A vital and underappreciated dimension of social interaction is the way individuals justify their actions to others, instinctively drawing on their experience to appeal to principles they hope will command respect. Individuals, however, often misread situations, and many disagreements can be explained by people appealing, knowingly and unknowingly, to different principles. On Justification is the first English translation of Luc Boltanski and Laurent Thévenot's ambitious theoretical examination of these phenomena, a book that has already had a huge impact on French (...) sociology and is likely to have a similar influence in the English-speaking world. In this foundational work of post-Bourdieu sociology, the authors examine a wide range of situations where people justify their actions. The authors argue that justifications fall into six main logics exemplified by six authors: civic (Rousseau), market (Adam Smith), industrial (Saint-Simon), domestic (Bossuet), inspiration (Augustine), and fame (Hobbes). The authors show how these justifications conflict, as people compete to legitimize their views of a situation. On Justification is likely to spark important debates across the social sciences. (shrink)

There is great diversity in in vitro fertilization (IVF) funding and reimbursement policies and practice throughout Europe and the rest of the world. While many existing reimbursement and regulatory frameworks address safety and legal concerns, economic factors also assume a central role. However, there are several problems with the evidence that is available on the economics of IVF. This suggests there is a need for more robust cost-effectiveness studies. It also indicates the need for alternative rationales to justify the reimbursement (...) of IVF, which might more fully account for the social, political, ethical, and philosophical considerations embedded in notions of infertility and technology-driven reproductive treatments. The merits and limitations of five alternative rationales are discussed. The review suggests that while no existing single rationale provides a complete framework with which to support funding decisions, taken together they provide guideposts which signal important issues for consideration and highlight where further research, action, and debate are needed. (shrink)

This article summarizes some of the results of the BIOMED II project “Basic Ethical Principles in European Bioethics and Biolaw” connected to a research project of the Danish Research Councils “Bioethics and Law”. The BIOMED project was based on cooperation between 22 partners in most EU countries. The aim of the project was to identify the ethical principles of respect for autonomy, dignity, integrity and vulnerability as four important ideas or values for a European bioethics and biolaw. The research concluded (...) that the basic ethical principles cannot be understood as universal everlasting ideas or transcendental truths but they rather function reflective guidelines and important values in European culture. The method of the research was conceptual, philosophical analysis of the cultural background of the four values or normative ideas that people use and find important in their existence. Moreover, this was combined with analysis of empirical legal material and policy documents. Also, a number of qualitative interviews with relevant experts were carried out. Another important result of the BIOMED project was the partner's Policy Proposals to the European Commission, the Barcelona Declaration, unique as a philosophical and political agreement between experts in bioethics and biolaw from many different countries. The Policy Proposals are reprinted here at the end of the article. (shrink)

Edited by four leading members of the new generation of medical and healthcare ethicists working in the UK, respected worldwide for their work in medical ethics, Principles of Health Care Ethics, Second Edition_is a standard resource for students, professionals, and academics wishing to understand current and future issues in healthcare ethics. With a distinguished international panel of contributors working at the leading edge of academia, this volume presents a comprehensive guide to the field, with state of the art introductions to (...) the wide range of topics in modern healthcare ethics, from consent to human rights, from utilitarianism to feminism, from the doctor-patient relationship to xenotransplantation. This volume is the Second Edition of the highly successful work edited by Professor Raanan Gillon, Emeritus Professor of Medical Ethics at Imperial College London and former editor of the Journal of Medical Ethics, the leading journal in this field. Developments from the First Edition include:_ The focus on ‘Four Principles Method’ is relaxed to cover more different methods in health care ethics. More material on new medical technologies is included, the coverage of issues on the doctor/patient relationship is expanded, and material on ethics and public health is brought together into a new section. (shrink)

Virtue ethics is perhaps the most important development within late twentieth-century moral philosophy. Rosalind Hursthouse, who has made notable contributions to this development, here presents a full exposition and defense of her neo-Aristotelian version of virtue ethics. She shows how virtue ethics can provide guidance for action, illuminate moral dilemmas, and bring out the moral significance of the emotions.

From 1995 to 1998, the European Commission supported the “Basic Ethical Principles in European Bioethics and Biolaw” research project. The project was based on cooperation between 22 partners coming from most EU countries. Its aim was to identify the ethical principles relating to autonomy, dignity, integrity and vulnerability as four important ideas or values for a European bioethics and biolaw. An important resume of the BIOMED project was the partner’s Policy Proposals to the European Commission, the Barcelona Declaration of 1998, (...) which is unique as a philosophical and political agreement between experts in bioethics and biolaw from many different countries. In this article, we want to compare the Barcelona Declaration with some other recent international Documents on bioethics and biolaw. We will relate the Barcelona Declaration to the framework of different international documents and codes of conduct about bioethics and biolaw. In particular, we will look at the similarities and differences when compared with the Council of Europe’s Convention for the Protection on of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Medicine, adopted by the Committee of Ministers in 1996. Moreover, we will look at The UNESCO Declaration on the Humane Genome from 1997. Thus, the Barcelona Declaration does not only represent European ethical principles for bioethics and biolaw, but the document should also be conceived as a conceptual clarification and articulation of major ethical principles, which are central to international concerns for a universal bioethics and biolaw. (shrink)

The so-called European principles of bioethicsare a welcome enrichment of principlistbioethics. Nevertheless, vulnerability, dignityand integrity can perhaps be moreaccurately understood as anthropologicaldescriptions of the human condition. Theymay inspire a normative language, but they donot contain it primarily lest a naturalisticfallacy be committed. These anthropologicalfeatures strongly suggest the need todevelop deontic arguments in support of theprotection such essential attributes ofhumanity require. Protection is to beuniversalized, since all human beings sharevulnerability, integrity and dignity, thusfundamenting a mandate requiring justice andrespect for fundamental human (...) rights.Being a feature of all humanity, vulnerabilityis improperly extended to designatedestitute individuals and populations. Rather,they are in a state of fallen vulnerability,for they already are harmed in some way, andhave become deprived of their range ofcapabilities. These individuals are destituteand are no longer in command of theirfundamental human rights. They have lost thestatus of unharmed vulnerability;identifying them as susceptible – vulnerated andno longer only vulnerable – stresses thepoint that bioethics demands specific socialaction to palliate or remove their distress.When harm does occur – in the form of disease,for example –, individuals are no longervulnerable – for they have ceased to be intact–, they become susceptible to additionaldeprivations and sickness; integrity isdemeaned and dignity is offended, leading tostates of dysfunction that require specificremedial social practices, aimed at treatingand removing injuries.The main point this paper addresses is thatvulnerability – as well as dignity and integrity – are descriptive characteristics ofhuman beings qua humans, which are not normative in themselves, but fundamental enoughto inspire bioethical requirements of protection and respect for human rights in thewake of social justice. A clear distinction must be made in regard to human beings who areinjured by poverty, sickness, discriminating deprivations or suffer otherdestitutions, having ceased to be only vulnerable for they are no longer intact. Theseindividuals and populations require more than protection, their needs must be met byspecific care and remedial measures to be identified and instigated by bioethics quaapplied ethics. (shrink)

Concern for human vulnerability seems to be at the heart of bioethical inquiry, but the concept of vulnerability is under-theorized in the bioethical literature. The aim of this article is to show why bioethics needs an adequately theorized and nuanced conception of vulnerability. We first review approaches to vulnerability in research ethics and public health ethics, and show that the bioethical literature associates vulnerability with risk of harm and exploitation, and limited capacity for autonomy. We identify some of the challenges (...) emerging from this literature: in particular, how to reconcile universal human vulnerability with a context-sensitive analysis of specific kinds and sources of vulnerability; and how to reconcile obligations to protect vulnerable persons with obligations to respect autonomy. We then briefly survey some of the theoretical resources available within the philosophical literature to address these challenges, and to assist in understanding the conceptual connections between vulnerability and related concepts such as harm, exploitation, needs, and autonomy. We also sketch out a taxonomy of sources and kinds of vulnerability. Finally, we consider the implications for policy evaluation of making vulnerability an explicit and central focus of bioethics. Our investigation is in the form of a broad survey motivating a research agenda rather than a detailed analysis. (shrink)

Analysis has always been at the heart of philosophical method, but it has been understood and practised in many different ways. Perhaps, in its broadest sense, it might be defined as a process of isolating or working back to what is more fundamental by means of which something, initially taken as given, can be explained or reconstructed. The explanation or reconstruction is often then exhibited in a corresponding process of synthesis. This allows great variation in specific method, however. The aim (...) may be to get back to basics, but there may be all sorts of ways of doing this, each of which might be called ‘analysis’. The dominance of ‘analytic’ philosophy in the Englishspeaking world, and increasingly now in the rest of the world, might suggest that a consensus has formed concerning the role and importance of analysis. This assumes, though, that there is agreement on what ‘analysis’ means, and this is far from clear. On the other hand, Wittgenstein's later critique of analysis in the early (logical atomist) period of analytic philosophy, and Quine's attack on the analytic-synthetic distinction, for example, have led some to claim that we are now in a ‘post-analytic’ age. Such criticisms, however, are only directed at particular conceptions of analysis. If we look at the history of philosophy, and even if we just look at the history of analytic philosophy, we find a rich and extensive repertoire of conceptions of analysis which philosophers have continually drawn upon and reconfigured in different ways. Analytic philosophy is alive and well precisely because of the range of conceptions of analysis that it involves. It may have fragmented into various interlocking subtraditions, but those subtraditions are held together by both their shared history and their methodological interconnections. It is the aim of this article to indicate something of.. (shrink)

Are there distinctly European values in bioethics, and if there are, what are they? Some Continental philosophers have argued that the principles of dignity, precaution, and solidarity reflect the European ethos better than the liberal concepts of autonomy, harm, and justice. These principles, so the argument goes, elevate prudence over hedonism, communality over individualism, and moral sense over pragmatism. Contrary to what their proponents often believe, however, dignity, precaution, and solidarity can be interpreted in many ways, and it is not (...) clear which reading would, or should, be favored by popular opinion. It is therefore dangerous to think that any one understanding of ``European'', or any other, values could be legitimately imposed on those who have different ideas about morality in health care and related fields. Bioethical principles should be employed to promote discussion, not to suppress it. (shrink)

New reproductive technologies, such as in vitrio fertilization, have been the subject of intense public discussion and debate worldwide. In addition to difficult ethical, moral, personal and political questions, new technologies of assisted conception also raise novel socio-cultural dilemmas. How are parenthood, kinship and procreation being redefined in the context of new reproductive technologies? Has reproductive choice become part of consumer culture? Embodied Progress offers a unique perspective on these and other cultural dimensions of assisted conception techniques. Based on ethnographic (...) research in Britain, this study foregrounds the experiences of women and couples who undergo IVF, whilst also asking how such experiences may be variously understood. (shrink)

The four principles approach to bioethics, an approach most associated with the work of Tom Beauchamp and James Childress, is supposed to provide a framework for reasoning through moral issues in medicine. One might wonder, if one were to guide one’s thinking by the method suggested by principlism, will one identify and perform the objectively morally right action? Will one’s decision making be justified, and consequently, will the action that flows from that decision itself be justified? In this paper, I (...) show that principlism can, and has been, characterized in these two different ways. I also argue that when it is understood according to the first characterization, the view cannot be put into practice. However, when it is understood as an account of justification, there is reason to think that it is indeed action-guiding. Given the problems that confront the first version of the view, perhaps it is best to understand principlism, and biomedical ethical theories generally, not as action-guiding theories of right action, but rather, as procedures by which one’s decisions and actions in medicine can achieve a reasonable degree of moral justification. (shrink)

The paper offers a modelling of the sense of justice as it is displayed in ordinary situated disputes. While this model accounts for a plurality of legitimate forms of evaluation which are used in the process of critique and justification, it escapes a relativism of values by demonstrating that all these forms satisfy a set of common requirements. The reasonable character of the everyday sense of justice is also anchored in a reality test involving the engagement of objects which qualify (...) for a certain form of evaluation. The paper discusses this model in relation to competing theories of justice, and models of social action and interaction. (shrink)