Background/IntroductionInfertile couples that travel to another country for reproductive treatment do not refer to themselves as “reproductive tourists”. They might even be offended by this term. “Tourism” is a metaphor with hidden connotations. We will analyze these connotations in public media discourses on “reproductive tourism” in Israel and Germany. We chose to focus on these two countries since legal, ethical and religious restrictions give couples a similar motivation to travel for reproductive care, while the cultural backgrounds and conceptions of reproduction (...) are different. Results: Our research shows that the use of the metaphor “reproductive treatment” and its hidden messages depends on the writers’ intention and the target population. Although the phenomenon of patients travelling for reproductive treatment can fit into the definitions of tourism, the term emphasizes aspects that do not reflect patients’ reality. In both the German and the Israeli public media debate the term “reproductive tourism” is either used to criticize the economic aspects of the phenomenon or to attract patients as potential clients. Conclusions: Ethicists should be cautious when borrowing metaphors like “reproductive tourism” from the public debate. Our findings support Penning’s suggestion to use instead an unloaded term like cross-border reproductive care to describe the phenomenon in a more neutral way and to make it explicit whenever criticism is necessary. (shrink)

Principles of distributive justice are normative principles designed to guide the allocation of the benefits and burdens of economic activity.

Bioethics has increasingly become a standard part of medical school education and the training of healthcare professionals more generally. This is a promising development, as it has the potential to help future practitioners become more attentive to moral concerns and, perhaps, better moral reasoners. At the same time, there is growing recognition within bioethics that nonideal theory can play an important role in formulating normative recommendations. In this chapter we discuss what this shift toward nonideal theory means for ethical curricula (...) within healthcare education. In particular, we contend that more attention to the particularities of historical and social context needs to be incorporated into bioethics training. To make this argument, we focus on two examples: teaching units on race and medicine and those that focus on stigma and coercion in mental health. For both, we show how a pedagogical approach in which educators focus on social injustice could influence how practitioners engage in ethics in the clinic. This chapter, then, demonstrates what a commitment to nonideal theory can mean practically when it comes to bioethics education. (shrink)

I construct an analysis of social trust that attends distinctively to cooperation in social relations that has the capability to (begin to) counter the default social distrust obtained due to oppressive conditions via a form of collective reasoning. For social trust to overcome oppression it must be a normatively transparent form of trust. Transparent trust can counter the effects of oppression on social interaction and foster social cooperation by correcting unequal positions of social vulnerability and improving disparities in credibility resultant (...) of oppression since collective reasoning in norm legitimization permits all individuals to participate in the process of self and other defining and the development of the concomitant norms that guide these processes. (shrink)

In this article an analysis of ‘trust’ is given and two basic forms of trust are distinguished, viz., trust in powers and trust in inclinations. These forms of trust allow us to gain a better understanding in the pivotal role trust plays in the relationship between caretakers, parents and children. It is argued that it makes no sense to speak about basic mistrust of infants, and that having unlimited trust in the inclinations of adults is only a virtue in children. (...) By having trust in both the powers and inclinations of children, parents stimulate the development of their self-confidence and moral identity. (shrink)

Feminist ethics and medical ethics are critical of contemporary moral theory in several similar respects. There is a shared sense of frustration with the level of abstraction and generality that characterizes traditional philosophic work in ethics and a common commitment to including contextual details and allowing room for the personal aspects of relationships in ethical analysis. This paper explores the ways in which context is appealed to in feminist and medical ethics, the sort of details that should be included in (...) the recommended narrative approaches to ethical problems, and the difference it makes to our ethical deliberations if we add an explicitly feminist political analysis to our discussion of context. It is claimed that an analysis of gender is needed for feminist medical ethics and that this requires a certain degree of generality, i.e. a political understanding of context. (shrink)

If we cannot define science using only analysis or description, then we must rely on imagination to provide us with suitable objects of philosophical inquiry. This process ties our intellectual findings to the particular ways in which we philosophers think about scientific practice and carve out a cognitive space between real world practice and conceptual abstraction. As an example, I consider Heather Douglas’s work on the responsibilities of scientists and document her implicit ideal of science, defined primarily as an epistemic (...) practice. I then contrast her idealization of science with an alternative: “technoscience,” a heuristic concept used to describe nanotechnology, synthetic biology, and similar “Mode 2” forms of research. This comparison reveals that one’s preferred imaginary of science, even when inspired by real practices, has significant implications for the distribution of responsibility. Douglas’s account attributes moral obligations to scientists, while the imaginaries associated with “technoscience” and “Mode 2 science” spread responsibility across the network of practice. This dynamic between mind and social order, I argue, demands an ethics of imagination in which philosophers of science hold themselves accountable for their imaginaries. Extending analogous challenges from feminist philosophy and Mills’s. “Ideal Theory’ as Ideology,” I conclude that we ought to reflect on the idiosyncrasy of the philosophical imagination and consider how our idealizations of science, if widely held, would affect our communities and broader society. (shrink)

This essay distinguishes three types of appeals to experience in ethics, identifies problems with appealing to experience, and argues that appeals to experience must be open to critical assessment, if experientially-based arguments are to be useful. Unless competing and potentially irreconcilable experiences can be assessed and adjudicated, experientially-based arguments will be problematic. The paper recommends thinking of the appeal to experience as a kind of storytelling to be evaluated as other stories are.

Virginia Held's Feminist Morality defends the idea that it is possible to transform the “public” sphere by remaking it on the model of existing “private” relationships such as families. This paper challenges Held's optimism. It is argued that feminist moral inquiry can aid in transforming the public sphere only by showing just how much the allegedly “private” realms of families and personal relationships are shaped—and often misshapen—by public demands and concerns.

Virginia Held's Feminist Morality defends the idea that it is possible to transform the "public" sphere by remaking it on the model of existing "private" relationships such as families. This paper challenges Held's optimism. It is argued that feminist moral inquiry can aid in transforming the public sphere only by showing just how much the allegedly "private" realms of families and personal relationships are shaped-and often misshapen-by public demands and concerns.

Ethics guidance and ethical frameworks are becoming more explicit and prevalent in health policy proposals. However, little attention has been given to evaluating their roles and impacts in the policy arena. Before this can be investigated, fundamental questions must be asked about the nature of ethics in relation to policy, and about the nexus of the fields of applied ethical analysis and health policy analysis. This paper examines the interdisciplinary stretch between bioethics and health policy analysis. In particular, it highlights (...) areas of scholarship where a health policy ethicsspecialization—as distinctive from bioethics—might develop to address health policy concerns. If policy and ethics both ask the same question, that question is: “What is the good, and how do we achieve (create, protect, cultivate) it?” To answer this question, the new field of “health policy ethics” requires development. First, we should develop a full set of ethical principles and complementary ethical theories germane to public policy per se. Second, we must understand better how explicit attention to ethical concerns affects policy dynamics. Third, we require new policy and ethical analytic approaches that contribute to constructive (not obstructive) policy making. Finally, we need indicators of robust, high quality ethical analysis for the purpose public policy making. (shrink)

Throughout the development of an "ethic of care" different from an "ethic of justice," the relationship between the two has been problematic. Are they theories between which one must choose? Are they complementary? Are they domain-specific? In support of my view that neither is adequate by itself, I here examine the private domain of care of the dying by intimates, and find there important issues both of care and of justice.

It may be thought that the ethics of care has developed important insights into the moral values involved in the caring practices of family, friendship, and personal caregiving, but that the ethics of care has little to offer in dealing with violence. The violence of crime, terrorism, war, and violence against women in any context may seem beyond the ethics of care. Skepticism is certainly in order if it is suggested that we can deal with violence simply by caring. Violence (...) seems to call for the harsh arm of law and enforcement, not the soft touch of care. Elsewhere I have discussed how the ethics of care would recommend respect for international law and how it would thus approach issues of military intervention. I will concentrate here on how the ethics of care can contribute guidance in dealing with family violence and in confronting terrorism. (shrink)

. Morality is often dismissed as irrelevant in what is seen as the global anarchy of rival states each pursuing its national interest. When morality is invoked, it is usually the morality of justice with its associated moral conceptions of individual rights, equality, and universal law. In the area of moral theory, an alternative moral approach, the ethics of care, has been developed in recent years. It is beginning to influence how some see their global responsibilities.

: Many activities formerly not in the market are being "marketized," and women's labor is increasingly in the market. I consider the grounds on which to decide what should and what should not be "in" the market. I distinguish work that is paid from work done under "market norms," and argue that market values should not have priority in education, childcare, healthcare, and many other activities. I suggest that a feminist ethics of care is more promising than Kantian ethics or (...) utilitarianism for recommending social decisions concerning limits on markets. (shrink)

"The Personal is Political": This was an often-heard slogan of feminist groups in the late sixties and early seventies. The slogan is no doubt open to many interpretations. There is one interpretation which touches on the epistemology of social facts, viz. the slogan claims that in assessing the features of a political system, personal experiences have privileged evidentiary value. For instancte, in the face of third person reports about political corruption, I may remain unmoved in my belief that the political (...) powers are morally upstanding, and it is only when I myself am adversely affected, that I come to change my views. There are two standard patterns of explanation of this type of belief formation: (i) We know that third-person reports may be lessreliable than first-person experiences; (ii) If the third-person reports are no less reliable than first-person experiences, we may just be dealing with a standard pattern of epistemic irrationality. However, we argue that there is also a much more surprising pattern of explanation: under certain conditions, a Bayesian argument can be proffered to the effect that it is rational to change one's beliefs in the face of personal experiences and not in the face of third-person reports, even if these experiences and reports are equally reliable. Hence, the feminist slogan (at least on one particular interpretation of it) receives unexpected support from Bayesian comers. We also show that this pattern of explanation has surprising repercussions on the question of the evidentiary value of miracles in philosophy of religion. (shrink)

In "The Virtues of Sharing" I defend two central theses: that sharing is our most overarching ethical ideal, and that virtue ethics is able to serve as a comprehensive and free-standing approach to moral theory. My arguments for these theses are intertwined, because they are also designed to show how a virtue-ethical theory that treats the "Will to Share" as the basis of moral agency helps to resolve the contemporary Justice/Care Debate.