The ethical theories employed in health care today assume, in the main, a modern Western philosophical framework. Yet the diversity of cultural and religious assumptions regarding human nature, health and illness, life and death, and the status of the individual suggest that a cross-cultural study of health care ethics is needed. A Cross-Cultural Dialogue on Health Care Ethics provides this study. It shows that ethical questions can be resolved by examining the ethical principles present in each culture, critically assessing each (...) value, and identifying common values found within all traditions, It encourages the development of global awareness and sensitivity to and respect for the diversity of peoples and their values and will advance understanding as well as help to foster a greater balance and a fuller truth in consideration of the human condition and what makes for health and wholeness. (shrink)

Analytic moral philosophers have generally failed to engage in any substantial way with the cultural history of morality. This is a shame, because a genealogy of morals can help us accomplish two important tasks. First, a genealogy can form the basis of an epistemological project, one that seeks to establish the epistemic status of our beliefs or values. Second, a genealogy can provide us with functional understanding, since a history of our beliefs, values or institutions can reveal some inherent dynamic (...) or pattern which may be problematically obscured from our view. In this paper, I try to make good on these claims by offering a sketchy genealogy of emancipatory values, or values which call for the liberation of persons from systems of dominance and oppression. The real history of these values, I argue, is both epistemologically vindicatory and functionally enlightening. (shrink)

While Hegel’s political philosophy has been attacked on the left by republican democrats and on the right by feudalist reactionaries, his apologists see him as a liberal reformer, a moderate who theorized about the development of a free-market society within the bounds of a stabilizing constitutional state. This centrist view has gained ascendancy since the end of the Second World War, enshrining Hegel within the liberal tradition. In this book, Renato Cristi argues that, like the Prussian liberal reformers of his (...) time, Hegel was committed to expand the scope of a free economy and concurrently to ensure that the social practice of subjective freedom did not endanger political stability and order. Aware that a system of mutual advantage failed to integrate the members of civil society and that profound social disharmonies were ineradicable, Hegel adopted the views of the French liberal _doctrinaires_, who sought to realize the principles of the French Revolution by supporting Louis XVIII’s sovereign assertion of the monarchical principle. Not surprisingly, Hegel hailed the French _Charte_ of June 1814 as a beacon of freedom. Endorsement of the monarchical principle was meant to prevent the atomized individuals of civil society from gaining control of the state through appeals to popular sovereignty. This challenges most conventional interpretations of Hegel’s theory of the state and draws it closer to the conservative-authoritarian end of the political spectrum than is usual. (shrink)

The aim of this paper is to address the problem of unemployment. Economists generally agree that a zero rate of unemployment is not only unattainable but also undesirable within capitalism. This is problematic because, as it will be shown, unemployment has adverse effects on both individuals and societies. Assuming that the primary aim of economics is to improve people’s lives, it behooves us to find a solution to the problem of unemployment. Two solutions will be offered. The first works within (...) the confines of the capitalist system –it requires instituting welfare policies that alleviate the adverse effects of unemployment. The second involves a paradigm change –it requires replacing capitalism with an alternative economic system that is consistent with a zero rate of unemployment. (shrink)

What do we want from a theory of justice? Amartya Sen argues that what we should not want is to follow the social contract approach revived by John Rawls, or transcendental institutionalism, in its preoccupation with perfectly just institutions. Sen makes an effective case against approaches, such as G. A. Cohen’s, concerned with transcendent, fact-independent principles of justice, but not against Rawls’ constructivist approach to justice when this is properly interpreted as making a weak transcendental argument. Situating Rawls’ approach within (...) the tradition of the liberalism of freedom provides a basis for interpreting his Kantian constructivism as a form of transcendental institutionalism, and for revealing the affinities between Rawls’ idea of reflective equilibrium and Jürgen Habermas’ method of rational reconstruction. Such a Kantian conception of justice, concerned with constituting relations of equal liberty between free and equal citizens, remains essential for orienting our pursuit of justice. (shrink)

Social contract thought has always contained multiple and mutually conflicting lines of argument; the minimalist contractarianism so influential today represents the weaker of two main constellations of claims. I make the case for a Kantian contract theory that emphasizes the bedrock principle of consent of the governed instead of the mere heuristic device of the exit from the state of nature. Such a shift in emphasis resolves two classic difficulties: tradi- tional contract theory’s ahistorical presumption of a pre-political settlement, and (...) its impossibly high demands on citizens seeking to practice self-rule. Kant’s solutions to these problems of property rights and citizenship are found in his political works, rather than the ethical works through which Kant’s political theory is usually interpreted. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Joseph de Maistre’s Civilization and its DiscontentsGraeme GarrardIn his study of Sigmund Freud’s social and political thought Paul Roazen claims that Freud was the first to depict the human psyche as torn between two fundamentally antithetical tendencies:The notion of a human nature in conflict with itself, disrupted by the opposition of social and asocial inclinations, the view that the social self develops from an asocial nucleus but that the (...) social trends are also dynamic and emotional in nature, and finally the conception that reason’s control can be extended by a detailed knowledge of the repressed asocial tendencies—all this was not known before Freud. 1Although Freud is undoubtedly the most famous modern exponent of this conception of human nature at war with itself, he was by no means its first, let alone only, proponent. Kant, for example, wrote of the “unsocial sociability of men” over a century earlier. 2 An even more unlikely precursor of this basic assumption of Freudian social psychology is the Catholic reactionary Joseph de Maistre (1753–1821). The social theory elaborated by this arch-paladin of throne and altar—who was, quite literally, plus royalist que le roi, plus catholique que le Pape—is strikingly similar to that expressed by Freud in his famous essay Civilization and Its Discontents (1929). 3 [End Page 429]Both conceived of the individual as “a being both social and evil,” 4 perpetually struggling to prevent the innate aggressiveness of the species from plunging society into a Hobbesian war of all against all. That is why Freud insisted that it “has to use its utmost efforts in order to set limits to man’s aggressive instincts,” 5 a view advanced over a century earlier by Maistre. Events in Europe after 1789 led many conservatives such as Maistre, as events after 1914 would lead Freud, to reject the common Enlightenment view of human beings as naturally sociable and of social life as a reflection of the spontaneous harmony of a natural world governed by laws established by God and discoverable by reason. In Maistre’s view, social and political life are better understood as the artificial and fundamentally precarious imposition of order on the violent flux of nature. Anticipating Freud, he asserts that individuals, if left to their own devices in society, would soon be plunged into a state of social warfare identical to that which Hobbes had attributed to the state of nature. His particular brand of extreme conservative thought derives its social and political authoritarianism from these deeply pessimistic social assumptions, which leave him with more in common (on this subject) with Freud than with either the Enlightenment or fellow conservatives such as Edmund Burke.Homo Homini LupusThe pessimistic, even tragic, argument of Civilization and Its Discontents is that human beings are driven by extremely powerful instincts, the full satisfaction of which is incompatible with social life. According to Freud, the “cultural frustration” that ensues from this incompatibility “dominates the large field of social relationships between human beings. As we already know, it is the cause of the hostility against which all civilizations has to struggle.” 6 Unhappiness, understood as the non-satisfaction of these basic libidinal urges, is therefore a necessary part of human association. “One feels inclined to say that the intention that man should be ‘happy,’” Freud writes pessimistically, “is not included in the plan of ‘Creation.’” 7Freud also argues that, in addition to these basically erotic instincts, there is a “constitutional inclination in human beings to be aggressive towards one another,” 8 which “constitutes the greatest impediment to civilization.” 9 [End Page 430] This ineliminable tendency accounts for Freud’s Hobbesian view of the precariousness of civilization: 10[M]en are not gentle creatures who want to be loved, and who at the most can defend themselves if they are attacked; they are, on the contrary, creatures among whose instinctual endowments is to be reckoned a powerful share of aggressiveness. As a result, their neighbour is for them not only a potential helper or sexual object, but also someone who tempts them to satisfy their aggressiveness on him, to exploit his capacity for work without compensation, to... (shrink)

At several points in his writings, Levinas is implicitly critical of Hobbes's view that the political order is required to restrict violent conflict and competition and make morality possible. This paper makes Levinas's criticisms explicit by comparing Hobbes's descriptions of human nature and human relations with Levinas's radically different descriptions of the ethical relation of responsibility and the consequent kinship of the human community. I use insights from Levinas to argue that ethics cannot be reduced to politics and that the (...) primacy of the ethical relation provides a more adequate description of human relations and justice in the human community. (shrink)

This paper critically examines moral contractarianism, a moral theory centred on rational agreements among self-interested individuals to establish moral rules and social norms. It explores the challenges faced by moral contractarianism while also highlighting its strengths. Major issues, such as accommodating justice and fairness within the contractarian framework, are discussed, along with other challenges. Additionally, the paper provides a brief discussion of moral contractualism (a theory similar to moral contractarianism in certain aspects), highlighting its strengths in addressing some of the (...) challenges faced by moral contractarianism while also discussing its limitations. The paper concludes by offering a revised framework of moral contractarianism that provides solutions to the major problems of injustice and partiality that the theory faces. (shrink)

Thomas Hobbes has recently been cast as one of the forefathers of political realism. This article evaluates his place in the realist tradition by focusing on three key themes: the priority of legit...

Over the last 50 years, the term professionalism has undergone a widespread expansion in its use and a semantic shift in its meaning. As a result, it is at risk of losing its descriptive and analytical value and becoming instead simply an empty evaluative label, a fate described by C. S. Lewis as ‘verbicide’. This article attempts to rescue professionalism from this fate by down-sizing its extension and reassigning some of its work to two other ethical domains, introduced as the (...) neologisms organizationalism and sur-moralism. Professionalism is defined as a morality based in system of obligations that are assumed by physicians over the course of their professional training and which primarily refer to two groups: patients and colleagues, including trainees. Organizationalism is also a morality, but the obligations are owed to the employing organization and on different grounds. A third ethical domain, here called sur-moralism, comprises actions that are not based in obligations. They are discretionary and potentially meritorious; they cannot be required by the profession or organization. This article presents a conceptual model of the three ethical domains and the shifting borders between them. One practical benefit of this typology is that physicians can more accurately understand the nature and sources of obligations that they are asked to accept, and when necessary prioritize them. Another is that physicians will be able to describe the potential tension between the three domains and understand how and why the borders between them can move. Both should help physicians to be more ethically oriented to their work settings. (shrink)

Thomas Hobbes has recently been cast as one of the forefathers of political realism. This article evaluates his place in the realist tradition by focusing on three key themes: the priority of legitimacy over justice, the relation between ethics and politics, and the place of imagination in politics. The thread uniting these themes is the importance Hobbes placed on achieving a moral consensus around peaceful coexistence, a point which distances him from realists who view the two as competing goals of (...) politics. The article maintains that only a qualified version of the autonomy of the political position can be attributed to Hobbes, while arguing more generally that attending to the relation between ethics and politics is central to assessing his liberal credentials from a realist perspective. Against the prevalent reading of Hobbes as a hypothetical contract theorist, the article proceeds to show that the place of consent in his theory is better understood as part of his wider goal of transforming the imagination of his audience: a goal which is animated by concerns that realists share. (shrink)

Despite the strength of arguments for veganism in the animal rights literature, alongside environmental and other anthropocentric concerns posed by industrialised animal agriculture, veganism remains only a minority standpoint. In this paper, I explore the moral motivational problem of veganism from the perspectives of moral psychology and political false consciousness. I argue that a novel interpretation of the post-Marxist notion of political false consciousness may help to make sense of the widespread refusal to shift towards veganism. Specifically, the notion of (...) false consciousness fills some explanatory gaps left by the moral psychological notion of akrasia, often understood to refer to a weakness of will. Central to my approach is the idea that animal exploitation is largely systemic and the assumption that moral motivation is inseparable from moral thinking. In this light, the primary obstacle to the adoption of veganism arises not so much from a failure to put genuine beliefs into action, but rather in a shared, distorted way of thinking about animals. Thus, common unreflective objections to veganism may be said to be manifestations of false consciousness. (shrink)

The comparison between the concept state of nature, as it appears in the contractualist theories of XVII and XVIII centuries, and the original position of the the- ory of justice by John Rawls, reveals the assumptions, difficulties and limitations of the latter. In spite of its claims, the original position does not justify the search and existence of a well ordered society, and it is far away from reach the brightness and coherence with which their predecessors argued on behalf of (...) societies where safety, freedom or equality ruled. Besides, Rawls, on amounting justice to a material welfare which must arrive, does not know the important role that the historical memory plays when claiming the resolution of the injustices from the pastLa comparación entre el concepto de estado de naturaleza, tal y como aparece en las teorías contractualistas de los siglos XVII y XVIII, y la posición original de la teoría de la justicia de John Rawls, sirve para poner de manifiesto los supuestos, dificultades y limitaciones de esta última. A pesar de sus pretensiones, la posición original no justifica la búsqueda y existencia de una sociedad bien ordenada, y está lejos de alcanzar la brillantez y coherencia con la que sus antecesores argumentaron a favor de sociedades donde reinara la seguridad, la libertad o la igualdad. Además, Rawls, al reducir la justicia a un bienestar material que ha de llegar, desconoce el importante papel que la memoria histórica desempeña a la hora de reclamar la resolución de las injusticias del pasado. (shrink)

Political philosophers tend to think that Rousseau is significant because his contractarianism anticipates Kant. However, reading Rousseau in this way requires us to ignore his frequent and emphatic appeals to the role of happiness as collective flourishing in establishing the rational authority of justice. I offer a reading of Rousseau’s political theory which accounts for this eudaimonistic aspect of his thought. I argue that for Rousseau, as for Kant, obligations are structured by the autonomous willing of agents who bind themselves (...) by the norms of reason alone. But unlike Kant, Rousseau thinks that such formal considerations of rational autonomy provide necessary but not sufficient reasons for fulfilling our duties to one another. This is because the ultimate reason for valuing individual autonomy is that it enables the flourishing of individuals insofar as they are members of a just political community. (shrink)

The main question explored by the book is: How can cross-border access to human genetic resources, such as blood or DNA samples, be governed in such a way as to achieve equity for vulnerable populations in developing countries? The book situates the field of genomic and genetic research within global health and research frameworks, describing the concerns that have been raised about the potential unfairness in exchanges during recent decades. Access to and sharing in the benefits of human biological resources (...) are aspects not regulated by any international legal framework such as the Convention on Biological Diversity, which applies only to the exchange of plants, animals and microorganisms, as well as to associated traditional knowledge. Examples of genetic research perceived as exploitative are provided in order to illustrate the legal vacuum concerning the global governance of human genetic resources. The main conclusions drawn from the legal and ethical analysis are: - Benefit sharing is crucial in order to avoid the exploitation of developing countries in human genetic research. - With functioning research ethics committees, undue inducement is less of a concern in genetic research than in other areas of medical research (e.g. clinical trials). - Concerns remain over research involving indigenous populations; accordingly, recommendations are provided. In drawing these conclusions, the book addresses in detail a highly pressing topic in global bioethics and international law. In this regard, it combines bioethical arguments with jurisprudence, in particular with reference to the law of equity and the legal concepts of duress (coercion), unconscionable dealing, and undue inducement. (shrink)

This article proposes a specific logic of dynamics for integrative social contracts theory that combines two empirically oriented process extensions strengthening concreteness of Donaldson and Dunfee’s conceptualization, namely international policy regime theory and Tiebout migration. While either would help “dynamize” and “concretize” ISCT, the two combined are even more insightful. Real-world policy regime processes can develop concrete action-guiding norms instantiating hypernorms to guide business decisions. Donaldson and Dunfee placed empirical reliance on expectation of converging parallel evolution of universal principles and (...) authentic local values. ISCT remains vague on how global or local norms can develop and change, for two reasons. First, ISCT does not explain mechanisms for how proposed hypernorms can become actual global norms and also become accepted across extant authentic communities. International policy regime theory explains how hypernorms can become instantiated as global norms expressed in policy regimes. Second, a basic element in ISCT is implied consent positing free exit from voluntary moral communities. Empirically, individuals or businesses may be unable to exit from undesired membership in authentic communities to which they do not consent. The Tiebout migration model provides valuable insights concerning how substantive mobility or its absence improves on the minimum ISCT assumption of implied consent. An integrated logic of ISCT dynamics generates a three-level framework in which instantiated hypernorms and authentic community norms can empirically change, and individuals or businesses can migrate more freely across extant communities. (shrink)

The alliance of pure market economies with democratic polities has traditionally been a problematic one. It is argued that orthodox theoretical conceptualizations of market behaviour and the application of such theory to our communal lives have entrenched an incoherent alliance. In particular, the reductive mechanism characteristic of both neo-classical economic theory and its deployment in our socio-economic order has severely undermined the telic agency required for the autonomy or self-rule definitive of an authentic democratic order. Such reduction is observed to (...) function through the disabling of the cognitive capacity of consumers and by disempowering the agency of workers such that coercion is misconceived as freely agreed contract. (shrink)