First ed. published in 1946 under title: Medical ethics for nurses.

While discussions of the ethics of the placebo have usually dealt with their use in a research context, the authors address here the question of the placebo in clinical practice. It is argued, firstly, that the placebo can be an effective treatment. Secondly, it is demonstrated that its use does not always entail deception. Finally guidelines are presented according to which the placebo may be used for clinical purposes. It is suggested that in select cases, use of the placebo may (...) even be morally imperative. The argument is illustrated by three case vignettes. (shrink)

The Brave New World–style utilitarian dystopia is a familiar feature of the cultural landscape; Kantian dystopias are harder to come by, perhaps because, until Rawls, Kantian morality presented itself as a primarily personal rather than political program. This asymmetry is peculiar for formal reasons, because one phase of the deliberative process on which Kant insists is to ask what the world at large would be like if everyone did whatever it is one is thinking of doing. I do not propose (...) to write a Kantian Brave New World myself, but I am going to ask, of what these days is called “the CI-procedure,” what would happen if everybody followed it. I will argue that if the CI-procedure works as advertised, it exposes a practical incoherence in the commitment to having it govern one’s actions: in the Kantian vocabulary that goes with the territory, that the Categorical Imperative gives rise to a contradiction in the will. (shrink)

Using a fictional but representative general practice consultation, involving the diagnosis of irritable bowel syndrome in a patient who is anxious for some relief from the discomfort his condition entails, this paper argues that when both a drug fails to out-perform placebo and the condition in question is a functional illness with no demonstrable underlying pathology, then the action of the drug is not only no better than placebo, and it is also no different from it either. The paper also (...) argues that, in the circumstances of the consultation described, it is striking that current governance deems it ethical for a practitioner to prescribe either a drug or a placebo, both of which appear to rely for their effectiveness on a measure of concealment on the part of the doctor, yet deems it unethical for a practitioner openly to prescribe a harmless and enjoyable substance which is likely to be no less effective than either drug or placebo and is also likely to be better-tolerated and cheaper than the drug. (shrink)

In The Virtues of Ignorance the author demonstrates that classical theories of virtue are flawed and developes a consequentialist theory of virtue. ;Virtues are excellences of character. They are traits which are considered to be valuable in some way. A person who is virtuous is one who has a tendency to act well. Classical philosophers, such as Plato and Aristotle, believed that virtues, as human excellences, could not involve ignorance in any way. On their view, the virtuous agent, when acting (...) well, knows what she is doing under the description which makes the action conform to virtue. For example, the generous person must know that she is, in fact, helping others in need. Yet, there is a class of virtues, the "virtues of ignorance," which essentially involve ignorance. For example, modesty requires that the agent underestimate self worth. In the first portion of the dissertation, this class of virtues is discussed, and problems raised for the traditional theories of virtue. ;In the latter portion of the dissertation, the author outlines a consequentialist theory of virtue. It is argued that the only hope of developing a unified theory of virtue is along consequentialist lines, because attempts at identifying the psychological state which is necessary for virtue have failed. On a consequentialist theory, a virtue is defined in terms of its consequences. Thus, the moral quality of the character trait is determined by how much good it brings about . The virtues of ignorance can easily be accommodated in such a theory because these traits do bring about good, even if the agent possessing the trait acts out of ignorance. (shrink)