Towards Justice and Virtue challenges the rivalry between those who advocate only abstract, universal principles of justice and those who commend only the particularities of virtuous lives. Onora O'Neill traces this impasse to defects in underlying conceptions of reasoning about action. She proposes and vindicates a modest account of ethical reasoning and a reasoned way of answering the question 'who counts?', then uses these to construct linked accounts of principles by which we can move towards just institutions and virtuous lives.

This paper explores the level of obligation called for by Milton Friedman’s classic essay “The Social Responsibility of Business is to Increase Profits.” Several scholars have argued that Friedman asserts that businesses have no or minimal social duties beyond compliance with the law. This paper argues that this reading of Friedman does not give adequate weight to some claims that he makes and to their logical extensions. Throughout his article, Friedman emphasizes the values of freedom, respect for law, and duty. (...) The principle that a business professional should not infringe upon the liberty of other members of society can be used by business ethicists to ground a vigorous line of ethical analysis. Any practice, which has a negative externality that requires another party to take a significant loss without consent or compensation, can be seen as unethical. With Friedman’s framework, we can see how ethics can be seen as arising from the nature of business practice itself. Business involves an ethics in which we consider, work with, and respect strangers who are outside of traditional in-groups. (shrink)

Contemporary philosophy of health has been quite focused on the problem of determining the nature of the concepts of health, illness and disease from a scientific point of view. Some theorists claim and argue that these concepts are value-free and descriptive in the same sense as the concepts of atom, metal and rain are value-free and descriptive. To say that a person has a certain disease or that he or she is unhealthy is thus to objectively describe this person. On (...) the other hand it certainly does not preclude an additional evaluation of the state of affairs as undesirable or bad. The basic scientific description and the evaluation are, however, two independent matters, according to this kind of theory. Other philosophers claim that the concept of health, together with the other medical concepts, is essentially value-laden. To establish that a person is healthy does not just entail some objective inspection and measurement. It presupposes also an evaluation of the general state of the person. A statement that he or she is healthy does not merely imply certain scientific facts regarding the person’s body or mind but implies also a (positive) evaluation of the person’s bodily and mental state. My task in this paper will be, first, to present the two principal rival types of theories and present what I take to be the main kind of reasoning by which we could assess these theories, and second, to present a deeper characterization of the principal rival theories of health and illness. (shrink)

What's wrong with designer children, bionic athletes, and genetic engineering.

To what extent should we use technological advances to try to make better human beings? Leading philosophers debate the possibility of enhancing human cognition, mood, personality, and physical performance, and controlling aging. Would this take us beyond the bounds of human nature? These are questions that need to be answered now.

We all know that doctors accept gifts from drug companies, ranging from pens and coffee mugs to free vacations at luxurious resorts. But as the former Editor-in-Chief of The New England Journal of Medicine reveals in this shocking expose, these innocuous-seeming gifts are just the tip of an iceberg that is distorting the practice of medicine and jeopardizing the health of millions of Americans today. In On the Take, Dr. Jerome Kassirer offers an unsettling look at the pervasive payoffs that (...) physicians take from big drug companies and other medical suppliers, arguing that the billion-dollar onslaught of industry money has deflected many physicians' moral compasses and directly impacted the everyday care we receive from the doctors and institutions we trust most. Underscored by countless chilling untold stories, the book illuminates the financial connections between the wealthy companies that make drugs and the doctors who prescribe them. Kassirer details the shocking extent of these financial enticements and explains how they encourage bias, promote dangerously misleading medical information, raise the cost of medical care, and breed distrust. Among the questionable practices he describes are: the disturbing number of senior academic physicians who have financial arrangements with drug companies; the unregulated "front" organizations that advocate certain drugs; the creation of biased medical education materials by the drug companies themselves; and the use of financially conflicted physicians to write clinical practice guidelines or to testify before the FDA in support of a particular drug. A brilliant diagnosis of an epidemic of greed, On the Take offers insight into how we can cure the medical profession and restore our trust in doctors and hospitals. (shrink)

The importance of business ethics is not contrdicted in any way by Adam Smith’s pointer to the fact that our “regards to our own interests” provide adequate motivation tor exchange. There are many important economic relationships other than exchange, such as the institution of production and arrangements of distribution. Here business ethics can playa major part. Even as far as exchange is concerned, business ethics can be crucially important in terms of organization and behavior, going weil beyond basic motivation.

The normal and the pathological are terms used for structures, activities, individual or collective situations proper to living beings and especially to man. The relation of a fact and a norm is its positive or negative value. Can the assessment of behaviours be reduced to noting a necessity? Is a living being's disease a fact similar to universal attraction? The author maintains that diseases are not merely predetermined effects, but are revealing of a normative regulation proper to living beings and (...) man. (shrink)

Towards Justice and Virtue is Onora O’Neill’s most developed account thus far of her distinctive approach to moral and political philosophy. Readers who are already familiar with O’Neill’s articles and her two previous books will appreciate the way it brings together in one sustained and rigorous argument the various themes which have occupied her attention over the years. Those who are new to O’Neill’s work will find in it a lucid, accessible, and provocative challenge to contemporary ethical theories.

I argue that our traditional conception of the duties imposed by human rights is unable to acknowledge the nature of many contemporary human rights violations. The traditional conception is based on a broadly deontological view according to which human rights impose primarily negative and perfect duties, and these duties are held to be specific prohibitions on certain kinds of actions . I argue that given this conception of the nature of the duties imposed by human rights, not only claims to (...) aid, but in addition, claims against many of the most serious and prevalent contemporary active harms will not count as genuine human rights claims. These harms increasingly result from extremely complex causal chains involving the behaviour of a huge number of agents, few or none of whom can be singled out as responsible for a serious harm to any specific victim. Institutional structures can have just as central a role to play in specifying and allocating responsibility for fulfilling many of the negative duties imposed by human rights as the positive duties. These structures can therefore be equally important in the realisation of both kinds of rights. Before the necessary institutional reforms have taken place, both kinds of rights are equally genuine, and ground the imperative of justice to reform existing social institutions. (shrink)

Imagine first the case of J (who might be anybody, jemand). J used to inhabit a social order, or rather an area within a social order, where socially approved roles were unusually well-defined. Responsibilities were allocated to each such role and each sphere of role-structured activity was clearly demarcated. These allocations and demarcations were embodied in and partly constituted by the expectations that others had learned to have of those who occupied each such role. For those who occupied those roles (...) to disappoint those expectations by failing to discharge their assigned responsibilities was to invite severe disapproval and other sanctions. To refuse to find one's place within the hierarchies of approved roles, or to have been refused a place, because judged unfit for any such role, was to be classified as socially deviant and irresponsible. The key moral concepts that education had inculcated into J were concepts of duty and responsibility. His fundamental moral beliefs were that each of us owes it to others to perform her or his assigned duties and to discharge her or his assigned responsibilities. A good human being performs those duties, discharges those responsibilities, and does not trespass into areas that are not her or his concern. A philosopher who comes across the likes of J will understand his attitudes as cultural parodies, in part of Plato (conceiving of justice as requiring ‘that each do her or his own work and not meddle with many things’ Republic 433a) and in part of Kant (doing one's duty just because it is one's duty and not for the sake of any further end), authors who had influenced J's school teachers. A sociologist will entertain the suspicion that in certain types of social order it may be only in the form of parodies that some types of concept can continue to find expression. But for the moment let us put this thought on one side and return to J. (shrink)

This book explores the controversial relationship between physicians and the pharmaceutical industry, identifies the ethical tensions and controversies, and proposes numerous reforms both for medicine's own professional integrity and for effective public regulation of the industry.

Andrew Carnegie popularized the principles of charity and stewardship in 1899 when he published The Gospel of Wealth. At the time, Carnegie''s ideas were the exception rather than the rule. He believed that businesses and wealthy individuals were the caretakers or stewards of their property holding it in trust for the benefit of society as a whole.One of the most visible ways a business can help a community is through corporate philanthropy. While the courts have ruled that charitable contributions fall (...) within the legal and fiduciary powers of the corporation''s policymakers, some critics have argued that corporate managers have no right to give away company money that does not belong to them and any income earned by the company should be either reinvested in the company or distributed to the stockholders. (shrink)

This paper constitutes a defence of the basic philosophical enterprise of characterising concepts such as disease and health, as well as other medical concepts. I argue that these concepts play important roles, not only in medical, but also in other scientific and social contexts. In particular, medical decisions about health and diseasehood have important ethical, social and economic consequences. The role played is, however, not always a rational one. But the greater is the need for a reconstruction of this network (...) of concepts for the purpose of efficient and rational communication. (shrink)

This paper constitutes a defence of the basic philosophical enterprise of characterising concepts such as 'disease' and 'health', as well as other medical concepts. I argue that these concepts play important roles, not only in medical, but also in other scientific and social contexts. In particular, medical decisions about health and diseasehood have important ethical, social and economic consequences. The role played is, however, not always a rational one. But the greater is the need for a reconstruction of this network (...) of concepts for the purpose of efficient and rational communication. (shrink)

There are individuals, including children, dying needlessly in poverty-stricken third world countries. Many of these deaths could be prevented if pharmaceutical companies provided the drugs needed to save their lives. Some believe that because pharmaceutical companies have the power to save lives, and because they can do so with little effort, they have a special obligation. I argue that there is no distinction, with respect to obligations and responsibilities, between pharmaceutical companies and other types of companies. As a result, to (...) hold pharmaceutical companies especially responsible for saving lives in third world countries is unjustified. (shrink)

When philosophers undertake to say what it is that makes life worth living, they generally display a procrustean habit of thought which the practice of philosophy itself does much to encourage. As a result, they arrive at an image of the human good that is far more controversial than they suspect. The canonical view among philosophers ancient and modern has been, in essence, that the life lived well is the life lived in accord with a rational plan. To me this (...) conception of the human good seems manifestly wrong. The idea that life should be the object of a plan is false to the human condition. It misses the important truth which Proust, by contrast, discerned and made into one of the organizing themes of his great meditation on disappointment and revelation, A la recherche du temps perdu : The happiness that life affords is less often the good we have reason to pursue than the good that befalls us unexpectedly. (shrink)

This paper aims at investigating perfectionism, as the project, shared by biotechnologies and nanotechnologies, of human enhancement. This project is commonly criticized (by Jean-Pierre Dupuy or Michael Sandel) as representing a kind of hyper-agency, a Promethean aspiration to remake nature, including human nature, to serve our purposes, and satisfy our desires. It should thus be addressed as a metaphysical or even theological problem. We would like to argue that this project is not so much Promethean as it is Pelagian. It (...) does not aim so much at being as powerful as God, than at achieving individual, personal felicity, the way Pelagus argued that all men could achieve their own perfection. We argue that the claim of perfectionism is first an ethical one, since it pertains to what Sidgwick called 'egoist hedonism'. We then question this claim from a social point of view: What kind of social relationships is implied by the quest for individual perfectionism. This is an ethical as well as an epistemological question. (shrink)

This book is the first systematic, detailed treatment of the approaches to ethical issues taken by biotech and pharmaceutical companies. The application of genetic/genomic technologies raises a whole spectrum of ethical questions affecting global health that must be addressed. Topics covered in this comprehensive survey include considerations for bioprospecting in transgenics, genomics, drug discovery, and nutrigenomics, as well as how to improve stakeholder relations, design ethical clinical trials, avoid conflicts of interest, and establish ethics advisory boards. The expert authors represent (...) multiple disciplines including law, medicine, bioinformatics, pharmaceutics, business, and ethics. (shrink)