This essay introduces this special issue on virtue ethics in relation to military AI. It describes the current situation of military AI ethics as following that of AI ethics in general, caught between consequentialism and deontology. Virtue ethics serves as an alternative that can address some of the weaknesses of these dominant forms of ethics. The essay describes how the articles in the issue exemplify the value of virtue-related approaches for these questions, before ending with (...) thoughts for further research. (shrink)

When is it morally acceptable to expose others to risk? Most moral philosophers have had very little to say in answer to that question, but here is a moral philosopher who puts it at the centre of his investigations.

One of the most common contemporary approaches for developing an ethics of artificial intelligence (AI) involves elaborating guiding principles. This essay explores the limitations of this approach, using the history of bioethics as a comparative case. The examples of bioethics and recent AI ethics suggest that principles are difficult to implement in everyday practice, fail to direct individual action, and can frequently result in a pure proceduralism. The essay encourages an additional attention to virtue, which forms the dispositions (...) of actors, directs them to valued ends, and encourages right action in particular situation to complement principles. Practices and professions like medicine or warfighting that already have rich traditions of reflection on virtue ethics will be especially fruitful fields for developing an AI ethics of virtue. (shrink)

In this paper we set out to explore the enactments of risk by clinicians involved in the development of stem cell therapy for liver disease. In the process, we contribute to a performative re-thinking of how ‘risk’ can be analytically treated in relation to health. The bulk of the paper, drawing on interview data, is concerned with how clinicians’ accounts about the risks entailed in their research-oriented work performatively ‘make’ clinicians themselves, but also various other ‘constituencies’ – notably, (...) publics and regulatory actors, and also such diverse ‘entities’ as scientific rigour and ethics. We trace the ways in which they enact the complexities of taking risks in the context of public demands, regulatory constraints, and resource limitation and explore how clinicians tend to represent themselves as caught between the ‘rock of courage’ and the ‘hard place of caution’. (shrink)

Over ten years have elapsed since Virginia passed the nation's first criminal DNA banking law, which authorized law enforcement authorities to collect DNA samples from certain categories of offenders for the purposes of performing profile analysis. Within nine years, Rhode Island became the fiftieth state to enact a similar statute. The passage of a decade since the first enactment provides a convenient opportunity to assess the strengths and weaknesses of ethical safeguards under present law as well as predict the likely (...) direction of future developments.DNA forensics are merely the latest in a long line of biologically based identifying law enforcement technologies that include fingerprints and serotyping. Nevertheless, DNA has properties that make it significantly different than its predecessors with respect to the ethical and social concerns it raises. (shrink)

Societal decisions regarding the possible granting of permission for industrial and power plants, waste disposals, traffic routes and other facilities implementing modern science and technology (here simply called technology-decisions) often provoke debates regarding the risks involved. A main theme in these debates concerns the magnitudes of these risks and whether or not they are worth taking to reach some aim. This is also a main theme in traditional risk-analysis and critical discussions of risk-management. However, sometimes the fact that (...) some people do not want to be exposed to the risks in question has been suggested as an independent argument, i.e. regardless of the magnitudes of these risks. A well known phenomenon in this respect on the local and national level is what has been labelled "not in my backyard" (NIMBY), but the argument also has been used on an international level. In accordance, the view that unwanted risks are less acceptable than wanted or indifferent ones (regardless of their magnitudes) has been proposed as being highly relevant for technology-decisions. The paper explores to what extent there are good reasons for accepting such a proposal. The main part of the paper is devoted to an examination of the extent to which the view that unwanted risks are less acceptable than wanted ones can be supported by, on the one hand, welfare-based ethical theories underlying standard models for risk-analysis, such as utilitarianism, and, on the other, a moral requirement to respect the autonomy of individual persons. Also, the very concept of an unwanted risk is explored and some peculiarities are noted. It is argued that no categorical impermissibility of exposing people to unwanted risks can be supported. However, there are still good reasons for policy-makers to consider the degree to which risks are unwanted as a factor in technology-decisions that is relevant independently of the welfare-gains at stake. In particular, policy-makers should avoid paternalism in risk-management, i.e.. (shrink)

In public debate over agricultural biotechnology, at issue hasbeen its self-proclaimed aim of further industrializingagriculture. Using languages of ’risk‘, critics and proponentshave engaged in an implicit ethics debate on the direction oftechnoscientific development. Critics have challenged thebiotechnological R&D agenda for attributing socio-agronomicproblems to genetic deficiencies, while perpetuating the hazardsof intensive monoculture. They diagnosed ominous links betweentechnological dependency and tangible harm from biotechnologyproducts.In response to scientific and public concerns, theEuropean Community enacted precautionary legislation for theintentional release of genetically modified (...) organisms (GMOs). Inits implementation, choices for managing and investigatingbiotechnological risk involve an implicit environmental ethics.Yet the official policy language downplays the inherent valuejudgments, by portraying risk regulation as a matter of’objective‘ science.In parallel with safety regulation, thestate has devised an official bioethics that judges where to’draw the line‘ in applying biotechnological knowledge, as ifthe science itself were value-free. Bioethics may also judge howto ’balance‘ risks and benefits, as if their definition were notan issue. This form of ethics serves to compensate for theunacknowledged value-choices and institutional commitmentsalready embedded in R&D priorities.Thus the state separates’risk‘ and ’ethics‘, while assigning both realms to specialists.The risk/ethics boundary encourages public deference to theexpert assessments of both safety regulators and professionalethicists. Biotechnology embodies a contentious model of controlover nature and society, yet this issue becomes displaced andfragmented into various administrative controls. At stake arethe prospects for democratizing the problem-definitions thatguide R&D priorities. (shrink)

Risk, ethics and compliance requirements are a daily reality for most organisations. Regulators and stakeholders (including employees) demand more of most organisations, from equality, to anti-corruption, to supply chain ethics. Start-ups stutter and unicorns crash to earth when they get risk wrong. What should be done? Where should you start? How can risk management enable, not hinder, the organization's strategic goals? This book answers these questions -- rightsizing risk for every organization -- using frontline-tested (...) tools, tips, and techniques. Whether you're a purpose-driven changemaker or just struggling to comply with a seemingly unending stream of regulation, we will make risk work for you. (shrink)

The online version of the original article can be found under doi:10.1007/s11948-007-9045-2.

Ethical dilemmas involving tax issues were identified by members of the American Institute of Certified Public Accountants as posing the most difficult ethical problem for them (Finn et al., Journal of Business Ethics 7(8), pp. 607–609, 1988). The KPMG tax shelter fraud case proves that the tax profession has not gone untainted in the age of numerous accounting and corporate scandals, such as the Enron débâcle (Sikka and Hampton, Accounting Forum 29(3), 325–343, 2005). High-profile scandals serve to highlight the (...) problems caused by differences in ethical judgement among accountants and tax practitioners and the issue of ethics has been brought publicly to the forefront of the profession. Nevertheless, the nature and dimension of ethical issues in tax practice have been largely unexplored (Erard, Journal of Public Economics 52(2), 163–197, 1993; Marshall et al., Journal of Business Ethics 17(12), 1265–1279, 1998; Frecknall Hughes, Unpublished PhD Thesis, The University of Leeds, 2002). This research aims to contribute to the debate on ethics in tax practice by reporting interview data on tax practitioners’ perceptions of ethics in the jurisdictions of Ireland and the United Kingdom and exploring the link or equation of ethics with risk management. (shrink)

The discovery of induced pluripotent stem (iPS) cells in 2006 was heralded as a major breakthrough in stem cell research. Since then, progress in iPS cell technology has paved the way towards clinical application, particularly cell replacement therapy, which has refueled debate on the ethics of stem cell research. However, much of the discourse has focused on questions of moral status and potentiality, overlooking the ethical issues which are introduced by the clinical testing of iPS cell replacement therapy. First-in-human (...) trials, in particular, raise a number of ethical concerns including informed consent, subject recruitment and harm minimisation as well as the inherent uncertainty and risks which are involved in testing medical procedures on humans for the first time. These issues, while a feature of any human research, become more complex in the case of iPS cell therapy, given the seriousness of the potential risks, the unreliability of available animal models, the vulnerability of the target patient group, and the high stakes of such an intensely public area of science. Our paper will present a detailed case study of iPS cell replacement therapy for Parkinson's disease to highlight these broader ethical and epistemological concerns. If we accept that iPS cell technology is fraught with challenges which go far beyond merely refuting the potentiality of the stem cell line, we conclude that iPS cell research should not replace, but proceed alongside embryonic and adult somatic stem cell research to promote cross-fertilisation of knowledge and better clinical outcomes. (shrink)

Like all policies, contemporary human research policies are the product of their history. The scandals and traumas motivating their creation — the Nazi doctors trials, Tuskegee, the Milgram experiment on obedience — however different in their particulars, all share a common narrative: a scientist, pursuing valued social ends, runs roughshod over the personal interests of disadvantaged human subjects. From the Nuremberg code through the latest revisions of the Declaration of Helsinki, research ethics policies have sought to erect a sphere (...) of protection around the latter.As a consequence of this history, all major policies start with a well-rehearsed model of human investigations. Clinical research is viewed as an encounter between investigators and volunteers. The clinical investigator is given certain duties. The human volunteer has certain moral entitlements. What is ethically at stake in human investigations inheres in the nature and quality of the interactions between investigators and volunteers. These interactions involve an asymmetry because the investigator has privileged knowledge and influence. (shrink)

Despite their crucial role in the translation of pre-clinical research into new clinical applications, phase 1 trials involving patients continue to prompt ethical debate. At the heart of the controversy is the question of whether risks of administering experimental drugs are therapeutically justified. We suggest that prior attempts to address this question have been muddled, in part because it cannot be answered adequately without first attending to the way labor is divided in managing risk in clinical trials. In what (...) follows, we approach the question of therapeutic justification for phase 1 trials from the viewpoint of five different stakeholders: the drug regulatory authority, the IRB, the clinical investigator, the referring physician, and the patient. Our analysis shows that the question of therapeutic justification actually raises multiple questions corresponding to the roles and responsibilities of the different stakeholders involved. By attending to these contextual differences, we provide more coherent guidance for the ethical negotiation of risk in phase 1 trials involving patients. We close by discussing the implications of our argument for various perennial controversies in phase 1 trial practice. (shrink)

This volume explores various aspects of risk taking. It offers an analysis of financial, entrepreneurial and social risks, as well as a discussion of the ethical implications of empirical findings. The main issues examined in the book are the financial crisis and its implications for business ethics. The book discusses unethical behaviour as a reputational risk (e.g., in the case of Goldman Sachs) and the question is raised as to what extent the financial crisis has changed the (...) banks’ entrepreneurial strategy. The book presents an analysis of the reasons leading to the crisis and identifies them as ethical dilemma structures. In addition, it looks at general questions regarding ethical behaviour and risk taking, such as: To what extent does the social embeddedness or abstraction play a role in guaranteeing ethical behaviour? What conclusions can be drawn from institutional or evolutionary perspectives on risk management? Finally, the book discusses further issues that become factors of risk within and between societies, such as work insecurity, corruption or the problem of facilitation payments as a risk in international transactions. (shrink)

New technologies create new complexities. Since non-invasive prenatal tests (NIPTs) were first introduced, keeping pace with complexity constitutes an ongoing task for medical societies, politics, and practice. NIPTs analyse the chromosomes of the fetus from a small blood sample. Initially, NIPTs were targeted at detecting trisomy 21 (Down syndrome): meanwhile there are sequencing techniques capable of analysing the entire genome of the unborn child. These yield findings of unclear relevance for the child’s future life, resulting in new responsibility structures and (...) dilemmas for the parents-to-be.The industry’s marketing strategies overemphasize the benefits of the tests while disregarding their consequences. This paper chooses the opposite path: starting with the underestimated consequences, it focuses on adverse developments and downsides. Disparities, paradoxes, and risks associated with NIPTs are illustrated, ethical conflicts described. Indications that new technologies developed to solve problems create new ones are examined. In the sense of critical thinking, seemingly robust knowledge is scrutinized for uncertainties and ambiguities. It analyses how the interplay between genetic knowledge and social discourse results in new dimensions of responsibility not only for parents-to-be, but also for decision-makers, authorities, and professional societies, illustrated by a review of different national policies and implementation programmes. As shown by the new NIPT policy in Norway, the consequences can be startling. Finally, a lawsuit in the United States illustrates how an agency can risk forfeiting its legitimation in connection with the inaccuracy of NIPTs. (shrink)

An orthodox view in marketing ethics is that it is morally impermissible to market goods to specially vulnerable populations in ways that take advantage of their vulnerabilities. In his signature article “Marketing and the Vulnerable,” Brenkert (Bus Ethics Q Ruffin Ser 1:7–20, 1998) provided the first substantive defense of this position, one which has become a well-established view in marketing ethics. In what follows, we throw new light on marketing to the vulnerable by critically evaluating key components (...) of Brenkert’s general arguments. Specifically, we contend that Brenkert has failed to offer us any persuasive reasons to think that it is immoral to market to the vulnerable in ways that take advantage of their vulnerability. Although Brenkert does highlight the fact that the specially vulnerable are at greater risk of being harmed by already immoral marketing practices (e.g., deception, manipulation), he fails to establish that the specially vulnerable are a unique moral category of market clients or that there are special moral standards that apply to them. Moreover, even if Brenkert’s position were theoretically defensible, the practical implications of his position are far less tenable than he suggests. If our criticisms are sound, then Brenkert and others who endorse his position are seriously mistaken regarding how one can permissibly market products to vulnerable populations, and, in addition, they have improperly categorized certain morally permissible marketing practices as being immoral. (shrink)

This article inquires into what the gospel of peace might mean for Christian theological engagement with international law and sets a provisional agenda for peace ethics in an age of global risks. Two warnings are sounded with respect to the language of ‘peace ethics’ and ‘the rule of law’. Three priorities are identified: (i) thinking with and about the global poor in ways that do not render ‘the other’ somehow different from myself; (ii) retrieval of the twin ideas (...) of ‘naturalness’ and distributive justice in natural law reasoning as they bear upon international law and the use of force; (iii) how to conceive of international common good by considering ‘peace through law’ as a potentially subversive endeavour when employed in the service of the global poor. (shrink)

Stem cells are likely to be used as an alternate source of biological material for neural transplantation to treat Parkinson’s disease in the not too distant future. Among the several ethical criteria that must be fulfilled before proceeding with clinical research, a favourable benefit to risk ratio must be obtained. The potential benefits to the participant and to society are evaluated relative to the risks in an attempt to offer the participants a reasonable choice. Through examination of preclinical studies (...) transplanting stem cells in animals and the transplantation of fetal tissue in patients with Parkinson’s disease, a current set of potential benefits and risks for neural transplantation of stem cells in clinical research of Parkinson’s disease are derived. The potential benefits to research participants undergoing stem cell transplantation are relief of parkinsonian symptoms and decreasing doses of parkinsonian drugs. Transplantation of stem cells as a treatment for Parkinson’s disease may benefit society by providing knowledge that can be used to help determine better treatments in the future. The risks to research participants undergoing stem cell transplantation include tumour formation, inappropriate stem cell migration, immune rejection of transplanted stem cells, haemorrhage during neurosurgery and postoperative infection. Although some of these risks are general to neurosurgical transplantation and may not be reduced for participants, the potential risk of tumour formation and inappropriate stem cell migration must be minimised before obtaining a favourable potential benefit to risk calculus and to provide participants with a reasonable choice before they enrol in clinical studies. (shrink)

In Risk and Luck in Medical Ethics Donna Dickenson explains in brilliant fashion the tension between ethics and luck, be it luck in outcomes of action on the one hand or luck in antecedent circumstances, in the problems that have to be faced, or character on the other. According to Dickenson, most of the philosophical debate so far has focused on how luck in outcomes affects agents’ ability to act as morally responsible people. But Dickenson thinks it (...) is equally important to discuss how to modify one’s own luck through character development and environmental changes.Throughout her lively inquiry, packed with interesting real life case studies, Dickenson requires her readers to consider philosophers’ desire “to minimize the effects of chance on moral character and the rightness of ethical choices” , a desire so intense that it led Kant to proclaim that even if the good will was “…wholly lacking in power to accomplish its purposes … it would [still] sparkle like a jewel in its own right, as something that had full worth in itself” . Philosophers want to believe that human beings control their own destiny. Yet they fear that nothing is really in their own control, and that the foundation of morality—autonomy, choice, freedom—is illusory.Dickenson claims that we can both acknowledge the role luck and risk play in our lives and maintain a robust Kantian sense of self if we properly limit that for which we are responsible . Moral agents are not responsible for all the outcomes of their actions, but only for some. Similarly, moral agents are not responsible for the way they initially find themselves in the world; but they are responsible …. (shrink)

Net‐risk pediatric research encompasses interventions and studies that pose risks and do not offer a compensating potential for clinical benefit. These interventions and studies are central to efforts to improve pediatric clinical care. Yet critics argue that it is unethical to expose children to research risks for the benefit of unrelated others. While a number of ethical justifications have been proposed, none have received widespread acceptance. This leaves funders with uncertainty over whether they should support and institutional review boards (...) with uncertainty over whether they should approve net‐risk pediatric research. To try to answer these questions, this article describes a justification that I previously proposed and considers two objections to it. This analysis reveals that the opportunity to contribute to a valuable project can justify exposing children to risks even though some trials turn out to be valueless and others turn out to be harmful. It follows that, to protect pediatric participants, institutional review boards need to assess whether trials have the potential to collect socially valuable information and whether they are likely to enroll and retain a sufficient number of participants. (shrink)

'A comprehensive and important collection that includes essays by some of the leading figures in the field....Essential reading for anyone interested in risk assessment.' Professor Kristin Shrader-Frechette, University of Notre Dame 'The editors are to be congratulated for bringing together a distinguished international group of theorists to reflect on the issues. This volume will be sure to raise the level of debate while at the same time showing the importance of philosophical reflection in approaches to the problems of the (...) age.' Professor Jonathan Wolff, University College London This volume brings together top authors from the fields of risk, philosophy, social sciences and psychology to address the issue of how we should decide how far technological risks are morally acceptable or not. The underlying principles are examined, along with methodological challenges, public involvement and instruments for democratization. A strong theoretical basis is complemented by a range of case studies from some of the most contentious areas, including medical ethics and GM crops. This book is a vital new resource for researchers, students and anyone concerned that traditional approaches to risk management don't adequately address ethical considerations. (shrink)

Despite the nuclear accident at the Fukushima Daiichi plant in Japan, a growing number of countries are interested in expanding or introducing nuclear energy. However, nuclear energy production and nuclear waste disposal give rise to pressing ethical questions that society needs to face. This book takes up this challenge with essays by an international team of scholars focusing on the key issues of risk, justice, and democracy. The essays consider a range of ethical issues, including radiological protection, the influence (...) of gender in the acceptability of nuclear risk, and environmental, international, and intergenerational justice in the context of nuclear energy. They also address the question of when, and under which conditions, nuclear energy should play a role in the world's future supply of electricity, looking at both developing and industrialized countries. The book will interest readers in ethics and political philosophy, social and political sciences, nuclear engineering, and policy studies. (shrink)

Human Research Ethics Committee (HREC) reviewers often provide similar feedback across applications, which suggests that the problem lies in researcher awareness of key issues rather than novel, unsolvable challenges. If common problems can be addressed before lodgement by applicants referencing clear evidence-based supports (e.g., FAQs on common application shortcomings), it would improve efficiency for HREC members and expedite approvals. We aim to inform such supports by analysing the patterns in the most frequent feedback made by HREC members during review (...) processes. We collected every instance (_N_ = 4,195) of feedback made on _N_ = 197 ‘low-risk’ protocols by all HREC staff (_N_ = 16) at one institution over the course of a full year (2019). Reflexive thematic analysis to identify themes (and content analysis to determine relative frequency) revealed that the top three themes are consistent with existing literature: Consent, Administrative, and Methodological concerns. However, we identified important new themes that are not captured in previous research, including ‘Risk to Researchers’, ‘Commercial benefit, scope and scale’, ‘Diversity’ (covering issues of cultural sensitivity, language and accessibility), as well as fair right to a complaints process. Our thorough exploration of information-rich primary data marks an important methodological improvement over previous studies and offers a theoretical contribution to understanding themes that have heretofore been overlooked in the ethics review process. By identifying the common challenges experienced in HREC review we can better inform tailored supports to applicants (by extension reducing workload burdens on HREC systems) and reduce their perceived barriers to engaging in challenging but meaningful research. (shrink)

Vietnam is a vibrant and emerging South East Asian economy. However, the country faces a challenging task in meeting rising energy demand and the need to securitize energy while addressing the negative environmental impact of fossil fuel utilization. Growing concerns about sustainable development have led Vietnam to develop civilian nuclear energy for electricity generation. Nuclear power is widely recognized as a clean, mature and reliable energy source. Its inclusion in Vietnam’s energy mix by 2030 is expected to supplement other energy (...) sources from fossil fuel, hydropower plants, renewable resources and energy imports. Despite strong reservations in the aftermath of the Fukushima disaster, Vietnam has pursued its national nuclearization program. Civilian nuclear energy development has been widely regarded as a controversial issue, although it is intended for peaceful purposes and as a solution for long-term energy security. Anxiety over nuclear safety measures, inadequate nuclear regulatory mechanisms, lack of institutionalized radioactive waste management, the threat of nuclear accident, theft and terrorism, and nuclear proliferation have marred public perception. The apprehension towards nuclear energy development has raised serious questions on the ethics and risks of the technology. Using a qualitative approach of reviewing published scholarly research, we investigated the ethical and risk issues that manifest in civilian nuclear energy development in Vietnam. Our findings reveal that the conundrum of civilian nuclear energy revolves around balancing energy security, environment preservation and societal well-being with ethical and risk predicaments of nuclear energy. (shrink)

Mainstream moral theories deal with situations in which the outcome of each possible action is well-determined and knowable. In order to make ethics relevant for problems of risk and uncertainty, moral theories have to be extended so that they cover actions whose outcomes are not determinable beforehand. One approach to this extension problem is to develop methods for appraising probabilistic combinations of outcomes. This approach is investigated and shown not to solve the problem. An alternative approach is then (...) developed. Its starting-point is that everyone has a prima facie moral right not to be exposed to risk. However, this right can be overridden if the risk-exposure is part of an equitable system for risk-taking that works to the advantage of the individual risk-exposed person. (shrink)

In the wake of the current financial crises triggered by risky mortgage-backed securities, the question of ethics and risk-taking is once again at the front and center for both practitioners and academics. Although risk-taking is considered an integral part of strategic decision-making, sometimes firms could be propelled to take risks driven by reasons other than calculated strategic choices. The authors argue that a firm's risk-taking propensity is impacted by its ethical climate (egoistic or benevolent) and its (...) emphasis on output control to manage its marketing function. The firm's long-term orientation is argued to moderate the control–risk propensity relationship. The authors also extend research on risk and performance and argue that the association of risk-taking propensity and firm performance is contingent on the ownership (publicly traded versus privately held) structure of the firm. Based on survey data from a sample of manufacturing industries in the United States, the results show significant impact of ethical climate and marketing output control on a firm's risk-taking propensity; also risk-taking propensity shows a stronger association with firm performance in privately held firms than in publicly traded firms. (shrink)

This paper examines an issue that is becoming increasingly relevant as the pressures of a warming planet, changing climate and changing ecosystems ramp up. The broad context for the paper is the intragenerational, intergenerational, and interspecies equity implications of changing the climate and the value orientations of adapting to such change. In addition, the need to stabilize the planetary climate by urgent mitigation of change factors is a foundational ethical assumption. In order to avoid further animal and plant extinctions, or (...) at the very least, their increased vulnerability to becoming rare and endangered; the systematic assisted colonization of “at risk” species is being seriously considered by scientists and managers of biodiversity. The more practical aspects of assisted colonization have been covered in the conservation biology literature; however, the ethical implications of such actions have not been extensively examined. Our discussion of the value issues, using a novel case study approach, will rectify the limited ethical analysis of the issue of assisted colonization of species in the face of climate change pressures. Beyond sustainability ethics, both animal and environmental ethical approaches will be used and intrinsic versus instrumental value orientations in the literature shall form the basis of our discussion. After the application of all the ethical approaches to the case studies, we conclude that without mitigation and the prospect of a future stable climate, assisted colonization will be involved in an inherently unethical process and a “move and lose it” outcome. With mitigation, there is wide-ranging ethical support for assisted colonization. (shrink)

In a recent commentary, Kim and colleagues argued that minimal-risk research should be deregulated so that such studies do not require review by an institutional review board. They claim that regulation of minimal-risk studies provides no adequate counterbalancing good and instead leads to a costly human subjects oversight system. We argue that the counterbalancing good of regulating minimal-risk studies is that oversight exists to ensure that respect for persons and justice requirements are satisfied when they otherwise might (...) not be. (shrink)

There are complex considerations when planning to disclose an attenuated psychosis syndrome diagnosis. In this review, we evaluate ethical, legal, and clinical perspectives as well as caveats related to full, non- and partial disclosure strategies, discuss societal implications, and provide clinical suggestions. Each of the disclosure strategies is associated with benefits as well as costs/considerations. Full disclosure promotes autonomy, allows for the clearest psychoeducation about additional risk factors, helps to clarify and/or correct previous diagnoses/treatments, facilitates early intervention and bolsters (...) communication between providers but there are important considerations involving heritability, comorbidity, culture, and stigma. Non-disclosure advances nonmaleficence by limiting stigma and stress, and confusion in a sensitive developmental period but is complicated by varying patient preferences and the possibility that, as new treatments without adverse effects become available, the risk with false positives no longer justifies the accompanying loss of autonomy. Partial disclosure balances ethical considerations by focusing on symptoms instead of labels, but evidence that laypersons may interpret this information as a pseudo-diagnosis and that symptoms alone also contribute to stigma limits the efficacy of this approach. In addition, there are notable societal considerations relating to disclosure involving conservatorship, the reach of insurance companies, and discrimination. We advocate a hybrid approach to disclosure and recommend future research aimed at understanding the effects of stigma on clinical course and a renewed focus on those help-seeking cases that do not transition but remain clinically relevant. (shrink)

The key concept in Business Ethics has changed from ‘corporate social responsibility’ to ‘integrated risk‐management’. This change, first wrought by American laws, has been extended to other countries through globalization. The most important laws concern corruption, anti‐trust, consumer safety, environmental protection and insider‐trading. The ‘Federal Corporate Sentencing Guidelines’ have particularly been helpful in identifying and valuing business risks. The author proposes a ‘next‐generation’ Business Ethics integrating personal, professional and organizational ethics in the context of an institutionalized, (...) country‐sensitive ‘corporate culture’. (shrink)

The mortality and morbidity resulting from noncommunicable diseases including cancer in sub- Saharan Africa are predicted to overtake that of infectious diseases by the year 2030. Esophageal cancer is on the increase in Tanzania. This study estimates risk factors for esophageal cancer, ethical issues and the level of awareness of cancer related services among adults in rural Kilimanjaro. A cross sectional descriptive study was conducted of adults aged 18 years and above in three wards, namely, Kahe, mabogini and Arusha (...) Chini, Moshi Rural District, Kilimanjaro region. Face-to-face interviews were conducted with a total of 419 individuals. The mean age was 36.47 =13.49) years. Of those who participated, 211 were male and 60% reported to have completed primary education. A majority of participants were knowledgeable about esophageal cancer risk factors. Overall, 15% and 23% of the participants reported to have been smoking and drinking alcohol, respectively. Male respondents were almost three times more likely to be smokers as compared to female respondents. Moreover, people who were self-employed were about five times more likely to be smokers as compared to those who were unemployed.. Male respondents were almost two times more likely to be drinkers as compared to female respondents. Overall, the level of awareness of cancer related health services was about 70%. The study findings confirm that despite a good level of knowledge about risk factors for esophageal cancer, the practice of exposure to risk factors is alarmingly high. Awareness of where to seek cancer related health services was high with hospitals been mentioned by the majority though there was low understanding on modalities of treatment among adults in Rural Kilimanjaro. Intervention measures should aim at further increasing knowledge of cancer risk factors and reduce the practice of such risks. Ethical matters including truth telling, ageism and autonomy need to be addressed to improve the perception of cancer related health issues and health seeking behaviour. (shrink)

The paper describes a project in which the thesis of the social determinants of health is used in order to help identify groups that will be among the least advantaged members of society, when disadvantage is understood in terms of lack of genuine opportunity for secure functioning. The analysis is derived from the author's work with Avner de-Shalit in Disadvantage (Oxford University Press, 2007).

Moral theory should be simple: the moral theorist attends to ordinary human action to explain what makes some acts right and others wrong, and we need no microscope to observe a human act. Yet no moral theory that is simple captures all of the morally relevant facts. In a set of vivid examples, stories, and cases Judith Thomson shows just how wide an array of moral considerations bears on all but the simplest of problems. She is a philosophical analyst of (...) the highest caliber who can tease a multitude of implications out of the story of a mere bit of eavesdropping. She is also a master teller of tales which have a philosophical bite. Beyond these pleasures, however, she brings new depth of understanding to some of the most pressing moral issues of the moment, notably abortion. Thomson's essays determinedly confront the most difficult questions: What is it to have a moral right to life, or any other right? What is the relation between the infringement of such rights and restitution? How is rights theory to deal with the imposition of risk? (shrink)

How do engineers respond to ethical dilemmas that occur in practice? How do they view their individual and collective responsibilities? How do they make decisions before all the facts are in? Using the space shuttle programme as the framework, this book examines the role of ethical decision making in the practice of engineering. In particular, the book considers the design and development of the main engines of the space shuttle as a paradigm for how individual engineers perceive, articulate, and resolve (...) ethical dilemmas in a large, complex organisation. A series of in-depth case studies show engineers at work on various stages of the project as they balance budgets, deadlines and risks. By documenting the historical development of a single system, the book provides a unique opportunity to explore the complex interactions between political, organisational and technical pressures and engineering and management decisions. (shrink)

Robot is definitely playing important role in human society. Low contact on machine standards is mostly on industrial robot while close contacts are in increasing demand in service robot, etc. The development of robotics with advanced hardware and artificial intelligence (AI) provide the possibility with human beings while close contacts raise many new issues on ethics and risks. For interaction, the related technique of perception, cognition and interaction are briefly introduced. For ethics, rules should be given for the (...) robot designers to include ethics for certain application while risks should be evaluated during the experiment test. To make efficient decision, safety design with AI technology should be put on agenda for roboticists. Except from the risks, ethics raise many challenges while most of them can be solved by developing technologies while some of the problems exist in human’s society which also raise the questions for the human beings. More broader vision should be taken from different social departments together to avoid the possible embarrassed issues. It’s time to welcome the world of robotics and related techniques will make life more efficient while human-robot coexistence society will come one day and law should be imposed on both. (shrink)

The first in a new series on ethics in the counselling professions, Navigating Relational Ethics in Day-to-Day Practice contextualises the series and provides a practical 'how to' guide for bringing the theoretical concepts of ethics into practice. Lynne Gabriel and Andrew Reeves provide a compelling explanatory narrative on the importance of translating ethical concepts into meaningful pragmatic practice and practitioner tools. They set out key theories, concepts, and contemporary challenges in practice ethics, offering multiple lenses through (...) which to make meaning of complex practice or risk scenarios and settings. Importantly, the book considers contemporary concepts associated with social justice including working in anti-oppressive ways. The chapters feature an array of engaging material, including a round table dialogue on working ethically in day-to-day practice, a 'tool-kit' for working ethically across multiple contexts and presenting issues, and a rich collection of case examples from the authors' lived experience. This text supports trainees and practitioners in taking ethical frameworks into their direct work with clients and in their wider role in practice. (shrink)

Lack of supportive workplaces may be depriving babies and mothers of the health advantages of breastfeeding. This citizen science pilot project set out to engage women in photographing and sharing information on the available facilities for breastfeeding and expressing and storing breastmilk in Australian workplaces. While some useful insights were gained, the project failed in the sense that 234 people ‘liked’ the project Facebook page set up to recruit participants, but only nine photographs were submitted. The heaviest loss of participation (...) occurred after the ethics committee requirements were explained, in particular, the requirement for employer consent to take a photograph, or alternatively, for a participant to agree to bear the risk of taking a photo without permission. The ethics committee also made stipulations about the formality of language to be used. Thus, the project’s potential role as an enabler for health action was neutered. We argue that the ethics requirements worked contrary to our purpose and possibly acted to reinforce the powerlessness some women experience at work. (shrink)

The way our decisions and actions can affect future generations is surrounded by uncertainty. This is evident in current discussions of environmental risks related to global climate change, biotechnology and the use and storage of nuclear energy. The aim of this paper is to consider more closely how uncertainty affects our moral responsibility to future generations, and to what extent moral agents can be held responsible for activities that inflict risks on future people. It is argued that our moral responsibility (...) to posterity is limited because our ability to foresee how present decisions and activities will affect future people is limited. The reason for this is primarily that we are in a situation of ignorance regarding the pace and direction of future scientific and technological development. This ignorance reduces our responsibility in a temporal dimension because in most areas it is impossible to predict the interests and resource needs of future generations. In one area, however, we have fairly reliable knowledge about future people. It is reasonable to assume that future human beings will have the same basic physiological (physical and biological) needs as we have. On this basis, it is argued that we can be held responsible for activities causing avoidable damage to critical resources that are necessary to provide for future physiological needs. Furthermore, it is suggested that it is prima facie immoral to impose risks upon future generations in cases where the following conditions are fulfilled: (1) the risk poses a threat to the ability of future generations to meet their physiological needs, and (2) the risk assessment is supported by scientifically based harm scenarios. (shrink)

Journal of Medical Ethics Concise Argument (editorial).

The most common solutions to the problem of high pharmaceutical prices have taken the form of regulations, price negotiations, or changes in drug coverage by insurers. These measures for the most part transfer the burden of drug expenditures between pharmaceutical companies and payers or between payers. The aim of this study is to propose an alternative model for the relationship between the main stakeholders involved in the price setting and purchasing of pharmaceuticals, one that encourages a more cooperative approach. We (...) draw from principles of ethics and health economics and apply them to the context of the pharmaceutical industry. The model prioritises two objectives, to make drugs financially accessible to the patients who need them, and to keep pharmaceutical companies viable and profitable. It is centered around the sharing of financial risk between the main stakeholders, which we describe as ‘enlightened risk sharing’. After establishing the foundations of this model, we expand on the type of policies that can follow these principles with current day examples. (shrink)

Packed with examples pulled straight from recent headlines, ENGINEERING ETHICS, Sixth Edition, helps engineers understand the importance of their conduct as professionals as well as reflect on how their actions can affect the health, safety and welfare of the public and the environment. Numerous case studies give readers plenty of hands-on experience grappling with modern-day ethical dilemmas, while the book's proven and structured method for analysis walks readers step by step through ethical problem-solving techniques. It also offers practical application (...) of the Engineering Code of Ethics and thorough coverage of critical moral reasoning, effective organizational communication, sustainability and economic development, risk management, ethical responsibilities, globalized standards for engineering and emerging challenges relating to evolving technology. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. (shrink)

Ethics is of vital importance to the Swedish educational system, as in many other educational systems around the world.Yet, it is unclear how ethics should be dealt with in school, and prior research and evaluations have found serious problems regarding ethics in education.The field of moral education lacks clear and widely accepted definitions of key concepts, and these ambiguities negatively impact both research and educational practice. This thesis draws a distinction between three approaches to ethics in (...) school – the descriptive ethics approach, the value transmission approach, and the inquiry ethics approach – and studies in what way (if at all) they are prescribed by the national curriculum for the Swedish compulsory school, how they relate to students’ moral reasoning about technology choices and online behaviour, and what pedagogical merits and disadvantages they have. Hopefully, this both contributes to reducing the ambiguities of the field, and to answering the question of how ethics should be dealt with in education. The descriptive ethics approach asserts that school should teach students empirical facts about ethics, such as what views and opinions people have. The value transmission approach holds that school should mediate some set of predefined values to the students and make sure the students come to accept these values.The inquiry ethics approach is the view that school should teach students to reason and think critically about ethics and to engage in ethical inquiry. The role of ethics in the curriculum has not been studied in light of the above distinction, in prior research,and such an investigation is undertaken here.The results suggest that ethics has a prominent, but complicated, role in the Swedish national curriculum. Although no explicit distinction is drawn or acknowledged in the curriculum, all three approaches are prescribed throughout the curriculum, albeit to different degrees. In the general section of the curriculum, the value transmission and inquiry ethics approaches are more extensively prescribed than the descriptive ethics approach. It was found that most of the syllabi contained explicit references to ethics, while some only contained implicit references to ethics, and two syllabi lacked references to ethics altogether. In the syllabi, the inquiry ethics approach is the most dominant, both in the sense of being present in the most syllabi, and in the sense of being more strongly prescribed in many of the syllabi where several approaches occur.The value transmission approach has the weakest role in the syllabi. In total, the inquiry ethics approach is the approach most strongly prescribed by the curriculum. But prior research has shown that inquiry ethics is very rarely implemented in the classroom. In this thesis, it is found that the inquiry ethics and the value transmission approaches are incompatible, given certain reasonable interpretations, which makes the finding that inquiry ethics is rarely implemented less surprising, since value transmission is practiced in schools. Some possible causes, and some consequences, of this is discussed. The students, in their moral reasoning about technology choices, reasoned in accordance with several classical normative theories – including consequentialism, deontological ethics and virtue ethics – and in doing so, they expressed reasoning that in the discussion is found to be in conflict with the values of the value foundation in the curriculum. These findings complement earlier findings, for example that students in their actions contradict the value foundation, by adding that such conflicts also exist in their reasoning. The existence of these conflicts is found to be problematic for a value transmission approach. Many of the students defended very restrictive views on disclosing personal information online, and prior research as well as the present data has shown that adults typically hold views that are very similar to these, concerning how they think that young people ought to act online. On the other hand, youths’ actual online behaviour, as reported in earlier studies, differs considerably from this. In line with this, the students also seemed to endorse a form of private morals view, according to which moral choices are simply up to one’s own taste, which would yield an escape exit from the restrictive views mentioned above, and permit any behaviour. In the discussion, it is argued that this is the result of an attempt at value transmission from the grown-up community, probably including teachers, which might seem to work, since the students claim to hold certain views, but which likely instead constitutes a false security, since these values are not actually accepted, but only paid lip service to, and the adults are therefore wrong in their belief that the students are protected by a certain set of values (that they think the students are upholding), since the students in fact do not uphold, and therefore do not act based upon, these values. This situation risks making the students more vulnerable than had no value transmission attempt been taken in the first place. Hence, the attempted value transmission runs the risk of counteracting its purpose of helping the students acquire a safe online behaviour. Throughout the moral reasoning mentioned above, extensive variations in the students’ reasoning were found, both interpersonally and intrapersonally, both in the decision method and in the rightness criterion dimensions, as well as in between the dimensions.The existence of such variations is a novel finding, and while possible applications in future research are discussed, it is also noted that this existence constitutes a reason to question the successfulness of both the value transmission and the inquiry ethics endeavours of the educational system. The results and discussions described above highlight the importance of investigating the merits of the different approaches. Several arguments that arise from the material of this thesis are presented, evaluated and discussed. The ability of each approach to fulfil some alleged key aims of ethics education is scrutinised; their abilities to educate for good citizenship, to educate for quality of life of the individual, and to facilitate better educational results in other subjects are all investigated, as well as the ability of each approach to help counteract the influence from online extremist propaganda aimed at young people and to promote safe online behaviour in general. It is concluded that the inquiry ethics approach has the strongest support from the material of this thesis. Some consequences for school practice are discussed, and it is concluded that changing the role of ethics in the curriculum would be beneficial, downplaying the role of value transmission and further increasing, and making more explicit and clear, the role of inquiry ethics. It is also shown that there are strong reasons for the inclusion of a new subject in the Swedish compulsory education with special focus on ethics. (shrink)

Background As health education robots may potentially become a significant support force in nursing practice in the future, it is imperative to adhere to the European Union’s concept of “Responsible Research and Innovation” (RRI) and deeply reflect on the ethical risks hidden in the process of intelligent robotic health education. Aim This study explores the perceptions of professional nursing professionals regarding the potential ethical risks associated with the clinical practice of intelligent robotic health education. Research design This study adopts a (...) descriptive phenomenological approach, employing Colaizzi’s seven-step method for data analysis. Participants and research context We conducted semi-structured interviews with 17 nursing professionals from tertiary comprehensive hospitals in China. Ethical considerations This study has been approved by the Ethics Committee of the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Chinese Medicine Hospital. Findings Nursing personnel, adhering to the principles of RRI and the concept of “person-centered” care, have critically reflected on the potential ethical risks inherent in robotic health education. This reflection has primarily identified six themes: (a) threats to human dignity, (b) concerns about patient safety, (c) apprehensions about privacy disclosure, (d) worries about implicit burdens, (e) concerns about responsibility attribution, and (f) expectations for social support. Conclusions This study focuses on health education robots, which are perceived to have minimal ethical risks, and provides rich and detailed insights into the ethical risks associated with robotic health education. Even seemingly safe health education robots elicit significant concerns among professionals regarding their safety and ethics in clinical practice. As we move forward, it is essential to remain attentive to the potential negative impacts of robots and actively address them. (shrink)

ABSTRACT We have previously argued that there are forms of greenhouse gas offsetting for which, when one emits and offsets, one imposes no risk. Orri Stefansson objects that our argument fails to distinguish properly between the people who stand to be harmed by one’s emissions and the people who stand to be benefited by one’s offsetting. We reply by emphasizing the difference between acting with a probability of making a difference to the distribution of harm and acting in a (...) way that worsen’s someone’s prospect. (shrink)

BackgroundThe boundaries between health-related research and practice have become blurred as initiatives traditionally considered to be practice increasingly use the same methodology as research. Further, the application of different ethical requirements based on this distinction raises concerns because many initiatives commonly labelled as “non-research” are associated with risks to patients, participants, and other stakeholders, yet may not be subject to any ethical oversight. Accordingly, we sought to develop a tool to facilitate the systematic identification of risks to human participants and (...) determination of risk level across a broad range of projects and health-related contexts. This paper describes the development of the Public Health Ontario Risk Screening Tool.MethodDevelopment of the PHO Risk Screening Tool included: preparation of a draft risk tool ; expert appraisal; internal stakeholder validation; external validation; pilot testing and evalution of the draft tool; and revision after 1 year of testing.ResultsA risk screening tool was generated consisting of 20 items organized into five risk domains: Sensitivity; Participant Selection, Recruitment and Consent; Data/Sample Collection; Identifiability and Privacy Risk; and Commercial Interests. The PHO Risk Screening Tool is an electronic tool, designed to identify potential project-associated risks to participants and communities and to determine what level of ethics review is required, if any. The tool features an easy to use checklist format that generates a risk score associated with a suggested level of ethics review once all items have been completed. The final score is based on a threshold approach to ensure that the final score represents the highest level of risk identified in any of the domains of the tool.ConclusionsThe PHO Risk Screening Tool offers a practical solution to the problem of how to maintain accountability and appropriate risk oversight that transcends the boundaries of research and practice. We hope that the PHO Risk Screening Tool will prove useful in minimizing the problems of over and under protection across a wide range of disciplines and jurisdictions. (shrink)

Background: Positioned at the frontlines of the battle against COVID-19 disease, nurses are at increased risk of contraction, yet as they feel obligated to provide care, they also experience ethical pressure. Research question and objectives: The study examined how Israeli nurses respond to ethical dilemmas and tension during the COVID-19 outbreak, and to what extent this is associated with their perceived risk and motivation to provide care? Research design: The study implemented a descriptive correlative study using a 53-section (...) online questionnaire, including 4 open-ended questions. Participants and research context: The questionnaire was complete by 231 registered and intern nurses after being posted on nurses’ Facebook and WhatsApp groups, and through snowball sampling. Ethical considerations: The research was pre-approved by the ethics committee of the Faculty of Social Welfare and Health Sciences at the University of Haifa, Israel. Findings: In all, 68.8% of the respondents had received some form of training about COVID-19. Respondents positioned themselves at perceived high risk levels for contracting the virus. About one-third feared going to work because of potential contraction and due to feeling inadequately protected. While 40.9% were scared to care for COVID-19 patients, 74.7% did not believe they have the right to refuse to treat certain patients. When asked about defining an age limit for providing patients with scarce resources (such as ventilation machines) in cases of insufficient supplies, respondents stated that the maximum age in such scenarios should be 84 (standard deviation (SD = 19) – yet most respondents (81.4%) believed that every patient has the right to receive optimal treatment, regardless of their age and medical background. Discussion: Correlating with their strong commitment to care, nurses did not convey intention to leave the profession despite their stress, perceived risk, and feelings of insufficient support and protection at work. The nurses did not hold a utilitarian approach to resource allocation, thereby acknowledging the value of all people and their entitlement to care, regardless of optimal outcomes. Conclusion: While experiencing significant personal risk and emotional burden, nurses conveyed strong dedication to providing care, and did not regret working in the nursing profession, yet they did seek a supportive climate for their needs and ethical concerns. (shrink)

How should we choose on behalf of groups of agents who violate expected utility theory by being risk averse or risk seeking? Unfortunately, we sometimes have to choose either acts that everyone disprefers or acts that are sure to turn out worse than another act. This observation is particularly troubling for risk-expected utility theorists: neither option sits comfortably with their view.

Examining those risk and benefit perceptions utilised in the formation of attitudes and opinions about emerging technologies such as nanotechnology can be useful for both industry and policy makers involved in their development, implementation and regulation. A broad range of different socio-psychological and affective factors may influence consumer responses to different applications of nanotechnology, including ethical concerns. A useful approach to identifying relevant consumer concerns and innovation priorities is to develop predictive constructs which can be used to differentiate applications (...) of nanotechnology in a way which is meaningful to consumers. This requires elicitation of attitudinal constructs from consumers, rather than measuring attitudes assumed to be important by the researcher. Psychological factors influencing societal responses to 15 applications of nanotechnology drawn from different application areas were identified using repertory grid method in conjunction with generalised Procrustes analysis. The results suggested that people differentiate nanotechnology applications based on the extent to which they perceive them to be beneficial, useful, necessary and important. The benefits may be offset by perceived risks focusing on fear and ethical concerns. Compared to an earlier expert study on societal acceptance of nanotechnology, consumers emphasised ethical issues compared to experts but had less concern regarding potential physical contact with the product and time to market introduction. Consumers envisaged fewer issues with several applications compared to experts, in particular food applications. (shrink)

We identify three distinct ethical problems that can arise with risk displacement. Risk displacement is the shifting of extant risk from one or more individuals to other individual(s) such that the reduction of risk to the first group is causally implicated in increasing risk to the second group. These problems are: concentration of risk in inequitable ways; transfer of risk to already vulnerable or disadvantaged populations; and exercise of undue influence over potential research (...) participants. The first two arise in both public policy and research initiatives, whereas the third is a special concern that only applies to research initiatives. We argue that when one or more of these is of high magnitude, then the study or policy intervention may be ethically wrong. Finally, we conclude that although some risk displacement is ethically permissible, researchers and policymakers still have ethical reasons to reduce the magnitude of these problems. (shrink)