I served as a medical student and resident in the 1960s. Science as a belief system had reached a pinnacle. Yet Not infrequently in those days, I found myself caring, with little available backup, for a hospital ward filled with sick and dying people. It was a lonely and often frightening responsibility. I began to encounter situations that were at odds with our collective certainty that science would provide the answers. Some of these memories I repressed for almost a decade. (...) I was unable to process them until I had personally experienced a more humanistic side of medicine. (shrink)

Specification is an integral part of Tom L Beauchamp and James F Childress' principlist approach to biomedical ethics. At the same time, the authors give much space conceding to critics that the method has significant limits. Although their pointing to limitations is not unreasonable as such, the emphasis Beauchamp and Childress put on them does not serve countering the critics' view that specification is insufficient for its intended purpose in applied ethics. This paper defends specification against Carson Strong's critique, showing (...) that his casuistic approach shares strong structural and functional similarities with specification. It concludes with the more general point that specification or some closely related method for determining morally relevant facts of concrete cases and issues is indispensable for any account of applied ethics. Beauchamp and Childress should endorse and defend specification more vigorously than they appear to do. (shrink)

Every day, wild animals suffer and die from myriad natural causes. For those committed to non-speciesism, what wild animal suffering entails for us morally is a question of the utmost importance, and yet there remains significant disagreement at the level of normative theory. In this paper I argue that in situations of moral urgency environmental managers and policy makers should refer to widely-agreeable moral principles for guidance. I claim that the principles of beneficence, non-maleficence, autonomy and justice do well to (...) capture our widely-held values, and that the first three principles all support large-scale interventions in nature. I then argue that balancing these against non-maleficence will still allow for the careful consideration of interventions, although is unlikely to support lethal methods. This argument is intended to provide a reasonable starting point for theory-agnostic decision makers, and places the burden of proof on those who oppose intervention. -/- . (shrink)

The idea of moral reform requires that morality be more than a description of what people do value, for there has to be some measure against which to assess progress. Otherwise, any change is not reform, but simply difference. Therefore, I discuss moral reform in relation to two prescriptive approaches to common morality, which I distinguish as the foundational and the pragmatic. A foundational approach to common morality (e.g., Bernard Gert’s) suggests that there is no reform of morality , but (...) of beliefs, values, customs, and practices so as to conform with an unchanging, foundational morality. If, however, there were revision in its foundation (e.g., in rationality), then reform in morality itself would be possible. On a pragmatic view, on the other hand, common morality is relative to human flourishing, and its justification consists in its effectiveness in promoting flourishing. Morality is dependent on what in fact does promote human flourishing and therefore, could be reformed. However, a pragmatic approach, which appears more open to the possibility of moral reform, would need a more robust account of norms by which reform is measured. (shrink)

Even if there is a common morality, many would argue that it provides little guidance in resolving moral disputes, because universally accepted norms are both general in content and few in number. However, if we supplement common morality with commonly accepted factual beliefs and culture-specific norms and utilize coherentist reasoning, we can limit the range of acceptable answers to disputed issues. Moreover, in the arena of public policy, where one must take into account both legal and moral norms, the constraints (...) on acceptable answers will narrow the extent of reasonable disagreement even further. A consideration of the debate over legalization of assisted dying supports this claim. (shrink)

The main question examined is: How do nurses and other healthcare professionals ensure ethical interprofessional collaboration-in-practice as an everyday practice actuality? Ethical interprofessional collaboration becomes especially relevant and necessary when interprofessional practice decisions are contested. To illustrate, two healthcare scenarios are analyzed through three ethics lenses. Biomedical ethics, relational ethics, and virtue ethics provide different ways of knowing how to be ethical and to act ethically as healthcare professionals. Biomedical ethics focuses on situated, reflective, and nonabsolute principled justification, all things (...) considered; relational ethics on intersubjective, professional, and institutional relations; and virtue ethics on prephilosophical tradition and what it means to be good and to be human embedded in social and political community. Analysis suggests that interprofessional collaboration-in-practice may be more rhetoric than actuality. Key challenges of interprofessional collaboration-in-practice and specific conditions perpetuating dissension and conflict are outlined with specific education and policy recommendations included. (shrink)

The main question examined is: How do nurses and other healthcare professionals ensure ethical interprofessional collaboration-in-practice as an everyday practice actuality? Ethical interprofessional collaboration becomes especially relevant and necessary when interprofessional practice decisions are contested. To illustrate, two healthcare scenarios are analyzed through three ethics lenses. Biomedical ethics, relational ethics, and virtue ethics provide different ways of knowing how to be ethical and to act ethically as healthcare professionals. Biomedical ethics focuses on situated, reflective, and nonabsolute principled justification, all things (...) considered; relational ethics on intersubjective, professional, and institutional relations; and virtue ethics on prephilosophical tradition and what it means to be good and to be human embedded in social and political community. Analysis suggests that interprofessional collaboration-in-practice may be more rhetoric than actuality. Key challenges of interprofessional collaboration-in-practice and specific conditions perpetuating dissension and conflict are outlined with specific education and policy recommendations included. (shrink)