The advent of COVID-19 has been the occasion for a renewed interest in the principles governing triage when the number of critically ill patients exceeds the healthcare infrastructure’s capacity in a given location. Some scholars advocate that it would be morally acceptable in a crisis to withdraw resources like life support and ICU beds from one patient in favor of another, if, in the judgment of medical personnel, the other patient has a significantly better prognosis. The paper examines the arguments (...) for and against this approach from the point of view of natural law theory, especially using the principle of double effect. We conclude that it is inadmissible to withdraw life-saving medical interventions from patients who are still benefiting from them, on the sole grounds that other patients might benefit more. Those who are currently using such technology should only interrupt their treatment if, in the judgment of medical personnel and, if possible, taking into account the wishes and needs of the patient and his family, the treatment is deemed futile, burdensome, or disproportionate. (shrink)

In a series of articles, I set out my belief that investigators and subjects of research should work together in a partnership based in shared aims. Such a relationship – quite different from what is usual today – would impose duties on both partners. In earlier papers I explored the origin and nature of the duties that would fall on patients; here I examine their limits.

This series of articles argues for a different relationship between investigators and subjects of clinical research based on partnership in shared aims and recognition, by each, of their duties within this partnership. This second essay describes how those duties arise and explores the basis on which, and by and to whom, they are owed. The conclusion that patients have duties in research raises a number of moral issues which, ultimately, question the concept of consent. Discussion of these will be continued (...) in future articles. (shrink)

If patients are to be partners rather than subjects, contributing effectively to clinical research in which they have an interest, both they and investigators must change their ways. The case is argued here that the conduct of clinical research fulfils an essential need of society and that, therefore, in the interests of society, there is a moral imperative that it be done. Further essays will develop this theme, questioning along the way whether consent is a redundant concept.

For Kant, education was understood as the ‘means’ to become human—and that is to say, rational. For Rousseau by contrast, and the many child‐centred educators that followed him, the adult world, far from representing reason, is essentially corrupt and given over to the superficialities of worldly vanity. On this view, the child, as a product of nature, is essentially good and will learn all she needs to know from experience. Both positions have their own problems, but beyond this ‘internal debate’, (...) the change in the content of education (i.e. child‐rearing and schooling) is now furthermore due to a radical pluralism that has swept the world. Moreover, there may be differences in value between individual parents and between values held within the family and those held in society at large. Among other reasons this has put more generally children's (and parents’) ‘rights’ on the agenda, which differs from thinking of education in terms of a ‘practice’. The paper develops this latter concept and the criticisms to which it has been subject and argues that there is no necessary incompatibility between initiation into an existing practice and transforming that practice in some way, if it is emphasized how practices are learned and enacted. It then turns to the tendency in education and child‐rearing, as in other spheres of human interaction, for more laws and codes of conduct and to call upon experts for all kind of matters. It argues that performativity rules on the level of the practitioner, of the experts, and even on the level of educational research. It argues that many governments have adopted in matters of schooling the language of output and school effectiveness and that something similar is now bound to happen in the sphere of child‐rearing (with talk of parenting skills and courses). This is made credible due to a particular model of educational research, i.e. an empiricist quasi‐causal model of explaining human behaviour. The paper then discusses the problems with this stance and argues that we should part company from the entrepreneurial manipulative educator to open up a sphere of responsiveness for the child and that for these reasons, the concept of the ‘practice of child‐rearing’ should be revisited. Insisting on the complexities that have to be taken into account and thus surpassing a discourse of effectiveness and output as well as of codes of conduct and rulings of courts of law, may help us to focus on what is really at stake: to lead a meaningful life, to be initiated into what is ‘real for us’ and what we value. It concludes that thus restoring a place for child‐rearing as a practice will do justice to the responsiveness to which each child is entitled. (shrink)

It is generally acknowledged that school discipline is failing. Through a comparison of two very different disciplinary situations, I inquire into possible causes of failure and conditions of success. The argument is made that if discipline is to succeed, students must believe in and identify with the goals it is designed to support. Questions are raised as to just how embracing (pervasive throughout school life), lofty (transcending the classroom), and moralized (emphasizing social over personal) such goals should be. Without specifying (...) the ideal scope and content of an educational mission, I conclude that a moral component is both practical and proper; for it responds to a child's aspirations, builds self-esteem, and provides the social 'glue' that binds members of a society. (shrink)

The pace of globalisation has quickened considerably in the last ten to fifteen years. The process has yielded benefits but also resulted in conflicts. The benefits would be enhanced if the conflicts could be resolved. One source of conflicts is the desire to maintain cultural identity. Can Confucianism contribute to the working out of a universal global justice that can help resolve conflicts, particularly conflicts of cultural identities? Can it be part of the globalisation process without sacrificing its cultural identity? (...) I argue that it can on both counts and thus it is neither a villain blocking the progress of universal justice, a necessary condition for conflict-free globalisation, nor a helpless victim of that progress. (shrink)

Wolves have a special resonance in many human cultures. To appreciate fully the wide variety of views on wolves, we must attend to the scientific, social, and ethical discourses that frame our understanding of wolves themselves, as well as their relationships with people and the natural world. These discourses are a configuration of ideas, language, actions, and institutions that enable or constrain our individual and collective agency with respect to wolves. Scientific discourse is frequently privileged when it comes to wolves, (...) on the assumption that the primary knowledge requirements are matters of ecology, cognitive ethology, and allied disciplines. Social discourse about wolves implicitly challenges this privilege and provides a rich array of social perspectives on human-wolf relations. Ethical discourse has until recently lagged behind the other two. So too, ethicists are increasingly challenging the adequacy of scientific and social discourse. They do so by calling attention to the value-laden character of all discourse, and the unavoidable ethical questions that confront us as we learn to share the landscape with large predators like wolves. (shrink)

Cartesian scepticism poses the question of how we can justify our belief that other humans experience consciousness in the same way that we do. Wittgenstein’s response to this scepticism is one that does not seek to resolve the problem by providing a sound argument against the Cartesian sceptic. Rather, he provides a method of philosophical inquiry which enables us to move past this and continue our inquiry without the possibility of solipsism arising as a philosophical problem in the first place. (...) In this paper, I propose that Wittgenstein’s method of dismissing the Cartesian sceptic can also be applied to the problems posed by the ‘moral sceptic’, who denies the truth of all ethical or moral claims. I will argue that in the same way Wittgenstein’s focus on public language enables us to dismiss the traditional problem of other minds, a focus on public moral practices or language-games also enables us to dismiss the idea that moral claims are always ‘meaningless’, ‘false’ or ‘nonsensical’. On this account, the moral sceptic is misguided in much the same way as the solipsist who implicitly admits the existence of other minds in her practices. The moral sceptic who still engages in moral activities also implicitly admits the existence of meaningful moral positions. Wittgenstein’s dismissal of the Cartesian sceptic, as I understand it, can be broadly divided into two parts. The first part is an account of language acquisition. This part outlines how we might come to see other humans as conscious, thinking, feeling beings from a causal perspective. This suggests that we can arrive at an understanding of other minds as a primary perception itself - without needing to posit this perception as a kind of deductive or inductive hypothesis. Secondly, we can see how this relates to an epistemic model of language. This focuses on the role of language as something which consists of rule-governed activities, where the existence of other minds is embedded in our understanding of the world as a kind of grammatical rule, rather than an observational hypothesis. From both these arguments the Cartesian sceptic is,, irrelevant to some forms of philosophical inquiry. This is because the sceptic takes the existence of other minds to be a rational hypothesis/inference when it is not. I suggest that this approach can be applied to moral scepticism if we take certain normative claims as grammatical dispositions, rather than rational or metaphysical propositions. Hence, the moral sceptic who offers a rational or logical critique of these moral foundations is not necessarily saying anything relevant to our practices – the moral stances which they refute as rationally meaningless were never based on purely rational or logical hypotheses in the first place. (shrink)

Next SectionCultural differences in end-of-life care and the moral disagreements these sometimes give rise to have been well documented. Even so, cultural considerations relevant to end-of-life care remain poorly understood, poorly guided, and poorly resourced in health care domains. Although there has been a strong emphasis in recent years on making policy commitments to patient-centred care and respecting patient choices, persons whose minority cultural worldviews do not fit with the worldviews supported by the conventional principles of western bioethics face a (...) perpetual struggle in getting their care needs met in a meaningful, safe, and healing way. In this essay, attention is given to exploring why cultural differences exist, why they matter, and how health care providers should treat them in order to reduce the incidence and impact of otherwise preventable harmful moral outcomes in end-of-life care. In addressing these questions, a novel application of the renowned terror management theory will be made. (shrink)

A problem for natural scientific accounts, psychology in particular, is the existence of value. An ecological account of values is reviewed and illustrated in three domains of research: carrying differing loads; negotiating social dilemmas involving agreement and disagreement; and timing the exposure of various visual presentations. Then it is applied in greater depth to the nature of language. As described and illustrated, values are ontological relationships that are neither subjective nor objective, but which constrain and obligate all significant animate activity (...) physically, socially, and morally. As an embodied social activity, conversational dialogue is characterized in terms of values, pragmatics, and presence rather than in terms of syntactic and semantic rules. In particular the nature of dialogical arrays is explored, and the hypothesis that language is an action system, a perceptual system, and a caring system is explored. Language expands horizons and makes it possible for humans to realize their calling as culture makers and caretakers. (shrink)