IntroductionClassifying the ethical issues in clinical ethics consultations is important to clinical practice and scholarship. We conducted a systematic review to characterize the typologies used to analyze clinical ethics consultations.MethodsWe identified empirical studies of clinical ethics consultation that reported types of ethical issues using PubMed. We screened these articles based on their titles and abstracts, and then by a review of their full text. We extracted study characteristics and typologies and coded the typologies.ResultsWe reviewed 428 articles; 30 of the articles (...) fulfilled our inclusion criteria. We identified 27 unique typologies. Each typology contained five to 47 categories (mean = 18). The most common categories were do-not-attempt-resuscitation orders (19 typologies, 70 percent), capacity (18 typologies, 67 percent), withholding (18 typologies, 67 percent), withdrawing (17 typologies, 63 percent), and surrogate or proxy (16 typologies, 59 percent). Only seven (26 percent) of the typologies contained all five of the most common categories. The typologies we used to characterize clinical ethics consultations exhibit significant heterogeneity and several conceptual limitations. A common typology is needed whose development may require multi-institutional collaboration and could be facilitated by professional organizations. (shrink)

Hastings Center Report, Volume 51, Issue 5, Page 8-11, September‐October 2021.

Most theories of parenthood assume, at least implicitly, that a child will grow up to be an independent, autonomous adult. However, some children with cognitive limitations or psychiatric illness are unable to do so. For this reason, these accounts do not accommodate the circumstances and responsibilities of parents of such adult children. Our article attempts to correct this deficiency. In particular, we describe some of the common characteristics and experiences of this population of parents and children, examine the unique aspects (...) of their relationships, review several philosophical accounts of parental obligations, consider how these accounts might be extrapolated to semiautonomous adult children, and provide suggestions about parental obligations to promote autonomy and independence in adult children with cognitive limitations or psychiatric illness. In extending accounts of parental responsibilities to the case of semiautonomous adults, we find that the parental role includes the duty to continue to provide care—indefinitely if necessary—while cultivating autonomy and independence. (shrink)

The rationality of concern for oneself has been taken for granted by the authors of western moral and political thought in a way in which the rationality of concern for others has not. While various authors have differed about the morality of self-concern, and about the extent to which such concern is rationally required, few have doubted that we have at least some special reasons to care for our selves, reasons that differ either in degree or in kind from those (...) we have to care for others. The rationality of prudence as traditionally conceived was thus taken to be threatened by Lockean accounts of personal identity. For taking a person’s identity through time to consist in psychological continuity is often thought to result in the numerical distinctness of his present and future selves, thus leaving his present self in the unsavoury position of having to ask, “Why care specially about my future self, if he won’t really be me?”. (shrink)

Upward mobility through the path of higher education has been an article of faith for generations of working-class, low-income, and immigrant college students. While we know this path usually entails financial sacrifices and hard work, very little attention has been paid to the deep personal compromises such students have to make as they enter worlds vastly different from their own. Measuring the true cost of higher education for those from disadvantaged backgrounds, Moving Up without Losing Your Way looks at the (...) ethical dilemmas of upward mobility—the broken ties with family and friends, the severed connections with former communities, and the loss of identity—faced by students as they strive to earn a successful place in society. -/- Drawing upon philosophy, social science, personal stories, and interviews, Jennifer Morton reframes the college experience, factoring in not just educational and career opportunities but also essential relationships with family, friends, and community. Finding that student strivers tend to give up the latter for the former, negating their sense of self, Morton seeks to reverse this course. She urges educators to empower students with a new narrative of upward mobility—one that honestly situates ethical costs in historical, social, and economic contexts and that allows students to make informed decisions for themselves. -/- A powerful work with practical implications, Moving Up without Losing Your Way paves a hopeful road so that students might achieve social mobility while retaining their best selves. (shrink)

Political corporate social responsibility (PCSR) calls for firms to implement and engage in deliberative democracy processes and structures, addressing governance gaps where governments are unwilling or unable to do so. However, an underlying assumption that the implementation of PCSR will enrich democratic processes in society has been exposed and challenged. In this conceptual article, we explore this challenge by developing a framework to reveal the dynamics of firms’ deliberative democratic processes and structures (meso level), and those at nation state (macro (...) level). Using existing cases as illustrative examples, we demonstrate that despite the public good premise of PCSR theory toward thickening the overall democracy in a society, corporate democratization at meso level can have the opposite effect and may actually erode macro-level democratic control of society and the economy. These findings imply a need for multilevel analysis in PCSR research and greater consideration of state-level public institutions and the responsibilities of business firms toward those institutions. Furthermore, we contribute to the PCSR literature by identifying the disruptive mechanisms associated with these dynamics and outline two alternative perspectives to allow firms to continue to take on political responsibilities. (shrink)

Professions have traditionally treated advocacy as a collective duty, best assigned to professional associations to perform. In North American nursing, advocacy for issues affecting identifiable patients is assigned instead to their nurses. We argue that nursing associations’ withdrawal from advocacy for patient care issues is detrimental to nurses and patients alike. Most nurses work in large institutions whose internal policies they cannot influence. When these create obstacles to good care, the inability of nurses to affect change can result in avoidable (...) distress for them and for their patients. We illustrate this point with a case study: the circumstances of the death of Michael Joseph LeBlanc, an inmate at Kingston Penitentiary Regional Hospital (Ontario). We conclude that patients and their nurses will suffer unnecessarily unless or until nursing associations cease to burden individual nurses with the responsibility for patient advocacy. (shrink)

Health and Social Justice (Ruger 2009a) developed the ?health capability paradigm,? a conception of justice and health in domestic societies. This idea undergirds an alternative framework of social cooperation called ?shared health governance? (SHG). SHG puts forth a set of moral responsibilities, motivational aspirations, and institutional arrangements, and apportions roles for implementation in striving for health justice. This article develops further the SHG framework and explains its importance and implications for governing health domestically.

It is commonly thought that moral rules and principles, such as ‘Keep your promises,’ ‘Respect autonomy,’ and ‘Distribute goods according to need ,’ should play an essential role in our moral deliberation. Particularists have challenged this view by arguing that principled guidance leads us to engage in worse decision making because principled guidance is too rigid and it leads individuals to neglect or distort relevant details. However, when we examine empirical literature on the use of rules and principles in other (...) domains, we find that people can learn to use rules discriminately and that rule-based models tend to outperform even expert judgment. I argue that this evidence poses a problem for the moral particularist. If the particularist claims that we should not rely on decision-making rules when making practical decisions and it turns out that these rules help us make better decisions, then the particularists’ prescriptive account is deficient. However, if the particularist claims that we should rely on practical decision-making rules but not on moral rules, she needs to explain how practical rules are different from moral rules and why we should rely on the former but not the latter. (shrink)

Three main themes emerge from this edited collection. First, there has been an increased incidence of intervention for humanitarian purposes since the end of the Cold War. In these cases, the alleged conflict between sovereignty and human rights has been addressed in one of two ways: through an evolution in the notion of sovereignty, from ‘sovereignty as authority’ to ‘sovereignty as responsibility’; and through an expanded definition of what constitutes a threat to international peace and security under Chapter VII of (...) the UN Charter. Second, despite this new climate of permissiveness, humanitarian intervention remains a controversial norm in international relations – largely because of continued opposition from certain members of international society, and concerns about its potentially negative consequences. Third, while the post Cold War period has seen some successful cases of intervention to address humanitarian catastrophes, the current capability of international organizations to undertake humanitarian interventions remains limited. Indeed, as the book demonstrates, the issue of humanitarian intervention has the potential to divide international institutions such as the UN and damage their credibility. (shrink)

Although gender differences in attitudes toward animal research have been reported in the literature for some time, exploration into the nature of these differences has received less attention. This article examines gender differences in responses to a survey of attitudes toward the use of animals in research. The survey was completed by college students and consisted of items intended to tap different issues related to the animal research debate. Results indicated that women were more likely than men to support tenets (...) of the animal protection movement. Likewise, women were more likely than men to favor increased restrictions on animal use and were more concerned than men about the suffering of research animals. Analysis of item contents suggested that women endorsed items reflecting a general caring for animals, were more willing than men to make personal sacrifices such as giving up meat and medical benefits in an effort to protect animals, and were more likely than men to question the use of animals in research on scientific grounds. Men, on the other hand, tended to emphasize the potential benefits arising from the use of animals in research. (shrink)

This volume argues that educational problems have their basis in an ideology of binary opposites often referred to as dualism, and that it is partly because mainstream schooling incorporates dualism that it is unable to facilitate the thinking skills, dispositions and understandings necessary for autonomy, democratic citizenship and leading a meaningful life. Bleazby proposes an approach to schooling termed social reconstruction learning, in which students engage in philosophical inquiries with members of their community in order to reconstruct real social problems, (...) arguing that this pedagogy can better facilitate independent thinking, imaginativeness, emotional intelligence, autonomy, and active citizenship. (shrink)

Returning to John P. Reeder's 1978 essay on “Religious Ethics as a Field and Discipline,” this essay explores debates surrounding the original intentions for the Journal of Religious Ethics (JRE) and for the field of religious ethics, as these have played out over the decades among an influential group of scholars involved with the JRE since its inception: Arthur Dyck, Ronald Green, Stanley Hauerwas, and Jeffrey Stout. While the JRE and its founding mission are in need of ongoing critique and (...) transformation, we might well still affirm the journal's ongoing importance as a site for the negotiation of a commons, the identification of possibilities for shared life, imagined beyond exclusion and domination. (shrink)

While there is a growing body of work on moral issues and global governance in the fields of global justice and international relations, little work has connected principles of global health justice with those of global health governance for a theory of global health. Such a theory would enable analysis and evaluation of the current global health system and would ethically and empirically ground proposals for reforming it to more closely align with moral values. Global health governance has been framed (...) as an issue of national security, human security, human rights, and global public goods. The global health governance literature is essentially untethered to a theorized framework to illuminate or evaluate governance. This article ties global health justice and ethics to principles for governing the global health realm, developing a theoretical framework for global and domestic institutions and actors. (shrink)

This book explores Hume's concern with the destructiveness of religious factions and his efforts to develop, in his moral philosophy, a solution to factional conflict. Sympathy and the related capacity to enter into foreign points of view are crucial to the neutralization of religious zeal and the naturalization of ethics. Jennifer Herdt suggests that Hume's preoccupation with religious faction is the key which reveals the unity of his varied philosophical, aesthetic, political and historical works.

IntroductionThose in mental health-related consumer movements have made clear their demands for humane treatment and basic civil rights, an end to stigma and discrimination, and a chance to participate in their own recovery. But theorizing about the politics of recognition, 'recognition rights' and epistemic justice, suggests that they also have a stake in the broad cultural meanings associated with conceptions of mental health and illness.ResultsFirst person accounts of psychiatric diagnosis and mental health care (shown here to represent 'counter stories' to (...) the powerful 'master narrative' of biomedical psychiatry), offer indications about how experiences of mental disorder might be reframed and redefined as part of efforts to acknowledge and honor recognition rights and epistemic justice. However, the task of cultural semantics is one for the entire culture, not merely consumers. These new meanings must be negotiated. When they are not the result of negotiation, group-wrought definitions risk imposing a revision no less constraining than the mis-recognizing one it aims to replace. Contested realities make this a challenging task when it comes to cultural meanings about mental disorder. Examples from mental illness memoirs about two contested realities related to psychosis are examined here: the meaninglessness of symptoms, and the role of insight into illness. They show the magnitude of the challenge involved - for consumers, practitioners, and the general public - in the reconstruction of these new meanings and realities.ConclusionTo honor recognition rights and epistemic justice acknowledgement must be made of the heterogeneity of the effects of, and of responses to, psychiatric diagnosis and care, and the extent of the challenge of the reconstructive cultural semantics involved. (shrink)

Person‐centred practice indubitably seems to be the antithesis of technology. The ostensible polarity of technology and person‐centred practice is an easy road to travel down and in their various forms has been probably travelled for decades if not centuries. By forging ahead or enduring these dualisms, we continue to approach and recede, but never encounter the elusive and the liminal space between technology and person‐centred practice. Inspired by Haraway's work, we argue that healthcare practitioners who critically consider their cyborg ontology (...) may begin the process to initiate and complicate the liminal and sought after space between technology and person‐centred practice. In this paper, we draw upon Haraway's idea that we are all materially and ontologically cyborgs. Cyborgs, the hybridity of machine and human, are part of our social reality and embedded in our everyday existence. By considering our cyborg ontology, we suggest that person‐centred practice can be actualized in the contextualized, embodied and relational spaces of technology. It is not a question of espousing technology or person‐centred practice. Such dualisms have been historically produced and reproduced over many decades and prevented us from recognizing our own cyborg ontology. Rather, it is salient that we take notice of our own cyborg ontology and how technological, habitual ways of being may prevent (and facilitate) us to recognize the embodied and contextualized experiences of patients. A disruption and engagement with the habitual can ensure we are not governed by technology in our logics and practices of care and can move us to a conscious and critical integration of person‐centred practice in the technologized care environments. By acknowledging ourselves as cyborgs, we can recapture and preserve our humanness as caregivers, as well as thrive as we proceed in our technological way of being. (shrink)

Constitutivism locates the ground of practical normativity in features constitutive of rational agency and rests on the concept of a constitutive norm – a norm that is internal to a thing such that...

John Cooper and Pierre Hadot suggest that contemporary philosophy can no longer be regarded as a way of life as it has become an academic discipline of study that is theoretical and abstract. According to them, for philosophy to be considered a way of life, it has to be able to shape one’s understanding of the world, guide how one should respond from moment to moment, and reach an existential level in defining one’s being. In this article, I discuss how (...) Jean-Paul Sartre’s existentialist philosophy is a way of life that has been overlooked by Cooper and Hadot. I show that Sartre’s existentialism presents an interconnected perspective of human existence and human development in history, is able to guide our philosophical reasoning about our everyday decisions, and offers a practical guide to living an authentic life through assuming responsibility for our life choices and engaging with our situations. (shrink)

As Japan marks the 75th anniversary of World War II in 2020, Prime Minister Shinzo Abe did not offer a fresh apology and maintained that future generations should not have to keep apologizing for past mistakes. This paper uses the unresolved war issue of the military comfort women system as a context to discuss what it means for political apologies to be more than mere political gestures founded on political interests and discusses what it takes to facilitate forgiveness. It will (...) examine the features of a repentant wrongdoer who deserves forgiveness based on how one relates to one’s past wrongdoing in order to distinguish political apologies that are genuine from those that are mere gestures aimed at hasty reconciliation. This will be discussed through the works of Jacques Derrida and Vladimir Jankélévitch. Next, through Jankélévitch’s and Paul Ricoeur’s ideas of forgiveness, it will be discussed how matters of justice and forgiveness should be understood as well as how the history of past wrongs and injustice is necessary for a genuine apology and makes forgiveness possible. It is also a moral responsibility for both perpetrators and victims to remember history in order to achieve personal forgiveness as well as begin social and political reconciliation. (shrink)

Most Sartrean scholarship attributed Sartre’s ontology of hostile intersubjectivity to Hegel’s theory of recognition, and a Sartrean politics of violence to Hegel’s master-slave dyad. This article sets out to examine Sartre and Hegel in three areas of their work: first, a reassessment of Sartre’s ontology which was commonly thought to be founded on Hegel’s thymos; second, a reconsideration of Fukuyama’s conceptualisation of democracy as the end of Hegel’s historical progress and Sartre’s critique of democracy based on a humanist version of (...) Marxism as philosophy of our time; and finally, a re-evaluation of the conceptualisation of freedom through Hegel’s universal will and Sartre’s principle of universal fraternity. (shrink)

In this paper, we will examine the role that intuitions and responses to thought experiments play in confirming or disconfirming theories of reference, using insights from both debates as our starting point. Our view is that experimental evidence of the type elicited by MMNS does play a central role in the construction of theories of reference. This, however, is not because such theory construction is accurately characterized by "the method of cases." First, experimental philosophy does not directly collect data about (...) intuitions, but rather about peoples responses to thought experiments, which may reflect their intuitions but may well not. Second, unusually in the case of the theory of reference, experimental prompts involve elicitation of the phenomenon under investigation—that is, referring—and it is the reference facts rather than the intuitions that a theory of reference should capture. Finally, "best fit" models like the method of cases are inconsistent with the actual practice of semantic theorists, who appeal to general principles of theory construction as well as considerations native to the theory of reference, often in the service of rejecting intuitions. Indeed, Kripke himself viewed several claims of his theory as unintuitive, but felt no pressure to alter them on that account. These facts, we'll argue, suggest that the relevance of experimental methods in the theory of reference cannot be straightforwardly extended to other fields: an experimental prompt containing Newtons two rocks tied together in empty space may elicit referring, and may also elicit intuitions, but it doesn't also elicit the phenomenon under investigation. Furthermore, the considerations native to the theory of reference are not part of physics, which has its own distinct set of principles and considerations. This suggests that an evaluation of the centrality of intuitions/ responses to thought experiments in philosophical methodology must proceed in a piecemeal fashion. We conclude that the potential contributions of experimental philosophy will take different forms in different sub-fields of philosophical inquiry. (shrink)

Recent years have seen growing concerns about threats to academic freedom in light of the changing norms of and demands on the university. This volume brings together contributions from leading philosophers about the latest issues - ranging from safe spaces to social media controversies - and traditional challenges for academic freedom.

In the closing years of the eighteenth century, a great intellectual and moral challenge to European empire was launched by many of the most innovative thinkers of the day, including Kant, Adam Smith, Bentham, Burke, Diderot, and Condorcet. They drew on a strikingly wide range of ideas to argue against empire: among others, the rights of man and the imperative of popular self‐determination, the economic wisdom of free trade and foolishness of conquest, the corruption of natural man by a degenerate (...) civilization, the hypocrisy required for self‐governing republics to rule despotically over powerless subjects, and the impossibility of sustaining freedom at home while practicing despotism abroad. (shrink)

One of the persistent features of historical writing about the sciences in the last twenty years has been the concern of a number of historians who insist on the need for a new awareness of the role of visual images and image making. The author believes that, rather than reducing the analysis of visual culture to a single set of principles, the point of the academic study of scientific images is the recognition of their heterogeneity, the different circumstances of their (...) production, and the variety of cultural and social functions they serve. This essay challenges historians to discover new ways of framing the historical meanings of scientific images within the larger contexts of signifying symbols, images, and mediations that make up culture. The study of nineteenth‐century practices of building collections of scientific photographs provides the background for a discussion of the significance of picture archives in the history of science, of the historical mechanisms that frame some pictures as “scientific” and others as “unscientific,” and of the need for further research on how scientific images generate meaning. (shrink)

A characteristically Humean pattern of explanation starts by claiming that we have a certain kind of feeling in response to some objects and then takes our having such feelings to provide an explanation of how we come to think of those objects as having some feature that we would not otherwise be able to think of them as having. This core pattern of explanation is what leads Simon Blackburn to dub Hume ‘the first great projectivist.’ This paper critically examines the (...) philosophical and textual basis for interpreting Hume as a causal projectivist. I argue that projectivist interpretations of Hume's account of causation are motivated by two convictions: that beliefs about causation, according to Hume, are not just beliefs about regularity relations and that believing that two events are necessarily connected, according to Hume, is not merely having a belief about something that occurs in one's mind. I suggest that the latter conviction is worth revisiting, both for textual and philosophical reasons. (shrink)

If it's not good for something, then it's good for nothing. The Director of the Centre for Business and Professional Ethics at the University of Leeds continues her examination of basic terms frequently used in business ethics.

We can assent to a proposition, build a theory around it, base our actions on it, and affirm its truth—without ever taking it to heart. This frequently happens, for example, to recipients of bad news who figure out what is entailed by the news, make appropriate plans, and pass the news on to others—all without really "taking it in." It happens to those who accept a scientific claim without abandoning their more private views of how things work, and it happens (...) to members of a jury who confidently arrive at a verdict of "guilty" yet remain, on some deeper level, unconvinced. Conversely, people may dismiss their prejudices as mere prejudices while continuing to hold onto them, and a friend may acknowledge a remark to be innocuous yet be offended. Such phenomena are widespread, diverse, and philosophically intriguing. They are not simply cases of weak versus strong belief, or belief that something has a low probability versus a high probability ; nor are they cases of accepting on authority what we only partially understand. Rather, in each case, there is certain lack of depth to one's beliefs. (shrink)

Context plays a crucial role in our propositional attitude reporting practices. A belief-reporting sentence which seems true in one context may seem false in another, as Kripke showed us in ‘A Puzzle About Belief.’ To put it a bit sloppily, may seem true when we are discussing Peter's beliefs regarding Paderewski-the-pianist and false when we are discussing his beliefs regarding Paderewski-the-statesman. Peter believes that Paderewski is a fine musician.A number of recent theorists have taken this contextual variation very seriously, and (...) attempted to provide accounts which accommodate it in one way or another. Salmon and Soames accommodate the variation in pragmatics, arguing that our intuitions about attitude reporting often result from mistaking pragmatic implicatures for semantic content. Other theorists have offered semantic accounts which yield contextually varying truth conditions for belief reporting sentences. I have a great deal of sympathy for the project: I think the contextually varying intuitions do exist, and that they need to be accommodated, in one way or another. I am not so sure, however, that this can be done. (shrink)

Against a backdrop of non-ideal political and legal conditions, this article examines the health capability paradigm and how its principles can help determine what aspects of health care might legitimately constitute positive health care rights—and if indeed human rights are even the best approach to equitable health care provision. This article addresses the long American preoccupation with negative rights rather than positive rights in health care. Positive health care rights are an exception to the overall moral range and general thrust (...) of U.S. legal doctrine. Some positive rights to health care have arisen from U.S. Constitutional Eighth Amendment cases and federal and state laws like Medicare, Medicaid, the State Children’s Health Insurance Program, the Emergency Medical Treatment and Active Labor Act, and the Patient Protection and Affordable Care Act. Finally, this article discusses some of the difficulties inherent in implementing a positive right to health care in the U.S. (shrink)

Economists often consult multiple models in order to combat model uncertainty in the face of misspecification. By examining modeling practices at the Bank of England, this paper identifies an important, but underappreciated modeling procedure. Sometimes an idealized model is manipulated to reproduce the results from another distinct auxiliary model, ones which it could not produce on its own. However, this procedure does not involve making the original model “more realistic,” insofar as this means adding in additional causal factors. This suggests (...) that there are ways to make models more representationally adequate that do not involve de-idealization in the straightforward sense. (shrink)

This book offers an intelligent and thought-provoking analysis of the genealogy of Western capitalist 'development'. Jennifer Beard departs from the common position that development and underdevelopment are conceptual outcomes of the Imperialist Era and positions the genealogy of development within early Christian writings in which the western theological concepts of sin, salvation, and redemption are expounded. In doing so, she links the early Christian writings of theologians such as Augustine and , Anselm and Abelard to the processes of modern (...) identity formation of which the West, the First World, the Rule of Law and the individual subject and his or her freedoms are but a part. The concept of development is thus identified within western culture as a symptom of loss within the desire for completion; as the logic behind the economic restructuring of nations as underdeveloped is revealed as that ruthless imaginary by which First World nations maintain their ideal of themselves. Drawing upon anthropology, economics, historiography, philosophy of science, theology, feminism, cultural studies and development studies, this book contains the best of interdisciplinary work in international law. (shrink)