This is a new edition of Joseph Fletcher's 1966 work that ignited a firestorm of controversy at the time of its publication.

In controversies about technology and society, there is no idea more pro vocative than the notion that technical things have political qualities. At issue is the claim that the machines, structures, and systems of modern material culture can be accurately judged not only for their contributions of efficiency and pro-ductivity, not merely for their positive and negative environmental side effects, but also for the ways in which they can embody specific forms of power and authority. Since ideas of this kind (...) have a persistent and troubling presence in discussions about the meaning of technology, they deserve explicit attention... (shrink)

We all have beliefs, even strong convictions, about what is just and fair in our social arrangements. How should these beliefs and the theories of justice that incorporate them guide our thinking about practical matters of justice? This wide-ranging collection of essays by one of the foremost medical ethicists in the USA explores the claim that justification in ethics, whether of matters of theory or practice, involves achieving coherence between our moral and non-moral beliefs. Amongst the practical issues addressed in (...) the volume are the design of health-care institutions, the distribution of goods between the old and the young, and fairness in hiring and firing. In combining ethical theory and practical ethics this volume will prove especially valuable to philosophers concerned with ethics and applied ethics, political theorists, bioethicists, and others involved in the study of public policy. (shrink)

_Internet_ is een van de eerste boeken waarin het filosofische inzicht -van Plato tot Kierkegaard - betrokken wordt op het debat over de mogelijkheden en onmogelijkheden van het internet. Dreyfus laat zien dat de onstoffelijke, 'vrij zwevende' websurfer zijn oorsprong vindt in Descartes' scheiding van geest en lichaam, en hoe Kierkegaards inzichten in de opkomst van het moderne leespubliek vooruitlopen op de nieuwsgierige, maar elk risico vermijdende internet-junkie. Uitgaande van recente onderzoeken naar het isolement dat veel internetgebruikers ervaren, toont Dreyfus (...) aan hoe het internet, door zijn nadruk op privé-ervaringen, gebruikers berooft van wezenlijke, belichaamde vermogens zoals vertrouwen, stemmingen en betrokkenheid bij met anderen gedeelde lokale aangelegenheden. _Internet_ is verplichte kost voor iedereen die on line is en is geïnteressseerd in onze plaats in de 'e-revolutie'. (shrink)

Owen Flanagan argues in this book for a more psychologically realistic ethical reflection and spells out the ways in which psychology can enrich moral philosophy. Beginning with a discussion of such "moral saints" as Gandhi, Mother Teresa, and Oskar Schindler, Flanagan charts a middle course between an ethics that is too realistic and socially parochial and one that is too idealistic, giving no weight to our natures.

This book approaches ethical and legal issues in medicine from the patient's viewpoint and argues that many patients do not want the full burden of decision making that contemporary bioethics has thrust upon them.

Empirical research pertaining to cardiopulmonary resuscitation (CPR), clinician behaviors related to do-not-resuscitate (DNR) orders and substituted judgment suggests potential contributions to medical ethics. Research quantifying the likelihood of surviving CPR points to the need for further philosophical analysis of the limitations of the patient autonomy in decision making, the nature and definition of medical futility, and the relationship between futility and professional standards. Research on DNR orders has identified barriers to the goal of patient involvement in these life and death (...) discussions. The initial data on surrogate decision making also points to the need for a reexamination of the moral basis for substituted judgment, the moral authority of proxy decision making and the second-order status of the best interests standard. These examples of empirical research suggest that an interplay between empirical research, ethical analysis and policy development may represent a new form of interdisciplinary scholarship to improve clinical medicine. (shrink)

Abstract:This paper outlines three conceptions of the relationship between normative and empirical business ethics, views we refer to asparallel, symbiotic, andintegrative. Parallelism rejects efforts to link normative and empirical inquiry, for both conceptual and practical reasons. The symbiotic position supports a practical relationship in which normative and/or empirical business ethics rely on each other for guidance in setting agenda or in applying the results of their conceptually and methodologically distinct inquiries. Theoretical integration countenances a deeper merging ofprima faciedistinct forms of (...) inquiry, involving alterations or combinations of theory, metatheoretical assumptions, and methodology. This paper explicates these positions, summarizes arguments for and against each, and considers their implications for the future of business ethics research. (shrink)

"This is a timely collection of important papers.

In lieu of an abstract, here is a brief excerpt of the content:The Ideal of Shared Decision Making Between Physicians and PatientsDan W. Brock (bio)IntroductionShared treatment decision making, with its division of labor between physician and patient, is a common ideal in medical ethics for the physician-patient relationship.1 Most simply put, the physician's role is to use his or her training, knowledge, and experience to provide the patient with facts about the diagnosis and about the prognoses without treatment and with (...) alternative treatments. The patient's role in this division of labor is to provide the values—his or her own conception of the good—with which to evaluate these alternatives, and to select the one that is best for himself or herself. As a rough guide to practice, this is a reasonable conception; most of the time it is likely to produce sound treatment decisions. However, as an ideal it is too simplistic, and is subject to several challenges that I will explore in this paper.Some challenges relate to the physician's role. This facts/values division of labor seems to assume that the physician can and should provide the facts about treatment alternatives in a value-neutral form. But some have questioned whether the sciences on which medicine is based are, or can be, value free. Moreover, the concepts of health and disease, and of the normal and pathological, are held by many to be value laden. And even if it is possible for physicians to provide only value-neutral facts to the patient, should the physicians' role be restricted in this way?Other challenges that I will present in the paper are to the patient's role [End Page 28] as provider of the values for the evaluation of the different treatment alternatives. One defense of this role is based on the claim that physicians are not in a position to know reliably what is in a patient's best interests (Buchanan, forthcoming). I believe at least as influential—even if often not explicitly stated—is an extreme subjectivism about values that assumes that the patient's own ultimate values, which define his or her own conception of the good, are incorrigible. By incorrigible, I mean they cannot be mistaken. In the standard case in which treatment is pursued for the patient's benefit, this extreme subjectivism is thought to support the patient's values guiding treatment decision making and treatment. I will explore this incorrigibility claim and will argue that on each of the main philosophical conceptions of the good for persons it is indefensible and should not be the basis for shared treatment decision making.Underlying this view of the physician-patient division of labor are assumptions and beliefs about the nature and relation of facts and values, and science and ethics, that are largely the legacy of a logical positivism that has long since been rejected by most philosophers. It is time that these unstable foundations for our normative ideal of the physician-patient relation were finally removed and replaced with more defensible underpinnings.Two Models of the Physician-Patient RelationshipPositivists insisted on a relatively sharp distinction between descriptive or empirical claims and science, on the one hand, and evaluative claims and ethics, on the other.2 Descriptive statements and the claims of science were to be true or false according to whether they in fact correctly described and explained the world. By remaining properly descriptive or empirical, science could, at least in principle, be entirely value neutral or value free.In its more extreme versions, positivism held that ethical judgments lacked cognitive content, but were instead expressions of emotions or attitudes, and as such could be neither true nor false, correct or mistaken. Because no evaluative statements were held to be logically entailed by any descriptive or empirical statements, moral reasoning was thought to be properly understood not as reasoning but as attempts at nonrational persuasion.3 Many drew from this an extreme subjectivism in ethics along the lines of what I have called above the incorrigibility thesis—there is no meaningful sense in which an individual's ultimate values defining his or her own conception of the good life could be mistaken, false, or unfounded.These... (shrink)

This book is a reprint of Part II of Dewey and Tufts 1938 version of the Ethics.

Palliation is a relatively new concept that is used in connection with the integral care provided to those who are unable to recover from their illness. The specific meaning of the concept has not been clearly defined. This article explores the possibilities offered by a responsive approach to evaluation that can facilitate a reflexive dialogue on this ambiguous concept. In doing so it draws on a case study of a palliative care project in a Dutch health care authority. The article (...) begins with an overview of the characteristics of a responsive approach to evaluation and addresses interpretative, representational and practical dilemmas. It goes on to present a series of dialogues between health professionals, informal caregivers, patients and evaluators. These dialogues take the form of juxtaposed stories, transcribed conversations and interpretations. Finally, the learning experiences are summarised and the appropriateness of the responsive approach to evaluate palliative care is discussed. (shrink)

Based on a conference held at McGill Univeristy in 1988.

This discussion is a critical assessment of the methods employed by some leading writers in the field of bioethics. The author agrees with those in the field who regard its primary or essential method as moral philosophy, but he nevertheless finds a prevalent tendency among bioethical writers merely to apply received moral principles to issues and to avoid penetrating theoretical analysis, even when such analysis is unavoidably required. He explains these deficiencies in terms of the exigencies of interdisciplinary work and (...) the affinity of much early bioethics with policy- or legislatively-oriented "public ethics". The discussion ends with a call for increased theoretical sophistication in this field. Keywords: bioethics, ethics, medical ethics, method CiteULike Connotea Del.icio.us What's this? (shrink)

Science is not value-free and ethics is not fact-free. Science and ethics should be similar, but they are not. The author indicates how research in ethics is to change in the face of this. Ethicists should accommodate empirical work in their programs and they should take heed of methodologies developed in science and philosophy of science. They should abandon the search for a single overarching theory of morality. Controversies in ethics are often spurious for lack of articulate methodological key concepts. (...) For example, disagreements over the value of general theories are misguided since disputants implicitly use different notions of generality and different notions of theory. An appropriate methodology does not suffice for the resolution of controversies but it is indispensable for consensus. The book argues these theses in a general way and applies them to the subject of egoism and altruism in ethics. Further case studies concern the environment and psychiatric disorders. (shrink)

Legal and moral reasoning share much methodology, and they address similar problems. This volume charts two shared problems: the relation between theory, principles and particular judgments; and the role of facts and factual assertions in normative settings. The relation between 'theory' and 'practice' and between 'principle' and 'particular judgment' has become the subject of much debate in moral philosophy. In the ongoing debate, some moral philosophers refer to legal philosophy for a support of their views on the primacy of 'practice' (...) over 'theory'. According to them, legal philosophy should have a more balanced view in that relation. In the contributions to Part One this claim is critically analysed. The role of the facts is underestimated in discussions on legal reasoning and legal theory, as well as moral reasoning and ethical theory. Factual statements enter into moral and legal discussions not only because they link the conclusion with a rule. They also play a role as background assumptions in supporting a theory. Its focus on the role of facts in normative reasoning makes this book of special interest to scholars of legal and moral argumentation. (shrink)