Background Requirements for organ donation after cardiac or imminent death have been introduced to address the transplantable organs shortage in the United States. Organ procurement organizations (OPOs) increasingly use the Internet for organ donation consent. Methods An analysis of OPO Web sites available to the public for enrollment and consent for organ donation. The Web sites and consent forms were examined for the minimal information recommended by the United States Department of Health and Human Services for informed consent. Content scores (...) were calculated as percentages of data elements in four information categories: donor knowledge, donor consent reinforcement, donation promotion, and informed consent. Results There were 60 Web sites for organ donation enrollment serving the 52 states. The median percent (10 percentile-90 percentile) content scores of the Web sites for donor knowledge, donor consent reinforcement, and donation promotion were 33% (20–47), 79% (57–86), and 75% (50–100), respectively. The informed consent score was 0% (0–33). The content scores for donor knowledge and informed consent were significantly lower than donor consent reinforcement and donation promotion for all Web sites (P < .05). The content scores for the four categories were similar among the 11 regions of the United Network for Organ Sharing. Conclusion The Web sites and consent forms for public enrollment in organ donation do not fulfill the necessary requirements for informed consent. The Web sites predominantly provide positive reinforcement and promotional information rather than the transparent disclosure of organ donation process. Independent regulatory oversight is essential to ensure that Internet enrollment for organ donation complies with legal and ethical standards for informed consent. (shrink)

There has been increasing interest in the relevance of virtue approaches to ethics over the past 15 years. However, debate surrounding the virtue approach in the business, management and organisational studies literature has lacked progress. First, this literature focuses on a narrow range of philosophers, and, second, it has failed to analyse properly the consequences of virtue theory for action in practical settings other than in abstract terms. In order to begin addressing these issues, this paper compares what two virtue (...) frameworks—one focused on virtue in the context of community and the other on individuals as virtuous agents—lead to when evaluating the actions of parties to the 2002–2004 UK Fire Service dispute. The analysis argues that the virtue frameworks proposed by MacIntyre and Slote offer different but complimentary evaluations. Both not only point to potential problems with industrial disputes, but also recognise the legitimacy of action that is based in good motivations and carried out with regard for the virtues. It seems that fire fighters and their immediate supervisors, on the whole, met the conditions of virtue, but that it is open to question if the leaders of the Fire Brigades Union and the Government did the same. The analysis goes on to suggest which modes of negotiation would be acceptable under the virtue frameworks, and the implications for those involved in industrial dispute. (shrink)

Spanish translation of Field, S. L. (2014). 'Hobbes and the question of power'. Journal of the History of Philosophy, 52(1), 61-86. Thomas Hobbes has been hailed as the philosopher of power par excellence; however, I demonstrate that Hobbes’s conceptualization of political power is not stable across his texts. Once the distinction is made between the authorized and the effective power of the sovereign, it is no longer sufficient simply to defend a doctrine of the authorized power of the sovereign; such (...) a doctrine must be robustly complemented by an account of how the effective power commensurate to this authority might be achieved. Nor is this straightforward: for effective political power can fluctuate, sometimes severely. In this light, the prevalent juridical reading of Hobbes’s political philosophy is inadequate. (shrink)

ZusammenfassungEntscheidungen der Therapiebegrenzung und in der Betreuung am Lebensende sind häufig komplex und von ethischen Problemen begleitet. Im Mittelpunkt der Untersuchung steht die entscheidende Frage, wie hilfreich existierende „Ethik-Richtlinien“, die eine ethische Orientierung bei solchen Entscheidungen geben sollen, in der klinischen Praxis tatsächlich sind. Die Frage, welchen Nutzen „Ethik-Richtlinien“ bei der Entscheidungsfindung haben oder haben können, wird hier exemplarisch an einem klinischen Fallbeispiel aus einer Ethik-Kooperationsstudie in der Intensivmedizin analysiert. Vergleichend werden hierzu „Ethik-Richtlinien“ aus Deutschland, der Schweiz und aus Großbritannien (...) herangezogen, die Gegenstand eines internationalen Projekts zur Analyse von Richtlinien waren. Die Möglichkeiten und Grenzen einer ethischen Orientierung an „Ethik-Richtlinien“ bei Entscheidungsproblemen der Therapiebegrenzung und in der Betreuung am Lebensende werden anhand der Fallstudie diskutiert und illustriert. Abschließend werden Schlussfolgerungen für die Entwicklung ethischer Richtlinien für die klinische Praxis formuliert. (shrink)

According to several commentators, Kurt Godel's incompleteness discoveries were assimilated promptly and almost without objection by his contemporaries - - a circumstance remarkable enough to call for explanation. Careful examination reveals, however, that there were doubters and critics, as well as defenders and rival claimants to priority. In particular, the reactions of Carnap, Bernays, Zermelo, Post, Finsler, and Russell, among others, are considered in detail. Documentary sources include unpublished correspondence from Godel's Nachlass.

On March, 24, 2020, 818 cases of COVID-19 had been reported in New South Wales, Australia, and new cases were increasing at an exponential rate. In anticipation of resource constraints arising in clinical settings as a result of the COVID-19 pandemic, a working party of ten ethicists was convened at the University of Sydney to draft an ethics framework to support resource allocation decisions. The framework guides decision-makers using a question-and-answer format, in language that avoids philosophical and medical technicality. The (...) working party met five times over the following week and then submitted a draft Framework for consideration by two groups of intensivists and one group of academic ethicists. It was also presented to a panel on a national current affairs programme. The Framework was then revised on the basis of feedback from these sources and made publicly available online on April 3, ten days after the initial meeting. The framework is published here in full to stimulate ongoing discussion about rapid development of user-friendly clinical ethics resources in ongoing and future pandemics. (shrink)

Narrative is increasingly being recognised as an important tool both to manage and understand organisations. In particular, narrative is recognised to have an important influence on the perception of environmental issues in business, a particularly contested area of modern management. Management literature is, however, only beginning to develop a framework for evaluating the quality and legitimacy of narratives. Due to the highly fluid nature of narratives, the traditional notion of truth as reflecting ' objective reality' is not useful here. In (...) this article, an alternative approach that evaluates a narrative in two stages is developed. First, a horizontal reading investigates the surface of the narrative, its textual features, instrumental devices and its integrity as a text, to assess the quality of a narrative. Second, a more philosophical or vertical reading makes explicit the underlying value assumptions that author and reader bring to the writing and reading of the narrative to assess the narrative's claim to legitimacy. The framework is then tested against a narrative on the relationship between business and environment as espoused by a supply chain manager of a UK-based manufacturing company. (shrink)

In recent years, organisational theorists have been interested in the tensions faced by healthcare organisations. In this paper, these tensions are examined using the virtue approach to ethics of Alasdair MacIntyre. It is argued that although MacIntyre's framework shares many concerns with organisational studies, it supplements the analysis with a focus on moral content and evaluation. By providing moral evaluation of the stories told in organisations, an ethical analysis compels action on a basis that organisational studies does not. Nevertheless, it (...) is the analysis of stories in organisation studies that provides the tools for taking action. The analysis presented here provides an example of how ethics and organisational studies can be brought together to provide a stronger analysis of organisational phenomena. Indeed, it provides support for Nielsen's position that organisational theory and ethics are co‐dependent and suggests that greater attention should be paid to ethical concepts in the study of organisational phenomena. (shrink)

ABSTRACT In recent years there has been intense debate regarding the level of medical care provided to ‘standard care’ control groups in clinical trials in developing countries, particularly when the research sponsors come from wealthier countries. The debate revolves around the issue of how to define a standard of medical care in a country in which many people are not receiving the best methods of medical care available in other settings. In this paper, we argue that additional dimensions of the (...) standard of care have been hitherto neglected, namely, the structure and efficiency of the national health system. The health system affects locally available medical care in two important ways: first, the system may be structured to provide different levels of care at different sites with referral mechanisms to direct patients to the appropriate level of care. Second, inefficiencies in this system may influence what care is available in a particular locale. As a result of these two factors locally available care cannot be equated with a national ‘standard’. A reasonable approach is to define the national standard of care as the level of care that ought to be delivered under conditions of appropriate and efficient referral in a national system. This standard is the minimum level of care that ought to be provided to a control group. There may be additional moral arguments for higher levels of care in some circumstances. This health system analysis may be helpful to researchers and ethics committees in designing and reviewing research involving standard care control groups in developing country research. (shrink)

Research ethics is an integral part of research, especially that involving human subjects. However, concerns have been expressed that research ethics has come to be seen as a procedural concern focused on a few well-established ethical issues that researchers need to address to obtain ethical approval to begin their research. While such prospective review of research is important, we argue that it is not sufficient to address all aspects of research ethics. We propose retrospective review as an important complement to (...) prospective review. We offer two arguments to support our claim that prospective review is insufficient. First, as currently practiced, research ethics has become for some a ‘tick box’ exercise to get over the ‘hurdle’ of ethics approval. This fails to capture much of what is important in ethics and does not promote careful reflection on the ethical issues involved. Second, the current approach tends to be rules-based and we argue that research ethics should go beyond this to develop people’s capacity to be sensitive to the relevant moral features of their research, their ethical decision-making skills and their integrity. Retrospective review of a project’s ethical issues, and how they were addressed, could help to achieve those aims better. We believe that a broad range of stakeholders should be involved in such retrospective review, including representatives of ethics committees, participating communities and those involved in the research. All stakeholders could then learn from others’ perspectives and experiences. An open and transparent assessment of research could help to promote trust and understanding between stakeholders, as well as identifying areas of agreement and disagreement and how these can be built upon or addressed. Retrospective review also has the potential to promote critical reflection on ethics and help to develop ethical sensitivity and integrity within the research team. Demonstrating this would take empirical evidence and we suggest that any such initiatives should be accompanied by research into their effectiveness. Our article concludes with a discussion of some possible objections to our proposal, and an invitation to further debate and discussion. (shrink)

Zygmunt Bauman’s sociology has often been seen as a bleak worldview; he has been called the ‘sociologist of misery’. This article argues that assigning pessimism and misery to Bauman’s work relies on a reading which does not fully consider his sociology of morality. When this is accounted for, Bauman can be seen to have a very optimistic worldview. The significance of such an observation rests on where Bauman’s optimism lies—namely in the hands of inevitably moral individuals who can acquiesce to, (...) reject or modify the demands of liquid modernity. This article argues, with reference to G.H. Mead’s concept of the ‘genius’, that this is where the potential for agency lies in Bauman’s conception of liquid modernity. This is given a political dimension by both Mead and Bauman’s advocacy of democratic forms to help realise this agency. Democracy operates as a ‘societal’ form of morality which builds upon Bauman’s ‘pre-societal’ discussion. (shrink)

This paper expands on “An Ethics Framework for Making Resource Allocation Decisions within Clinical Care: Responding to COVID-19,” which is also published in this special issue of the Journal of Bioethical Inquiry. I first describe and explain the steps we took to develop this framework, drawing on previous experience and literature to explain what frameworks can and cannot do. I distinguish frameworks from other kinds of guidance and justify why our framework takes the form it does. Our key aim was (...) to help answer practical questions faced by frontline clinicians. I then explain some of the normative issues that shape the content of the framework itself. Here, I engage critically with the resource allocation literature and justify the particular positions that we take in the framework. Although we undertook this work to address resource allocation decisions anticipated during the unfolding COVID-19 pandemic, it will also serve as an example for others who wish to design practical ethics frameworks for other bioethical issues that will emerge in the future. (shrink)

This conceptual paper argues that change makers, here called transformation stewards, attempting to catalyze transformational change need three core skillsets specific to stewarding transformative change, and further argues that mindfulness practices can potentially enhance these capacities. One skillset is reflexive systems-based awareness and understanding. Another includes capacities for fostering what gives life in complexly wicked social-ecological systems. A third is having capacity for and willingness to steward whole system change, rather than lead it in the conventional sense, which is made (...) necessary because of the nature of organizing transformation stewards in complex, life-oriented systems. Tentative evidence from the literature supports the idea that a combination of experience and mindfulness practices of various sorts can enhance these capabilities. (shrink)

Idealism became the dominant philosphical school of thought in late nineteenth-century Britain. In this original and stimulating study, Sandra den Otter examines its roots in Greek and German thinking and locates it among the prevalent methodologies and theories of the period: empiricism and positivism, naturalism, evolution, and utilitarianism. In particular, she sets it in the context of the late nineteenth- and early twentieth-century debate about a science of society and the contemporary preoccupation with `community'.

. The use of narrative to communicate and convey particular points of view in society has increasingly become the focus of academic attention in recent years. In particular, MacIntyre. (1985, 1988, 1990, 1999) has paid attention to the role of narrative in the conflict between different traditions when developing his virtue approach to ethics. Whilst there has been continued debate about the application of virtue approaches, some arguing that it is incompatible with business, I disagree and have already argued for (...) a form of virtue that will focus business on society’s needs rather than better business itself. Here I continue to develop the argument in two ways. First, I will explore the predominant business narrative and offer some comment on the ‘virtues’ that it promotes. However, rather than accepting this narrative, I want to challenge it with a narrative from the environmental tradition. I consider how adopting the virtues promoted by an environmental narrative it would shape business practices and challenge current business conventions. As a second step, I will focus on how we can change managers’ perceptions of business to reflect these environmentally based virtues. (shrink)

Plato believed that behind everything in the universe lie mathematical principles. Plato was inspired by Pythagoras (571 BCE), who developed a school of mathematics at Crotona that studied sacred geometry as a form of religion. The school’s motto was “God is number,” or “All is Number”. Pythagoras believed that numbers represented God in pattern, symmetry, and infinity. When one of its students, Hippasus told the world the secret of the existence of irrational numbers, Greek geometry was born and Pythagoras’ idea (...) of divinity in numbers died because how could God not be perfect and symmetrical? In Plato’s Republic he discusses something called The Divided Line, which is a map, of sorts, for reaching what he calls the highest Good, which is the ultimate truth where one realizes the true state of the universe and can see the world for what it really is. Many mathematicians have attempted to plot Plato’s Divided Line only to come across a litany of problems and conundrums. Some have said that it the Divided Line cannot be plotted and is merely an allegory not meant to be plotted. This paper discusses some of the conundrums preventing the plotting of Plato’s Divided Line (not an exhaustive list), including Whole ‘vs’ Separate, Equality ‘vs’ Ontological Dissimilarity, Linear ‘vs’ Non-linear, and Infinity ‘vs’ Finite. This paper also explores a new understanding of the Allegory of the Cave in light of ‘the problem of the irrational.’ In exploring the link between the Divided Line and the ‘the problem of the irrational,’ I was able to plot it. It was found that the Divided Line is not a line in the linear sense, but a spiral, the Golden Ratio! This paper is an example of a new category of scholarly inquiry I call “Math Theory” based on scholarly mathematical axioms in theory, rather than including actual maths. In my papers I use existing mathematical equations and place them in an encompassing theory, rather than finding new formulae to fit an existing theory. Keywords: Pythagoras, divided line, math theory, highest good, all is number. (shrink)

In crafting our paper on addressing the ethical challenges in HIV prevention research with people who inject drugs,1 we had hoped to stimulate further discussion and deliberation about the topic. We are pleased that three commentaries on our paper have begun this process.2 3 4 The commentaries rightly bring up important issues relating to community engagement and problems in translating research into practice in the fraught environments in which PWID face multiple risks. These risks include acquisition of HIV as well (...) as criminalisation, stigma and lack of access to needed healthcare, prevention and social services. We take this opportunity to respond to the excellent points raised by the commentators. All of the commentaries support our emphasis on robust community engagement with PWID and other stakeholders in designing and conducting HIV prevention research, but urge us to go farther. Wolfe highlights the difficulty of even engaging with community members in oppressive settings, where authorities severely restrict civil liberties of PWID so that even discussing issues related to drug use and enforcement may place individuals at risk. To overcome such limitations, he appropriately suggests interviewing confidentially those who have previously been detained in closed settings as part of the community engagement process. Similarly, Wolfe observes that critical issues can be overlooked with a narrow focus on study procedures if contextual factors before, during or after a study are ignored. For example, he cites the risk of overdose for study participants who have been abstinent during a study and subsequently resume injecting when the study concludes. These kinds of risks may not be obvious …. (shrink)

Collins, John Francis; Carroll, Sandra The publication of the 'Norms for the Formation of Permanent Deacons and Guidelines for the Ministry and Life of Permanent Deacons' by the Australian Catholic Bishops Conference, in August 2016, has renewed focus on the role of permanent deacon. This article uses a heuristic structure to discuss the role of the permanent deacon in the Catholic Church in Australia. It then provides a historical perspective and background on the worker priest movement from the mid-twentieth (...) century to explore the possibility of its application to the contemporary role of permanent deacon. (shrink)

Presentists deny that past or future things exist. Some presentists also deny that there are any underlying truths about the past or future. While this seems to conflict with our everyday tensed discourse, presentists might avoid conflict by adopting a theory of hermeneutic fictionalism about the non-present. Under such a theory, everyday utterances of non-present-tensed sentences are taken to engage with a fiction, rather than expressing truths about the past or future. In this paper I defend a specific version of (...) this view: meta-fictionalism about the non-present. Under this view there is a socially-understood non-present fiction, a 'story of history', derived from apparent records existing in the present. Meta-fictionalists take our everyday tensed discourse to involve assertions about the content of that fiction. I argue that this view is plausible, and that it fares better than pretence fictionalism, a competing view that has already seen discussion in the literature. (shrink)

As we have now completed 15 years of journal content, it seems like a good time to take stock and reflect upon the development and nature of public health ethic.

The article analyses fashion as a reflex of philosophy of identity in everyday life. Contemporary fashion is not imaginable without postulation of national and/or regional identity. Worldly recognisable French, Italian and other regional fashions show a variety of models that have recognisability. Internationally recognisable as fashion that represents particular national identity it still can be seen as not the only possible its identity version. Contemporary variety in identity models in fashion design are reflecting identity models in general. Identity is understood (...) as changeable and liquid that can reflect aspects of identity depending on participants of interaction. Fashion, differently, is a form of mass communication that does not change the message depending on the receiver. (shrink)

Recent attempts to develop scientific research strategies for cultural evolution have mostly drawn upon evolutionary biology, but within anthropology there is also an influential tradition of non-biological evolutionary thought whose basic principle is adaptation to the environment. This article is mainly concerned with the "cultural materialist" school of Marvin Harris, but also treats the recent attempt of Jared Diamond to create a more radical model of evolutionary ecology. I argue that the ecological tradition does not represent a real alternative to (...) neo-Darwinism and is in fact a pseudo-Darwinist theory. I also suggest that the bias in favor of materialistic explanation in cultural evolution may not be justified. (shrink)

In 1968, the Democratic Party of the United States held its convention in Chicago. Thousands of anti-war protestors arrived to picket the democratic process and voice their concerns over the Vietnam War for the upcoming presidential election. With prior knowledge of the coming protests, the Chicago Police Department and city administration expected violence and prepared themselves accordingly. As a result, the convention was plagued all week by violence in the streets as protestors clashed with the police. At the end, the (...) violence was declared be the result of excessive police brutality. Scholarly works on the pre-existing conditions of Chicago that lead to violence have not been fully considered. In looking at the complexity of violent protest, this essay intends to examine the leaders and their intentions – on both sides of the conflict – and determine the causes and impact of one of the most iconic political clashes in twentieth century America. (shrink)