Public health ethics in the future will be distinguished from public health ethics in the past by this new subfield being labeled as such, acknowledged, and called upon for service. Ethical dilemmas have been present throughout the history of public health. The question of whether to force Henning Jacobson to be immunized in 1905 in accordance with the 1902 Massachusetts smallpox vaccination law was one of ethics as well as law. How Thomas Parran, Surgeon General in 1936, chose to respond (...) to a raging syphilis epidemic in the United States in the early part of the 2W century raised considerable moral debate in determining the appropriate public health response for a government? More recently, questions have arisen concerning the appropriate reach of government in controlling HIV banning smoking, or promoting healthy lifestyles. Debates over government infringement, morality, and justice recur throughout the history of public health. (shrink)

BackgroundCommunity engagement in research is valuable for instrumental and intrinsic reasons. Despite existing guidance on how to ensure meaningful CE, much of what it takes to achieve this goal differs across settings. Considering the emerging trend towards mandating CE in many research studies, this study aimed at documenting how CE is conceptualized and implemented, and then providing context-specific guidance on how researchers and research regulators in Uganda could think about and manage CE in research.MethodsWe conducted qualitative interviews and focus group (...) discussions involving forty-one respondents who were experienced in HIV/aids biomedical research involving CE. Thirty-eight of these were directly or indirectly associated with Uganda’s leading research institution in the field of HIV/aids. They included Principal Investigators, Community Liaisons Officers, Research Ethics Committee members and Community Advisory Board Members. Three respondents were from Uganda National Council for Science and Technology. Data were collected between August 2019 and August 2020, using audio-taped focus group discussions and key informant interviews, transcribed and analyzed manually to generate themes and subthemes.ResultsThree major themes emerged: goals or value of CE; the means of CE, and, the evaluation of CE. Goals or value of CE generated four subthemes representing the overarching goals of CE: Promote communities’ agency; Generate and sustain trust; Protect and promote communities’ rights and interests; and, Help studies optimize participation in the form of enrolment and retention of participants. What usually comes under the nomenclatures of methods, strategies, and approaches of CE, such as town-hall meetings, sports events, drama, and the like, should simply be understood as the means of CE, and it is not desirable to hold pre-conceived and fixed ideas about the best means to conduct CE in research since a lot depend on the context. Finally, the study found that despite CE’s critical importance, which suggests the need to track and evaluate it, CE is currently intermittently evaluated, and for inadequate motivations.ConclusionsExisting guidance on how to conduct robust CE in research is no substitute for creativity, flexibility, and reflexivity on the part of both researchers and research regulators. (shrink)

_Virtue as Social Intelligence: An Empirically Grounded Theory_ takes on the claims of philosophical situationism, the ethical theory that is skeptical about the possibility of human virtue. Influenced by social psychological studies, philosophical situationists argue that human personality is too fluid and fragmented to support a stable set of virtues. They claim that virtue cannot be grounded in empirical psychology. This book argues otherwise. Drawing on the work of psychologists Walter Mischel and Yuichi Shoda, Nancy E. Snow argues that (...) the social psychological experiments that philosophical situationists rely on look at the wrong kinds of situations to test for behavioral consistency. Rather than looking at situations that are objectively similar, researchers need to compare situations that have similar meanings _for the subject_. When this is done, subjects exhibit behavioral consistencies that warrant the attribution of enduring traits, and virtues are a subset of these traits. Virtue can therefore be empirically grounded and virtue ethics has nothing to fear from philosophical situationism. (shrink)

Since the beginning of the AIDS epidemic, the proportion of AIDS cases among women has continued to rise. Women constituted 23 percent of the AIDS cases reported to the Centers for Disease Control and Prevention in 1995, and 81 percent of these women were of childbearing age. It was not until 1991, however, that epidemiological studies of women were initiated. By comparison, the representation of HIV-infected women in clinical trials gradually has grown. Undoubtedly, a consequence of the increased numbers of (...) women in clinical and epidemiological research is the earlier identification of and more appropriate treatments for HIV-related syndromes when women present in the clinical setting. Despite this expanded focus on women, however, clear information to guide the treatment of HIV-infected women who are pregnant is still lagging behind. (shrink)

It is widely assumed that informing prospective subjects about the risks and possible benefits of research not only protects their rights as autonomous decisionmakers, but also empowers them to protect their own interests. Yet interviews with patient‐subjects conducted under the auspices of the Advisory Committee on Human Radiation Experiments suggest this is not always the case. Patient‐subjects often trust their physician to guide them through decisions on research participation. Clinicians, investigators, and IRBs must assure that such trust is not misplaced.

Abuses at Abu Ghraib prison in Iraq confront us with the question of how seemingly ordinary soldiers could have perpetrated harms against prisoners. In this essay I argue that a Stoic approach to the virtues can provide a bulwark against the social and personal forces that can lead to abusive behavior. In part one, I discuss Abu Ghraib. In two, I examine social psychological explanations of how ordinary, apparently decent people are able to commit atrocities. In three, I address a (...) series of questions: why should we turn to ethics for help with these problems, and why, in particular, to Stoicism instead of other ethical theories, such as utilitarianism or Kantianism? Given the power of situations in influencing behavior, is a turn to character ethics a viable response to problems such as those at Abu Ghraib? I argue in part four that character formation drawing on Stoic values can provide soldiers with the inner resilience to resist the situational factors that press them to unwarranted aggression. (shrink)

This Element provides an overview of the central components of recent work in virtue ethics. The first section explores central themes in neo-Aristotelian virtue ethics, while the second turns the discussion to major alternative theoretical perspectives. The third section focuses on two challenges to virtue ethics. The first challenge is the self-centeredness or egoism objection, which is the notion that certain kinds of virtue ethics are inadequate because they advocate a focus on the person's own virtue and flourishing at the (...) expense of, or at least without due regard for, the concerns of others. The second is situationist challenges to the ideas that there are indeed virtues and that personality is integrated enough to support virtues. (shrink)

The needless proliferation of virtues is a possible pitfall of the explosion of work in virtue ethics. I discuss two positions on proliferation and offer my own. Russell takes the first approach, arguing that virtue ethical right action is impossible unless we adopt a finite and specifiable list of the virtues. I argue against this. Hursthouse offers a second perspective, looking first to standard Aristotelian virtues, and adding virtues only when the standard list fails to capture something of moral importance. (...) Like Hursthouse, I believe that questions arising from applied ethics present the real challenge to the adequacy of traditional lists of virtues. These challenges are becoming increasingly urgent. Technologies are not only shaping our conceptions of ourselves, the human good, and virtues, but also, through germline gene editing, have the potential to change human nature. My position takes its cue from Hursthouse but goes beyond her by arguing for an “anthropological turn” in virtue ethics. The anthropological turn examines forms of life, especially those influenced by technology and science, and how they affect articulations of the human good and the virtues needed to attain it. Any new virtues, I argue, should be identified through study of how dispositions conducive to human good arise organically within forms of life. In this way, virtues remain grounded in what is good for humans, yet the anthropological turn recognizes that what counts as human good is now in flux because of science and technology. (shrink)

ABSTRACT We appreciate and respond to Cokelet’s thoughtful criticisms of our book. First, he points to deliberative forms of practical wisdom as objectionable to anti-rationalist’s. In response, we point to non-conscious (yet complex) forms of deliberation that occur as individuals automatically process and respond to virtue-relevant stimuli. Second, Cokelet states that reflecting upon one’s life as a whole may be unnecessary and ineffective for virtue development. We clarify that reflection is not the only means of virtue cultivation, and even flawed (...) reflection is likely helpful. Finally, Cokelet recommends aiming for ‘theoretical neutrality’ by recasting these core tenets as empirical hypotheses. We argue against a neutral perspective that accommodates antirationalist views that we think are on the wrong track. Non-neutral claims help generate testable empirical hypotheses that can move virtue science forward. (shrink)

Methodological objectivism is a conception of bias which obscures the contingent and limited nature of methodological principles behind the guise of fixed a priori standards. I suggest as an alternative a more flexible view of the operation of bias which I call the attribution model. The attribution model makes explicit the working principles of both parties to an actual charge of bias. It enables those involved to identify the issues in dispute between them, and is the basis for an approach (...) to handling charges of bias within the process of discussion and negotiation which characterizes normal scientific decision-making. (shrink)

The Moral Psychology Handbook is a contribution to a relatively new genre of philosophical writing, the “handbook.” In the first section, I comment on an expectation about handbooks, namely that handbooks contain works representative of a field, and raise concerns about The Moral Psychology Handbook in this regard. In the rest of the article I comment in detail on two Handbook articles, “Moral Motivation” by Timothy Schroeder, Adina Roskies, and Shaun Nichols, and “Character” by Maria W. Merritt, John M. Doris, (...) and Gilbert Harman. Both articles illustrate the perils as well as the promise of reliance on empirical studies for philosophers who work in moral psychology. (shrink)

Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)

Participants in clinical research sometimes view participation as therapy or exaggerate potential benefits, especially in phase I or phase II trials. We conducted this study to discover what methods might improve cancer patients’ understanding of early-phase clinical trials. We randomly assigned 130 cancer patients from three U.S. medical centers who were considering enrollment in a phase I or phase II cancer trial to receive either a multimedia intervention or a National Cancer Institute pamphlet explaining the trial and its purpose. Intervention (...) participants were 32 times more likely to believe that the trial’s purpose was to examine safety and 60 % less likely to believe they would experience long-term benefit or cure. There was no difference in enrollment decision. However, while patients’ understanding of the trial’s purpose improved and expectations of long-term benefit diminished, half the respondents still believed they would experience long-term benefit or cure from participation. Therefore, we conclude that multimedia interventions such as this one may help oncologists to explain the risks and benefits of early-phase cancer trials in a way that patients can more easily understand, helping them to make more informed decisions about participation. But further research into other factors that influence patients’ beliefs about the outcome of enrollment is needed, both to modify the interventions and to determine how malleable patient beliefs are. (shrink)

In the past ten years, there has been growing interest in and concern about protecting the privacy of personal medical information. Insofar as medical records increasingly are stored electronically, and electronic information can be shared easily and widely, there have been legislative efforts as well as scholarly analyses calling for greater privacy protections to ensure that patients can feel safe disclosing personal information to their health-care providers. At the same time, the volume of biomedical research conducted in this country continues (...) to grow. The budget of the National Institutes of Health, for example, was $20,298 million in 2001, having more than doubled from a budget of $9,218 million 10 years before. This growing body of research includes increased efforts to use stored medical records as a source of data for health services, epidemiologic, and clinical studies. (shrink)

This book is an important example of how philosophers can make their work better known to the nonacademic public without sacrificing too much by way of rigor. Miller’s academic work stands at the intersection of philosophy and psychology: he draws on a wide array of psychological studies to help make the case for ‘mixed traits.’ He does the same here, though in a very accessible way. Here I remark on ways in which I think the book might have been stronger, (...) and engage with some of the psychological studies. Finally, I introduce a recent meta-analysis of 24,512 controlled psychological studies of helping behavior. I am curious whether Lefevor et al.’s conclusions will induce Miller to rethink his approach to helping studies or will have other implications for his future research. (shrink)

Mary Wollstonecraft was one of the most influential and controversial women of her age. No writer, except perhaps her political foe, Edmund Burke, and her fellow reformer, Thomas Paine, inspired more intense reactions. In her brief literary career before her untimely death in 1797, Wollstonecraft achieved remarkable success in an unusually wide range of genres: from education tracts and political polemics, to novels and travel writing. Just as impressive as her expansive range was the profound evolution of her thinking in (...) the decade when she flourished as an author. In this collection of essays, leading international scholars reveal the intricate biographical, critical, cultural, and historical context crucial for understanding Mary Wollstonecraft's oeuvre. Chapters on British radicalism and conservatism, French philosophes and English Dissenters, constitutional law and domestic law, sentimental literature, eighteenth-century periodicals and more elucidate Wollstonecraft's social and political thought, historical writings, moral tales for children, and novels. (shrink)

The late twentieth and early twenty-first centuries have seen a renaissance in the study of virtue -- a topic that has prevailed in philosophical work since the time of Aristotle. Several major developments have conspired to mark this new age. Foremost among them, some argue, is the birth of virtue ethics, an approach to ethics that focuses on virtue in place of consequentialism or deontology. The emergence of new virtue theories also marks this new wave of work on virtue. Put (...) simply, these are theories about what virtue is, and they include Kantian and utilitarian virtue theories. Concurrently, virtue ethics is being applied to other fields where it hasn't been used before, including bioethics and education. In addition to these developments, the study of virtue in epistemological theories has become increasingly widespread to the point that it has spawned a subfield known as 'virtue epistemology.' This volume therefore provides a representative overview of philosophical work on virtue. It is divided into seven parts: conceptualizations of virtue, historical and religious accounts, contemporary virtue ethics and theories of virtue, central concepts and issues, critical examinations, applied virtue ethics, and virtue epistemology. Forty-two chapters by distinguished scholars offer insights and directions for further research. In addition to philosophy, authors also deal with virtues in non-western philosophical traditions, religion, and psychological perspectives on virtue. (shrink)

ABSTRACT In this commentary, I delve into areas in which I agree as well as disagree with Glen Pettigrove’s interesting ideas. I am very much in agreement with his views about the limited use of the proportionality principle in attempting to explain what virtue adds to value. The main portion of his essay, however, lies in his treatment of three approaches purporting to explain how virtue adds to value: Hurka’s recursive theory; what Pettigrove calls the ‘response-dependent’ view; and his own (...) account, which he calls the ‘modus operandi’ view. Though I agree with his criticisms of the recursive theory, I express concerns about his treatment of the response-dependent view, as well as about Pettigrove’s own modus operandi account. (shrink)

Can a virtuous person act contrary to the virtue she possesses? Can virtues have “holes”—or blindspots—and nonetheless count as virtues? Gopal Sreenivasan defends a notion of a blindspot that is, in my view, an unstable moral category. I will argue that no trait possessing such a “hole” can qualify as a virtue. My strategy for showing this appeals to the importance of motivation to virtue, a feature of virtue to which Sreenivasan does not adequately attend. Sreenivasan’s account allows performance alone (...) to be a reliable indicator of the possession of virtue. I argue that, at least with respect to a classical, Aristotelian conception of virtue, this assumption is mistaken: a person is said to possess a virtue only when she is properly motivated. In my view, the nature of motivation required for the possession of Aristotelian virtue does not admit of blindspots. I am not primarily interested in details about the situationist critique of virtue theory but rather the implications that blindspots have for our conception of virtue. I argue that because the practical reasoning of the virtuous requires both cognitive and motivational coherence, the motivational structure of the virtuous agent cannot accommodate blindspots. My conclusion is neither a defense of motivational internalism nor of an idealized conception of Aristotelian virtue. My aim is to show that because blindspotted virtue does not cohere well with Aristotle’s conception of virtuous agency, friends of virtue theory must choose one or the other; they cannot have both. (shrink)

Situationism is the view, now familiar in contemporary ethics, that virtue ethics is empirically inadequate. The central complaint is that virtues are global or robust traits, that is, traits that are deeply entrenched parts of personality manifested in regular behavior across different types of situations, and that a wealth of social psychological experiments show either that such traits do not exist, or are so scarce that they are not significant factors in producing behavior. Specific situationist complaints take a variety of (...) forms. For example, Harman complains that social psychology gives us no reason to think that the kinds of traits that can be virtues exist, and, thus, no reason to think that we can become the kinds of people that virtue ethics tells us to be.See Gilbert Harman, “Moral Philosophy Meets Social Psychology: Virtue Ethics and the Fundamental Attribution Error,” Proceedings of the Aristotelian Society, Vol. 99 , p. 316. Indeed, he is so negatively disposed to .. (shrink)

ABSTRACTWe introduce a special issue of articles that emerged from teams of interdisciplinary researchers, social scientists and philosophers, who were funded under the auspices of the Self, Motivation and Virtue Project. The articles in the special issue demonstrate nuance and complexity in the structure of virtuous motivations. Several articles examine the nature of virtue, specific virtues such as humility, perceptions of moral virtues and how they are shaped. Two articles address well-being or flourishing whereas two articles address aspects of life (...) that limit or undermine virtue expression. (shrink)

ABSTRACT Nine articles appear in this special issue of The Journal of Moral Education. Each is the product of a team of multidisciplinary scholars who have researched topics related to the self, virtue, and public life. The essays bring fresh perspectives on civic virtues and the self in studies that are conceptually grounded and empirically informed. They bring to the fore novel ideas about what can count as a civic virtue or enhance civic participation, for example, intellectual humility, forgiveness, and (...) a sense that civic engagement is an authentic exercise of agency. Given the present polarization that plagues our societies today, these articles could not be more timely. All explore implications for education, broadly conceived. (shrink)

Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)