Euthanasia and assisted suicide have proved to be very contentious topics in medical ethics. Some ethicists are particularly concerned that allowing physicians to carry out these procedures will undermine their professional obligations and threaten the very goals of medicine. However, I maintain that the fundamental goals of medicine not only do not preclude the practice of euthanasia and assisted suicide by physicians, but can in fact be seen to support these practices in some instances. I look at two (...) influential views of the goals of medicine, one based on the broad guiding principles of autonomy, beneficence and nonmaleficence, and the other focusing on several more concrete aims, concluding that both approaches can be seen to support euthanasia and assisted suicide. I then turn to the popular concern that allowing physicians to carry out euthanasia and assisted suicide will lead to widespread abuse. I argue that the possibility for abuse can be minimised if we make the patient's autonomous consent an essential requirement of the practice. (shrink)

The problem of standard of care in clinical research concerns the level of treatment that investigators must provide to subjects in clinical trials. Commentators often formulate answers to this problem by appealing to two distinct types of obligations: professional obligations and natural duties. In this article, I investigate whether investigators also possess institutional obligations that are directly relevant to the problem of standard of care, that is, those obligations a person has because she occupies a (...) particular institutional role. I examine two types of institutional contexts: (1) public research agencies – agencies or departments of states that fund or conduct clinical research in the public interest; and (2) private-for-profit corporations. I argue that investigators who are employed or have their research sponsored by the former have a distinctive institutional obligation to conduct their research in a way that is consistent with the state's duty of distributive justice to provide its citizens with access to basic health care, and its duty to aid citizens of lower income countries. By contrast, I argue that investigators who are employed or have their research sponsored by private-for-profit corporations do not possess this obligation nor any other institutional obligation that is directly relevant to the ethics of RCTs. My account of the institutional obligations of investigators aims to contribute to the development of a reasonable, distributive justice-based account of standard of care. (shrink)

This paper is based on the assumption that the high incomes of some professional sports athletes, such as players in professional leagues in the United States and Europe, pose an ethical problem of social justice. I deal with the questions of what should follow from this evaluation and in which ways those incomes should be regulated. I discuss three different options: a) the idea that the incomes of professional athletes should be limited, b) the idea that they (...) should be vastly taxed by the state, and c) the idea that there is a moral obligation for the athletes to spend portions of their incomes on good causes. I will conclude that in today’s circumstances there are good reasons to advocate both option one (limitation) and option two (taxation), but that priority should be given to taxation. (shrink)

In this paper, I argue that businesses bear a pro tanto, negative, moral obligation to refuse to engage in economic relationships with representatives of intolerable ideologies. For example, restaurants should refuse to serve those displaying Nazi symbols. The crux of this argument is the claim that normal economic activity is not a morally neutral activity but rather an exercise of political power. When a business refuses to engage with someone because of their membership in some group, e.g., Black Americans, this (...) is a use of political power to signal that Black Americans are other. Conversely, when businesses engage with someone who is clearly representing an intolerable ideology, this is a use of political power that signals the acceptability of that ideology. Businesses should not do this. (shrink)

In this paper, we argue that providers who conscientiously refuse to provide legal and professionally accepted medical care are not always morally required to refer their patients to willing providers. Indeed, we will argue that refusing to refer is morally admirable in certain instances. In making the case, we show that belief in a sweeping moral duty to refer depends on an implicit assumption that the procedures sanctioned by legal and professional norms are ethically permissible. Focusing on examples of (...) female genital cutting, clitoridectomy and ‘normalizing’ surgery for children with intersex traits, we argue that this assumption is untenable and that providers are not morally required to refer when refusing to perform genuinely unethical procedures. The fact that acceptance of our thesis would force us to face the challenge of distinguishing between ethical and unethical medical practices is a virtue. This is the central task of medical ethics, and we must confront it rather than evade it. There are no data in this work. (shrink)

There are two main questions that any account of corporate lawyers’ moral obligations needs to answer: (1) Do corporate lawyers have moral obligations to third parties? and (2) In cases of conflict between obligations to the corporation and obligations to third parties, which should prevail? This Article offers answers to these questions in the context of lawyers working in medical corporations. I argue that lawyers do have moral obligations to third parties, and that in cases (...) where patients’ rights are being violated by a medical company, patients’ rights should prevail. Consequently, attorney–client confidentiality rules should be relaxed to allow for attorney disclosures in egregious cases of potential harm to third parties. (shrink)

There is significant controversy over whether patients have a ‘right not to know’ information relevant to their health. Some arguments for limiting such a right appeal to potential burdens on others that a patient’s avoidable ignorance might generate. This paper develops this argument by extending it to cases where refusal of relevant information may generate greater demands on a publicly funded healthcare system. In such cases, patients may have an ‘obligation to know’. However, we cannot infer from the fact that (...) a patient has an obligation to know that she does not also have a right not to know. The right not to know is held against medical professionals at a formal institutional level. We have reason to protect patients’ control over the information that they receive, even if in individual instances patients exercise this control in ways that violate obligations. (shrink)

This paper examines the question whether physicians are obligated by their professional ethos to defend a pacifist position. The question is a more concrete and applied formulation of the general thesis that there are what I will call “pacifist professions”: professions whose ethos requires their members to act in a pacifist way. Since the present paper is rather one in applied philosophy than a theoretical one about the foundation of pacifism, it will concentrate on the practical issue of whether (...) and how physicians can execute their profession in or during war. Theoretical questions on the nature and extent of pacifism will be considered only to the extent necessary to treat the main issue. The introductory section will give a short overview of some histori- cal aspects of physicians’ participation in war and show the relevance of the issue with recent examples. The remainder of this section will thus serve to set the stage and to outline the connections between the medical profession and questions of war and peace. The paper will then be divided into three other main parts: the first part will be devoted to defining in a general manner so-called “professional pacifism”. The second part will investigate whether and to what extent the medical profession can be classified as a pacifist profession, and the third part will look at the consequences of such a classification. (shrink)

As complicated an affair as it may be to give a fully acceptable general characterization of professional codes of ethics that will capture every nuance, one theme that has attracted widespread attention portrays them as contrivances whose primary function is to secure certain obligations of professionals to clients, or to the external community. In contrast to such an "externalist" characterization of professional codes, it has occasionally been contended that, first and foremost, they should be understood as internal (...) conventions, adopted among professionals as a device for securing the "interests" of the professionals themselves. In what follows, I will argue that both of these lines are incomplete. As important as service to the community and the interests of professionals may be in the full understanding of the multiple role that "codes of ethics" play in many professions, it is equally important to see them as expressive of the romance of a profession. Professional codes should be understood not only in terms of their utility to the community, or in terms of their utility to practitioners, but as expressions of callings. Analyses of professional codes of ethics that do not take into consideration their role in evoking the romance of a professional calling are thus not entirely adequate. Professional standards and codes can be fully understood only if one appreciates that they are designed to contribute to and evoke feelings of dignity, self-worth-and, for better or for worse, even the superiority--of the professionals themselves; the code may seem to them to express essential features of what the profession really is. (shrink)

According to the Market Failures Approach to business ethics, beyond-compliance duties can be derived by employing the same rationale and arguments that justify state regulation of economic conduct. Very roughly the idea is that managers have a duty to behave as if they were complying with an ideal regulatory regime ensuring Pareto-optimal market outcomes. Proponents of the approach argue that managers have a professional duty not to undermine the institutional setting that defines their role, namely the competitive market. This (...) answer is inadequate, however, for it is the hierarchical firm, rather than the competitive market, that defines the role of corporate managers and shapes their professional obligations. Thus, if the obligations that the market failures approach generates are to apply to managers, they must do so in an indirect way. I suggest that the obligations the market failures approach generates directly apply to shareholders. Managers, in turn, inherit these obligations as part of their duties as loyal agents. (shrink)

Advanced AI systems are rapidly making their way into medical research and practice, and, arguably, it is only a matter of time before they will surpass human practitioners in terms of accuracy, reliability, and knowledge. If this is true, practitioners will have a prima facie epistemic and professional obligation to align their medical verdicts with those of advanced AI systems. However, in light of their complexity, these AI systems will often function as black boxes: the details of their contents, (...) calculations, and procedures cannot be meaningfully understood by human practitioners. When AI systems reach this level of complexity, we can also speak of black-box medicine. In this paper, we want to argue that black-box medicine conflicts with core ideals of patient-centered medicine. In particular, we claim, black-box medicine is not conducive for supporting informed decision-making based on shared information, shared deliberation, and shared mind between practitioner and patient. (shrink)

The market failures approach to business ethics has recently garnered substantial critical attention (see, e.g., Cohen and Peterson 2019; Moriarty 2020; Steinberg 2017; Hsieh 2017; von Kriegstein 2016; Smith 2018; Endorfer and Larue 2022; Singer 2018). Though precursors of this view can be found in the literature (e.g., McMahon 1981; Friedman 1970), it was Joseph Heath (2004, 2006, 2014, 2023) who developed the approach and gave it its name. The market failures approach (henceforth: MFA) is concerned with the ethical (...) class='Hi'>obligations of managers of firms (Heath 2014, 69). Roughly, it holds that managers ought not to conduct their businesses in a way that exploits market failures. “Market failure” is a technical term, meaning any failure of the conditions of the first fundamental welfare theorem, sometimes called the “Pareto conditions” (see Arrow 1951). The theorem states that if the Pareto conditions hold, then the market equilibrium will use society’s scarce resources efficiently, meaning that no one could be made better-off without making anyone else worse off. Efficiency, according to Heath (2014, chapter 7), is the implicit morality of the market. We coordinate much of our shared activity using markets, Heath claims, because of their ability to produce efficient results. Markets are good forms of social organization, according to Heath, because they are the best way to promote our values given empirical facts about the frailties of human psychology and the informational constraints that we face. As such, managers ought not compromise the very conditions that justify a market economy by profiting from breakdowns in the market’s efficiency. Managers are permitted to maximize profits, so long as they do not violate the market’s norm of efficiency in so doing. This is because the fundamental justification for the profit motive is that it is necessary for the operation of the price system which is essential to the efficiency properties of markets. In this paper, I will argue that the MFA is more general than even Heath himself claims. The MFA describes the professional obligations of managers, but the view I develop, the generalized market failures approach, describes the obligations of all market participants. Since efficiency is the implicit morality of the market, it binds not just managers, but all market participants, including consumers, investors and workers. Market participants are permitted to maximize the benefit they gain from market interactions, as long as they do so in a way that does not take advantage of any market failures. Generalizing the MFA in this way has three benefits: first, we gain a unified understanding of the ethics of non-managerial market roles; second, we will develop an even better understanding of the duties of managers; finally, it gives us the resources to respond to some familiar objections to the MFA found in the literature. In the next section, I will further motivate the MFA and explain how this motivation can be easily generalized to other market roles. Importantly, one can avoid benefiting from a market failure in two distinct ways: by avoiding transactions that exploit market failures or by transacting in such markets and then remediating the harm done, by compensating those negatively affected by the market failure. This section concludes by discussing how the remediation duties are to be split between the transacting parties and how to identify the parties to whom compensation is owed. In section 3, I use the tools of the generalized MFA to develop a unified ethics of consumption, investment and labor, respectively. This is the basis of a grand abductive argument for the generalized MFA. The view is strongly supported by the fact that it provides attractive and unifying explanations of our obligations in domains as variegated as carbon offsetting, CEO compensation, the reparations white Americans owe to black Americans and occupational licensure. Section 4 briefly concludes. (shrink)

Though it is evident that seriously and irreversibly defective infants are born in Poland, as well as in other socialist countries we do not know really what is the existing medical practice concerning their treatment or non-treatment. No representative empirical investigations were conducted with respect to it. We believe, however, that for the majority of doctors this is not a genuine moral problem at all. They feel simply morally, legally, and professionally obliged to treat those unhappy creatures without any regard (...) to economic and moral cost of treatment. It is highly plausible that this attitude is common to all socialist countries. All the factors mentioned in this paper (religion, ideology, medical education, paternalism, remembrance of Nazi doctors’ criminal practice, the legal situation, and the health care system) have a direct influence on the moral beliefs and attitudes of doctors in socialist countries. And even in those countries in which there are different religious traditions (like the Soviet Union, Yugoslavia, or the German Democratic Republic) there is a deeply-entrenched belief that preserving any human life is the principal and absolute duty of a doctor, one which must be fulfilled at any cost. We should also keep in mind that in this part of the world hardly any distinction at all is made between euthanasia and ordinary murder. (shrink)

The debate regarding the role of conscientious objection in healthcare has been protracted, with increasing demands for curbs on conscientious objection. There is a growing body of evidence that indicates that in some cases, high rates of conscientious objection can affect access to legal medical services such as abortion—a major concern of critics of conscientious objection. Moreover, few solutions have been put forward that aim to satisfy both this concern and that of defenders of conscientious objection—being expected to participate in (...) the provision of services that compromise their moral integrity. Here we attempt to bring some resolution to the debate by proposing a pragmatic, long-term solution offering what we believe to be an acceptable compromise—a quota system for medical trainees in specialties where a conscientious objection can be exercised, and is known to cause conflict. We envisage two main objectives of the quota system we propose. First, as a means to introduce conscientious objection into countries where this is not presently permitted. Second, to minimise or eliminate the effects of high rates of conscientious objection in countries such as Italy, where access to legal abortion provision can be negatively affected. (shrink)

The double subjectivity of conscience and the need to test conscientious objections -/- Abstract In spite of the collapse of the traditional objective concept of conscience and the subsequent subjectivation of conscience, conscientious objections are still often considered as a valid ground for exemption from legal and professional obligations. Conscientious objections are seen as more serious than ordinary moral objections. It is not evident why this is so. I argue, with Niklas Luhmann, that the function of conscience is (...) to protect the moral core of a person’s identity. Overruling conscientious objections threatens this core. Claims of conscience are usually founded on the right of freedom of conscience. This right is not absolute. I discuss the view of Richard Arneson who rejects the right of freedom of conscience and defends the right against conscience. I agree with Arneson that, at the one hand, conscientious objectors may constitute a threat to the social and legal order when their objections are not recognised and, at the other hand, too easy giving in to conscientious objections may also threaten the viability of social and legal order. That is why it is needed to determine when conscientious objections cannot be taken at face value, but should be subjected to a series of tests. The aim of these tests is to contain the number of objectors. I discuss 6 criteria for determining whether conscientious objections ground an exemption to legal and professional obligations. At the end of the article I discuss the conscientious objections of medical doctors. (shrink)

Medical ethicists conventionally assume that the requirement to employ informed consent procedures is grounded in autonomy. It seems intuitively plausible that providing information to an agent promotes his autonomy by better allowing him to steer his life. However, James Taylor questions this view, arguing that any notion of autonomy that grounds a requirement to inform agents turns out to be unrealistic and self-defeating. Taylor thus contends that we are mistaken about the real theoretical grounds for informed consent procedures. Through analysing (...) Taylor's arguments and showing that they do not stand up to scrutiny, it is possible to defend the view that autonomy is a plausible theoretical basis for informed consent, and to enhance our understanding of the relationship between autonomy and informed consent. (shrink)

Solidarity could be defined in the broad sense either as a means or as an end. Considered as an end, solidarity is the motive of any virtuous action based on altruistic reasons, such as helping others to rescue someone in order to prevent a harmful situation. E. g. contributing to lift and rescue a heavy person, lying unconscious in the street on the floor, who is being handled by rescuers, but who might be needing an additional person, could express the (...) value of solidarity as an end, since an answer to others request for help is given in the situation of emergency and risk, without having a particular obligation to help. Solidarity as a means (to an end, not an end), could be understood as a property of dependency of a set of parts to a whole (in solidum), as when in a family or a professional group, individual and collective roles and responsibilities are melt together to some extent.This idea of benefiting others could be understood either as a way of sharing together moral sentiments as love, social virtues as friendship and shared commitments and common economic and educational interests, in a limited community circle, that of the family. Even if the division of labour is not simply based on patriarchal authority, mutual consent of family members to rules and to a common circle of interests, those of the family, resemble to a egoism of the group, and not yet to truly social and altruistic values. Solidarity as cohesion of human beings, by the means of "interchangeability of ideas, services, goods, of workforce, virtues and vices", is solidarity limited to the constitution of a process of exchange that is a means that could be used to different ends. (shrink)

Military doctors and nurses, employees with a compound professional identity as they are neither purely soldiers nor simply doctors or nurses, face a role conflict between the clinical professional duties to a patient and obligations, express or implied, real or perceived, to the interests of a third party such as an employer, an insurer, the state, or in this context, military command (London et al. 2006). In the context of military medical ethics this is commonly called dual (...) loyalty (or, less commonly, mixed agency). Although other professionals in the military, for instance counsellors or lawyers, might experience similar problems of dual loyalties, it seems that the dual loyalties experienced by military medical personnel are particularly testing. (shrink)

How should historians treat one another? More generally, what are the ethical obligations that go with belonging to the profession of history? And more generally still, in what ways and in what sense is history a profession and how are professional ethics manifested in the profession? These are the questions I will canvass in this essay. In his introduction to The Historian’s Conscience, Stuart Macintyre observes that in the recent ‘public dispute over Australian history … there is surprisingly (...) little attention to the ethical dimensions of historical scholarship’. I will suggest that this lack of attention is a problem, and I will try to clarify the nature of the problem. (shrink)

The studies of ethics had long been under-dealt although it is the kind of primary in sustaining a civility. It is hardly deniable that the concept of efficiency and productivity has hailed on the mindedness and interest of academic community. The narrative of ethics or social justice would be ridiculed as the kind of Greek juggle on philosophy or put to be on neglect for its lacking or default on the modern disciplinary frame in the academics. A cure, however, seems (...) not to be from a juggernaut of modern capitalistic civilization and its supportive paradigm of understanding so that alternative way for any more realistic solution can be made exploitative from the ethics or similar tools of motivation. Now we talk about noblesse oblige or benevolent capitalism as one important dose for the new paradigm of social promise or reformed capitalism. The ethics studies have increasingly made its way as focused in the discipline of business and public administration. Typically, it is profiled in combination of leadership studies, and the civility tends to accept this narrative, beyond the liberal competition and fairness school, as one of important element when we consider the concept of social justice. The modern professionals, for example, bar members, medical doctors, and many of licensees for their business operation, also clone to carry their responsibility under a specific ethical code. This would be the kind of safety code from the abusive or madly profit-driven capitalism. More importantly, I believe that a sheer understanding of ethics and social justice would be assets and equipment for the ruling class in the contemporary society. In this context, the paper would survey an ethical theory or decision making model, history of Korea as well as a recent episode involving the chief prosecutor of South Korea. Korean leadership, typically for the powerful cores or inner circle princelings, can be revisited in purview of ethics studies, such as Cooper‟s design and ethical decision making model. (shrink)

This paper explores the level of obligation called for by Milton Friedman’s classic essay “The Social Responsibility of Business is to Increase Profits.” Several scholars have argued that Friedman asserts that businesses have no or minimal social duties beyond compliance with the law. This paper argues that this reading of Friedman does not give adequate weight to some claims that he makes and to their logical extensions. Throughout his article, Friedman emphasizes the values of freedom, respect for law, and duty. (...) The principle that a business professional should not infringe upon the liberty of other members of society can be used by business ethicists to ground a vigorous line of ethical analysis. Any practice, which has a negative externality that requires another party to take a significant loss without consent or compensation, can be seen as unethical. With Friedman’s framework, we can see how ethics can be seen as arising from the nature of business practice itself. Business involves an ethics in which we consider, work with, and respect strangers who are outside of traditional in-groups. (shrink)

In this article I clarify the concepts of ‘pain’, ‘suffering’. ‘pains of body’, ‘pains of soul’. I explore the relevance of an ethic to the clinical setting which gives patients a strong prima facie right to freedom from unnecessary and unwanted pain and which places upon medical professionals two concomitant moral obligations to patients. First, there is the duty not to inflict pain and suffering beyond what is necessary for effective diagnosis. treatment and research. Next, there is the duty (...) to do all that can be done to relieve all the pain and suffering which can be alleviated. I develop in some detail that individuality of pain sensitivity must be taken into account in fulfihing these obligations. I explore the issue of the relevance of informed consent and the right to refuse treatment to the matter of pain relief. And I raise the question of what conditions, if anv, should override the right to refuse treatment where pain relief is of paramount concern. (shrink)

There is much philosophical literature on the duty to rescue. Individuals who encounter and could save, at relatively little cost to themselves, a person at risk of losing life or limb are morally obligated to do so. Yet little has been said about the other side of the issue. There are cases in which the need for rescue could have been reasonably avoided by the rescuee. We argue for a duty to take rescue precautions, providing an account of the circumstances (...) in which it arises. This novel duty has important implications for public policy. We apply it to the situation of some of the uninsured in the United States. Given the US clinician's duty to provide emergency care to all people regardless of ability to pay, some of the uninsured have a moral duty to purchase health insurance. We defend the duty against objections, including the possibility that a right to rescue can be waived, thus undermining a duty to take rescue precautions, that the duty of many professionals is voluntarily incurred, and that a distinction between actively assumed and passively assumed risks matters morally. (shrink)

In 2019, several US states passed “heartbeat” bills. Should such bills go into effect, they would outlaw abortion once an embryonic heartbeat can be detected, thereby severely limiting an individual’s access to abortion. Many states allow health care professionals to refuse to provide an abortion for reasons of conscience. Yet heartbeat bills do not include a positive conscience clause that would allow health care professionals to provide an abortion for reasons of conscience. I argue that this asymmetry is unjustified. The (...) same criteria that justify protecting conscientious refusals to provide abortion also justify protecting positive conscientious appeals regarding abortion. Thus, if the law provides legal exemptions for health care professionals who, as a matter of conscience, refuse to provide abortions where it is legal, it should also provide exemptions for health care professionals who, as a matter of conscience, feel obligated to provide abortions where it is illegal. (shrink)

Miracle Max, it seems, is the only remaining miracle worker in all of Florin. Among other things, this means that he (unlike anyone else) can resurrect the recently dead, at least in certain circumstances. Max’s peculiar talents come with significant perks (for example, he can basically set his own prices!), but they also raise a number of ethical dilemmas that range from the merely amusing to the truly perplexing: -/- How much about Max’s “methods” does he need to reveal to (...) his patients? Is it really OK for Max to lie about Valerie’s being a witch, even though she really isn’t? Just how much of the “truth” does Max have to tell his patients? -/- Let’s suppose that Humperdinck had offered Max his old job back. Would it have been OK for Max to accept this offer? What about if Humperdinck wanted him to do experiments at “the Zoo”? -/- Is Max obligated to offer his services to everyone who needs them, such as the (mostly) dead Westley and friends? Or is he free to pick and choose? -/- In this chapter, I’ll consider how these questions might be addressed using concepts of medical ethics. As it turns out, Max’s dilemmas are not too different from the sorts of dilemmas that many medical professionals encounter in their daily lives, and exploring how Max could (or should) respond to them can help us figure out what we can do here in the “real” world. (shrink)

Physicians frequently ask whether they should give patients what they want, usually when there are considerations pointing against doing so, such as medicine’s values and physicians’ obligations. It has been argued that the source of medicine’s values and physicians’ obligations lies in what has been dubbed “the internal morality of medicine”: medicine is a practice with an end and norms that are definitive of this practice and that determine what physicians ought to do qua physicians. In this paper, (...) I defend the claim that medicine requires a morality that is internal to its practice, while rejecting the prevalent characterization of this morality and offering an alternative one. My approach to the internal morality of medicine is constructivist in nature: the norms of medicine are constructed by medical professionals, other professionals, and patients, given medicine’s end of “benefitting patients in need of prima facie medical treatment and care.” I make the case that patients should be involved in the construction of medicine’s morality not only because they have knowledge that is relevant to the internal morality of medicine—namely, their own values and preferences—but also because medicine is an inherently relational enterprise: in medicine the relationship between physician and patient is a constitutive component of the craft itself. The framework I propose provides an authoritative morality for medicine, while allowing for the incorporation, into that very morality, of qualified deference to patient values. (shrink)

Military doctors and nurses, working neither as pure soldiers nor as merely doctors or nurses, may face a ‘role conflict between the clinical professional duties to a patient and obligations, express or implied, real or perceived, to the interests of a third party such as an employer, an insurer, the state, or in this context, military command’. This conflict is commonly called dual loyalty. This chapter gives an overview of the military and the medical ethic and of the (...) resulting dual loyalty problem for medical personnel working in the military. It considers how dual loyalties relate to being a professional, something medical personnel are the paradigmatic examples of, but also something military personnel claim to be. Against that background, the chapter elaborates on the medical rules of eligibility used in Afghanistan, and on the policies concerning military involvement in local healthcare, to see what the existing rules and policies are, and whose interests they serve. (shrink)

The UN Convention against Torture defines torture as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person” by someone acting in an official capacity for purposes such as obtaining a confession or punishing or intimidating that person.1 It is unethical for healthcare professionals to participate in torture, including any use of medical knowledge or skill to facilitate torture or allow it to continue, or to be present during torture.2-7 Yet medical participation (...) in torture has taken place throughout the world and was a prominent feature of the US interrogation practice in military and Central Intelligence Agency (CIA) detention facilities in the years after the attacks of 11 September 2001.8-11 Little attention has been paid, however, to how a regime of torture affects the ability of health professionals to meet their obligations regarding routine clinical care for detainees. -/- The 2016 release of previously classified portions of guideline from the CIA regarding medical practice in its secret detention facilities sheds light on that question. These show that the CIA instructed healthcare professions to subordinate their fundamental ethical obligations regarding professional standards of care to further the objectives of the torturers. (shrink)

According to a recent survey by the HR Research Institute, as the presence of artificial intelligence (AI) becomes increasingly common in the workplace, HR professionals are worried that the use of recruitment algorithms will lead to a “dehumanization” of the hiring process. Our main goals in this paper are threefold: i) to bring attention to this neglected issue, ii) to clarify what exactly this concern about dehumanization might amount to, and iii) to sketch an argument for why dehumanizing the hiring (...) process is ethically suspect. After distinguishing the use of the term “dehumanization” in this context (i.e., removing the human presence) from its more common meaning in the interdisciplinary field of dehumanization studies (i.e., conceiving of other humans as subhuman), we argue that the use of hiring algorithms may negatively impact the employee-employer relationship. We argue that there are good independent reasons to accept a substantive employee-employer relationship, as well as an applicant-employer relationship, both of which are consistent with a stakeholder theory of corporate obligations. We further argue that dehumanizing the hiring process may negatively impact these relationships because of the difference between the values of human recruiters and the values embedded in recruitment algorithms. Drawing on Nguyen’s (2021) critique of how Twitter “gamifies communication”, we argue that replacing human recruiters with algorithms imports artificial values into the hiring process. We close by briefly considering some ways to potentially mitigate the problems posed by recruitment algorithms, along with the possibility that some difficult trade-offs will need to be made. (shrink)

Introduction The major burden of the COVID-19 pandemic has been mainly on healthcare workers (HCWs) and as a result many of them have been afflicted with the disease thus far. -/- Purpose The present study was an effort to investigate Tehran University of Medical Sciences HCWs' experiences of COVID-19 during the pandemic in Tehran, Iran. -/- Methods This study is essentially a conventional qualitative content analysis. Twenty-six HCWs (including 7 physicians, 16 nurses, and 3 physiotherapists) were purposefully selected to participate (...) in the study. The data were collected from April 2020 to January 2021 through semi-structured face-to-face interviews. The interviews were transcribed and then analyzed based on the Graneheim and Lundman method using MAXQDA 12. -/- Results Based on the qualitative content analysis which resulted in 364 initial codes, three themes and eight subthemes were extracted. The extracted themes were “support,” “control,” and “improvement.” -/- Conclusions HCWs are in close contact with COVID-19 patients as part of their professional careers and the provision of quality patient care in times of crises is unattainable unless HCWs enjoy support and their own health is maintained. Making institutional, national, and international preparations for their protection is an obligation. (shrink)

While virtually everyone recognizes the moral permissibility of whistleblowing under certain circumstances, most theorists offer relatively conservative accounts of when it is allowed, and are reluctant to offer a full recommendation of the practice as an important tool towards addressing ethical failures in the workplace. We think that accounts such as these tend to overestimate the importance of professional or personal obligations, and underestimate the moral obligation to shine light on severe professional malfeasance. Of course, a whistleblower, (...) even an anonymous one, often faces serious threats of retaliation and harm to their professional livelihoods and well-being. To address these challenges we argue in favor of a practice that we will call Preemptive Anonymous Whistleblowing (PAW). Such whistleblowing is preemptive in that a whistleblower provides information about malfeasance to a party in a position to do something about it without first raising the worry to one’s immediate superiors. At first blush, such preemption may seem unsettling, and PAW admittedly raises a number of worrisome issues. We defend PAW, however, as part of a larger argument that whistleblowing is morally required more often than is commonly thought. The availability of PAW as an option provides a method for allaying the concern that whistleblowing can be overly burdensome due to the risks of job and career. Insofar as that concern can be allayed, it is feasible for there to be substantial moral requirements to engage in whistleblowing in cases where severe harms can be prevented. With high enough stakes, there is a moral requirement for whistleblowing. (shrink)

Students with recent immigrant roots disproportionately choose educational trajectories in STEM. In addition to the perception that STEM represents the "path of least racism," many students assume the responsibility of contributing to their families' financial wellbeing. In this talk, I share my experience teaching at a pre-professional healthcare university with a large percentage of 1st and 2nd-generation Asian immigrant students. Many of them seek advice on how to negotiate the social and familial pressure to pursue STEM against their interests (...) in the humanities. The reply "Follow your heart" might be inappropriate when familial obligations and perceived bigotry are legitimate deterrents. By recognizing the grand tradition of one immigrant generation trying to improve the lot for the next, we strive not merely for financial freedom but freedom in general. As such, we ought to consider how we can spend our lives to best dismantle the barriers that limit our life choices. (shrink)

Aims and Objectives The purpose of this paper was to clarify the concept of ethical conflict in nursing and highlight the importance of tackling this issue. -/- Background Ethical conflict is on the rise in the nursing context. It is associated with the compromise of nurses' well-being and patient care. However, there is no thorough conceptual understanding of this concept. -/- Design Concept analysis. -/- Methods Databases (PubMed, PsycINFO, CINAHL, Scopus, Embase, Web of Science and SocINDEX) were searched for studies (...) between 1984 and 2021. Both quantitative and qualitative studies related to ethical conflict in nursing were included. Walker and Avant's method of concept analysis was used to identify the defining attributes, antecedents and consequences of the concept of ethical conflict in nursing. We followed the PRISMA-ScR checklist to report the study. -/- Results Thirty studies were included for conceptualization. Defining attributes were divided into four categories: (1) emotional responses, (2) incompatible values, (3) competing interests and (4) ambiguous obligations. The antecedents were (1) ethical sensitivity, (2) negative ethical climate, (3) insufficient authority, (4) unrealistic expectations, (5) poor collaboration and (6) inadequate resources. The consequences were identified as (1) moral residue, (2) loss of identity, (3) professional burnout and (4) poor patient care. -/- Conclusions A unified conceptual model of ethical conflict in nursing shed light on the ethical issues nurses might come across in practice. Despite the fact that ethical conflict is inherently negative, we conceptualised this concept as a neutral fact and an opportunity for nursing action. The construct identification provides basis for both the development of practice and the development of staff support and education. (shrink)

According to the brain drain argument, there are good reasons for states to limit the exit of their skilled workers (more specifically, healthcare workers), because of the negative impacts this type of migration has for other members of the community from which they migrate. Some theorists criticise this argument as illiberal, while others support it and ground a duty to stay of the skilled workers on rather vague concepts like patriotic virtue, or the legitimate expectations of their state and co-citizens. (...) In this article, on the contrary, we suggest that the liberal conception of states’ legitimate political authority demands, and not just permits, that developing states from which migration of skilled workers occurs set up contractual mechanisms. These mechanisms will ensure that state-funded training in the health sector is provided against a commitment on the part of future professionals to reciprocate with their services for the benefits obtained. If one of the conditions for the state to maintain legitimate political authority is to provide basic services such as healthcare to its subjects (while respecting at the same time their autonomy and freedom), then this is what developing states affected by the brain drain ought to do. What we call the authority-based approach to the brain drain also helps to clarify the obligations that other states have not to interfere with these contractual mechanisms when they exist, and not to profit from their absence. Inspired by FIFA’s legal instruments of training compensation and solidarity mechanism for the transfer of players, we conclude by suggesting a plausible global policy to complement this authority-based approach. (shrink)

Humanitarian aid workers typically reject the accolade of hero as both untrue and undesirable. Untrue when they claim not to be acting beyond the call of duty, and undesirable so far as celebrating heroism risks elevating “heroic” choices over safer, and perhaps wiser ones. However, this leaves unresolved a tension between the denial of heroism and a sense in which certain humanitarian acts really appear heroic. And, the concern that in rejecting the aspiration to heroism an opportunity is lost to (...) inspire more and better humanitarian action. Having set out this problem in more detail in Part I, the argument in Part II will suggest that a virtue ethics approach to humanitarian moral obligations can make good sense of our intuitions concerning the role of heroism in humanitarian action. In Part III I will argue that at least “professional” humanitarians, instead of rejecting heroism, should aim to be heroes, in the sense of displaying a virtue of humanity in high-stakes contexts, because this is consistent with the aim of humanitarian action. Finally, some lingering problems of demandingness and motivation are considered. (shrink)

When a theory, as the general relativity, linked to special relativity, is foundation of a scientific paradigm, through normal science and academy, scientifics, professionals, professors, students and journals of that scientific community, the paradigm, it self-sustains and reproduces. Thus, the research is obligated and limited to apply the model existent of the paradigm to formulate problems and solve them, without searching new discoveries. This self-protection of the paradigm causes it to end its cycle of life, only after a long time, (...) until that arise unresolved anomalies, some presents since origin, that they finally cause its change by other new paradigm. In this work, we study the most important anomalies that are part of the foundations of general relativity with the goal of promoting the call period of transition that is previous to scientific revolution. We use critical analysis method for rereading the general relativity, from the perspective of the history of science and philosophy of science. We find, the structural and complex anomaly of general relativity based on metaphysical spacetime that produces the metaphysics replaces physics. Also, two internal anomalies their direct consequences. These are: matter curves metaphysical spacetime, and metaphysical spacetime determines the geodesic motion of physical matter. We conclude that general relativity has no valid physical concept of spacetime, therefore of gravity. For these reasons, a new paradigm is needed. (shrink)

This paper outlines ethical problems with the regional quota systems used in Japanese medical schools from the perspective of the autonomous choice of doctors and medical students. “Regional quotas” have been established in university medical schools in Japan to cultivate doctors for rural areas, and the percentage of such quotas has been significantly increasing in recent years. This study mainly focuses on the regional quota systems for medical schools whereby medical students receive scholarships on the condition that they work in (...) community medicine for a certain period after graduating and are exempt from repaying the scholarship depending on the fulfillment of their obligations. In many cases, the regional quota systems impose penalties on those who leave to prevent withdrawal, and some claim that it is morally impermissible to withdraw from the contract. Thus, the study reviews regional quota systems and argues that these systems contain contracts that restrict the signatory’s freedom of residence and professional choice for more than a decade, and that it is difficult to withdraw from the contract because of the penalties. Consequently, it demonstrates that these contracts are morally unjust as they severely restrict the autonomous choice of doctors and medical students. In conclusion, the current regional quota systems are morally impermissible and local authorities should recruit new doctors without using such systems. (shrink)

The contention of this article is that parents do have obligations to care for their children, but for reasons that are not typically offered. I argue that this obligation to care for one’s children is unfair to parents but not unjust. I do not provide a detailed account of what our obligations are to our children. Rather, I focus on providing a justification for any obligation to care for them at all.

In this paper I discuss a number of different relationships between two kinds of obligation: those which have individuals as their subject, and those which have groups of individuals as their subject. I use the name collective obligations to refer to obligations of the second sort. I argue that there are collective obligations, in this sense; that such obligations can give rise to and explain obligations which fall on individuals; that because of these facts collective (...) obligations are not simply reducible to individual obligations; and that collective obligations supervene on individual obligations, without being reducible to them. The sort of supervenience I have in mind here is what is sometimes called ‘global supervenience’. In other words, there cannot be two worlds which differ in respect of the collective obligations which exist in them without also differing in respect of the individual obligations which exist in them. (shrink)

The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. Participation in research is a critical way to support an important public good. Consequently, all have a duty to participate. The (...) current social norm is that individuals participate only if they have a good reason to do so. The public goods argument implies that individuals should participate unless they have a good reason not to. Such a shift would be of great aid to the progress of biomedical research, eventually making society significantly healthier and longer lived. (shrink)

Do facts about what an agent would freely do in certain circumstances at least partly determine any of her moral obligations? Actualists answer ‘yes’, while possibilists answer ‘no’. We defend two novel hybrid accounts that are alternatives to actualism and possibilism: Dual Obligations Hybridism and Single Obligation Hybridism. By positing two moral ‘oughts’, each account retains the benefits of actualism and possibilism, yet is immune from the prima facie problems that face actualism and possibilism. We conclude by highlighting (...) one substantive difference between our two hybrid accounts. (shrink)

Aim: This research determined the relationship between university teachers’ professional identity and their work performance. -/- Methodology: The design that was used in this study is a Descriptive Comparative- Correlational research design using the quantitative approach. Participants in this study were taken from the 967 university teachers at Guangdong Business and Technology University from the 14 colleges. They were chosen randomly. The researcher used the Qualtrics calculator at a 5% margin of error to arrive at 275 respondents. Data analyses (...) include frequency count and percentage, weighted mean, and descriptive equivalent. A five-point scale was used in this study as a guide to answer the questionnaire. -/- Results: Based on the result, the highest manifestation of teachers’ professional identity was found to be on their professional behavior tendency which was ranked first among the four indicators. It was followed by professional values and professional belonging, while role values tend to be the least manifested professional identity based on the self -assessment of the teachers. The over-all mean value of 3.52 reveals that professional identity was highly manifested among the teachers of Guangdong Business and Technology University. Teacher respondents have manifested an outstanding work performance particularly on work attitude as this was given the highest rating by the teachers themselves. Second in rank was the interpersonal promotion, followed by completion of teaching activities which also shows an outstanding work performance. On the other hand, teachers’ work performance on student achievement was given the lowest assessment by the teachers showing a very satisfactory performance. Generally, the result reveals that teachers exhibited an outstanding work performance as perceived by themselves. Based on the result, there were no significant differences in the assessment of teacher respondents when they are grouped according to gender. This is taken to mean that male and female teachers have relatively the same assessment as regards their work performance in terms of work attitude, interpersonal promotion, completion of teaching activities, and student achievement. Generally, the result reveals that there was a significant relationship between the teachers’ professional identity and their work performance. The result reveals that professional identity of teachers has positive impact on their work performance. -/- Conclusion: Respondents are dominated by female teachers who are mostly in their middle age. A good number of teachers who have earned master’s and doctoral degrees are also evident. They perceived themselves to have a high level of professional identity specifically on professional behavior tendency, professional values, and professional belonging. Teachers have relatively the same assessments on their professional identity regardless of their gender, age, educational attainment, and monthly income. They exhibit an outstanding work performance particularly on work attitude, interpersonal promotion, and completion of teaching activities. However, they feel that they had less contribution to student achievement. Teachers have relatively the same assessments on their work performance regardless of their gender, age, educational attainment, and monthly income. Professional identity of teachers can somehow influence their work performance in general. Specifically, professional values and professional belonging give positive effect to work attitude of teachers, and to their completion of teaching activities. (shrink)

It is sometimes argued that non-agent collectives, including what one might call the ‘global collective’ consisting of the world’s population taken as a whole, cannot be the bearers of non-distributive moral obligations on pain of violating the principle that ‘ought implies can’. I argue that one prominent line of argument for this conclusion fails because it illicitly relies on a formulation of the ‘ought implies can’ principle which is inapt for contexts which allow for the possibility of non-distributive plural (...) predications of agency, which are precisely the contexts in which we might expect non-agents to be obligation-bearers. (shrink)

Very often when the vast majority of experts agree on some scientific issue, laypeople nonetheless regularly consume articles, videos, lectures, etc., the principal claims of which are inconsistent with the expert consensus. Moreover, it is standardly assumed that it is entirely appropriate, and perhaps even obligatory, for laypeople to consume such anti-consensus material. I maintain that this standard assumption gets things backwards. Each of us is particularly vulnerable to false claims when we are not experts on some topic – such (...) falsehoods have systematic negative impacts on our doxastic attitudes that we can neither prevent nor correct. So, when there is clear expert consensus on a given scientific issue, while it is permissible for experts to consume anti-consensus material, laypeople have an epistemic obligation to avoid such material. This argument has important consequences for philosophical discussions of our epistemic obligations to perform or omit belief-influencing actions. Such discussions typically abstract away from the important differences between experts and laypeople. Accordingly, we should reject this typical practice as problematic, and insist instead that laypeople and experts have fundamentally different epistemic obligations. (shrink)

Our aim in this paper is to present the distinct ways in which Wolff, Baumgarten, and Kant understand the relationship between necessitation, constraint, and reluctant action in an effort to illustrate the subtle ways in which their conceptions of obligation differ from each another. Whereas Wolff conceives of natural or moral obligation as incompatible with constraint, Baumgarten holds that constraint and reluctant action are, in some instances, compatible with natural obligation. Kant departs from Baumgarten by conceiving of obligation as necessarily (...) involving constraint: as Kant’s reply to Schiller’s famous objection reveals, obligation must take on the character of constraint to reluctant action on account of the fact that human beings possess inclinations that always threaten to impel them in directions that oppose morality. (shrink)

The Problem of Obligation is the problem of how to explain the features of moral obligations that distinguish them from other normative phenomena. Two recent accounts, the Second-Personal Account and the Relational Account, propose superficially similar solutions to this problem. Both regard obligations as based on the claims or legitimate demands that persons as such have on one another. However, unlike the Second-Personal Account, the Relational Account does not regard these claims as based in persons’ authority to address (...) them. Advocates of the Relational Account accuse the Second-Personal Account of falling prey to the Problem of Antecedence. According to this objection, the Second-Personal Account is committed to the implausible claim that we have an obligation to φ only if, and because, others demand that we φ. Since the Relational Account’s proposed solution to the Problem of Obligation does not face the Problem of Antecedence, its advocates argue that it is dialectically superior to the Second-Personal Account. In this paper, I defend the Second-Personal Account by arguing that, first, the Relational Account does not actually solve the Problem of Obligation and, second, the Second-Personal Account does not fall prey to the Problem of Antecedence. (shrink)

In this paper I argue that, in addition to having an obligation to resist the oppression of others, people have an obligation to themselves to resist their own oppression. This obligation to oneself, I argue, is grounded in a Kantian duty of self-respect.

In this paper, I defend the view that it is wrong for us to consume only, or overwhelmingly, media that broadly aligns with our own political viewpoints: that is, it is wrong to be politically “partisan” in our decisions about what media to consume. We are obligated to consume media that aligns with political viewpoints other than our own – to “diversify our sources”. This is so even if our own views are, as a matter of fact, substantively correct.

I explore various ways of integrating the framework for predeterminism, agency, and ability in[P.McNamara, Nordic J. Philos. Logic 5 (2)(2000) 135] with a framework for obligations. However,the agential obligation operator explored here is defined in terms of a non-agential yet personal obligation operator and a non-deontic (and non-normal) agency operator. This is contrary to the main current trend, which assumes statements of personal obligation always take agential complements. Instead, I take the basic form to be an agent’s being obligated (...) to be such that p. I sketch some logics for agential obligation based on personal obligation and agency, first in a fairly familiar context that rules out conflicting personal obligations (and derivatively, conflicting agential obligations), and then in contexts that do allow for conflicts (of both sorts). (shrink)