This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

In "Upheavals of Thought", Martha Nussbaum offers a theory of the emotions. She argues that emotions are best conceived as thoughts, and she argues that emotion-thoughts can make valuable contributions to the moral life. She develops extensive accounts of compassion and erotic love as thoughts that are of great moral import. This paper seeks to elucidate what it means, for Nussbaum, to say that emotions are forms of thought. It raises critical questions about her conception of the structure of emotion, (...) and about her conception of compassion, in particular. Finally, the paper seeks to show how analyzing the structure, as well as the moral value, of the emotions ultimately requires entering the realm of religious ethics. (shrink)

A scholarly edition of a work by David Hume. The edition presents an authoritative text, together with an introduction, commentary notes, and scholarly apparatus.

Jesse Prinz argues that recent work in philosophy, neuroscience, and anthropology supports two radical hypotheses about the nature of morality: moral values are based on emotional responses, and these emotional responses are inculcated by culture, not hard-wired through natural selection. In the first half of the book, Jesse Prinz defends the hypothesis that morality has an emotional foundation. Evidence from brain imaging, social psychology, and psychopathology suggest that, when we judge something to be right or wrong, we are merely expressing (...) our emotions. Prinz argues that these emotions do not track objective features of reality; rather, the rightness and wrongness of an act consists in the fact that people are disposed to have certain emotions towards it. In the second half of the book, he turns to a defense of moral relativism. Moral facts depend on emotional responses, and emotional responses vary from culture to culture. Prinz surveys the anthropological record to establish moral variation, and he draws on cultural history to show how attitudes toward practices such as cannibalism and marriage change over time. He also criticizes evidence from animal behavior and child development that has been taken to support the claim that moral attitudes are hard-wired by natural selection. Prinz concludes that there is no single true morality, but he also argues that some moral values are better than others; moral progress is possible. Throughout the book, Prinz relates his views to contemporary and historical work in philosophical ethics. His views echo themes in the writings of David Hume and Friedrich Nietzsche, but Prinz supports, extends, and revises these classic theories using the resources of cutting-edge cognitive science. The Emotional Construction of Morals will stimulate and challenge anyone who is curious about the nature and origin of moral values. (shrink)

This edition includes an Introduction by David Cartwright, a translator’s preface, biographical note, selected bibliography, and an index.

Despite its linguistic roots in ancient Greek, the concept of empathy is of recent intellectual heritage. Yet its history has been varied and colorful, a fact that is also mirrored in the multiplicity of definitions associated with the empathy concept in a number of different scientific and non-scientific discourses. In its philosophical heyday at the turn of the 19th to the 20th century, empathy had been hailed as the primary means for gaining knowledge of other minds and as the method (...) uniquely suited for the human sciences, only to be almost entirely neglected philosophically for the rest of the century. Only recently have philosophers become again interested in empathy in light of the debate about our folk psychological mindreading capacities. In the second half of the last century, the task of addressing empathy was mainly left to psychologists who thematized it as a psychological phenomenon and process to be studied by the method of the empirical sciences. Particularly, it has been studied by social psychologists as a phenomenon assumed to be causally involved in creating prosocial attitudes and behavior. Nevertheless, within psychology it is at times difficult to find agreement of how exactly one should understand empathy; a fact of which psychologists themselves have become increasingly aware. The purpose of this entry is to clarify the concept of empathy by surveying its history in various philosophical and psychological discussions and by indicating why empathy was and should be regarded to be of such central importance in understanding human agency in ordinary contexts, in the human sciences and for the constitution of ourselves as social and moral agents. (shrink)

Recent work in cognitive science provides overwhelming evidence for a link between emotion and moral judgment. I review findings from psychology, cognitive neuroscience, and research on psychopathology and conclude that emotions are not merely correlated with moral judgments but they are also, in some sense, both necessary and sufficient. I then use these findings along with some anthropological observations to support several philosophical theories: first, I argue that sentimentalism is true: to judge that something is wrong is to have a (...) sentiment of disapprobation towards it. Second, I argue that moral facts are response-dependent: the bad just is that which cases disapprobation in a community of moralizers. Third, I argue that a form of motivational internalism is true: ordinary moral judgments are intrinsically motivating, and all non-motivating moral judgments are parasitic on these. (shrink)

What is the proper role of a clinical ethics consultant’s religious beliefs in forming recommendations for clinical ethics consultation? Where Janet Malek has argued that religious belief should have no influence on the formation of a CEC’s recommendations, Clint Parker has argued a CEC should freely appeal to all their background beliefs, including religious beliefs, in formulating their recommendations. In this paper, I critique both their views by arguing the position envisioned by Malek puts the CEC too far from religion (...) and the position envisioned by Parker puts the CEC too close. For a CEC to give recommendations about what is morally prohibited, permissible, or obligatory in the clinic, I propose a view of the CEC that is neither religious nor non-religious but quasi-religious. I argue that a quasi-religious approach avoids the problems of both religious and non-religious views while preserving their benefits. Additionally, a quasi-religious view resists the marginalization of “religious” traditions that occurs when secular ethicists come to think of their approach as somehow distinctly non-religious. (shrink)

Religions often operate as comprehensive worldviews, attempting to answer the deepest existential questions that human beings can ask: Who am I? Where do I come from? Where am I going after I die? How should I live? Often ethical systems are embedded and justified within these broader narratives. Inevitably, the clinical ethics consultant will encounter and engage with religiously based ethical systems. In this issue, the authors reflect seriously and deeply on the implications of such engagement.

Empathy is sometimes so hard to achieve that one may wonder if it is a virtue for caregivers at all. Perhaps a caregiver cannot always know how a patient feels, and perhaps that knowledge is sometimes too painful to possess. A nuanced understanding of what empathy entails and of the conditions for attaining it can help ground its possibility.

Ethical reasoning is an integral part of the work of a clinical ethics consultant. Ethical reasoning has a close relationship with an individual’s beliefs and values, which, for religious adherents, are likely to be tightly connected with their spiritual perspectives. As a result, for individuals who identify with a religious tradition, the process of thinking through ethical questions is likely to be influenced by their religious worldview. The connection between ethical reasoning and one’s spiritual perspective raises questions about the role (...) that CECs’ personal religious worldviews should play in their professional lives and their consultative work. This paper offers numerous arguments critiquing the inclusion of a consultant’s own spiritual perspective in her work and has identified only limited circumstances under which such inclusion might be permissible. In particular, these arguments lead to the conclusion that a CEC’s personal beliefs should never influence her ethical analysis or development of a recommendation. Further, religious appeals should not be used in communication during decision-making conversations other than to describe the patient or surrogate’s stated perspective. There may be limited cases in which a CEC may share her spiritual worldview with a patient with the intent of building a collaborative relationship, but such situations should be approached with extreme caution. (shrink)

Book reviewed in this article: Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine. By Albert R. Jonsen, Mark Siegler, and William J. Winslade.

The Emotional Construction of Morals is a book about moral judgements – the kinds of mental states we might express by sentences such as, ‘It's bad to flash your neighbors’, or ‘You ought not eat your pets’. There are three basic questions that get addressed: what are the psychological states that constitute such judgements? What kinds of properties do such judgements refer to? And, where do these judgements come from? The first question concerns moral psychology, the second metaethics and the (...) third is best construed as belonging to a domain that has been neglected in analytic value theory: the genealogy of morals. These are all separate branches of ethics, but they are interconnected. The thesis of the book is that moral judgements are emotional attitudes that refer to response-dependent properties, and that these responses have been shaped by cultural history. I call the view Constructive Sentimentalism. The first half of the book deals with sentiments, and the second half with construction. The second half also deals with relativism, because I argue that moral values are constructed differently across cultures and across individuals.Thus described, The Emotional Construction of Morals is a conventional contribution to analytic moral philosophy, taking on some of the core questions in that field and defending positions that have a long philosophical pedigree. Indeed, the theory I defend has roots in Hume and Nietzsche, though it departs from both in various ways. What makes the book somewhat unusual is that it seeks to defend traditional theories by appeal to recent work in psychology, neuroscience, anthropology and related fields. It is an exercise in methodological naturalism and committed to the view that we can answer traditional philosophical questions while treating ethics as a social science. Ethics and naturalism are hard to reconcile because ethics is a normative domain, …. (shrink)

There is no doubt that emotions have an important effect on practices of moral reasoning such as clinical ethics consultation. Empathy is not only a basic human emotion but also an important and learnable skill for health care professionals. A basic amount of empathy is essential both in patient care and in clinical ethics consultation. This article debates the “adequate dose” of empathy in ethics consultations in clinical settings and tries to identify possible situations within the process of consultation in (...) which this crucial feeling is at risk. (shrink)

Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In (...) a moral case deliberation, the participants are invited to place themselves in the position of the case presenter and to investigate their own emotions in the situation. It is about critically assessing the facts in the case that cause the emotion and the related (moral) thoughts that accompany the emotion. It is also about finding the right emotion in a given situation and finding the right balance in dealing with that emotion. These steps in the moral inquiry give rise to group learning. It is a process of becoming open towards the perspectives of others, leading to new insights into what is an appropriate emotion in the specific situation. We show how this approach works in moral case deliberation. A physician presents a situation in which he is faced with a pregnant woman who is about to deliver multiple extremely premature infants at the threshold of viability. The moral deliberation of the case and the emotions therein leads to the participants’ conclusion that “compassion” is a more adequate emotion than “sadness”. The emotion “sadness” is pointed towards the tragedy that is happening to the woman. The emotion “compassion” is pointed towards the woman; it combines consideration and professional responsibility. Through the shift towards compassion, participants experienced more creativity and freedom to deal with the sad situation and to support the woman. The paper ends with an analysis and reflection on the deliberation process. In the conclusion we argue for more attention to emotions in clinical ethics support and offer some directions for doing this in the right way. (shrink)

This article suggests how Mengzian ideas of the way [dao], rightness [yi] and rites [li], as related to the presupposition that human nature is moral, respond to rigid notions of “truth” and “law,” which tolerate a banalization of evil. It further suggests that the Mengzian attitude is both rooted in human empathy and draws clear limits to it. This is demonstrated by responding to arguments raised by the protagonist Max Aue in Jonathan Little’s book The Kindly Ones.