough down the slippery slope envisioned by opponents of medical assistance-in-dying (MAiD), you eventually land in a ghastly society with industrialized euthanasia, rampant suicide, and devalued life. But what if the slippery slope leads us somewhere better? This paper explores the benefits of eliminating nearly all MAiD prohibitions and regulations. We anticipate three positive effects for public health: 1. Expanded access to those currently not qualified from MAiD by removing ineffective access criteria; 2. Harm reduction by (...) making MAiD safer and by rerouting suicidal patients into alternate care; and 3. Improvements to the health system through lowered healthcare costs and increased patient activation in end-of-life care. Safeguards and prohibitions deny those who wish to die the ability to do so to prevent the _potential_ danger of a few being subjected to an undesired early death. (shrink)

Although medical confidentiality is widely recognized as an essential principle in the therapeutic relationship, its systematic and coherent practice has been an ethically challenging duty upon healthcare providers due to various concerns of clinical, moral, religious, social, ethical and legal natures. Medical confidentiality can be breached to protect the patient and/or others if maintaining confidentiality causes serious harm. Healthcare professionals may encounter complicated situations whereby the divulgence of a patient’s confidential information may pose a threat to one party whereas (...) the concealment of such information may cause harm to another. After deliberating on the Islamic concept of harm (ḍarar), this paper focuses on the dual duty and conflicts of interests faced by healthcare professionals in the practice of medical confidentiality. Referring to serious infectious diseases with a special mention of AIDS, this study also provides discourse on how healthcare professionals deal with difficult scenarios of conflicts of interests and ethical dilemmas. (shrink)

This inspiring work presents a truly knowledge-based approach to education as an alternative to the current curriculum that is based on consolidating pre-conceived ideas. It demonstrates the advantages of the new curriculum, both in terms of acquiring knowledge and preventing current problems such as technological disasters, global injustice, and environmental destruction. It also shows how it can eliminate plagiarism, low retention in classrooms, non-representative grading, and other common problems. Examples are given from various disciplines, ranging from science and engineering to (...) philosophy and law. (shrink)

Recent scholarship has emphasized the contributions of the great Maliki jurist Shihāb al-Dīn al-Qarāfī to Islamic legal thought. However, al-Qarāfī’s compilation of legal maxims and distinctions, al-Furūq, has not yet been studied, nor has the collection of his teacher, the prominent Shafiʿi jurist Ibn ʿAbd al-Salām, known as al-Qawāʿid al-kubrā. Furthermore, the original thought of Ibn ʿAbd al-Salām and his formative influence on al-Qarāfī have been understated. This article compares their two works to demonstrate that al-Qarāfī based (...) his collection in large part on Ibn ʿAbd al-Salām’s al-Qawāʿid and it examines the techniques that al-Qarāfī used, which included reordering, refining, and supplementing borrowed maxims, and anonymizing references to his teacher. Most salient, however, is al-Qarāfī’s “Malikization” of maxims, which entailed replacing Shafiʿi doctrines and authorities with their Maliki counterparts and deploying maxims to defend Maliki doctrines. The article concludes by explaining al-Qarāfī’s authorial choices in light of his Maliki affiliation and the politics between the legal schools in Mamluk Cairo. (shrink)

Counterspeech is communication that tries to counteract potential harm brought about by other speech. Theoretical interest in counterspeech partly derives from a libertarian ideal – as captured in the claim that the solution to bad speech is more speech – and partly from a recognition that well-meaning attempts to counteract harm through speech can easily misfire or backfire. Here we survey recent work on the question of what makes counterspeech effective at remedying or preventing harm, in those cases where it (...) is effective, as well as work investigating when and why there is a duty to engage in counterspeech. We suggest that the most fruitful area for philosophical inquiry on this topic, currently, relates to the questions about efficacy. Specifically, we argue that there is a need for better frameworks for conceptualizing the efficacy of counterspeech. Philosophers have collaborative work to do, alongside social scientists, in developing these frameworks. (shrink)

Steinhoff defends the moral and legal permissibility of torture in a limited range of circumstances. This article criticizes Steinhoff’s arguments. The analogy between ordinary defensive violence and defensive torture which Steinhoff argues for is partly spoiled by the presence, within defensive torture, of opportunistic harm, in addition to eliminative harm. Steinhoff’s arguments that the mere legalization of defensive torture would not metastasize into a more full-fledged institutionalization of torture are also found wanting. As a minimal form of institutionalization, the (...) mere legalization of torture would already be at risk of further entrenchment and growth. (shrink)

The University of Michigan conference “Where Religion, Policy, and Bioethics Meet: An Interdisciplinary Conference on Islamic Bioethics and End-of-Life Care” in April 2011 addressed the issue of brain death as the prototype for a discourse that would reflect the emergence of Islamic bioethics as a formal field of study. In considering the issue of brain death, various Muslim legal experts have raised concerns over the lack of certainty in the scientific criteria as applied to the definition and (...) diagnosis of brain death by the medical community. In contrast, the medical community at large has not required absolute certainty in its process, but has sought to eliminate doubt through cumulative diagnostic modalities and supportive scientific evidence. This has recently become a principal model, with increased interest in data analysis and evidence-based medicine with the intent to analyze and ultimately improve outcomes. Islamic law has also long employed a systematic methodology with the goal of eliminating doubt from rulings regarding the question of certainty. While ample criticism of the scientific criteria of brain death (Harvard criteria) by traditional legal sources now exists, an analysis of the legal process in assessing brain death, geared toward informing the clinician’s perspective on the issue, is lacking. In this article, we explore the role of certainty in the diagnostic modalities used to establish diagnoses of brain death in current medical practice. We further examine the Islamic jurisprudential approach vis-à-vis the concept of certainty (yaqīn). Finally, we contrast the two at times divergent philosophies and consider what each perspective may contribute to the global discourse on brain death, understanding that the interdependence that exists between the theological, juridical, ethical, and medical/scientific fields necessitates an open discussion and active collaboration between all parties. We hope that this article serves to continue the discourse that was successfully begun by this initial interdisciplinary endeavor at the University of Michigan. (shrink)

In the period of the Saḥāba (Companions), Tābiʿīn (Successors), and Atbāʿ al-Tābiʿīn (Followers of the Successors), those who had the capacity to do ijtihād on religious issues would act according to their ijtihād without being tied to any a particular person or school. Those who did not have the capacity to perform ijtihād could obtain a fatwā from any muftī whom they consulted, without any school-sectarian affiliation. However, with the emergence of the schools of jurisprudence (madhhab) in II-IV centuries AH, (...) the issues of ijtihād, taqlīd and madhhab have been discussed and different opinions have emerged on the subject. Some scholars argue that those who do not have the capacity to do ijtihād should do taqlīd, while others argue that every legal person (mukallaf) should do ijtihād in their religious affairs according to their own capabilities and act according to the conclusions reached. While those who argue that taqlīd is necessary for a Muslim who does not have the proficiency in ijtihad claim that a Muslim should adhere to a madhhab in his religious-practical life, another group argues -based on the legal maxim “Ammī does not have a madhhab. His sect is that of the mufti he consults”- that a Muslim may act upon the consultation of the scholar he wants to follow. In this study, the issue related to the situation of the Muslim who does not have competence to do ijtihād has been examined. In this context, the nature of taqlīd is emphasized and scholars’ opinions regarding opinions about the taqlīd of the layperson (ʿāmmī) are addressed. (shrink)

The legal reasons that bind a judge and the moral reasons that bind all persons can sometimes pull in different directions. There is perhaps no starker example of such judicial dilemmas than in criminal sentencing. Particularly where mandatory minimum sentences are triggered, a judge can be forced to impose sentences that even the judge regards as “immensely cruel, if not barbaric.” Beyond those directly harmed by overly harsh laws, some courts have recognized that “judges who, forced to participate in (...) such inhumane acts, suffer a loss of dignity and humanity as well.” When faced with such a judicial dilemma—a powerful tension between the judge’s legal and moral reasons—the primary question is what a judge can do to resolve it. We argue that the two standard responses—sacrificing morality to respect the law (“legalism”), or sacrificing the law to respect morality (“moralism”)—are unsatisfying. Instead, this Article defends an underexplored third response: rather than abandoning one ideal to maximally promote the other, we argue that judges should seek to at least minimally satisfy the demands of both. Judges should, in other words, look for and employ what we dub Satisficing Options. These are actions that enjoy sufficient support from both the legal reasons and the moral reasons, and thus are both legally and morally permissible—even if the acts in question would not strictly count as optimal by the lights of the law or morality. This common sensical response to the problem is not only underappreciated in the literature, but also has great practical import. Focusing on the sentencing context, this Article demonstrates that judicial dilemmas can be systematically resolved, mitigated or avoided through a range of concrete strategies that on their own or in conjunction can constitute Satisficing Options: these strategies include seeking out legally permitted but morally preferable interpretations of the law, expressing condemnation of unjust laws in dicta, and seeking assistance or cooperation from other actors to help defendants facing substantively unjust mandatory sentences. While these strategies can at times also go too far, we argue that in certain contexts they can be sufficiently defensible on both legal and moral grounds to be a justifiable response to judicial dilemmas. This Article thus provides both a novel theoretical framework for understanding the justification of judicial responses to unjust laws, as well as a practical a menu of options which judges can use to guide their responses to the judicial dilemmas that they are increasingly likely to encounter within our criminal justice system. (shrink)

The phrase “minimal risk,” as defined in the United States’ federal research regulations, is ambiguous and poorly defined. This article argues that most of the ambiguity that one finds in the phrase stems from the “daily life risks” standard in the definition of minimal risk. In this article, the author argues that the daily life risks standard should be dropped and that “minimal risk” should be defined as simply “the probability and magnitude of the harm or discomfort anticipated in research (...) are not greater than those encountered during the performance of routine physical or psychological examinations or tests”. (shrink)

The foundation (waqf), which is a charity institution that was able to find an application area since the emergence of Islam, has developed over time in Islamic societies and has become a common institution. In the Ottoman Empire, these institutions had incorporated different services into its structure. This expansion has also led to the establishment of many different types and purposes of foundations such as charities; family, animal care, hospice, foodbank and educational institutions and mosques. Types of foundations in (...) which the incomes of the foundation were shared in different ways were also developed in this period. Family foundations are one of the types of foundations established for the purpose to share of income. Family foundations, which are characterized by many different names such as “zürri” (familial), “ehli” (domestic) and “evlatlık” (filial), have been criticized legally for various reasons in the last period of the Ottoman Empire and the Republic period, and their legitimacy has been questioned. This questioning of legitimacy, which started especially with orientalist studies, was also written among Turkish historians and lawyers, and attempts were made to base the claims that family foundations are illegitimate. In time, these criticisms came out of the family foundations and became legally questioning the entire Islamic foundation system. Investigating the justification of these criticisms, which have been popular since the end of the 19th century, is of particular importance for the development of today's foundation system. Because as a result of these criticisms, the foundations, which are one of the most effective institutions that provide social cohesion and that Islam has created and developed, have lost their importance over time and there has been a noticeable decrease in established foundations. Previously established foundations were somehow transferred to individual ownership on legal grounds. Based on these reasons, the study aims to determine the truth of these claims and to offer a critical approach to the debates on the legitimacy of family foundations in Islamic law, thus revealing the legal basis of the foundation system in Islam. In terms of nature, family foundations are a type of foundation for the purpose of the foundation. Although its name is described as family, it indicates a foundation that is broader than the concept of family. In this sense, it refers to foundations established first for private individuals and then for one of the general charity classes. Specially designated persons do not have to be among family members. It is referred to by this name as these foundations are mostly established for family members. When the evidence regarding the legitimacy of these foundations is examined, examples from the practices of the Prophet himself can be seen, as well as general verses from the Qur'an that will be included in the scope of these foundations. On the other hand, there are examples of family waqfs in foundations established by almost all of the Companions. The legitimacy of family foundations is challenged within the framework of four main reasons such as violation of the provisions of legacy, avoiding to be confiscated, preventing the fragmentation of property by the heirs and causing the feudal system and it is claimed to be illegitimate. However, the fact that these foundations have existed in Islamic societies since the golden age, including the Ottoman Empire raises a question about the authenticity of the criticisms. When examining the details of the criticisms, it can be easily seen that there is no question of legitimacy in the real sense, only a misinterpretation arising from misunderstanding. As a result, it will be seen that it is not possible to say that the practices of Muslims throughout history are illegitimate. Family waqfs have taken place in history as an institution that does not contradict the general provisions of Islam, on the contrary, by increasing Islamic foundation culture and social solidarity. It is extremely important for these foundations to find a field of application in social and economic terms now. (shrink)

There is a trend of recruiting faith leaders at mosques to overcome religious barriers to organ donation, and to increase donor registration among Muslims. Commentators have suggested that Muslims are not given enough information about organ donation in religious sermons or lectures delivered at mosques. Corrective actions have been recommended, such as funding campaigns to promote organ donation, and increasing the availability of organ donation information at mosques. These actions are recommended despite published literature expressing safety concerns (i.e., do no (...) harm) in living and end-of-life organ donation. Living donors require life-long medical follow-up and treatment for complications that can appear years later. Scientific and medical controversies persist regarding the international guidelines for death determination in end-of-life donation. The medical criteria of death lack validation and can harm donors if surgical procurement is performed without general anesthesia and before biological death. In the moral code of Islam, the prevention of harm holds precedence over beneficence. Moral precepts described in the Quran encourage Muslims to be beneficent, but also to seek knowledge prior to making practical decisions. However, the Quran also contains passages that demand honesty and truthfulness when providing information to those who are seeking knowledge. Currently, information is limited to that which encourages donor registration. Campaigning for organ donation to congregations in mosques should adhere to the moral code of complete, rather than selective, disclosure of information. We recommend as a minimal standard the disclosure of risks, uncertainties, and controversies associated with the organ donation process. (shrink)

Usury ceilings seem indefensible. Their opponents insist these caps harm the consumers they are intended to help. Low ceilings are said to prevent the least advantaged agents from accessing legal credit and drive them into the black market, where prices are higher and collection methods are harsher. But in this paper, I challenge these arguments and show that the benefits of interest-rate limitations in the most expensive credit markets clearly outweigh the costs. The test case is payday lending. Deregulated (...) pricing in this market produces negative externalities that justify usury restrictions. Unless prices are capped, the more solvent majority of borrowers is compelled to cross-subsidize the least solvent debtors, who have a high rate of default. Rationing the riskiest debtors out of this market by means of a moderate usury cap puts an end to this unfairness and produces fewer bad consequences than the advocates of deregulated pricing recognize. I argue that only an extreme principle like maximizing the minimum could justify a free market in payday credit. (shrink)

The present moment in human history is marked by the ever-accelerating movement across the world of materials, peoples and information, creating various problems and, of course, opportunities as well--especially, the movement of the people, which makes multiculturalism a major issue. Differences between the immigrants and the receiving society create conflict. One solution would be found in the legal provision for the equality of rights for all the members of society, including cultural minorities, but if the legal solution alone (...) is considered effective, there would be waste of resources accumulated in cultures as enabling agents of amenable human life. But multiple cultures in a single society easily become a source of conflict, as another culture encroaching upon one’s own culture is often felt as a threatening challenge to one’s identity, as identity is constructed in the subjective process of culture. It implies the master-and-slave struggle between two subjectivities. Cultural subjectivities, personal or collective, could be induced to constitute a complex system of federated subjectivities. Even such a system would not, however, completely eliminate tension and conflict. Intervention by an ethic universally conceived on the minimal basis would meet the urgent need to prevent escalation of conflict, but it would ultimately prepare a common ground for the development of a global culture incorporating multiple cultures as historically inherited resources for enrichment of human life. Ethical awareness is what reveals the otherness of the other and also the ontological ground of human life on earth ; as ethics and epistemology coincide, a human reason would emerge as the ground of a new global culture, and the world would hopefully become a single Lebensraum for entire humanity. (shrink)

Caring for unrepresented patients encompasses legal, ethical, and moral challenges regarding decision-making, consent, the patient’s values, wishes, best interest, and the healthcare team’s professional integrity and autonomy. In this article, I consider the impact of the aging population and the effects of the social determinants of health and suggest that without preventive intervention, the number of unrepresented patients will continue to increase. The health, social, and legal risk factors for becoming unrepresented require a multidisciplinary response. Medical-Legal Partnerships (...) (MLPs) bring healthcare and legal professionals together to address risk factors and health-harming legal needs. The article discusses the role of MLPs in identifying at-risk individuals, providing preventive interventions, and providing support. I make recommendations and conclude that proactive MLPs offer a sustainable approach to the ethical challenges in caring for unrepresented patients by providing interventions to prevent individuals from becoming unrepresented. (shrink)

Justificatory defenses apply to actions that are generally wrong and illegal—mainly since they harm people—when they are justified—usually since they prevent harm to others. A strict conception of justification limits justificatory defenses to actions that reflect all pertinent principles in the optimal manner. A more relaxed conception of justification applies to actions that do not reflect all pertinent principles optimally due to mistake but are not too far from this optimum. In the paper, I consider whether justificatory defenses should reflect (...) the strict conception of justification or a more relaxed conception of justification. This question is important since often the relevant actions are not strictly justified, while the alternative of an excuse is frequently irrelevant or does not provide an appropriate solution. Reflection on this question raises the following dilemma: On the one hand, the strict interpretation seems too harsh, especially with regard to legal liability. On the other hand, it is difficult to explain the basis for a more relaxed conception of justification. I conclude, first, that justification—and accordingly wrongfulness—is a matter of degree and that the strictly justified action is merely the peak of a continuum, and, second, that a practical reaction is in place only with regard to actions whose wrongness is above a minimal threshold. (shrink)

Sexual violence experienced by women during interstate and internal conflict has long escaped legal regulation. This article explores tile extent of that lacuna by analyzing and reflecting upon experiences of sexual violation during the Holocaust. While it is inappropriate to describe the Holocaust experience as a facet of war per se, its horrors did occur in the context of war and thus ex post facto legal accountability for the perpetration of those dreadful events fall under the legal (...) rubric of international humanitarian law. The article explores the extent to which humanitarian law has limited definitional capacity to address the unique ways in which violence is directed towards and experienced by women. The article also demonstrates that sexual harms combine direct sexual harm to women with broader objectives of eliminating the cultural, social, and physical integrity of the community to which the women belong. The article claims that both victims and perpetrators of sexual harms understand the compounded function of sexual violence, but that international law fails to name or adequately sanction either aspect sexual harms. The article goes on to assert that in establishing dual conceptions of harm, there may be multiple bearers of rights when questions of remedy arise. Traditional notions of individualized entitlement to rights are inadequate to fully account for the communities of harm resulting from gendered violence that takes place in the context of war. (shrink)

BackgroundThe prevention of HIV remains an ongoing global concern. The safety and welfare of participants in these trials are imperative. Research Ethics Committees (RECs) review all reports of serious adverse events, adverse events and social harms arising in the course of such trials. There is little guidance for RECs on how to respond appropriately to social harm reports.MethodologyThis paper reviews the literature on social harms in HIV prevention trials and offers suggestions for RECs on how to respond appropriately to such (...) reports.ResultsThis review confirms that social harms are reported in clinical trials in South Africa and that specific guidance on managing these is minimal.ConclusionSocial harms in South African HIV prevention trials need to be more systematically researched so that ethical evidence‐based prevention, care and treatment strategies can be developed. This review makes specific suggestions for further research on social harms that can inform further consultations to develop more specific guidance for stakeholders on appropriate responses to such social harms. Such future work may also inform future versions of relevant local and international ethics guidance on HIV prevention trials. (shrink)

It appears to be a feature of our ordinary understanding of morality that we ought not to act in certain ways at all. We ought not to kill, torture, deceive, break our promises (say)—exceptional circumstances apart. Many moral duties are thought of in this way. Killing another person would be wrong even if it achieved a great good, and even if it led to preventing the deaths of several others. This feature of moral thinking is at the core of deontological (...) ethics. But while it is also part and parcel of ordinary moral thought, it seems puzzling, because it requires an agent to act (or to abstain from acting) in certain ways, even if by violating the duty she could achieve a better outcome in terms of the very restriction that she is required to heed. If the explanation of the duty not to kill were that it preserves human life it would be hard to understand why killing is not morally permitted when it leads to preserving a greater number of lives. Moreover, why should we not violate a restriction if doing so leads to fewer violations of that very restriction? There are two questions here. (1) Why not violate a restriction whose point it is to preserve lives, if doing so leads to preserving a greater number of lives? (2) Why not violate a restriction if doing so minimizes the violation of that very restriction? The latter question concerns what is sometimes called ‘the paradox of deontology’ or the problem of ‘minimizing violations’. The former may concern the so-called trolley cases, for instance. After all, a trolley hurtling towards a number of innocent people is not about to violate the moral restriction on killing innocent people, as it is not the kind of thing that can be subject to such a restriction. In this paper I am concerned only with (2): the paradox of deontology. To put it in Nozick’s terms: ‘How can a concern for the nonviolation of C [i.e. some deontological constraint] lead to refusal to violate C even when this would prevent other more extensive violations of C? -/- Samuel Scheffler, puzzled by the same idea, put it in terms of ‘agent-centred restrictions’ (ACR), because the restriction requires an agent (not) to act in certain ways, contrasting thereby with a requirement that certain actions not be done. The restriction is thus an agent-relative rather than an agent-neutral one. Scheffler ended up rejecting the idea of agent-centred restrictions, as even on close investigation the puzzle would not dissolve. Scheffler maintains that ACRs have ‘an air of paradox’ to them, as they violate what he calls maximizing rationality. ACRs appear to clash with the idea of maximizing rationality, because they require an agent to choose the option that worse achieves her goal of not harming people. I call this, following common parlance, the paradox of deontology, even though it is not strictly speaking a paradox. Exploring whether there is really a problem here, and how it might be solved, is the main objective of this paper. I begin by explaining the puzzlement about agent-centred restrictions in more detail. I then discuss promising as an example of a kind of action which is thought to be subject to agent-centred restrictions. It turns out that they are surprisingly easy to explain. The difficult case is killing—and that should put us on guard. I argue that the problem is not with the very idea of deontological restrictions, but with puzzling aspects of the ethics of killing. (shrink)

During the 1990s, biomedical scientists and Muslim religious scholars collaborated to construe Islamic responses for the ethical questions raised by the AIDS pandemic. This is the first of a two-part study examining this collective legal reasoning (ijtihād jamā‘ī). The main thesis is that the role of the biomedical scientists is not limited to presenting scientific information. They engaged in the human rights discourse pertinent to people living with HIV/AIDS, gave an account of the preventive strategy adopted by the (...) World Health Organization, and offered an (Islamic) virtue-based preventive model. Finally, these scientists tried to draft a number of Islamic legal rulings (aḥkām), usually seen in Islamic jurisprudence as the exclusive business of Muslim religious scholars. This multilayered role played by the scientists reflects intriguing developments in the Islamic religio-ethical discourse in general and in the field of Islamic jurisprudence in particular. (shrink)

D.G. Brown’s revisionist interpretation, despite its interest, misrepresents Mill’s moral theory as outlined in Utilitarianism . Mill’s utilitarianism is extraordinary because it explicitly aims to maximize general happiness both in point of quality and quantity. It encompasses spheres of life beyond morality, and its structure cannot be understood without clarification of his much-maligned doctrine that some kinds of pleasant feelings are qualitatively superior to others irrespective of quantity. This doctrine of higher pleasures establishes an order of precedence among conflicting kinds (...) of enjoyments, including moral as well as non-moral kinds. In particular, as he indicates in Utilitarianism , Chapter V, the higher kind of pleasure associated with the moral sentiment of justice, namely, a feeling of ‘security’ for vital personal concerns that everyone has and that ought to be recognized as equal rights, is qualitatively superior to any competing kinds of pleasures regardless of quantity. Justice (more generally, morality) is conceived as a social system of rules and dispositions which has as its ultimate end the maximization of this pleasant feeling of security for everyone. The upshot is that an optimal social code that distributes and sanctions particular equal rights and correlative duties has absolute priority over competing considerations within his utilitarianism. The code seeks to prevent conduct that, in the judgment of suitably competent majorities, causes grievous kinds of harm to other people by injuring their vital personal concerns. To prevent the acts and omissions which are judged to cause such undue harm, the code assigns equal duties not to perform them, and authorizes due punishment of anyone who fails to fulfill his duties. Punishment is always expedient to condemn and deter wrongdoing. But it is properly a separate issue which particular ways of inflicting punishment are expedient in any particular situation. Given that feelings of guilt are a way of inflicting punishment, coercion is not necessary for punishment. Thus, Mill’s claim that wrongdoing always deserves to be punished in some way does not imply that coercive legal sanctions and public stigma are always expedient for the enforcement of moral duties. (shrink)

This study in moral, political, and legal philosophy contends that it is morally impermissible to circumcise male minors without a medical indication (nontherapeutic circumcision). Male minors have a moral anticipatory autonomy right-in-trust not to be circumcised. This right depends on norms of autonomy and bodily integrity. These norms generate three direct non-consequentialist arguments against nontherapeutic circumcision: (1) the loss of nonrenewable functional tissue, (2) genital salience, and (3) limits on a parental right to permanently modify their sons' bodies. An (...) indirect argument holds (4) that if it is morally impermissible to remove the female prepuce (clitoral hood), then it is also morally impermissible to remove the male prepuce (foreskin). Although there is debate across medical cultures, a reasonable understanding supports the claim that nontherapeutic circumcision causes some harms and imposes unwarranted risks on male minors. The overall moral case applies to secular circumcisions and, with some qualifications, to religious circumcisions in Judaism and Islam. Arguments of political philosophy that invoke the freedom of religion, toleration, multiculturalism, and social meaning qualify somewhat, but do not eliminate, the case against circumcising male minors without a medical indication. Nevertheless, the arguments deployed in this study do not warrant legal interference at this time with secular and religious practices of nontherapeutic circumcision. (shrink)

Human population genetic research (HPGR) seeks to identify the diversity and variation of the human genome and how human group and individual genetic diversity has developed. This book asks whether developing countries are well prepared for the ethical and legal conduct of human population genetic research, with specific regard to vulnerable target group protection. The book highlights particular issues raised by genetic research on populations as a whole, such as the capacity for current frameworks of Western developed countries to (...) provide adequate protections for target groups in human population genetic research, and explores potential groups of people that may suffer harm in this kind of research. Using The People's Republic of China as a key example, Yue Wang argues that since the target groups of HPGR are almost always vulnerable groups from isolated and rural areas of developing countries, the ethical and legal frameworks for human subject protection need to be reconsidered in order to eliminate, or at least reduce, the vulnerability of those groups. While most research in this field focuses on the impact on individuals, this book breaks new ground in exploring how the interests of target groups are also seriously implicated in genetic work. The book argues that current regulations are far from sufficient to prevent harm to vulnerable groups and puts forward an alternative model for group protection in the context of human population genetic research in developing countries. The book will be of great interest to students and academics of medical law, ethics, and the implications of genetic research. (shrink)

The goal of responsible engineers is the creation of useful and safe technological products and commitment to public health, while respecting the autonomy of the clients and the public. Because engineers often face moral dilemma to resolve such issues, different engineers have chosen different course of actions depending on their respective moral value orientations. Islam provides a value-based mechanism rooted in the Maqasid al-Shari‘ah (the objectives of Islamic law). This mechanism prioritizes some values over others and could help resolve (...) the moral dilemmas faced in engineering. This paper introduces the Islamic interpretive-evaluative maxims to two core issues in engineering ethics: genetically modified foods and whistleblowing. The study aims primarily to provide problem-solving maxims within the Maqasid al-Shari‘ah matrix through which such moral dilemmas in science and engineering could be studied and resolved. (shrink)

Ijmā is ranked as the third shariah evidence after the Qur’ān and Sunnah in the science of Uṣūl. Shafi was the first one who made Uṣūl which had been known and used by the Islamic scholars, into a written document and who ascertained that Ijmā was the third of the shariah evidences. Kalām is one of the sciences in which Ijmā evidence is used. The scholars of Kalām used this evidence as far as the science of Uṣūl made it (...) possible. They always used it without changing any basics of religious beliefs and acceptances. That the aqidah of Ahl al-Sunnah has been supported with Ijmā which is regarded as one of naqly evidences, played an important role in eliminating suspicions which were tried to be aroused in momins’ mind. In this article, the function and importance of Ijmā evidence, which is one of the primary sources of the science of Uṣūl, in the science of Kalām and Aqidah of Ahl al-Sunnah has been studied.SummaryWhat the Qur’ān demands from us is to emphasize the spirit of unity among ummah and to keep out the factors that could trigger separation and division. Indeed, Allah emphasizes in the following verses in the Qur’ān on the protection of the unitary structure of the ummah: “And hold firmly to the rope of Allah all together and do not become divided” (Āl a-Imrān 3/103) and “And do not be like the ones who became divided and differed after the clear proofs had come to them” (Āl al-Imrān 3/105). Allah has commanded the Ulul ‘Azm Prophets to hold the religion upright and to avoid division. (al-Shūrā 42/13). The command of holding the religion upright and not to be divided in this religion means to certify what needs to be confirmed in the religion of Allah and to obey those that must be obeyed. This is also the proclamation of the principle of religion that all the prophets have consensus over.Ahl al-Sunnah understanding of Islam is identical to the understanding of the Prophet and his companions. For this reason, Ahl al-Sunna is the school that represents the main backbone of Islam. In Ahl al-Sunna, in many subjects, be it usūlî / primary or furū’ī / secondary, there has been ijmā. These ijmās are Sahaba ijmās and deductive ijmās that come from mutakallimūn (theologians) ijtihāds. Therefore, ijmā and ijtihād are closely connected to each other. Ijmā is supported by ijtihād and ijtihād is also the source of ijmā. Thus, the issue is no longer just a pure ijtihād; it turns out to be a degree that gives a solid knowledge after it has risen to some degree just after the nass/texts.Ahl al- Sunnah theologians are talking about two kinds of ijmā. The first is “ijmā taṣdīqī” (approval consensus) which is the consensus based on Sahaba İjmā. These are the ijmās that occur on the principles called ḍaruratal-diniyya (necessities of the religion), and accepted as solid proofs in religion. Issues such as the principles of faith, obligation of prayer and the fasting are the subjects that are determined by the solid/definite ijmā. Such ijmās are valid approvals on existing provisions. These ijmās based on solid nass (verses and hadiths). Such ijmās do not give any new information. The existing information is strengthened by the alliance of Muslims. In these areas, ijtihād cannot be done and Muslims do not need ijtihād on these issues. There is an consensus of Ahl al-Sunnah scholars about the unfaithfulness of the one who denies one or more of the principles which are accepted as the main obligatory principles in Islam. The other is the “deductive ijmā which the ijtihāds have roles over. This kind of ijmās, are formed as a result of mujtahids’ consensus over the same opinion on the issue of theological secondary issues. The issues related to the secondary theological issues which were open to the ijtihāds and the different results obtained on matters are not accepted as the cause of takfīr. However, depending on the subject he/she can be a sinner. Istidlālī/deductive ijmās are not considered as an independent proofs in ‘Ilm al-Kalām, rather a supportive ones and are considered as textual evidences.Since, texts that are accepted as sources give supposed information. In this regard, the Ahl al-Sunnah scholars accepted other members of the sect who have in secondary theological issues opposed the ijmā of the salaf / predecessor as Ahl al-Qibla, but named them as Ahl al-Bid’a (innovator in religion) because of their opposition to Salaf’s İjmās. Moreover, the scholars of the Ahl al-Sunnah did not see them appropriate to participate in the Ijmās, which could occur between the generations that come after Sahābas/companions.Not all disputes have been criticized in Islam. It is a blessing for the ummah to claim different opinions on the issues subject to ijtihād. Since the ummah, in this way, will bring new solutions to emerging issues and as a result, Islam will have a mechanism to produce a dynamic solution. This can only be possible through ijtihād. Dispute is to propose different views on a subject. If this view is not in the actual matters that could harm the unity of the Ummah, rather in the case of ijtihādi issues, this conflict could turn to be mercy.The reason why the methodists evaluate the ijmā within the scope of the authorized evidence is that because they think it is essential that the ijmā be based on a proof. From this point of view, the alliances that occurred in mental matters were not considered as ijmā. The theologians always tried to support their claims with nass/textual proofs. When the ijmā is realized, whether known or not, they have stated that there is certainly a religious proof behind it. Because, the provisions that were reached through ijmā, cannot be against the provisions of the Prophet.Many issues in Islamic Belief and Kalām works are supported by the mental and textual evidences as well as by deductive ijmā. However, many of the claims of Ijmās in these works reflect the inter-sect ijmās of the Ahl al-Sunnah. The sects outside the Ahl al-Sunnah were excluded. This attitude is, above all, the aim of ensuring the integrity within the sect, and trying to protect the Ahl al-Sunnah belief. Since the ijmā evidence has a function that prevents all kinds of arbitrary and divisive thoughts and turns the supposed knowledge into the qat’ī/certain one, it raises the provision to the next level just after the nass, rather than merely being a ijtihādi provision. In the case of the forerunner of the Ahl al-Sunnah, the Māturīdes and Ash‘arites have not differed in in understanding of ijmā in terms of methodology.Although they have different views on the definition and content of the ijmā, they have a common understanding of alliances of Mujtahids on the same view. The mutakallims (theologians) of Māturīdī and Ash’arī schools have used the proof of ijmā as supportive evidence in the cases related to Kalām. al-Ash’arī not only adopted the proof of ijmā but also used it in practice in. He did not make any distinction in proof of ijmā as practical, theological, methodological or sub-divisional; he used it freely in every field. Māturīdī and Ash’arī scholars decided that the ijmā could occur in religious matters and that there would be evidence when it was formed; In the case of mental issues, they have required the knowledge to be based on solid information. In the case of ijmā in purely mental issues, they have disputed over the issue. While some Ahl al-Sunnah scholars stated that since purely mental matters were certain knowledge and therefore don’t need ijmā, they also ruled that because the mujtahids could get this knowledge from religious texts, therefore ijmā could occur in mental matters as well. (shrink)

In Islamic law paternity is treated as a consequence of a licit sexual relationship. Since DNA testing makes a clear distinction between legal and biological paternity possible, it challenges the continued correlation between paternity and marriage. This article explores the foundations of paternity regulations in the Islamic ethico-legal tradition, with a particular focus on what is termed here “the licit sex principle,” and investigates the extent to which a harm-based argument can be made either by appeal (...) to or against Islamic paternity regulations. It argues that in Islamic bioethics the definition of harm and its boundaries is a function of both: (1) identification of legal and religious rights and the extent to which these rights are violated; and (2) balancing and reconciling perceived harm against both specific principles in relation to a given issue and also the overarching objectives of Islamic law. The article is divided into three main sections addressing the Islamic legal, ethical, and bioethical dimensions of paternity. (shrink)

Photo ID 222412412 © US Navy Medicine | Dreamstime.com ABSTRACT In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. INTRODUCTION Medical resources in an austere environment without quick recourse for resupply or casualty evacuation are often (...) limited. The shortage extends not only to supplies like blood products and drugs, but physicians and other medical personnel. In the midst of a mass casualty scenario, such as a battle that includes intense ground fighting, the medical staff will stretch scarce resources and triage casualties according to specific criteria. Typically, they proceed by providing care for the most severely wounded first, referred to here as conventional triage. At times, though, the staff may reverse the triage so that soldiers with minor wounds can return to the fight. In a mass casualty situation, when medical personnel apply conventional triage and treat casualties from opposing forces, a dilemma may arise. We argue that it can be permissible for military physicians to prioritize their own soldiers over enemy combatants in a mass casualty triage, where reverse triage does not apply. The case we will focus on is as follows: Battlefield Triage: During combat operations on a remote island in the Pacific Ocean, a compatriot soldier and an enemy combatant arrive at the compatriot soldier country’s medical treatment facility. Both have similar gunshot wounds to the abdomen, and they arrive with similar conditions. Both have low oxygen saturation and excessive blood loss. The sole physician only has enough time to stabilize one person. The scenario is brief, and we are aware that medical rules of eligibility will most often dictate how the physician proceeds,[1] but this scenario is useful in setting up the question we focus on in this paper: would it be wrong to favor the stabilization of a soldier just because the soldier is the physician’s compatriot? In other words, can nationality serve as an ethically justified tiebreaker in a situation such as Battlefield Triage?[2] In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. The AMA’s Code of Medical Ethics asserts that physicians have “ethical obligations to place patients’ welfare above their self-interest and above obligations to other groups.”[3] The World Medical Association’s Declaration of Tokyo affirms that “no motive, whether personal, collective or political, shall prevail against this higher purpose” of alleviating distress.[4] Physicians are taught early on that triage decisions must be medically indicated and made without consideration of factors such as race, ethnicity, religion, social status, and nationality. They are taught that public trust and obligations of justice grounded in equality demand that only medical indications be considered. But military physicians in a military setting are beholden to obligations, duties, and responsibilities as members of the military, and when these obligations, duties, and responsibilities conflict, as they do in Battlefield Triage, which loyalties win out and why?[5] Critics of partiality on national grounds argue that partiality undermines public trust in medicine and justice because everyone should be treated equally regardless of nationality.[6] Proponents of partiality argue that military obligations supersede equality and that justice requires partiality in such cases.[7] Despite the critics’ disagreement, both agree that there is a morally right, perhaps even blameless, course of action. Drawing on insights from virtue ethics, we argue that Battlefield Triage is a moral tragedy in which justice is unattainable and there is no action without moral cost. The assumption that there is a morally right choice is flawed. We argue that while no decision in this scenario is free from moral blame, there are reasons to favor treating one’s soldiers over enemy combatants. I. The Case Against Partiality There is a common assumption that there is a morally right or just decision in Battlefield Triage. A number of organizations and scholars claim that it is wrong for military physicians to favor their own soldiers on the grounds of nationality or some form of ‘group membership.’ (In a conflict involving service members from multiple nations working as a coalition, a soldier from an allied country may receive the same priority as the US service member due to ‘group membership.’) The World Medical Association’s WMA Declaration of Lisbon on the Rights of the Patient, which was reaffirmed in 2015, posits that, “[i]n circumstances where a choice must be made between potential patients for a particular treatment that is in limited supply, all such patients are entitled to a fair selection procedure for that treatment. That choice must be based on medical criteria and made without discrimination.”[8] This echoes what was set forth in Article 12 of the Geneva Conventions, which states that “[o]nly urgent medical reasons will authorize priority in the order of treatment to be administered.”[9] The argument for impartiality in Battlefield Triage is that every person is morally equal, and equality entails that medical distribution is, “based on a combination of medical need and urgency.”[10] This is in keeping with the bioethical principles that are generally applied.[11] II. The Case for Partiality On the other side, there are arguments that favoritism is the ethically right decision in Battlefield Triage.[12] The argument asserts that members of the military form a morally significant community of friends and participation in these relationships demands partiality. Just as parents have strong ethical duties to their children and not just any children, military personnel have ethical duties to their group, a group that involves an affirmation of mutual aid and support. Some have termed these ‘associative duties. According to Michael Gross, obligations of friendship, care, and solidarity “leave very little room for generally applicable principles of justice that would obligate a medic to treat enemy or non-compatriot wounded ahead of their compatriots.”[13] This is true in Battlefield Triage, but it may also be true even if the enemy’s soldier were more seriously wounded: “the ethics of small group cohesion, largely an ethics of care, mostly replaces the demands of impartial justice.”[14] In a more recent article, Gross explains that preferential treatment is ethically justified based on fighting capability and “the special obligations people owe friends, family, and, no less, comrades-in-arms.”[15] To not show partiality to the US soldier would be morally wrong on the grounds of friendship and mutual care.[16] III. The Moral Tragedy of Battlefield Triage Defenders and critics of Battlefield Triage favoritism based on nationality both frame their position as just or fair. For example, Justin List argues that physicians are “bound to practice medical neutrality,”[17] Marcus Adams denies that physicians “possess special ethical obligations” to enemy combatants because of their profession.[18] These perspectives assume that there is a morally right decision and that justice is attainable. The assumption that there is or can be a morally right Battlefield Triage decision, and we need to put our heads together to figure it out, remains strongly entrenched. However, the facts of the situation should give us pause; there are too many people and too few resources, and this demands a decision-making process that determines who will receive scarce resources. By its very nature, a battlefield triage decision has to be made based on some characteristic or value, a characteristic or value that will inevitably favor some at the expense of others. This is precisely why competing analyses “in the military context struggle to resolve these conflicts satisfactorily.”[19] Drawing on the insights of virtue ethics, we suggest that Battlefield Triage is a moral tragedy. Virtue ethics suggests that morality is about acting virtuously, which is to say that we should do what a virtuous person would do in the situation. Ethics is about figuring out how a just, wise, compassionate, loving, and fair person would act, and then doing that, as one grows in virtue. But life is not always clear cut, and it is possible that virtuous people may find themselves in a moral tragedy, a situation in which, through no fault of one’s own, a person must make a morally objectionable decision. After the action the virtuous person “emerges having done a terrible thing, the very sort of thing that the callous, dishonest, unjust, or in general vicious agent would characteristically do.”[20] Stated differently, a moral tragedy presents a virtuous person with two or more courses of action, all of which have a moral cost.[21] In Battlefield Triage, no matter how the physician goes about deciding, there is going to be defensible concern from those not saved. The fact that there are more people than can be helped fosters competing values in battlefield triage: maximize lives saved, treat people equally, treat the worse off, and support the war effort. Treating people equally may create tension between treating the worse off, maximizing lives saved, and supporting the war effort. Reverse triage is a case in point, as supporting the war effort conflicts with treating the worse off first, as is a fair lottery system since deploying a lottery may not maximize lives saved or support the war effort. There can be reasons why one person is selected over another, to be sure. Yet, there are reasons for making a decision, and that the decision is subject to legitimate moral concern is another. To recognize the moral tragedy of Battlefield Triage is to recognize the impossibility of acting blamelessly in the situation. In this situation, the virtuous military physician is going to have to sacrifice important values such as justice, compassion, and respect for others, even with a defensible criterion in hand. The physician will grieve this sacrifice accordingly. The physician may find her decision difficult or stressful, and rightly so, because of what her circumstances require of her. This kind of moral tragedy results “in actions which betray and violate the rights of persons to whom there may be a strong duty of care. When this happens, it properly triggers an appropriate moral emotion since our moral integrity has been violated and this affects how we think of ourselves and what we have become.”[22] Rather than view her triage decision as the morally superior choice, the virtuous military physician will view her decisions in these circumstances in a different light: it is the least bad option in a terrible situation, and she did something ethically problematic, something that is contrary to her moral character. She deeply regrets the circumstances in which she had to act. IV. Virtue Ethics A virtue ethicist has insight into how one should go about deciding what to do in a moral tragedy, although virtue ethics may not be as helpful as one may hope. The goal of the virtuous military physician in Battlefield Triage is to adopt the best course of action or the action that she feels she ought to do, all things considered. This does not make her choice devoid of serious wrongdoing—a decision must be made, but that does not make it just. The virtuous military physician will approach the situation with courage, responsibility, and insight. She will think about the decision carefully, wisely, and conscientiously; she will weigh the goods and harms of the choices before her, in conjunction with a proper conception of the good life, human worth, and understanding of her obligations to others—including chain of command, fellow soldiers, and the medical community. She is attuned to the value of human life and has a reasonable idea of the various ways her decisions will affect others. She recognizes that she is in this non-ideal situation through no fault of her own: she is not the one fighting in battles; she is serving her country as a physician, whose job it is to save lives, treat everyone justly, and promote military objectives. She regrets the decision she is forced to make in battlefield triage, acting “with immense regret and pain,” Hursthouse explains, “instead of indifferently or gladly.”[23] This is because, no matter what decision is made, the virtuous military physician “does something terrible or horrible,” something she otherwise would not do and is contrary to her values.[24] V. A Resolvable Moral Tragedy Instead of asking whether there is a morally right decision, in which a decision is morally blameless and above reproach, the virtue ethicist asks whether there is a decision with a convincing rationale, knowing that a decision can have a clear rationale but still be morally tragic. It is perfectly reasonable to think that different virtuous persons will arrive at different courses of action: “two virtuous agents, in the same situation,” Hursthouse writes, “may act differently” in irresolvable moral tragedies, in cases in which there is no clear course of action.[25] Because a person must act in a moral tragedy, one goal is to identify reasons for choosing the chosen action. Some decisions are clearly indefensible—treating neither the compatriot soldier nor the enemy combatant in Battlefield Triage would be wrong—and some decisions are more problematic than others. If the military physician selects to treat the soldier because she does not like the enemy combatant’s skin color, such a reason would be deeply problematic. But much of the debate over how to act in a moral tragedy is not over clearly indefensible or problematic criteria. Instead, the literature is largely about different standards or implementations of justice. Some scholars defend nation-impartial triage as right, while others defend nation-aware triage as right, and each argues that the other side is promoting an unjust or otherwise wrong solution to Battlefield Triage. We suggest that Battlefield Triage is a resolvable moral tragedy and that virtue ethics offers convincing reasons to prefer the treatment of the compatriot soldier rather than the enemy combatant on the grounds of national identity. Virtues are integral to living a good life, a flourishing life, but as Aristotle observed long ago, human beings are inherently social, interdependent and interconnected in profound ways.[26] This goes beyond the obvious fact that we need each other to survive day to day (one person makes clothes, another farms, and another makes tools); the claim is that a good or flourishing life depends in large part on one’s social network or community. This is why many of Aristotle’s moral virtues are other facing: justice, friendship, generosity, and magnanimity, to name a few. Courage, a typically self-facing virtue, is understood by Aristotle to be the virtue that regards one’s fear of death in battle, a battle fought on behalf of one’s city.[27] All of this remains true today. Namely, there is an important sense in which our community matters to our lives: it is easier to live a good, flourishing life if one is part of a good, flourishing community. Our community is made up of smaller groups, and it is more accurate to say that we are simultaneous members of different groups within a broader community. A person may be part of a family, friend group, research team, large state university, city, state, and nation. Groups can function well or not, as we all have experienced, and this suggests that there are virtues or excellences that groups can instantiate. Good groups are unified in purpose, with each member doing their duty alongside others for the attainment of that purpose. Good groups manifest solidarity among their members. Although Aristotle does not list solidarity as a virtue, a number of modern-day virtue ethicists have begun examining how group solidarity can be a virtue that contributes to a good or flourishing life.[28] Solidarity is not conceptualized as an individual virtue, a virtue possessed by a person in isolation of others; instead, it is a collective virtue, a virtue that is shared among members of a defined group with particular ends.[29] “A group has solidarity to the extent that its members are disposed to: (1) share values, aims, or goals; (2) care about those values, aims, or goals; (3) act in accordance with those values, aims, or goals; (4) trust the testimony of other group members with respect to those values, aims, and goals; and (5) feel a sense of belonging to the group.”[30] The virtue of collective or group solidarity involves individuals having special concern for each other, shared aims and values, trust, loyalty, and a sense of belonging with these specific others. There is a oneness to the group in the pursuit of a definite goal or purpose, involving mutual support and affirmation of each member. As such, the group has ends and goods above and beyond the good of each individual person. Sometimes solidarity requires personal sacrifice for the collective (for example, a father sacrificing food so his child can eat). The virtue of collective or group solidarity is important to the military and medical community at every level, and for clear reasons. In the military, there is a clear hierarchy of command, unity of purpose and end, mutual trust and support in complex settings, and so on. Soldiers need to know they can count on one another, and solidarity grounds a soldier’s ability to trust others and be assured of mutual aid. In medicine, solidarity maintains self-regulation of the profession, shared values and goals, as well as public support, not to mention that day-to-day operations require physician trust, engagement, and effort toward the ends of clinical care. Physicians need to work together, along with others, in pursuit of health, and disunity is sowed when there is mistrust, selfishness, or disengagement among the healthcare team and organization. Importantly, just as we are all members of various groups and hence may manifest group solidarity in different settings, the virtuous military physician instantiates collective solidarity with both the medical profession and the military. Her dual loyalty contributes to the moral difficulty of acting in Battlefield Triage. The military physician has competing obligations to distinct groups and cannot satisfy all obligations in Battlefield Triage. Solidarity with the military supports the consideration of favoring the soldier for reasons of national identity, whereas solidarity with the medical community does not. Something has to give, which is why it is a moral tragedy. The virtuous military physician, therefore, must weigh the costs of each course of action. To fulfill her obligations to the medical community would require that she does not use nationality and other non-medical considerations in Battlefield Triage. Since the soldier and enemy combatant are equally injured, justice would demand a random process, perhaps a flip of the coin. Although this may satisfy obligations the military physician has to the medical community, this would be costly to the physician’s military group. If word gets out that the physician decides who to treat based on a coin toss, soldiers, families, and citizens may become frustrated and angry. Soldier morale may go down if it becomes known that a coin flip led to the preventable death of a soldier and the saving of an enemy combatant who had killed (or attempted to kill) other soldiers. As Gross highlights, military solidarity involves a mutual aid promise that military personnel promise to help one another.[31] A military physician is part of the military and, as such, is part of the mutual aid promise, which would appear to be violated if the physician flips a coin. Treating a member of one’s own team may be psychologically more beneficial than treating an enemy combatant and may lead to less moral distress.[32] Finally, treating soldiers rather than enemy combatants promotes broader military and social aims, including returning soldiers to health, maintaining unity of purpose, and minimizing community suffering from a soldier’s death. Favoring members of one’s group, that is, triage based on nationality in Battlefield Triage, would fulfill obligations of military group loyalty, which is contrary to the values and duties of medicine. It does not seem as though showing favoritism in this particular situation is very costly to the medical community or general public, but this is because there is recognition that the physician is in the military. Medicine is impartial to non-medical indications partly because of fairness and to promote public trust in medicine. However, Battlefield Triage is unique, as medicine is being practiced in a non-public, wartime setting. In ordinary circumstances, a patient’s identity is irrelevant, and physicians ought not play favorites. Since Battlefield Triage is not an ordinary circumstance, decisions based on patient identity may not undermine public trust in medicine. In addition, it is contestable that fairness in Battlefield Triage requires that no consideration be paid to one’s nationality. Fairness is about giving each person their due, what is owed to them, and the case can be made that soldiers who place themselves in danger for the sake of the common good or a just cause are owed special attention when they suffer harm in the line of duty. In other words, soldiers voluntarily undergo risk to themselves for the greater good, and society owes them for this sacrifice. This plausibly includes preferential treatment in a situation such as Battlefield Triage. So, while the medical community affirms justice demands non-preferential treatment, the military community can affirm the opposite. The demands of fairness are unclear at best or in conflict in this situation: demands of physician justice decry favoritism, while demands of military justice support favoritism. Triage not based on nationality is arguably unfair and triage based on nationality may not undermine public trust, after all. All things considered, there is a clear rationale for favoring nationality-based preferential treatment in Battlefield Triage. Adopting a nationality-based preference in this situation is more defensible than not. This does not make such a decision ethically right or just. Preference based on nationality is the least bad decision, but it is not morally blameless. It involves one in a serious moral wrong, a wrong otherwise avoided and contrary to one’s character. The virtuous military physician is in a situation in which obligations conflict, and we disagree with Gross, who posits that care of fellow soldiers “is important to the near exclusion of all else.”[33] Gross fails to appreciate the collective virtue of solidarity as applied to those in medicine. The military physician has duties to fellow soldiers but also to fellow physicians, to the medical community, and humanity. To favor a soldier on grounds of nationality violates her duties and responsibilities to this latter group. She is involved in a moral tragedy and can only seek the most just action given the circumstances, yet, at least in virtue ethics, the action remains far from blameless. CONCLUSION We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. As such, the virtuous military physician incurs a moral cost to acting as she does—there is a moral residue. However, despite being a moral tragedy, there are clear reasons to act in favor of treating one’s own, considering group solidarity. As such, these kinds of tragedies are resolvable: virtuous military physicians should favor treatment of their own, although they would do so with sorrow. - [1] Militaries set forth medical rules of eligibility or guidelines used to determine whether a person qualifies for specific medical interventions or treatments in certain circumstances, and these guidelines are binding for a military physician. For example, despite opposition from medical organizations, militaries have adopted reverse triage guidelines for military physicians to follow. For ethical discussion, see Falzone, Elisabeth, P. Pasquier, C. Hoffmann, O. Barbier, M. Boutonnet, A. Salvadori, A. Jarrassier, J. Renner, B. Malgras, and S. Mérat. "Triage in military settings." Anaesthesia Critical Care & Pain Medicine 36, no. 1 (2017): 43-51. https://doi.org/10.1016/j.accpm.2016.05.004 [2] There are issues that are related to this, including the triage of civilians and allied soldiers. We set related issues aside for purposes of this paper [3] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [4] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [5] This is termed the “dual loyalty” dilemma in military medicine and has been described at length elsewhere: Institute of Medicine (US) Board on Health Sciences Policy. Military Medical Ethics: Issues regarding Dual Loyalties: Workshop Summary. Washington (DC): National Academies Press (US); 2008. Toward a Framework for Resolving Dual Loyalties. Available from: https://www.ncbi.nlm.nih.gov/books/NBK214853/ [6] See Kenneth G. Swan and K.G. Swan, Jr., “Triage: The Past Revisited,” Military Medicine 161:8 (1996): 448–452. https://doi.org/10.1093/milmed/161.8.448; Jerome A. Singh, “American Physicians and dual loyalty obligations in the ‘war on terror,’” BMC Medical Ethics 4.4 (2003): 1–10. https://doi.org/10.1186/1472-6939-4-4; Beam, Thomas E. "Medical Ethics on the Battlefield." Military Medical Ethics: Sect. IV. Medical ethics in the military. Medical ethics on the battlefield: the crucible of military medical ethics 2 (2003): 369-402; Hereth, Blake. "Health justice for unjust combatants." Journal of Military Ethics 20, no. 1 (2021): 67-81. https://doi.org/10.1080/15027570.2021.1949782. [7] See Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. Gross, Michael L. "Comradery, community, and care in military medical ethics." Theoretical medicine and bioethics 32 (2011): 337-350. https://doi.org/10.1007/s11017-011-9189-6. Gross, Michael L. "The limits of impartial medical treatment during armed conflict." In Military medical ethics for the 21st century, pp. 71-84. Routledge, 2016. [8] World Medical Association, WMA Declaration of Lisbon on the Rights of the Patient. 5 December 2022, https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient/ [9] Geneva Convention for the Amelioration of the Condition of Wounded, Sick in Armed Forces in the Field. 12 August 1949. https://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.30_GC-I-EN.pdf. [10] List, Justin M. "Medical neutrality and political activism: physicians' roles in conflict situations." In Physicians at war: The dual-loyalties challenge, pp. 237-253. Dordrecht: Springer Netherlands, 2008. 240 [11] Beauchamp, T., and J. Childress. 2013. Principles of Biomedical Ethics, 7th ed. Oxford, United Kingdom: Oxford University Press. [12] Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. [13] Gross, "Comradery, community, and care in military medical ethics," 347. [14] Gross, “Comradery, community, and care in military medical ethics,” 349. [15] Gross, Michael L. "When medical ethics and military ethics collide." Narrative inquiry in bioethics 13, no. 3 (2023): 199-204. 202 https://dx.doi.org/10.1353/nib.2023.a924191 [16] Our argument draws on virtue ethics, from which care ethics derives, and it is worth clarifying how our argument relates to Gross’s. We do not think that the virtue of friendship grounds triage decisions, for we think it is unlikely that the physician and wounded soldier are friends. Instead, as explained below, we think the collective virtue of group solidarity better captures the moral significance of group loyalty and that Gross would agree with us. But since military physicians are part of distinct groups, with competing obligations, the military physician will be forced to sacrifice a value in battlefield triage cases. In other words, we think Gross downplays the dual group membership of a military physician. [17] List,”Medical neutrality and political activism,” 250. [18] Adams,”Triage priorities and military physicians,” 235. [19] London, Leslie, Leonard S. Rubenstein, Laurel Baldwin-Ragaven, and Adriaan Van Es. "Dual loyalty among military health professionals: human rights and ethics in times of armed conflict." Cambridge Quarterly of Healthcare Ethics 15, no. 4 (2006): 381-391. 383. [20] Hursthouse, R. On Virtue Ethics. OUP 1999. 74 [21] Nussbaum, Martha C. "The costs of tragedy: Some moral limits of cost-benefit analysis." The Journal of Legal Studies 29, no. S2 (2000): 1005-1036, 1007. [22] De Wijze, S. (2005). Tragic-remorse–the anguish of dirty hands. Ethical theory and moral practice, 7(5), 453-471, 457. https://doi.org/10.1007/s10677-005-6836-x [23] Hursthouse, 73 [24] Hursthouse, 81 [25] Hursthouse, 72 [26] Aristotle, Politics 1253a8. Reeve, C. D. C., Indianapolis: Hackett Publishing Co., 2017 [27] Aristotle, Nicomachean Ethics. III.6.114a, 34-35. 2002, Nicomachean Ethics, Christopher Rowe (trans.), Oxford: Oxford University Press [28] Byerly, T. Ryan, and Meghan Byerly. "Collective virtue." The Journal of Value Inquiry 50, no. 1 (2016): 33-50. https://doi.org/10.1007/s10790-015-9484-y; Federico, Veronica. "Conclusion: solidarity as a public virtue." Solidarity as a Public Virtue (2018): 495-542. https://doi.org/10.5771/9783845290058. Rehg, William. "Solidarity and the common good: An analytic framework." Journal of Social Philosophy 38, no. 1 (2007): 7-21. https://doi.org/10.1111/j.1467-9833.2007.00363.x [29] Byerly and Byerly. "Collective virtue." 43 [30] Battaly, Heather. "Solidarity: Virtue or vice?." In Social virtue epistemology, pp. 303-324. Routledge, 2022. 304 [31] Ibid., 2011: 341 [32] It might be thought that displaying altruism by helping an enemy combatant at the expense of one’s fellow soldier may be psychologically satisfiying. For evidence that military physicians find it difficult to treat enemy combatants, see Lundberg, Kristina, Sofia Kjellström, Anders Jonsson, and Lars Sandman. "Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties." Military medicine 179, no. 8 (2014): 821-826. https://doi.org/10.7205/MILMED-D-14-00038. Lamblin, Antoine, Clément Derkenne, Marion Trousselard, and Marie-Ange Einaudi. "Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study." BMC Medical Ethics 22 (2021): 1-13. https://doi.org/10.1186/s12910-021-00723-2 [33] Ibid., 2011: 344. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction to the Special Issue on Pediatric Decision-MakingErica K. SalterUnlike in the traditional decisional dyad in adult-based care, pediatric decision-making typically involves a triadic relationship among the patient, their parents, and the health-care providers. This complex relationship raises questions and concerns regarding each party’s expectations, obligations, and authority. For example, should a parent be allowed to withhold a poor diagnosis from an adolescent patient? Should an HLA-matched six-year-old sister (...) be permitted to serve as a bone marrow donor for her older sibling with lysosomal storage disease? Or, should parents be given decisional authority to consent to gender-affirming care for an adolescent with gender dysphoria? Cases like these are among the most ethically challenging decisions faced by parents and health-care providers because they present competing interests and values, and it’s not always clear what is in the best interests of the child.In the context of American medicine, the best interest standard has been identified as the primary ethical and legal guide for decision-making. In its most prominent form, the best interest standard requires parents and pediatric practitioners to choose the medical treatment that maximizes benefits and minimizes harms to the particular child in question. However, over the past few decades, the standard has come under significant scrutiny, with discussions and debate in the academic bioethics literature asking whether the standard is able to serve the [End Page 181] purposes it is thought to serve and whether alternative standards might be better suited to the task(s). Despite vigorous interest in these issues, the academic literature did not seem to generate any sense of identifiable consensus about how others ought to make health-care decisions on behalf of children.Thus, in June 2022, 17 scholar-experts on pediatric decision-making standards gathered in St. Louis, MO, for a three-day symposium of discussion and consensus-building. The participating authors represented different disciplinary perspectives and different viewpoints in the debate about guidance principles that underlie pediatrics. Despite apparent disagreement about such standards in the literature, the group was able to generate a set of six consensus-based recommendations (see Table 1) for pediatric decision-making. These recommendations, as well as their application, justification, and limitations, were published as a special article in Pediatrics in August 2023 (Salter et al. 2023), which was composed with the primary goals of accessibility, teachability, and implementability for practicing pediatric clinicians. Click for larger view View full resolutionTable 1.Six consensus recommendations for pediatric decision-makingWhile the group was able to find agreement about these six central principles of pediatric decision-making, there remained several related issues that were outside of the scope of the symposium aims. For example, should these recommendations apply to neonates, children in state custody, or adolescents, and if so, how would their application be operationalized? What specific conditions should justify state intervention on parental authority? How should parents and health-care providers think about obligations to siblings in health-care decisions? This [End Page 182] special issue of Perspectives in Biology and Medicine provides a forum for our authors and collaborators to further explore these, and other, important questions.The issue opens with a piece by the symposium organizers and editors of this special issue, Erica Salter, Lainie Friedman Ross, and D. Micah Hester, describing the symposium’s inspiration and design, its execution, and the implications it might have for pediatric ethics. This contribution compares the six symposium recommendations with existing statements about pediatric decision-making, in particular the statements developed by the American Academy of Pediatrics (AAP). In “How We Found Consensus on Pediatric Decision-Making and Why It Matters,” readers will find a detailed account of the process engaged to develop the six consensus-based recommendations, as well as a discussion of the value and limitations of such a process, which may serve as a model of consensus-building useful for other unsettled topics of interest in the bioethics community.The issue’s second article, “Childhood Interests: What They Are, and Why It Matters,” by Johan Bester and Jeffrey Blustein, dives into the conceptual foundation of the symposium’s first two recommendations. This... (shrink)

Islamic Perspectives on the Principles of Biomedical Ethics presents results from a pioneering seminar in 2013 between Muslim religious scholars, biomedical scientists, and Western bioethicists at the research Center for Islamic Legislation & Ethics, Qatar Faculty of Islamic Studies. By examining principle-based bioethics, the contributors to this volume addressed a number of key issues related to the future of the field. Discussion is based around the role of religion in bioethical reasoning, specifically from an Islamic perspective. (...) Also considered is a presentation of the concept of universal principles for bioethics, with a response looking at the possibility (or not) of involving religion. Finally, there is in-depth analysis of how far specific disciplines within the Islamic tradition -- such as the higher objectives of Sharia (maqāṣid al-Sharī'ah) and legal maxims (qawā'id fiqhīyah) -- can enrich principle-based bioethics. (shrink)

Background Advocates for a regulated system to facilitate kidney donation between unrelated donor-recipient pairs argue that monetary compensation encourages people to donate vital organs that save the lives of patients with end-stage organ failure. Scholars support compensating donors as a form of reciprocity. This study aims to assess the compensation system for the unrelated kidney donation program in the Islamic Republic of Iran, with a particular focus on the implications of Islam on organ donation and organ sales. Methods This (...) study reviews secondary documents for philosophical argumentation and ethical analysis of human organ donation and sale for transplantation. Results and discussion According to Islamic law, organ donation is an act of _sadaqatul jariyah,_ and individuals are permitted to donate organs with the intention of saving lives. The commercialization of humans as organ sellers and buyers is contrary to the Islamic legal maxim _eethaar_, undermining donors of ‘selfless’ or ‘altruistic’ motivations. Such an act should be considered immoral, and the practice should not be introduced into other countries for the sake of protecting human dignity, integrity, solidarity, and respect. I, therefore, argue that Iran’s unrelated kidney donation program not only disregards the position of the Islamic religion with respect to the provision or receipt of monetary benefits for human kidneys for transplantation but that it also misinterprets the Islamic legal proscription of the sale of human organs. I also argue that the implementation of Iran’s unrelated kidney donor transplantation program is unethical and immoral in that potential donors and recipients engage in a bargaining process akin to that which sellers and buyers regularly face in regulated commodity exchange markets. Conversely, I suggest that a modest fixed monetary remuneration as a gift be provided to a donor as a reward for their altruistic organ donation, which is permissible by Islamic scholars. This may remove the need to bargain for increased or decreased values of payment in exchange for the organ, as well as the transactional nature of ‘buyer and seller’, ensuring the philosophy of ‘donor and recipient’ is maintained. Conclusions Offering a fixed modest monetary incentive to organ donors would serve to increase organ supply while protecting donors’ health and reducing human suffering without legalizing the human organ trade. (shrink)

This paper draws on Friedrich Nietzsche’s work to defend the (admittedly non-Nietzschean) conclusion that a non-liberal egalitarian society is superior in two ways: first, as a moral ideal, it does not rest on questionable claims about essential human equality and, second, such a society would provide the optimal psychological and political conditions for individual wellbeing, social stability, and cultural achievement. I first explain Nietzsche’s distinction between forms of egalitarianism: noble and slavish. The slavish form promotes equality, defined negatively as the (...) elimination of privilege. It is non-liberal in its prioritization of equality over the interests of the advantaged. Nietzsche rejects both slavish egalitarianism and liberalism for the same reasons: they questionably assume the equal value of all persons, and they harm cultural achievement, sacrificing the potential of those who are most valuable to cultural development to the interests of the majority. Noble egalitarianism, in contrast, exemplifies Nietzsche’s conception of justice as ‘equality among equals’. It demands that individuals of equal worth or power (such as members of an artistic or political elite) treat each other as what they, in fact, are: equals. It avoids asserting essential equality, demanding instead—against both slavish and liberal forms—respect on the basis of shared superiority. And it escapes the charge of harm to cultural development, commanding respect only where equality already exists. Although Nietzsche quickly assumes that ‘noble egalitarianism’ requires the rejection of all forms of universal egalitarianism, concluding that we should ‘never make equal what is unequal’, in fact it only entails the rejection of slavish methods: equalization through harm to the advantaged. However, non-liberal forms of egalitarianism can be ‘noble’, promoting equality without harm to the advantaged—through, for example, unequal distribution of resources, the equalization of economic opportunities, and economic regulation to prevent the creation of substantial wealth disparities. If egalitarianism can ‘make equal’ without slavish methods, then Nietzsche’s demand for ‘equality for equals’ applies to the newly equal, too. More importantly, his moral psychology of power—the view that our source of happiness and incentive to self-development is the feeling of power in relation to equal resistance or ‘opponents who are our equals’ —supports the superiority of a nobly-achieved, non-liberal egalitarian society. For achieved, practical equality of wealth and opportunity would optimize conditions for the feeling of power: a balance of equal, oppositional powers serving as mutual limitation and resistance. Such a society is superior in three ways. First, it maximizes social happiness by promoting and maintaining the feeling of power in all. Liberal and aristocratic societies, in contrast, allow radical inequalities that not only diminish the power of the disadvantaged, but diminish the opportunities of the advantaged to encounter equal resistance, thus undermining the happiness of all. Second, it promotes social stability by preserving a balance of powers that prevents domination and exploitation, in contrast to the inevitable class conflicts of aristocratic and liberal societies. Finally, it promotes cultural achievement, since the feeling of power in relation to proportional resistance is the psychological incentive for self-development and cultural achievement. (shrink)

This paper draws on Friedrich Nietzsche’s work to defend the (admittedly non-Nietzschean) conclusion that a non-liberal egalitarian society is superior in two ways: first, as a moral ideal, it does not rest on questionable claims about essential human equality and, second, such a society would provide the optimal psychological and political conditions for individual wellbeing, social stability, and cultural achievement. I first explain Nietzsche’s distinction between forms of egalitarianism: noble and slavish. The slavish form promotes equality, defined negatively as the (...) elimination of privilege. It is non-liberal in its prioritization of equality over the interests of the advantaged. Nietzsche rejects both slavish egalitarianism and liberalism for the same reasons: they questionably assume the equal value of all persons, and they harm cultural achievement, sacrificing the potential of those who are most valuable to cultural development to the interests of the majority. Noble egalitarianism, in contrast, exemplifies Nietzsche’s conception of justice as ‘equality among equals’. It demands that individuals of equal worth or power (such as members of an artistic or political elite) treat each other as what they, in fact, are: equals. It avoids asserting essential equality, demanding instead—against both slavish and liberal forms—respect on the basis of shared superiority. And it escapes the charge of harm to cultural development, commanding respect only where equality already exists. Although Nietzsche quickly assumes that ‘noble egalitarianism’ requires the rejection of all forms of universal egalitarianism, concluding that we should ‘never make equal what is unequal’, in fact it only entails the rejection of slavish methods: equalization through harm to the advantaged. However, non-liberal forms of egalitarianism can be ‘noble’, promoting equality without harm to the advantaged—through, for example, unequal distribution of resources, the equalization of economic opportunities, and economic regulation to prevent the creation of substantial wealth disparities. If egalitarianism can ‘make equal’ without slavish methods, then Nietzsche’s demand for ‘equality for equals’ applies to the newly equal, too. More importantly, his moral psychology of power—the view that our source of happiness and incentive to self-development is the feeling of power in relation to equal resistance or ‘opponents who are our equals’ —supports the superiority of a nobly-achieved, non-liberal egalitarian society. For achieved, practical equality of wealth and opportunity would optimize conditions for the feeling of power: a balance of equal, oppositional powers serving as mutual limitation and resistance. Such a society is superior in three ways. First, it maximizes social happiness by promoting and maintaining the feeling of power in all. Liberal and aristocratic societies, in contrast, allow radical inequalities that not only diminish the power of the disadvantaged, but diminish the opportunities of the advantaged to encounter equal resistance, thus undermining the happiness of all. Second, it promotes social stability by preserving a balance of powers that prevents domination and exploitation, in contrast to the inevitable class conflicts of aristocratic and liberal societies. Finally, it promotes cultural achievement, since the feeling of power in relation to proportional resistance is the psychological incentive for self-development and cultural achievement. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics CommentaryMichael Robertson, Senior Research FellowThe French philosopher Michel Foucault once recounted the story of the English King, George III, being restrained by his guards at the direction of his physician Dr. Willis. King George, presumably deranged by a psychotic mania consequent upon porphyria, was incapable of self-rule and his power was usurped by the medical profession in an act of coercion tantamount to treason. This for Foucault was (...) a profound metaphor of psychiatric power.1The plight of Mdm. W yokes the two most emotive issues in psychiatry — involuntary treatment and the administration of ECT. Whilst only utilised at an extremity of clinical practice, both of these are the most misunderstood of actions performed by the psychiatric profession. Yet, in many circumstances, they are life-saving.In essence, we are confronted with a profoundly depressed woman, whose illness is seemingly resistant to first line treatment and poses a serious, credible risk of harm. Most psychiatrists would regard this as somewhat of a psychiatric emergency. We are informed that Mdm. W’s family has transcended any cultural taboos about mental illness and is engaged in her care, has an extensive lived experience of her severe mood disorder and accepts, indeed welcomes, the use of ECT to terminate a severe episode of depression. In the course of a psychotic depression, Mdm. W is suffering profound distress and presents a risk of either suicide or serious medical complications if the episode persists. Despite the minimal discomfort during the actual administration of ECT, Mdm. W’s distress will be compounded by the further restraint needed to prevent from her eating and drinking prior to anaesthesia.It is difficult to know what Mdm. W’s experience of this situation would [End Page 230] be. Through the prism of her disturbed mental state, with its derangements in thinking, cognitive functioning and apprehension of reality, she would likely experience the situation as one of fear or terror; she would likely interpret ECT and the enforced restriction of oral intake prior to the procedure as punitive — further evidence of her “sins”, reinforcing her delusional guilt and nihilism. Yet to speak to Mdm. W in circumstances of euthymia or normal mood, where such derangements no longer occur, might reveal an utterly different perspective on the situation. Like many people with episodic mental illnesses, Mdm. W might, when such a scenario was put to her, consent to future treatment with ECT without equivocation. Indeed, many patients with bipolar disorder formulate advance directives in regard to the specific management of their possible future episodes of illness.If the clinical and legal aspects of this situation are so clear, why is there a sense of a dilemma in the realm of clinical ethics? Beyond the emotive nature of the situation, we see a deeply distressed woman being provided potentially life-saving treatment, which is being denied to her by the profound impairments of insight and judgement consequent upon her illness.In Singapore, such detention and enforced treatment under the Mental Capacity Act (2010) applies to a person with a mental illness or disorder who lacks capacity to make decisions in their own best interests based upon impairment of mind or brain. This would be considered a “capacity” based mental health law. In other jurisdictions, the legal test and evidentiary justification for such care may be predicated upon risk of harm to self or others. In either setting, Mdm. W’s clinical situation provides adequate legal justification for such enforced care.The moral justification of such laws falls into two general categories — the “risk” argument and the “capacity” argument. In mental health legislation, the “harm principle”, as first elaborated in John Stuart Mill’s On Liberty,2 is usually defined in terms of the construct of “risk”. Risk is a term that has multiple meanings in different disciplinary contexts, although all approaches to “risk” attempt to apply knowledge to an area of uncertainty.3 The notion of “risk assessment” is usually considered as the process of categorising individuals by their perceived likelihood of causing serious harm to themselves or harm to others. In the insurance industry, actuarial assessment is a mathematical discipline aimed at computing a probability of adversity... (shrink)

Assisted migration (AM) is a translocation of the representatives of species to areas outside their natural habitats as a response to climate change. This article seeks to identify how customary norms and general principles of international environmental law could guide the development of regulation of AM maximizing the benefits of using AM and minimizing AM-related risks. Among the customary norms and principles of international environmental law discussed in the article and relevant to the regulation of AM are the permanent sovereignty (...) over natural resources, the principle of cooperation, the no-harm rule, the precautionary principle, the principles of prevention, due diligence, and obligation to conduct environmental impact assessment (EIA), the principles of integration and intergenerational equity, common but differentiated responsibilities, and the polluter pays principle, the principles of non-regression, progression, resilience, in dubio pro natura, the principle of ecological proportionality, and the principle of access to information, public participation, and access to justice in environmental matters (principle of good governance, environmental democracy). (shrink)

Artificial intelligence is a general-purpose technology (GPT), term given to technologies that shape an entire era and reorient innovations by reconfiguring the economy’s logic and functioning and bringing in new business models. AI offers unprecedented opportunities and risks. The benefits of AI are extraordinary, as are its potential harms. Potential damage does not have the same degree of problematization, since the intensity and extent of the damage varies according to the domain and the object of application. To address the scale (...) of this challenge, regulation is necessary but not sufficient. Standards, unwritten codes of compliance and arbitration procedures, supervision and auditability, AI governance, international agreements, compliance with current local and global standards and laws. All of this needs to be integrated. Society seems to have no alternative to facing the challenges of at least mitigating the damage already identified and trying to predict future damage in advance. The purpose of this article is to encourage reflection regarding the main initiatives that are available to society to protect its citizens and organizations from the potential harm caused by AI models, vis-à-vis the technology’s own limits to act in ethical and legal compliance. (shrink)