Discussions of both personal responsibility and the importance of trust in health-care settings are increasingly prominent in the bioethics literature. In this paper I link the two discussions and argue that health policies that include personal responsibility ought to address climates of social trust. Trust is a social good that is not always fairly distributed. Disadvantaged social groups often face default distrust. I suggest that agent-centered models in which responsibilities are negotiated do a better job of repairing social distrust than (...) authoritative models in which responsibilities are assigned . Attending to climates of trust, distrust, or antitrust is essential for addressing health inequalities. (shrink)

Two essays on utilitarianism, written from opposite points of view, by J. J. C. Smart and Bernard Williams. In the first part of the book Professor Smart advocates a modern and sophisticated version of classical utilitarianism; he tries to formulate a consistent and persuasive elaboration of the doctrine that the rightness and wrongness of actions is determined solely by their consequences, and in particular their consequences for the sum total of human happiness. In Part II Bernard Williams offers (...) a sustained and vigorous critique of utilitarian assumptions, arguments and ideals. He finds inadequate the theory of action implied by utilitarianism, and he argues that utilitarianism fails to engage at a serious level with the real problems of moral and political philosophy, and fails to make sense of notions such as integrity, or even human happiness itself. This book should be of interest to welfare economists, political scientists and decision-theorists. (shrink)

Over the past several years a cascade of corporate scandals have erupted. Savings and provisions for retirement have shrunk drastically. Jobs have been lost. One of the world's largest and best-known accounting firms is gone. Ordinary people have been hurt and they have lost confidence in business leaders. The on-going public debate over business ethics and corporate reform points to one common conclusion: Things cannot be corrected by simply adding more laws and new rules. The solution will come from high (...) moral leadership. The Heart of A Business Ethic is based on the Hansen-Wessner Lectureship Series established by the ServiceMaster Foundation to consider the source of moral authority and ethical behavior in business. The eight lectures in this series were presented at major universities in the U.S. and Britain, and brought together some of the most distinguished business experts of our time. What they have to say is important for business teachers and students, and business leaders at every level. The scandals at Enron, Tyco and others have generated many books on business ethics, but none offer the expertise or breadth of thinking that this volume does. The Heart of A Business Ethic is useful to professors, students, and practitioners who not only want to understand what has happened, but who also want to think through the basis for a new standard of morality in business. (shrink)

Lying in an area bounded by the Wabash, Ohio, and Mississippi rivers, the Southern Illinois country is rich in history, folklore, scenery, and natural resources. At about the latitude of southern Virginia, and extending from the flat prairie farmland of central Illinois to the rugged "Illinois Ozarks,” the area is the natural terminal boundary for hundreds of plant species reaching out to all points of the compass. It is also the oldest and most sparsely populated part of Illinois, a region (...) of small towns and independent people, typical of the vast heartland of the U.S.A. Surveying the area in words and pictures the authors sensitively and appreciatively portray the region’s special qualities. An uncommon portrayal of American life in a distinctive region, the book provides a memorable journey both in time and place. (shrink)

This article is guided by principles and practices of bioethics and public health ethics focused on health care reform within the context of promoting Optimal Health. The Tuskegee University National Center for Bioethics in Research and Health Care is moving beyond the traditions of bioethics to incorporate public health ethics and Optimal Health. It is imperative to remember the legacy of the ill-fated research entitled Tuskegee Study of Untreated Syphilis in the Negro Male. Human participant research and health care must (...) be connected to principles of bioethics and public health ethics if the Affordable Care Act is expected to positively impact on the health of people living in the United States. Optimal Health describes a strategy to achieve individual and population health. Health care reform offers an opportunity to shift from the traditional pathology focus of managing diseases to target disease prevention and health promotion with a new set of tools. Transformational change is possible if the lessons learned from the U.S. Public Health Service Syphilis Study at Tuskegee are considered and strategies in bioethics and public heath ethics are employed. (shrink)

We comment that covariances between brain divisions may be constraining or facilitating, depending on what is being selected, and that modern quantitative genetic methods provide the tools to discover and manipulate the genetic networks that give rise to the covariances described in the target article.

The emergence of Big Data has added a new aspect to conceptualizing the use of digital technologies in the delivery of public services and for realizing digital governance. This article explores, via the ‘value-chain’ approach, the evolution of digital governance research, and aligns it with current developments associated with data analytics, often referred to as ‘Big Data’. In many ways, the current discourse around Big Data reiterates and repeats established commentaries within the eGovernment research community. This body of knowledge provides (...) an opportunity to reflect on the ‘promise’ of Big Data, both in relation to service delivery and policy formulation. This includes, issues associated with the quality and reliability of data, from mixing public and private sector data, issues associated with the ownership of raw and manipulated data, and ethical issues concerning surveillance and privacy. These insights and the issues raised help assess the value of Big Data in government and smart city environments. (shrink)

With aims to both increase organ supply and better reflect individual donation preferences, many nations worldwide have shifted from ‘opt‐in’ to ‘opt‐out’ systems for post‐mortem organ donation (PMOD). In such countries, while a prospective donor's willingness to donate their organs/tissues for PMOD was previously ascertained—at least partially—by their having recorded positive donation preferences on an official register prior to death, this willingness is now presumed or inferred—at least partially—from their not having recorded an objection to PMOD—on an official organ donation (...) register. Using evidence regarding the presence and prevalence of selective donation preferences, and via exploration of how appeals to donation preferences are used to both motivate and legitimate shifts to opt‐out frameworks, this paper draws attention to a set of previously unexplored problems for opt‐out organ donation arising in contexts where: (a) individuals demonstrate selective post‐mortem organ/tissue donation preferences, (b) legislation provides prospective donors with the opportunity to selectively permit/refuse the donation of certain organs/tissues in line with these preferences. While selective preferences pose few problems for opt‐in systems where a selective occasion is built into the process of signing the donor register, this is not the case for opt‐out systems. The loss of this selective occasion can cause significant problems where appeals to preferences motivate/legitimate shifts to opt‐out but evidence regarding variable preferences does not feed into determinations regarding organ/tissue exclusions. The nature of these problems depends on how the authorization aspect of ‘opt‐out’ systems is framed (e.g. as presumed consent, deemed consent or, given the role of familial consent in many jurisdictions as consent in name only). (shrink)

This article explores the emergence of standards and regulation associated with the provision of Closed Circuit Television (CCTV) surveillance systems in the United Kingdom. It argues that despite the intrusive and controlling nature of CCTV technology there is limited formal intervention in the form of legislation, governing its introduction and use. Instead government has sought to influence the regulation of the technology indirectly through its ability to shape and govern policy networks in the policy arena. In doing so, it is (...) argued here, that government remains the dominant actor in the policy process. (shrink)

Through discourse with international groups of physicians, we conducted a cross-cultural analysis of the types of ethical dilemmas physicians face. Qualitative analysis was used to categorise the dilemmas into seven themes, which we compared among the physicians by country of practice. These themes were a-theoretically-driven and grounded heavily within the text. We then subjected the dilemmas to an analysis of moral intensity, which represents an important theoretical perspective of ethical decision making. These constructs represent salient determinants of ethical behaviour and (...) our cross-cultural sample afforded us the opportunity to consider both the pragmatic aspects of culture, as they are perceived by physicians, as well as the theory-driven concept of moral intensity. By examining both culture and moral intensity, we hope to better elucidate the complexities of ethical decision-making determinants among physicians in their daily practice. Doing so may potentially have practical implications for ethics training of medical students and foreign physicians. (shrink)

It would surely have been better to entitle this work ‘Reflexions on ethical theories’, for it cannot in any true sense of the word be called a study, a scientific study which entails detailed analysis and positive criticism. In fact Professor Mackinnon presents us with a series of considerations, highly personal and at times indeed penetrating and instructive, on the moral theories of certain British and continental philosophers—of the 19th century utilitarians ; of Kant, Hegel and their followers; of the (...) theologianphilosopher bishop of Durham, Joseph Butler; of Russell, Moore and others. The impression left on one after a careful perusal of the work is that it is no more than an agglomeration of ‘mights’ and ‘perhaps’, never a clear–cut judgment. The chief general defect of the book and the cause of much obscurity is certainly this: the absence of any welldefined distinction between exposé and critique. As often as not one does not know what the opinion of the author is as distinct from his interpretation of the authors he is studying. This defect would seem to be characteristic of a great part of the ethical writing produced by the Scottish and British schools, when they do not reduce ethical theory to anything better than semasiology, to a study of ethical language or linguistic usage. Prof. Mackinnon has certainly not freed himself from the ‘present confused state of moral philosophy in this country’, which he so rightly condemns. I had thought that all philosophers, of whatever ilk, were agreed that ethical science or moral philosophy was nothing more than the study of the human being on its way towards completeness in human being, from an initial embryonic stage, as it were, to the full flowering of human perfection, manifested in perfect human being and perfect human life—a journey or precess directed and controlled by the human subject itself, fully conscious of the end to be achieved and conscious too of the steps or means towards it. I would have thought too that if we are to set up moral science as distinct from mere semasiology, or from psychology, biology, zoology or botany, then all were agreed that we have to do with the domain of free activity, of voluntary conscious activity, which obviously brings with it the order of responsibility and willed subjection to a given objective order of things, that is, of human nature itself and human perfection. I would have taken for granted too that one could study all this field of the free development of the human being towards its ultimate perfection either with a view to the acquisition of knowledge and nothing more, or precisely with a view to being in a position to direct oneself and others towards that fullness of being. That would give us two distinct modes of moral or ethical theory, the speculative or theoretical and the practical and normative, the resolutive and the compositive. I am not so sure that Professor Mackinnon is ready to admit these presupposita. He speaks of the ‘curious and almost silly claim that we are free’, and at the same time he can write about the ‘frankly metaphysical reality of freedom’, or its ‘near–metaphysical reality’. This, in the language of the author, is just another way of proclaiming that human freedom is no more than a myth, lacking all substance and reality. Moral science as distinct from all other sciences, one would think, presupposes that the moral subject be conscious of itself and its activity, that is, that it fully and clearly know that its life and its activity is its own. It must be master of its own actions, and in that sense truly master of its own destiny. Then and only then are we in the order of moral activity. However, we are warned by Professor Mackinnon that “to know that an action is mine is a very strange sort of knowledge, quite different from knowing that an apple or a book is mine: to use the word ‘know’ in such a context is a venture fraught with intellectual peril”. I sincerely think it would have been better had the author denied straight out the possibility, not just of metaphysics, but of ethical theory tout court; for he denies often enough the existence of the moral subject, namely, man freely and deliberately ordaining himself towards human consummation. Had he done that at the outset he would have been spared the trouble of writing his book. All in all, one gets the distinct impression that the author is just not sure of his ground and has no really sound criterion whereby to judge of various ethical theories. In fact the book ends with a big question–mark: ‘If we speak and write thus, do we speak and write sound and fury signifying nothing?’. Reluctantly I am constrained to answer in the affirmative. And I should like to add, so as not to appear completely destructive, but in some way constructive: if, instead of dismissing Aristotle and his followers, ancient and modern, as mere ‘intuitionists’, Professor Mackinnon would only study them seriously he would first of all find out how unjustified is his condemnation of them and then, I venture to suggest, he would acquire a light to guide him surely through the maze of ethical theory with which he grapples aimlessly and would thus be enabled to extricate himself from ‘the present confused state of moral philosophy’ in Britain. (shrink)

Benedikt Stattler was born on January 30, 1728 in Kötzting in Bavaria. In 1745 he entered the Society of Jesus, to which he remained loyal in spirit and in deed until his death, in spite of its suppression in 1773 by Clement XIV From 1760 until 1781 he taught philosophy and theology in Staubing, Solothurn, Innsbruck and Ingolstadt, where the famous J. M. Sailer, Bishop of Regensburg, was his pupil. He died in Munich in 1797. Stattler, then, lived and worked (...) at the very height of the so-called Aufklarungszeit, a fact which had the deepest repercussions on his whole career. He was a zealous man and truly apostolic. Perhaps, if anything he was over-zealous and was in fact carried much too far in his spirit of accommodation and flexibility when faced with the rationalist enemies of the Church and Christianity. He was filled with the idea that they should be met on their own ground in order to win them for the Church. And in order to do that he decided that he must break with tradition. Modern modes of thinking must be used if there is to be even the possibility of discussion with present-day thinkers, was his principle. Accordingly he brushed aside Aristotle, St. Thomas and all the Scholastics and made his own the philosophy of Christian Wolff. For him that was the only way of preserving the Christian and Catholic faith and of safeguarding Christian morality, the Christian way of life. Filled with that idea he wrote indefatigably. Many of his works, however, very early fell foul of the Roman authorities and were put on the Index of forbidden books. And in fact, as Dr. Scholz rightly points out over and over again, Stattler became a victim of the Aufklärung which he sought to Christianize and he himself became a rationalist and, in morals, and out-and-out subjectivist. (shrink)

In recent years there has been a strong reaction perceptible amongst theologians against what has come to be regarded as traditional moral theology, a theology, namely, dealing with the notion of sin, examining not the way of perfection and of virtue, but the way rather of salvation alone. Theologians conscious of the need for something more positive have clamoured for something more positive, have called for a complete reorganization of moral science as taught to seminary students. Appeals have been made (...) for a so-called ‘kerygmatic’ and christocentric moral theology. Numerous attempts, more or less successful, have been made to elaborate such a new moral science. This small book of Father Tremeau is not at all meant to be a synthesis of moral philosophy; it is formally a work of theology. It contains what we might call all the elements of a sound fundamental moral theology. It is, in book form, the substance of a course in moral theology given by him at the Grand Seminaire of Langres 1955-1957. The work has its roots firmly planted in Sacred Scripture and Tradition; and at the same time the author shows himself to be fully aware of all modern problems, indicating them briefly and taking up a firm personal position with regard to them. We have here a first-class example of a theological work in the strictest sense of the term, of ‘fides querens intellectum’, and doing it with admirable success. (shrink)

The author of this little book makes no claim to being a philosopher, and is fully conscious of the very obvious limits of his writing ability. He is fully aware, too, of the nebulousness of his task, the task, namely, which he has taken upon himself of discussing what he calls universal religion on the basis of the Bible, the Talmud and the history of the Jewish people. Overcoming, however, his reluctance to divulge his ideas in writing because he feels (...) intuitively that he can transcend all his human frailty, he sets about presenting us with a philosophy of entire existence, as he himself puts it. A formidable task indeed. He would be grievously hurt, he tells us, were we to label his effort as theology. And still we are within our rights to ask: what else but theology could or should be the rational penetration of what God has spoken to men? In fact, the finished product turns out to be neither philosophy nor theology, but rather a series of pious, at times even pseudo-mystical reflections on God’s revelation as found in the Old Testament and as interpreted down the centuries in the various Jewish traditions. The serious philosopher or earnest theologian or the historian of religions will find nothing here. (shrink)

A recent legal case involving an ambiguous diagnosis in a woman with a severe disorder of consciousness raises pressing questions about treatment withdrawal in a time when much of what experts know about disorders of consciousness is undergoing revision and refinement. How much should diagnostic certainty about consciousness matter? For the judge who refused to allow withdrawal of artificial nutrition and hydration, it was dispositive. Rather than relying on substituted judgment or best interests to determine treatment decisions, he ruled that (...) withdrawal was categorically prohibited, even as he concluded that Hannah Capes was more likely than not in a permanent vegetative state. In many jurisdictions, his decision would likely be consistent with existing law. Evolving technological advances have demonstrated that biologically distinct diagnoses incorporated into state laws may be difficult to establish even under ideal conditions. We offer the Capes case for purposes of examining the consequences of enshrined legal distinctions between permanent vegetative state and other severe disorders of consciousness. Insistence on proof of the permanent absence of consciousness before treatment withdrawal is allowed fails to respect the rights of persons with disorders of consciousness. Even the well-established rights to treatment withdrawal for those in a permanent vegetative state may be in jeopardy if reform is not undertaken. (shrink)

The effect of oxytocin on cognitive bias was investigated in rats in a modified conditioned place preference (CPP) paradigm. Fifteen male rats were trained to discriminate between two different cue combinations, one paired with palatable foods (reward training), and the other paired with unpalatable food (aversive training). Next, their reactions to two ambiguous cue combinations were evaluated and their latency to contact the goal pot recorded. Rats were injected with either oxytocin (OT) or saline with the prediction that rats administered (...) oxytocin would display a shorter average latency to approach on ambiguous trials. There was no significant difference between latencies to approach on ambiguous trials compared to reward trials, but the rats were significantly slower on the aversive compared to the ambiguous conditions. Oxytocin did not affect approach time; however, it was unclear, after follow-up testing, whether the OT doses tested were sufficient to produce the desired effects on cognitive bias. Future research should consider this possibility. (shrink)

Women do most of the parenting. To provide a stable and healthier setting for children they must sublimate their own interests and feelings, which puts greater pressures on women to communicate needs clearly or to be deceptive when the occasion demands. The likely advantage in communication skills and self-control may ameliorate the impact of disorders like ADHD where the most serious deficit is in self-inhibition. This would account for the strikingly uneven male to female sex ratio of 2:1 (in epidemiological (...) samples) to 10:1 (in clinical settings), the higher threshold for females, and the sex difference in the pattern of associated mental disorders. (shrink)