This paper examines the status of Corporate Ethical Policies (CEP) in large companies in Argentina, Brazil and Spain, with a special emphasis on Corporate Ethics Statements (CES), documents that define the firms’ philosophy, values and norms of conduct. It is based on a survey of the 500 largest companies in these nations. The findings reveal many similarities between these countries. Among other things, it emerges that most companies give consideration to ethics in business and have adopted some (...) kind of formal or informal ethical policies. Regardless of whether or not they have a CES, companies agree that ethical conduct must be taken into account when selecting, appraising and promoting personnel as an important ethical policy. There is a growing tendency to draw up formal corporate ethics documents. These documents are perceived, first and foremost, as supporting the development of corporate culture. Most respondents believe that primary responsibility for ethical issues in the company rests with the CEO. Finally, the findings indicate that most companies that devote more resources to communicating and implementing CESs have two or more formal ethics documents. The main differences between the countries included in the study concern the emphasis given to specific aspects, such as avoiding misconduct or taking ethical criteria into account when selecting personnel. The emphasis is greatest in countries where corruption seems most prevalent. (shrink)

This manual is a compendium of various health care policies, guidelines, protocols, and programs that concern clinical issues with ethical implications. The collection of policies, guidelines, and procedures are helpful in drafting and reviewing institutional procedures and helping policymakers develop useful mechanisms for assuring ethical treatment of patients and staff.

Gaucher disease is a rare, chronic,ethnic-specific genetic disorder affecting Jewsof Eastern European descent. It is extremelyexpensive to treat and presents difficultdilemmas for officials and patients in Israelwhere many patients live. First, high-cost,high-benefit, but low volume treatment forGaucher creates severe allocation dilemmas forpolicy makers. Allocation policies driven bycost effectiveness, age, opportunity or needmake it difficult to justify funding. Processoriented decision making based on terms of faircooperation or decisions invoking the ``rule ofrescue'''' risk discriminating against minoritieswho may already suffer from inequitabledistribution (...) of heath care resources. Apartfrom cost, Gaucher disease prompts questionsabout abortion. Unlike severe geneticdisorders, Gaucher offers no grounds forabortion and, in many ways, is analogous togender based abortions that are prohibitedregardless of fetal age. Finally, Gaucherraises concerns about the disclosure of geneticinformation. These affect potential carriersasked to participate in population studies andcarriers and patients who must considerdisclosure to others. These concerns weigh theright to privacy against communal interests andbilateral commitments. (shrink)

Over the past twenty years, traditional commitments of policy analysis to empirical inquiry and expert knowledge have shaped the policy "solution" for addressing a public perception of ethical decline. Separation of facts and values, basic assumptions regarding the limits and fallibility of human reason, and confidence in the use of objective techniques to achieve social control have all contributed to a regulatory approach to ethics policy within our organizations. Few have questioned these assumptions. This dissertation argues that policy addressing (...) the ethical conduct of individuals cannot avoid a discussion of values, cannot reject the importance of human reason in resolving ambiguous ethical dilemmas, and cannot legislate ethical behavior by tightening the legal and bureaucratic system of rules and regulations. ;By integrating the perspectives of moral philosophy and policy inquiry, this dissertation presents a theoretical critique of the influence traditional regulatory policy approaches to organizational ethics can have on individuals within these organizations. An examination of diverse goals associated with ethics policy reveals three perspectives common to public administration debates--ethics policy as a vehicle for demonstrating social responsibility, as a tool of social control , and as window dressing to appease the public and to avoid further regulation . Concluding that morally responsible ethics policy requires the use of an interdisciplinary policy approach, a judgment-focused model is recommended to enable and empower individuals to develop a moral self capable of addressing ambiguous ethical dilemmas as they arise. (shrink)

Readers of Ethics, Place & Environment will notice at least one major change in this inaugural 2011 issue. Namely, we are no longer operating under the same name. At the Eastern Division American P...

Policy work is often cited as one of the primary functions of Hospital Ethics Committees (HECs), along with consultation and education. Hospital policies can have far reaching effects on a wide array of stakeholders including, care providers, patients, families, the culture of the organisation and the community at large. In comparison with the wealth of information available about the emerging practice of ethics consultation, relatively little attention has been paid to the policy work of HECs. In this (...) paper, we hope to advance the development of best practices in HEC policy work by describing the quality improvement process that we undertook at Hamilton Health Sciences, Hamilton, Ontario, Canada. In the first section of the paper we describe the context of our HEC policy work, and the shortcomings of our historical review process. In subsequent sections, we detail the quality improvement project we undertook in 2010, the results of the project and the specific tools we developed to enhance the quality of HEC policy work. Our goal in sharing this organisational case study is to prompt other HECs to publish qualitative descriptions of their policy work, in order to generate a body of knowledge that can inform the development of best practices for ethics policy review. (shrink)

In recent years, cross-national collaboration in medical research has gained increased policy attention. Policies are developed to enhance data sharing, ensure open-access, and harmonize international standards and ethics rules in order to promote access to existing resources and increase scientific output. In tandem with this promotion of data sharing, numerous ethics policies are developed to control data flows and protect privacy and confidentiality. Both sets of policy making, however, pay limited attention to the moral decisions and (...) social ties enacted in the everyday routines of scientific work. This paper takes its point of departure in the practices of a Danish laboratory with great experience in international collaboration regarding genetic research. We focus on a simple query, what makes genetic material and health data flow, and which hopes and concerns travel along with them? We explore what we call the flows, the nonflows, and the overflows of material and information, and we document the work producing the flows of health data and biomaterial. We call this work “ethics work” and argue that it is crucial for data sharing though it is rarely articulated in ethics policies, remains inadequately funded, and lacks acknowledgment in policies promoting international data sharing. (shrink)

Many large corporations now have written codes of ethics to guide the business/marketing activities of employees. The purpose of this study was to determine the frequency and types of topics which are covered in the ethics policy statements of large U.S. corporations. The results indicated that the topics covered most often (respectively) were: misuse of funds/improper accounting, conflicts of interest, political contributions, and confidential information. It is concluded that in addition to written ethics policy statements, top management (...) should communicate ethical values and demonstrate by example. (shrink)

Presents, for the student in social and political philosophy, a number of ethical theories, in an attempt to show their relevance for judging social policies. Included are essays on "Science and Values" and "General Social Ends," as well as appropriate readings in the history of the subject.--E. T.

Die Anforderungen an die ethische Kompetenzentwicklung im Rahmen der hochschulischen Pflegeausbildung sind anspruchsvoll und methodisch zu konkretisieren. Der Beitrag geht zunächst der Frage nach, wie Ethikkompetenz in Bezug auf die hochschulische Pflegeausbildung zu konturieren ist. Basierend auf dieser definitorischen Rahmung liegt das Augenmerk auf dem Prozess der Ethik-Leitlinienentwicklung als mögliche zu diskutierende Methode der Ethikkompetenzentwicklung. Hierbei ist die Frage leitend, ob der Prozess der Ethik-Leitlinienentwicklung im Rahmen des Studiums – analog zu den bis dato vielfach realisierten Fallanalysen – eine weitere (...) beziehungsweise ergänzende Methode der Ethikdidaktik sein könnte, um die für das professionelle Pflegehandeln relevanten Ethikkompetenzen im Rahmen der hochschulischen Pflegeausbildung anzubahnen und/oder zu verdichteten. (shrink)

Scientific journals may incur scientific error if articles are tainted by research misconduct. While some journals’ ethical policies, especially those on conflicts of interest, have improved over recent years, with some adopting a uniform approach, only around half of biomedical journals, principally those with higher impact factors, currently have formal misconduct policies, mainly for handling allegations. Worryingly, since a response to allegations would reasonably require an a priori definition, far fewer journals have publicly available definitions of misconduct. While (...) some journals and editors’ associations have taken significant steps to prevent and detect misconduct and respond to allegations, the content, visibility of and access to these policies varies considerably. In addition, while the lack of misconduct policies may prompt and maintain a de novo approach for journals, potentially causing stress, publication delays and even legal disputes, the lack of uniformity may be a matter of contention for research stakeholders such as editors, authors and their institutions, and publishers. Although each case may need an individual approach, I argue that posting highly visible, readily accessible, comprehensive, consistent misconduct policies could prevent the publication of fraudulent papers, increase the number of retractions of already published papers and, perhaps, reduce research misconduct. Although legally problematic, a concerted approach, with sharing of information between editors, which is clearly explained in journal websites, could also help. Ideally, journals, editors’ associations, and publishers should seek consistency and homogenise misconduct policies to maintain public confidence in the integrity of biomedical research publications. (shrink)

As euthanasia has become a widely debated issue in many Western countries, hospitals and nursing homes especially are increasingly being confronted with this ethically sensitive societal issue. The focus of this paper is how healthcare institutions can deal with euthanasia requests on an organizational level by means of a written institutional ethics policy. The general aim is to make a critical analysis whether these policies can be considered as organizational-ethical instruments that support healthcare institutions to take their institutional (...) responsibility for dealing with euthanasia requests. By means of an interpretative analysis, we conducted a process of reinterpretation of results of former Belgian empirical studies on written institutional ethics policies on euthanasia in dialogue with the existing international literature. The study findings revealed that legal regulations, ethical and care-oriented aspects strongly affected the development, the content, and the impact of written institutional ethics policies on euthanasia. Hence, these three cornerstones—law, care and ethics—constituted the basis for the empirical-based organizational-ethical framework for written institutional ethics policies on euthanasia that is presented in this paper. However, having a euthanasia policy does not automatically lead to more legal transparency, or to a more professional and ethical care practice. The study findings suggest that the development and implementation of an ethics policy on euthanasia as an organizational-ethical instrument should be considered as a dynamic process. Administrators and ethics committees must take responsibility to actively create an ethical climate supporting care providers who have to deal with ethical dilemmas in their practice. (shrink)

This book identifies and explores ethical themes in the structure and delivery of hospice care in the United States. As the fastest growing sector in the US healthcare system, in which over forty percent of patients who die each year receive care in their final weeks of life, hospice care presents complex ethical opportunities and challenges for patients, families, clinicians, and administrators. Thirteen original chapters, written by seventeen hospice experts, offer guidance and analysis that promotes best ethical practice for hospice (...) organizations and professionals. The book addresses common questions and issues faced by those who work in hospice care, a dynamic movement that, in only 30 years, has shifted from an all-volunteer care alternative at the end of life to a highly regulated industry in which over half of providers are for-profit enterprises in a very competitive health care marketplace. The chapters show how the history and philosophy of hospice care can inform the values and composition of care teams, the operations of inpatient units, and access to care for pediatric and long-term care populations. Various chapters propose frameworks for deliberating organizational approaches to ethical questions in changing regulatory and legal environments, including a model for hospice ethics committees. The final chapter outlines an expanded model of hospice as a community based, interdisciplinary, and holistic form of palliative care emphasizing advance planning, case management, and a flexible spectrum of services. This model can serve as a centrepiece for a new quality of life and social support approach, not only to terminal care, but also long-term care during the later stages of chronic illness and fraility. (shrink)

This article reports on a collective effort to position ethics policies within the context of a specific discipline – Applied Language Studies (ALS). Through a discussion of challenges to ALS-specific pedagogical and research practices, this article highlights (1) the need for consistency across institutional Research Ethics Boards in the application of general principles of ethics review, and (2) the recognition of local considerations that are informed by disciplinary approaches not envisioned in current ethics policies. (...) Ethics policies that are driven by substantive ethical intent will recognize pedagogical practices, research methodologies, and epistemological values and traditions that mark a discipline. (shrink)

Asymmetrical convergence is the increasing overlap between academic and industrial sectors, but with academia moving closer toward for-profit industrial norms than vice versa. Although this concept, developed by Kleinman and Vallas, is useful, processes of asymmetrical convergence in daily laboratory life are largely unexplored. Here, observations of three lab groups of chemical scientists in academic and industry contexts illustrate variation in interactions with ethics-related policies. Findings show more tension for academic science with business-based practices, such as the move (...) toward greater accountability, than for industrial science with academic practices. This asymmetry is evident in the process of purposive decoupling: for example, where academic scientists use humor to distance themselves from the performance of compliance in required reporting and top-down ethics training requirements. This distancing from meaningless requirements contrasts with mentoring around practices of professional behavior that are thought to matter. Convergence is evident in how safety policies seem more engaging than other kinds of policies. Yet, power structures shape engagement. Academic engagement often means rule following, and flows vertically from professor’s authority to student apprenticeship. Industry engagement includes collaborative problem solving and flows along a more horizontal peer structure where informal power is less visible. (shrink)

The Food and Drug Administration and the European Medicines Agency have launched a recent initiative to enhance collaboration in research, with the intent to “ensure that clinical trials submitted in drug marketing applications in the United States and European Union are conducted uniformly, appropriately, and ethically.” This initiative recalls efforts from two decades ago when the United States, the European Union and Japan formed the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use as a (...) mechanism for harmonizing clinical research regulations. The intent of harmonization was to improve patients’ “access to new drugs, to prevent unnecessary global development delays and to avoid animal and human study duplications” through policy reconciliation.FDA/EMA efforts at collaboration call for a reassessment of past harmonization efforts: to what extent are ICH member policies already synchronized and to what extent can they be harmonized in the future? This paper will focus on these questions through the lens of pediatric investigation. (shrink)

Since becoming independent from the Soviet bloc in the early 1990s, the Central Asian countries of Kazakhstan, Kyrgyzstan and Uzbekistan have established strategic priorities focused on the globalization and internationalization of higher education. These have emphasized the modernization of university systems with a focus on research to produce impactful knowledge and enhance global standing in knowledge production. Yet, the espoused strategic priorities have not been supported by policy development associated with research ethics. This article addresses the need for research (...) ethics policy to facilitate internationalized knowledge production and dissemination. Developing research ethics policy is not without its difficulties. In many developing research contexts, commentators have criticized policy internationalisation which involves the direct transfer of research ethics policy from the Global North rather than engaging with and adapting policy to other cultural contexts. In the light of recent scholarly debates over policy borrowing and translation, this mixed methods study considers how and in what ways higher education research ethics policy can or should develop within Central Asia. (shrink)

Hospital ethics committees (HECs) and ethicists generally describe themselves as engaged in four domains of practice: case consultation, research, education, and policy work. Despite the increasing attention to quality indicators, practice standards, and evaluation methods for the other domains, comparatively little is known or published about the policy work of HECs or ethicists. This article attempts to open the ?black box? of this health care ethics practice by providing two detailed case examples of ethics policy reviews. We (...) also describe the development and application of an evaluation strategy to assess the quality of ethics policy review work, and to enable continuous improvement of ethics policy review processes. Given the potential for policy work to impact entire patient populations and organizational systems, it is imperative that HECs and ethicists develop clearer roles, responsibilities, procedural standards, and evaluation methods to ensure the delivery of consistent, relevant, and high-quality ethics policy reviews. (shrink)

In its early periods, pesantren as a type of Islamic educational institution focused merely on religious teachings. Socio-political pressures and the need to carry out Islamic outreach have pushed kiai as pesantren leaders to negotiate their idealism according to the circumstances in different historical periods. Historical accounts from the Dutch colonial period to Indonesian independence show that kiai leadership becomes the decisive factor as well as the legitimation for pesantren to take certain actions during precarious situations. To examine the institutional (...) development of pesantren in the post-reformation era, a recent ethnographic fieldwork has been carried out in three pesantren in Madura, Java, and Lombok. This paper discusses the development and transformation of pesantren as an institution from the Dutch Ethical Policy Period until today. It demonstrates pesantren’s involvement in anti-Western campaigns and trials of affiliation with oppositions in the colonial period. This paper shows how Islamic virtues remain the heart of pesantren education and examines how innovation in contemporary pesantren regarding pedagogies and values translated in seemingly non-religious areas is substantially based on religious values. (shrink)

The field of medical rehabilitation is relatively new.... Until recently, the ethical problems of this new field were neglected. There seemed to be more pressing concerns as rehabilitation medicine struggled to establish itself, sometimes in the face of considerable skepticism or hostility. There also seemed no pressing moral questions of the kind and intensity to be encountered, say, in high-technology acute care medicine or genetic engineering.... Those in biomedical ethics could and did easily overlook the quiet, less obtrusive issues (...) of rehabilitation.... The Hastings Center set out in 1985 to rectify that situation.... To explore the issues, the Center assembled a group of practitioners in the field, Hastings Center staff members, and individuals experienced in other areas of medical ethics.... The report that follows was written by Arthur Caplan and Daniel Callahan, assisted by Dr. Janet Haas of the Moss Rehabilitation Hospital in Philadelphia... (shrink)

New anti‐obesity medications (AOMs) have received widespread acclaim in medical journals and the media, but they also raise critical ethical, public health, and public policy concerns that have largely been ignored. AOMs are very costly, need to be taken by a patient in perpetuity (since significant rebound weight gain otherwise occurs), and threaten to shift resources and focus away from other crucial efforts at obesity treatment and prevention. Many people may feel less motivated to exercise or reduce their caloric consumption, (...) if they assume that obesity is now medically treatable. Policy‐makers may similarly come to feel that the solution to the obesity pandemic is simply to prescribe medications and that prevention efforts are far less necessary. These drugs raise concerns about justice (since AOMs will disproportionately benefit the wealthy), medicalization, and marketing. Policy‐makers, clinicians, and others need to engage in multipronged educational and policy efforts to address these challenges. (shrink)

Research ethics regulation in parts of the Global North has sometimes been initiated in the face of biomedical scandal. More recently, developing and recently developed countries have had additional reasons to regulate, doing so to attract international clinical trials and American research funding, publish in international journals, or to respond to broader social changes. In Taiwan, biomedical research ethics policy based on ‘principlism’ and committee- based review were imported from the United States. Professionalisation of research ethics displaced (...) other longer-standing ways of conceiving ethics connected with Taiwanese cultural traditions. Subsequently, the model and its discursive practices were extended to other disciplines. Regulation was also shaped by decolonizing dis- courses associated with asserting Indigenous peoples’ rights. Locating research ethics regulation within the language and practices of public policy formation and transfer as well as decolonization, allows analysis to move be- yond the self-referential and attend to the social, economic and political context within which regulation operates. 研究倫理規範甚至法制化的濫觴,過去在有些北美國家是為了回應其國內發生的醫學研究倫 理醜聞。但近年來,無論是發展中或已開發國家,往往是為了爭取國際醫學臨床試驗計畫能在 其國內執行、爭取美國相關研究經費、能在英語的國際期刊發表文章、或是因應國內相關社會變化。 以台灣來說,基於「原則主義」的醫學領域之研究倫理政策及規範,以及在研究機構內成立 委員會專責倫理審查的運作模式,可說完全移植自美國。這種運作模式及研究倫理的專業化, 不但逐漸取代過去已融合台灣文化的研究倫理觀쳀,且在這種運作模式下的倫理論述及實作, 更從醫學領域擴展至其他研究領域。在此同時,台灣的研究倫理規範之發展,也受到台灣原住 民族的去殖民化及群體權主張等影響。. (shrink)

We must understand that with the possibility of commercial space travel on our horizon, it comes with a number of significant practical and moral challenges. This volume provides the first comprehensive and unifying analysis concerning the rise of private space exploration, with a view toward developing policy that may influence real-world decision making. The plethora of questions demanding serious attention - privatisation and commercialisation, the impact on the environment, health futures, risk assessment, responsibility and governance - are directly addressed in (...) this scholarly work. (shrink)

This paper addresses the issue of how local and global norms and requirements are negotiated in the early stages of development of Social Science research ethics policy in a Global South context. A review of relevant literature followed by analysis of relevant national and institutional policies highlights both tensions and creative potential for ongoing research ethics initiatives. It was found that safety, trust and confidentiality issues are common problems reported by social science researchers in Kyrgyzstan. National level (...) documents do not directly address these ethical research issues, but the need for international research ethics principles is recognized. A limited number of institutional policies address research ethics issues, with the majority of relevant documents being codes of conduct focused on virtue ethics. The paper argues that this analysis of the current situation in Kyrgyzstan is likely to be of relevance to many countries, where those responsible for governance of research at all levels are grappling with the tensions of navigating research ethics in ways that are meaningful in local contexts while being congruent with Global North ethics requirements of funders and publishers. (shrink)

This work examines Japanese government policies that impact on the environment in order to determine whether they incorporate a sufficient ethical substance. In the enquiry into the ethics of the policies, Kagawa-Fox explores how Western philosophers combined their theories to develop a 'Western environmental ethics code'; she also reveals the existence of a unique 'Japanese environmental ethics code' built on Japan's cultural traditions, religious practices, and empirical experiences. The discovery of the distinctive Japanese code is (...) not only important for what it discloses as a new philosophy, but most importantly how it can be used to analyse the ethical framework of the Japanese policies. In spite of the positive contributions that Japan has shown towards the global environment, the government has failed to show a corresponding moral obligation to the world ecology in its global environmental policy. The policies examined in the three case studies comprising whaling, nuclear energy, and forestry, have also been found wanting in ecological ethical considerations, both from a Western and Japanese perspective. The main reason for this is that the integrity of the policies has been compromised by Japanese vested interest groups; business and political interests ensure that the policies are primarily focused on maintaining sustainable economic growth. Whilst Japan's global environmental policy initiatives are the key to its economic survival into the 21st century, and these initiatives may achieve their aim, they do however fail the Japanese code of environmental ethics."--Publisher's description. (shrink)

The purpose of this article is to explore the law related to identity theft, to review corresponding rights, and responsibilities of stakeholders involved in identity theft and to formulate a system of best practices businesses could engage in to prevent or reduce identity theft threats. Utilizing two ethical frameworks based on deontological approaches, the authors conclude that there should be a well-defined management scheme to prevent identity theft, which is easy to comprehend and comply with for all stakeholders. Our proposed (...) management scheme incorporates both legal and ethical elements such that identity theft will be more difficult. Further, our proposal would also address business entities’ practices that are so careless that identity theft is made possible at all or made easier: ethical business practice can do much to reduce or eliminate identity theft. (shrink)

Bioethical, legal, and professional discussions concerning human stem cell science have moved away from the contentious, and possibly irreconcilable, debates about human embryos to other sources of pluripotent stem cells. While there is an array of ethical and legal issues associated with all types of pluripotent stem cells, in recent years complex issues have arisen with regard to the premature use of somatic or "adult" stem cells. Of particular concern is the global emergence of an industry selling products and services (...) marketed as stem cells direct to the consumer, typically over the internet, for a range of serious medical conditions that lack credible evidence of safety and efficacy (Sipp et... (shrink)

BackgroundGenetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges. A range of ethics and regulatory issues need to be addressed through comprehensive policy frameworks that integrate with local environments. While important efforts have been made to enhance understanding and awareness of ethical dimensions of GGR in Africa, including through the H3Africa initiative, there remains a need for in-depth policy review, at a country-level, (...) to inform and stimulate local policy development and revision on the continent.MethodsTo identify and characterize existing ethics-related guidelines and laws applicable to GGR across much of Africa, we conducted a scoping review of English language policy documents identified through databases, repositories, and web searches. Thirty-six documents were included and coded using a framework that contained a range of themes across five analytical categories: (1) respect, (2) beneficence, (3) justice, (4) independent oversight, and (5) bans and prohibitions. Data analysis software (NVivo 12) was used to organize, code, and tabulate information according to document characteristics and topics. Illustrative examples of policy requirements were selected for inclusion.ResultsDocuments that met inclusion criteria spanned 20 years; published between 1996 and 2018, with the majority (58%) published after 2009. About two-thirds were denoted as “guidelines,” and slightly more than half were non-exclusive to GGR. Very few (six) country-level documents identified were specific to GGR. Requirements related to the principle of “respect” appeared most often across all documents, relative to other principles and processes. The most commonly stated ban was on reproductive cloning. Other prohibitions applied to germline editing, undue inducements in research, sample use for commercial purposes, employee mandatory DNA testing, fetal sex selection, stem cell use, eugenics, and research without public health benefits.ConclusionsEnforceable policies that are indispensable to the ethical conduct and review of GGR are either deficient or missing in many African countries. Existing international, GGR-specific ethics guidelines can be used to inform GGR policy development at a country-level, in conjunction with insight from country specific ethics committees and other local stakeholders. (shrink)

Esteemed moral philosopher James Rachels here collects fifteen essays, some classic and others extensively revised, on the nature and limits of moral reasoning. Rachels argues that, rather than simply expressing societal conventions, moral philosophy can subvert received opinion and replace it with something better. Combining a concern for ethical theory with a discussion of practical moral issues such as euthanasia, the rights of animals, privacy, and affirmative action. Can Ethics Provide Answers is an excellent collection for students, scholars, and (...) anyone concerned with the degree to which our principles can guide our policies. (shrink)

The child was 2 years, 8 months old and weighed 25 pounds, one-fifth the weight of her mother, for whom she was to be the bone marrow donor. The mother had suffered a relapse of acute myelogenous leukemia; her physicians recommended a bone marrow transplant. The child was the closest human leukocyte antigen match and thus the best donor candidate for her mother's transplant.

Who owns frozen human embryos? Are "surrogate motherhood" arrangements dangerous for women? Should access to in vitro fertilization be limited or increased? With the development of complex reproductive technologies and the ensuing controversies in reproductive ethics, there is an urgent need for more careful examination of moral principles, current practices, and social policies pertaining to reproduction. The issues examined in this collection of nine papers focusing of the Canadian experience include abortion, the cryopreservation of embryos, the selective termination (...) of fetuses within multiple pregnancies, social policy for gestational "surrogacy," and the regulation of in vitro fertilization. Adopting a feminist perspective, the book places reproductive autonomy at the center of debates about the control of reproduction. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law (...) and medicine, truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

How should liberal-democratic governments deal with emerging vaccination hesitancy when that leads to the resurgence of diseases that for decades were under control? This article argues that vaccination policies should be justified in terms of a proper weighing of the rights of children to be protected against vaccine-preventable diseases and the rights of parents to raise their children in ways that they see fit. The argument starts from the concept of the ‘best interests of the child involved’. The concept (...) is elaborated for this context into the dual regime structure in which parents have fiduciary authority over what they consider to be best for their child, and the state has fiduciary authority over a child’s basic interests. This argument leads to conditional mandatory vaccination programs that should be informed by a correct balancing of the two legal principles of proportionality and precaution. This results in contextual childhood vaccination policies of upscaling interference: a three-tiered approach of increased intrusion, from voluntary program when possible and mandatory or even compulsory programs when necessary to protect the child’s basic interests. (shrink)

In this collection of essays, leading environmentalists and philosophers explore the relationship between environmental ethics and policy, both in theory and practice. The first section of the book focuses on four approaches to change in ethical theory: ecological science, feminist metaphysics, Chinese philosophy, and holistic postmodern technology. In subsequent sections the contributors emphasize the need for nontraditional solutions and attempt to expand awareness of the most pressing practical problems. Among the topics discussed are the possibilities of real international cooperation, (...) the inequitable but economically intractable issue of global gasses, the political and ethical challenges of city planning, and the growing evidence of fundamental inappropriateness in treating land as legal private property. This volume is based on essays presented in 1992 at the Second International Conference on Ethics and Environmental Policy. The conference was held in response to the increasing need for a new ethics that would counter the traditional human-centered, dominantly individualistic approach of the industrial world toward the environment. (shrink)

Stem cell policy in the United States is an amalgam of federal and state policies. The scientific development of human pluripotent embryonic stem cells triggered a contentious national stem cell policy debate during the administration of President George W. Bush. The Bush “compromise” that allowed federal funding to study only a very limited number of ESC derived cell lines did not satisfy either the researchers or the patient advocates who saw great medical potential being stifled. Neither more restrictive legislation (...) nor expansion of federal funding proved politically possible and the federal impasse opened the door for a variety of state-based experiments. In 2004, California became the largest and most influential state venture into stem cell research by passing “Prop 71,” a voter initiative that created a new stem cell agency and funded it with $3 billion. Several states followed suit with similar programs to protect the right of investigators to do stem cell research and in some cases to invest state funding in such projects. Other states devised legislation to restrict stem cell research and in five states, criminal penalties were included. Thus, the US stem cell policy is a patchwork of multiple, often conflicting, state and federal policies. (shrink)

Research question and aim Clinical Ethics Committees (CECs) aim to support healthcare professionals (HPs) and healthcare organizations to deal with the ethical issues of clinical practice. In 2020, a CEC was established in an Oncology Research Hospital in the North of Italy. This paper describes the development process and the activities performed 20 months from the CEC’s implementation, to increase knowledge about CEC’s implementation strategy. Research design We collected quantitative data related to number and characteristics of CEC activities carried (...) out from October 2020 to June 2022 using the CEC internal database. Data were reported descriptively and compared with data from the literature to provide a complete overview of the CEC’s development and implementation process. Participants and research context The study has been conducted at the local health authority (LHA) of Reggio Emilia. It is a report of the activities provided by the CEC, where no HPs or patients were involved. Ethical Considerations The report is part of a larger study named EVAluating a Clinical Ethics Committee implementation process (EvaCEC), which has been approved by the Local Ethics Committee (AUSLRE Protocollo n° 2022/0026554 of 24/02/2022). EvaCEC is also the first author's PhD project. Findings In total, the CEC performed 7 ethics consultations (EC), published three policies related to particular ethical questions of clinical and organizational practice, provided one educational online course on ethics consultation targeting employed HPs, and promoted a specific dissemination process among the different departments of the LHA. According to our results, the CEC widely fulfilled the standard threefold set of clinical ethics support services tasks (namely, ethics consultation, ethics education, and policy development), but further investigations are needed to evaluate the CEC’s impact on clinical practice. Conclusion Our findings may increase knowledge regarding the composition, role, and tasks of a CEC in an Italian setting, informing future strategies and efforts to regulate these institutions officially. (shrink)