(2014). Getting Even More Specific About Physicians’ Obligations: Justice, Responsibility, and Professionalism. The American Journal of Bioethics: Vol. 14, No. 9, pp. 46-47.

Organ tourism occurs when individuals in countries with existing organ transplant procedures, such as the United States, are unable to procure an organ by using those transplant procedures in enough time to save their life. In this paper, I am concerned with the following question: When organ tourists return to the United States and need another transplant, do US transplant physicians have an obligation to place them on a transplant list? I argue that transplant physicians have a duty not to (...) relist organ tourists. Specifically, I contend that we should locate physicians’ duties in these cases within the new role of “transplant physician.” This role results from transplant physicians’ participation in a system that depends on organ donors’ voluntary act of donation. (shrink)

abstract Trusting agents characteristically anticipate beneficial outcomes, under conditions of uncertainty, in their engagement with others. However, debates about trust incorporate different interpretations of risk, uncertainty, calculation, affect, morality and motivation in explaining when trust is appropriate and how it operates. This article argues that discussions about trust have produced a concept without coherent boundaries and with little operational value. Two paradigms are identified, which distinguish the characteristics of trust and confidence. It is argued that a reliance on confidence in (...) human affairs makes trust redundant and that this has undesirable moral consequences. Discussion is illustrated by the UK Government's ‘modernisation’ policy in health and social care, which privileges confidence in systems over trust in moral agents. (shrink)

This paper challenges the leading common morality accounts of medical ethics which hold that medical ethics is nothing but the ethics of everyday life applied to today’s high-tech medicine. Using illustrative examples, the paper shows that neither the Beauchamp and Childress four-principle account of medical ethics nor the Gert et al 10-rule version is an adequate and appropriate guide for physicians’ actions. By demonstrating that medical ethics is distinctly different from the ethics of everyday life and cannot be derived from (...) it, the paper argues that medical professionals need a touchstone other than common morality for guiding their professional decisions. That conclusion implies that a new theory of medical ethics is needed to replace common morality as the standard for understanding how medical professionals should behave and what medical professionalism entails. En route to making this argument, the paper addresses fundamental issues that require clarification: what is a profession? how is a profession different from a role? how is medical ethics related to medical professionalism? The paper concludes with a preliminary sketch for a theory of medical ethics. (shrink)

In pediatric health care, parents and clinicians sometimes have competing ideas of what should be done for a child. In this article, we explore the idea that notions of what should be done for a child partly depend on one's perception of one's role in the child's life and care. Although role‐based appeals are common in health care, role‐differentiated approaches to understanding parent‐clinician conflicts are underexplored in the pediatric bioethics literature. We argue that, while the parental role is recognized as (...) having social content or value, and sometimes legal force, it is not always recognized as having ethical content or value, as the clinician's role is. We draw together key insights from the normative and empirical literature on parental roles to show how a role‐based lens might inform clinicians’ and clinical ethicists’ approach to cases in which parents and clinicians disagree. (shrink)

The same person can make different moral judgments about the same activity in their professional role and in their personal life. For example, people may follow a different moral code when making purchases at work compared with in their private lives. This potential difference has largely remained unexamined. This study explores differences in felt moral responsibility in workplace and private purchasing settings, regarding the impacts of purchasing decisions on supply chain workers, and explores the influence of personal values and ethical (...) work climate. The case of a high-profile university in the United Kingdom is studied, which has made strong commitments to socially responsible public procurement. Based on a survey of 318 university staff who make purchases at work, stronger moral values related to harm/care are associated with higher felt responsibility in personal purchasing than in workplace purchasing, whereas less strong harm/care values are associated with higher felt responsibility in workplace purchasing than personal purchasing. In relation to ethical work climate, detailed awareness of organizational ethical procurement commitments is found to be associated with higher felt responsibility in workplace purchasing and is also found to increase the discrepancy between workplace and personal felt responsibility, increasing felt responsibility in the workplace but not in personal purchasing. These findings demonstrate the influence of individual and contextual factors on felt responsibility across different roles. Recommendations are made for further empirical research on felt responsibility across roles and additional internal communication on social responsibility for devolved public procurement contexts. (shrink)

Doernberg and Truog (2023) claim that physicians increasingly serve in multiple roles outside the traditional clinical encounter, roles with various and divergent aims that nonetheless “invoke the...

Doernberg and Truog (2023) present a thoughtful analysis of the ethical tensions that arise from physicians increasingly occupying “multiple roles in healthcare”1 I take no issue with the classific...

The medical profession contains five “spheres of morality”: clinical care, clinical research, scientific knowledge, population health, and the market. These distinct sets of normative commitments require physicians to act in different ways depending on the ends of the activity in question. For example, a physician-scientist emphasizes patients’ well-being in clinic, prioritizes the scientific method in lab, and seeks to maximize shareholder returns as a board member of a pharmaceutical firm. Physicians increasingly occupy multiple roles in healthcare and move between them (...) frequently, creating the possibility of conflict between the ethical obligations of their various roles. This paper examines the entire moral landscape of medicine through the lens of role morality. It develops a novel framework that helps physicians recognize how their moral commitments depend on the nature and context of the situation, clarifies ethical conflicts that physicians face, and concludes with ideas for resolving these conflicts. (shrink)

Public relations helps an organisation and its publics adapt mutually to each other. However, this does not mean that the profession is value neutral or anything goes. There will be cases where professionals have to make discretionary ethical decisions and negotiate their roles and responsibilities, especially when faced with novel or difficult issues. In this conceptual paper, we describe how the notion of professional role morality not only shapes the individual struggles that practitioners endure but also highlights the organisational structures (...) that foster or shun ethics in the decision-making process. Thus we provide a means of assessing professional action that balances the urge to become a hired gun who simply abdicates personal responsibility and completely adopts the employer’s moral viewpoint on the one hand, and moral torpedoes who rely exclusively on their personal views without any concern for wider implications on the other. Investigating role morality as played out in public relations is important because it may explain why practitioners often find themselves at odds with their best moral judgments. Here we present five fictionalised narratives to illustrate the conceptual issues and highlight the most significant moral distinctions that have practical consequences for both the theory and practice of public relations. (shrink)