In recent years, the case has been made for special attention to be paid to a branch of research in the field of bioethics called ‘translational bioethics’. In this paper, we start by considering some of the assumptions that those advancing translational approaches to bioethics make about bioethics and compare them to the reality of bioethics as an academic field. We move on to explain how those who make this case, implicitly or explicitly, for translational bioethics go awry because of (...) how they understand the ‘gap’ between bioethical inquiry and practical settings that requires bridging. We consider three interpretations of this ‘translation gap’ in bioethics: (i) the gap between theory and practice, (ii) the gap between the force of normative claims and practical contextual realities and (iii) the gap between relevance or applicability to practice and actual application or implementation in practice. In each case, we show how a proper understanding of the nature of the academic field of bioethics undermines how these gaps have been formulated, and how any need for talk of ‘translational bioethics’ is removed. (shrink)

Many research institutions and funders have recently stated their commitment to actively support and promote ‘Equality, Diversity and Inclusion’ (EDI) in various aspects of health research including Patient and Public Involvement (PPI). However, translating this commitment into specific research projects presents significant challenges that existing approaches, practical guidelines and initiatives have not adequately addressed. In this paper, we explore how the lack of clear justifications for the EDI commitment in existing guidelines inadvertently complicates the work of those involved with PPI (...) and we stress the need for conceptual clarity for any EDI effort to yield meaningful results. Our focus centres on the first principle of the EDI discourse, ‘equality’, particularly in the form of ‘equality of opportunity’ as outlined in current guidance provided by the National Institute of Health Research in the United Kingdom. We examine challenges related to justifying and implementing a general, unspecified commitment to equality of opportunity and explain that this reflects a lack of consensus regarding the moral value of PPI in research – a profound problem that remains unaddressed. We then discuss how the presence of several opposing moral perspectives on PPI, makes determining the most appropriate way of addressing barriers to involvement complex and controversial, raising ethical implications for the work of health researchers, PPI specialists and coordinators. Finally we make suggestions on how future research can enrich the concept of ‘equality of opportunity’ in PPI and improve practice. While our primary focus is on the NIHR, a strong advocate of PPI in research, this analysis will point to normative and ethical considerations that may be relevant to other research institutions and funding organisations aiming to promote equality of opportunity in their public and patient involvement strategies. (shrink)

Research involving adults who lack capacity to consent relies on proxy (or surrogate) decision making. Proxy decisions about participation are ethically complex, with a disparity between normative accounts and empirical evidence. Concerns about the accuracy of proxies’ decisions arise, in part, from the lack of an ethical framework which takes account of the complex and morally pluralistic world in which proxy decisions are situated. This qualitative study explored the experiences of family members who have acted as a research proxy in (...) order to develop an understanding of the ethical concepts involved, and the interactions between those concepts. Proxies described a complex process of respecting the wishes and preferences of the person they represented, whist integrating preferences with what they viewed as being in the interests of the person. They aimed to make a decision that was ‘best’ for the person and protected them from harm; they also aimed to make the ‘right’ decision, viewed as being authentic to the person’s values and life. Decisions were underpinned by the relationship between the person and their proxy, in which both trust and trustworthiness were key. Proxies’ decisions, based both on respect for the person and the need to protect their interests, arose out of their dual role as both proxy and carer. The findings raise questions about accounts which rely on existing normative assumptions with a focus on accuracy and discrepancy, and which fail to take account of the requirement for proxies to make authentic decisions that arise out of their caring obligations. (shrink)

Thus far, little work in bioethics has specifically focused on global health research priority-setting. Yet features of global health research priority-setting raise ethical considerations and concerns related to health justice. For example, such processes are often exclusively disease-driven, meaning they rely heavily on burden of disease considerations. They, therefore, tend to undervalue non-biomedical research topics, which have been identified as essential to helping reduce health disparities. In recognition of these ethical concerns and the limited scholarship and dialogue addressing them, we (...) convened an international workshop in September 2015. The workshop aimed to initiate discussion on the appropriate relationship between global and national levels of health research priority-setting and to begin exploring what might be ethically required for priority-setting at each of those levels. This paper comprises our reflections following the workshop. Its main objective is to launch a research agenda for the ethics of global health research priority-setting. We identify three domains of global health research priority-setting—scope, underlying values and substantive requirements, and procedural considerations. For each domain, specific research questions are highlighted and why they need to be explored is explained. Some preliminary thoughts and normative arguments as to how the research questions might be answered are also offered. For example, we provide initial ideas about the appropriate relationship between different priority-setting levels and what values and substantive considerations should guide or underpin global health research priority-setting as a matter of justice. We anticipate that framing a new research agenda for the ethics of global health research priority-setting will spur ethicists, researchers, and policymakers to refocus their efforts on developing more rigorous and ethically sound approaches to priority-setting. (shrink)

Data platforms represent a new paradigm for carrying out health research. In the platform model, datasets are pooled for remote access and analysis, so novel insights for developing better stratified and/or personalised medicine approaches can be derived from their integration. If the integration of diverse datasets enables development of more accurate risk indicators, prognostic factors, or better treatments and interventions, this obviates the need for the sharing and reuse of data; and a platform-based approach is an appropriate model for facilitating (...) this. Platform-based approaches thus require new thinking about consent. Here we defend an approach to meeting this challenge within the data platform model, grounded in: the notion of ‘reasonable expectations’ for the reuse of data; Waldron’s account of ‘integrity’ as a heuristic for managing disagreement about the ethical permissibility of the approach; and the element of the social contract that emphasises the importance of public engagement in embedding new norms of research consistent with changing technological realities. While a social contract approach may sound appealing, however, it is incoherent in the context at hand. We defend a way forward guided by that part of the social contract which requires public approval for the proposal and argue that we have moral reasons to endorse a wider presumption of data reuse. However, we show that the relationship in question is not recognisably contractual and that the social contract approach is therefore misleading in this context. We conclude stating four requirements on which the legitimacy of our proposal rests. (shrink)

This paper responds to comments by Maxime Doyon and Thomas Sheehan on aspects of my book, Normativity and Phenomenology in Husserl and Heidegger (Cambridge University Press, 2013). Among the topics discussed are the relations between phenomenology and analytic philosophy, the difference between a Brentanian and an Husserlian approach to intentional content, the normative structure of the intentional content of noetic states such as thinking and imagining, the implications of taking a phenomenological approach to Heidegger’s concept of “being,” Heidegger’s “correlationism,” (...) and the normative character of Heidegger’s analysis of Angst, death, and conscience. (shrink)

"Dissecting Bioethics," edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics. The section is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people's actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are therefore particularly appreciated. The themes covered in the section (...) so far include dignity, naturalness, public interest, community, disability, autonomy, parity of reasoning, symbolic appeals, and toleration. (shrink)

Many people consider Martin Heidegger the most important German philosopher of the twentieth century. He is indisputably controversial and influential. Athough much has been written about Heidegger, this may be the best single volume covering his life, career, and thought. For all its breadth and complexity, Heidegger's perspective is quite simple: he is concerned with the meaning of Being as disclosure. Heidegger's life was almost as simple. He was a German professor, except for a brief but significant period in which (...) he supported the Nazi regime. While that departure from philosophy continues to haunt his name and work, one must question whether his thought from 1912 to 1976 should be measured by the yardstick of his politics from May, 1933, through February, 1934. Th is anthology addresses his complex but simple thought and his simple but complex life. In a real sense, Sheehan claims, there is no content to Heidegger's topic and legacy, only a method. But method must not be taken to mean a technique or procedure for philosophical thinking. Rather, the topic of Heidegger's thought and his pursuit of that topic, the "what" and the "how," are one and the same thing. Heidegger writes, "Alles ist Weg," "Everything is way," and man's Being is to be on-the-way in essential movement. Heidegger, argues in our essence we humans are the topic and the point is not to be led there so much as to come to know what we already know and to become what we already are. This brilliant collection confirms this truism, and is an excellent introduction to the work of this seminal thinker. (shrink)

Much has been written in the last decade about how we should understand the value of the sociology of bioethics. Increasingly the value of the sociology of bioethics is interpreted by its advocates directly in terms of its relationship to bioethics. It is claimed that the sociology of bioethics (and related disciplinary approaches) should be seen as an important component of work in bioethics. In this paper we wish to examine whether, and how, the sociology of bioethics can be defended (...) as a valid and justified research activity, in the context of debates about the nature of bioethics. We begin by presenting and arguing for an account of bioethics that does justice to the content of the field, the range of questions that belong within this field, and the justificatory standards (and methodological orientations) that can provide convincing answers to these questions. We then consider the role of sociology in bioethics and show how and under what conditions it can contribute to answering questions within bioethics. In the final section, we return to the sociology of bioethics to show that it can make only a limited contribution to the field. (shrink)

Both older persons and those who havedisabilities can encounter discrimination whenthey seek medical care. Just as ageism andstereotypes about older persons mayinappropriately limit medical care for theelderly, limits may be placed on medical carefor those who are disabled simply because ofthe presence of a disability. At the sametime death is the natural end of the lifespanfor all individuals and there are situationswhen aggressive medical care is not indicated. It is not right to always insist on ``doingeverything'' for a person even (...) if that personmay be at risk otherwise for discrimination. Using the example of the elderly, this paperexamines the risks of discrimination and thedangers of overtreatment in caring for olderpersons and suggests parallels in theappropriate care of those who havedisabilities. (shrink)

The use of charged-particle radiation therapy is an increasingly important development in the treatment of cancer. One of the most pressing controversies about the use of this technology is whether randomised controlled trials are required before this form of treatment can be considered to be the treatment of choice for a wide range of indications. Equipoise is the key ethical concept in determining which research studies are justified. However, there is a good deal of disagreement about how this concept is (...) best understood and applied in the specific case of CPRT. This report is a position statement on these controversies that arises out of a workshop held at Wolfson College, Oxford in August 2011. The workshop brought together international leaders in the relevant fields , including proponents on both sides of the debate, in order to make significant progress on the ethical issues associated with CPRT research. This position statement provides an ethical platform for future research and should enable further work to be done in developing international coordinated programmes of research. (shrink)

This interdisciplinary book considers the relationship between language and thought from a philosophical perspective, drawing both on the philosophical study of language and the purely formal study of grammar, and arguing that the two should align. The claim is that grammar provides homo sapiens with the ability to think in certain grammatical ways and that this in turn explains the vast cognitive powers of human beings. Evidence is considered from biology, the evolution of language, language disorders, and linguistic phenomena.

A masterful survey of the history of Marxist philosophy of science. Now with a new afterword. Skillfully deploying a large cast of characters, Sheehan retraces the development of Marxist philosophy of science through detailed and highly readable accounts of the debates that have characterized it. Approaching Marxism from the perspective of the philosophy of science, Sheehan shows how Marx's and Engel's ideas on the development and structure of natural science had a crucial impact on the work of early (...) twentieth-century natural philosophers, historians of science, and natural scientists. From the ideas of Marx and Engels, those of the Marxist theoreticians of the Second International to the debates within Russian Marxism up to World War II, Sheehan masterfully surveys the history of marxist philosophy of science, concluding with a close analysis of the development of the debate among non-Soviet Marxists, placing particular emphasis on the contributions of leading British Marxists in the 1930s. (shrink)

by Victor Farías, translated from Spanish and German into French by Myriam Benarroch and Jean-Baptiste Grasset, preface by Christian Jambet. Editions Verdier, 332 pp., Fr125 (paper).

El plan de estudios no preceptivo de historia de Educación Secundaria de Nueva Zelanda les permite a los maestros que tienen una gran experiencia intelectual en el conocimiento disciplinar la oportunidad de desarrollar programas innovadores que aborden los intereses de sus alumnos. El currículo o el marco de evaluación no requieren conocimiento de eventos históricos particulares, de personalidades o de temas concretos. Sin embargo, para el profesorado que no tiene una comprensión sólida de cómo funciona la disciplina de la historia, (...) la ausencia de límites plantea un desafío. La base para elegir contenidos o temas puede carecer de coherencia, ser en gran medida arbitraria y basarse en la experiencia limitada de individualidades en lugar de en los conocimientos especializados de los investigadores. Este artículo examina las implicaciones de un currículum de historia de alta autonomía con un enfoque basado en el conocimiento. En él se sostiene que, si los jóvenes deben tener acceso a formas intelectualmente poderosas de comprender el pasado, el conocimiento histórico debe diferenciarse entre los marcos disciplinares del pensamiento y el conocimiento que no requiere una dimensión crítica. (shrink)

Since those times "nature" has become the basic word designating essential relations that Western historical humanity has to beings, both to itself and to beings other than itself. This fact is shown by a rough list of dichotomies that have become prevalent: nature and grace (i.e., super-nature).

The world, the all-inclusive unity of entities in real actuality, is the field whence the various positive sciences draw their realms of research. Directed straight at the world, these sciences in their allied totality seem to aim at a complete knowledge of the world and thus to take charge of answering all questions that can be asked about entities. It seems there is no field left to philosophy for its own investigations. But does not Greek science, already in its first (...) decisive beginnings, direct its unceasing efforts towards entities as such? Do not entities as such serve it as the subject matter of a fundamental science of being, a "first philosophy"? For Greek science, to directly determine entities -- both individuals and even the universal whole, and in whatever regard they be taken -- did not mean to understand entities as such. Entities as entities -- that is, with regard to their being -- are enigmatic.2 For a long time the lines of inquiry and the answers remain tangled in obscurities. Nonetheless, in the first steps of this "first philosophy"3 one may already see the source whence springs the questionability of entities as such. Parmenides seeks to clarify being4 via a reflection on one's thinking about entities. Plato's disclosure of the Ideas takes its bearings from the soul's.. (shrink)

This bibliography presents information on the English translations of Heidegger’s Gesamtausgabe as they are known to me as of September 2014. Sometimes, but not always, earlier or alternate translations are also given.Texts already published between 1910 and 1976GA 1: Frühe Schriften, ed. Friedrich-Wilhelm von Herrmann, 1978; first edition 1972; texts from 1912-16.GA 1: 1–15, “Das Realitätsproblem in der modernen Philosophie ” = “The Problem of Reality in Modern Philosophy,” trans. Philip J. Bossert, revised Aaron Bunch, Becoming Heidegger: On the Trail (...) of His Early Occasional Writings, 1910–1927, ed. Theodore Kisiel and Thomas Sheehan, Evanston: Northwestern University Press, 2007, 20–9.[Earlier, “The Problem of Reality in Modern Philosophy ,” trans. Philip J. Bossert and John van Buren, Supplements: From the Earliest Essays to Being and Time and Beyond, ed. John van Buren, Albany: State University of New York Press, 2002, 39–48.]GA 1: 17–43, “Neuere Forschungen über Logik .. (shrink)

Patient choice, we might think, is the popular version of the ideas of informed consent and the principle of respect for autonomy and intimately connected to the politics of liberal individualism. There are various accounts to be given for why patient choice, in all its forms, has dominated thinking in bioethics and popular culture. All of them, I suggest, will make reference to the decline of paternalism. The bad old days of ‘doctor knows best’ are gone and were replaced by (...) the primacy of patient choice and informed consent.The response to the dominance of the principle of patient choice has been slow in building but it has come in a number of ways. Two sets of papers in this issue of the Journal of Medical Ethics show just how far this response has come and the degree to which the pendulum is swinging back in the other direction. Neil Levy's Feature article, ‘Forced to be free? Increasing patient autonomy by constraining it’, argues that we should go to greater lengths to correct patients' mistaken decisions . In the ‘Author meets critics’ section, Sarah Conly's book, Against Autonomy: Justifying Coercive Paternalism is the focus of comment . Both authors draw on a similar range of empirical evidence to undermine the sanctity of patient and individual choice. An array of commentators draw on these target pieces to give a clear picture of the ways in which the popular view can justifiably be undermined.Levy's paper focuses on the process of informed consent in clinical contexts. He argues that, while this process is crucially important, it systematically fails because of well-documented frailties of human reason. The evidence of these frailties comes from cognitive and social psychology, on biases and heuristics. The key question is how …. (shrink)

All too often, the requirements for actionability and accountability of data infrastructures are conceptualised as incompatible and leading to a trade-off situation where increasing one will unavoidably decrease the other. Through a comparative analysis of two data infrastructures used to share genomic data about the SARS-COV-2 virus, we argue that making data actionable for knowledge development involves a commitment to ensuring that the data in question are representative of the phenomena being studied and accountable to data subjects and users. This (...) in turn presupposes that: (1) enough data are contributed by a wide and diverse set of relevant sources; (2) mechanisms of feedback and inclusion are set up to ensure that data contributors can participate data governance and interpretation, thereby helping to adequately contextualise data; and (3) accountability extends to the ways in which data infrastructures are run, financed and positioned vis-à-vis the communities they are meant to serve. Such a model of data sharing can only work on the understanding that data do not need to be easily accessible to be actionable; rather, actionability depends on the responsiveness and accountability of data infrastructures, and the efforts invested in ensuring open communication among contributors. (shrink)

The central issue that I consider in this paper is the use of the so‐called ‘Rule of Rescue’ in the context of resource allocation. This ‘Rule’ has played an important role in resource allocation decisions in various parts of the world. It was invoked in Ontario to overturn a decision not to fund treatment for Gaucher's Disease and it has also been used to justify resource decisions in Israel concerning the same condition. -/- In the paper I consider the nature (...) of the Rule of Rescue and its moral justification. The latter involves consideration of the distinction between agent‐relative and agent‐neutral obligations. If the Rule of Rescue is to be justified, it is plausible to think that it will be in the context of agent‐relative obligations. Two problems with this suggestion are considered: the role of identifiability in the Rule of Rescue and the extent to which policy makers in a health care system can be taken to have such obligations. It is argued that in both cases these problems can be overcome and hence that there is a prima facie obligation to follow the Rule of Rescue. (shrink)

Interpretations of Heidegger often fail to distinguish between two very different matters -- on the one hand “the turn” (die Kehre), and on the other hand “the change in Heidegger’s thinking” (die Wendung im Denken), that is, the shift in the way Heidegger formulated and presented his philosophy beginning in the 1930s. Failure to make this distinction can be disastrous for understanding Heidegger, and the danger becomes more acute the closer one gets to texts like Introduction to Metaphysics, where both (...) the “turn” and the “change” begin to come into their own.1.. (shrink)

This important book opens a new path in Heidegger research that will stimulate dialogue within Heidegger studies, as well as with philosophers outside the phenomenological tradition and scholars in theology, literary criticism, and existential psychiatry.

In the Early Modern era of encyclopedias, the Bible functioned as a tool for managing and organizing the superabundance of information. From Johann Alsted to Johann Scheuchzer, this paper traces the use of the Biblical encyclopedia and the ways that the Bible was deployed to control the data that flooded the world of Early Modern scholarship. In a variety of contexts, the Bible served as a structure for generating meaningful statements from informational noise. In turn, the use of the Bible (...) as a principle of organization would have profound implications for the status of the Bible in Early Modern scholarly culture. (shrink)

Two problems continue to haunt Heideggerian scholarship and to pose needless obstacles to those who seek to enter his thought. One is the almost ritualistic repetition of the master’s terminology—especially at its most manneristic—on the part of his disciples. Another is the tendency, which is found in Heidegger as well as in his disciples, to hypostasize “being” into an autonomous “other” that seems to function on its own apart from entities and from man. Both of these problems gather around Heidegger’s (...) key word Ereignis and therefore around his interpretation of the history of philosophy, and they obscure a clear insight into what he was trying to say. (shrink)

In 1987 Victor Farías' Heidegger et le nazisme dropped like a bomb on the quiet chapel where Heidegger's disciples were gathered, and blew the place to bits. The myth Heidegger had concocted after the war -- that he supported the Nazis briefly and only to protect the university -- was shattered by the evidence Farías mustered of Heidegger's deep and long-lasting commitment to National Socialism, his blatant anti-Semitism, his blackballing of colleagues for no more than holding pacifist convictions, associating with (...) Jews, or being "unfavorably disposed" toward the Nazi regime. (shrink)

When it comes to using patient data from the National Health Service for research, we are often told that it is a matter of trust: we need to trust, we need to build trust, we need to restore trust. Various policy papers and reports articulate and develop these ideas and make very important contributions to public dialogue on the trustworthiness of our research institutions. But these documents and policies are apparently constructed with little sustained reflection on the nature of trust (...) and trustworthiness, and therefore are missing important features that matter for how we manage concerns related to trust. We suggest that what we mean by ‘trust’ and ‘trustworthiness’ matters and should affect the policies and guidance that govern data sharing in the NHS. We offer a number of initial, general reflections on the way in which some of these features might affect our approach to principles, policies and strategies that are related to sharing patient data for research. This paper is the outcome of a ‘public ethics’ coproduction activity which involved members of the public and two academic ethicists. Our task was to consider collectively the accounts of trust developed by philosophers as they applied in the context of the NHS and to coproduce an argumentative position relevant to this context. (shrink)

For the past 3 years, since acquiring formal training in healthcare ethics and philosophy, I have been one of those physicians who “does” ethics. I teach medical students and residents, write articles, speak at conferences, chair an ethics committee, and informally consult with colleagues on cases where they request advice related to ethical issues in the care of patients. These activities have been a rewarding and challenging part of my practice. There has also been a fair amount of frustration. Unfortunately, (...) both in teaching and patient care, it has been a frequent experience to finish a discussion with physicians only to be told that what I said was nice but had no bearing in the real world. In the words of a medical resident: 'You know, this ethics stuff is really a lot of crap, isn't it?'. (shrink)

This article outlines the distinctive contribution of Marxism to science studies. It traces the trajectory of Marxist ideas through the decades from the origins of Marxism to the present conjuncture. It looks at certain key episodes, such as the arrival of a Soviet delegation at the International History of Science Congress in London in 1931, as well as subsequent interactions between Marxists and exponents of other positions at later international congresses. It focuses on the impact of several generations of Marxists (...) who have engaged with science in diverse ways. It examines the influence of Marxism on contemporary trends in science studies. It concludes that Marxism survives in circuitous and complex ways. It argues not only for a positive interpretation of its contribution in the past but for its explanatory and ethical power in the present and future. (shrink)

As the COVID-19 pandemic impacts on health service delivery, health providers are modifying care pathways and staffing models in ways that require health professionals to be reallocated to work in critical care settings. Many of the roles that staff are being allocated to in the intensive care unit and emergency department pose additional risks to themselves, and new policies for staff reallocation are causing distress and uncertainty to the professionals concerned. In this paper, we analyse a range of ethical issues (...) associated with changes to staff allocation processes in the face of COVID-19. In line with a dominant view in the medical ethics literature, we claim, first, that no individual health professional has a specific, positive obligation to treat a patient when doing so places that professional at risk of harm, and so there is a clear ethical tension in any reallocation process in this context. Next, we argue that the changing asymmetries of health needs in hospitals means that careful consideration needs to be given to a stepwise process for deallocating staff from their usual duties. We conclude by considering how a justifiable process of reallocating professionals to high-risk clinical roles should be configured once those who are ‘fit for reallocation’ have been identified. We claim that this process needs to attend to three questions that we consider in detail: (1) how the choice to make reallocation decisions is made, (2) what justifiable models for reallocation might look like and (3) what is owed to those who are reallocated. (shrink)

This essay is an attempt to think through some of the problems of idolatry and sacrifice for the early modern period and more generally, for the constitution of religious and political community. In particular, it argues that the altars of the idols condensed two problems: first, the problem of communion, and specifically the Protestant ability to communicate with God; and second, the problem of distinction. At a time when the nature of the religious polity was in question, the analysis of (...) idolatry and sacrifice produced a conceptual structure for understanding, in anthropological fashion, the very constitution of religious and political community. In fact, this essay will suggest, this structure lives on, alive and well, among modern theorists seeking to diagnose the ailments of modernity. (shrink)

The language of ethics expertise has become particularly important in bioethics in light of efforts to establish the value of the clinical ethics consultation, to specify who is qualified to function as a clinical ethics consultant, and to characterize how one should evaluate whether or not a person is so qualified. Supporters and skeptics about the possibility of ethics expertise use the language of ethics expertise in ways that reflect competing views about what ethics expertise entails. We argue for clarity (...) in understanding the nature of expertise and ethics expertise. To be an ethics expert, we argue, is to be an expert in knowing what ought to be done. Any attempt to articulate expertise with respect to knowing what ought to be done must include an account of ethics that specifies the nature of moral truth and the means by which we access this truth or a theoretical account of ethics such that expertise in another domain is linked to knowing or being better at judging what ought to be done and the standards by which this “knowing” or “being better at judging” is determined. We conclude with a discussion of the implications of our analysis for the literature on ethics expertise in CEC. We do think that there are clear domains in which a clinical ethics consultant might be expert but we are skeptical about the possibility that this includes ethics expertise. Clinical ethics consultants should not be referred to as ethics experts. (shrink)