Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

The paper addresses the issue of how indemocratic societies a procedure might be formulatedto facilitate ethical judgements on modernbiotechnologies used in food production. A frameworkfor rational ethical analysis, the Ethical Matrix, isproposed. The Matrix adapts the principles describedby Beauchamp and Childress for application to medicalissues, to interest groups (e.g., producers,consumers, and the biotic environment) affected bythese technologies. The use of the Matrix isillustrated by applying it to an example of a ``novelfood,'' viz., a form of genetically modified maize.

Ethical frameworks are often used in professional fields as a means of providing explicit ethical guidance for individuals and institutions when confronted with ethically important decisions. The notion of an ethical framework has received little critical attention, however, and the concept subsequently lends itself easily to misuse and ambiguous application. This is the case with the ‘ethical framework’ offered by Canada’s Nuclear Waste Management Organization (NWMO), the crown-corporation which owns and is responsible for the long-term management of Canada’s high-level nuclear (...) fuel waste. It makes a very specific claim, namely that it is managing Canada’s long-lived radioactive nuclear fuel waste in an ethically responsible manner. According to this organization, what it means to behave in an ethically responsible manner is to act and develop policy in accordance with its ethical framework. What, then, is its ethical framework, and can it be satisfied? In this paper I will show that the NWMO’s ethical and social framework is deeply flawed in two respects: (a) it fails to meet the minimum requirements of a code of ethic or ethical framework by offering only questions, and no principles or rules of conduct; and (b) if posed as principles or rules of conduct, some of its questions are unsatisfiable. In particular, I will show that one of its claims, namely that it seek informed consent from individuals exposed to risk of harm from nuclear waste, cannot be satisfied as formulated. The result is that the NWMO’s ethical framework is not, at present, ethically acceptable. (shrink)

This paper explores the usefulness of the 'ethical matrix', proposed by Ben Mepham, as a tool in technology assessment, specifically in food ethics. We consider what the matrix is, how it might be useful as a tool in ethical decision-making, and what drawbacks might be associated with it. We suggest that it is helpful for fact-finding in ethical debates relating to food ethics; but that it is much less helpful in terms of weighing the different ethical problems that it uncovers. (...) Despite this drawback, we maintain that, with some modifications, the ethical matrix can be a useful tool in debates in food ethics. We argue that useful modifications might be to include future generations amongst the stakeholders in the matrix, and to substitute the principle of solidarity for the principle of justice. (shrink)

Several studies have indicated that scientists are likely to have an outlook on both facts and values that are different to that of lay people in important ways. This is one significant reason it is currently believed that in order for scientists to exercise a reliable ethical reflection about their research it is necessary for them to engage in dialogue with other stakeholders. This paper reports on an exercise to encourage a group of scientists to reflect on ethical issues without (...) the presence of external stakeholders. It reports on the use of a reflection process with scientists working in the area of animal disease genomics (mainly drawn from the EADGENE EC Network of Excellence). This reflection process was facilitated by using an ethical engagement framework, a modified version of the Ethical Matrix. As judged by two criteria, a qualitative assessment of the outcomes and the participants’ own assessment of the process, this independent reflective exercise was deemed to be successful. The discussions demonstrated a high level of complexity and depth, with participants demonstrating a clear perception of uncertainties and the context in which their research operates. Reflection on stakeholder views and values appeared to be embedded within the discussions. The finding from this exercise seems to indicate that even without the involvement of the wider stakeholder community, valuable reflection and worthwhile discourse can be generated from ethical reflection processes involving only scienitific project partners. Hence, the previous assumption that direct stakeholder engagement is necessary for ethical reflection does not appear to hold true in all cases; however, other reasons for involving a broad group of stakeholders relating to governance and social accountability of science remain. (shrink)

Over recent decades, public participation in technology assessment has spread internationally as an attempt to overcome or prevent societal conflicts over controversial technologies. One outcome of this new surge in public consultation initiatives has been the increased use of participatory consensus conferences in a number of countries. Existing evaluations of consensus conferences tend to focus on the modes of organization, as well as the outcomes, both procedural and substantial, of the conferences they examine. Such evaluations seem to rest on the (...) assumption that this type of procedure has universally agreed goals and meanings, and that therefore consensus conferences can readily be interpreted and applied across national boundaries. This article challenges this approach to consensus conferences. The core of the article is a study of national differences in ideas about what constitutes legitimate goals for participatory arrangements. The study looks at three consensus conferences on GMOs, which took place in France, Norway, and Denmark. Drawing on this study, the article discusses the ways in which interpretations of the concept of participation; the value attributed to lay knowledge vs. technical expertise; as well as ideas about the role of the layperson, are all questions that prompt entirely different answers from country to country. Further, the article analyses these national differences within a theoretical framework of notions of democratic legitimacy. (shrink)

A number of EU institutions and government committees across Europe have expressed interest in developing methods and decision-support tools to facilitate consideration of the ethical dimensions of biotechnology assessment. As part of the work conducted in the EC supported project on ethical tools (Ethical Bio-TA Tools), a number of ethical frameworks with the potential to support the work of public policy decision-makers has been characterized and evaluated. One of these potential tools is the Delphi method. The Delphi method was originally (...) developed to assess variables that are intangible and/or shrouded in uncertainty by drawing on the knowledge and abilities of a diverse group of experts through a form of anonymous and iterative consultation. The method has hitherto been used by a diversity of practitioners to explore issues such as technology assessment, environmental planning, and public health measures. From the original (classical) Delphi, a family of Delphi-related processes has emerged. As a result of the evaluation of the various Delphi processes, it is proposed that the classical method can be further developed and applied as a form of ethical framework to assist policy-makers. Through a series of exercises and trials, an Ethical Delphi has been developed as a potential approach for characterizing ethical issues raised by the use of novel biotechnologies. Advantages and disadvantages of the method are discussed. Further work is needed to develop the procedural aspects of the Ethical Delphi method and to test its use in different cultural contexts. However, utilizing an ethical framework of this type combines the advantages of a methodical approach to capture ethical aspects with the democratic virtues of transparency and openness to criticism. Ethical frameworks such as the Ethical Delphi should contribute to better understanding of and decision-making on issues that involve decisive ethical dimensions. (shrink)

None of us can avoid being interested in food. Our very existence depends on the supply of safe, nutritious foods. It is then hardly surprising that food has become the focus of a wide range of ethical concerns: Is the food we buy safe? Is it produced by means which respect the welfare of animals and sustain the land? Are modern biotechnologies employed in food production immoral? This book addresses such issues by applying ethical principles to many areas of current (...) concern. The contributors provide original and thought-provoking treatments of a number of highly topical issues - from global hunger and its ethical implications to the cultural habits affecting consumption. This interdisciplinary study will prove to be essential reading for all those concerned with food, as professionals, students or consumers. (shrink)

The Ethical Matrix was developed to help decision-makers explore the ethical issues raised by agri-food biotechnologies. Over the decade since its inception the Ethical Matrix has been used by a number of organizations and the philosophical basis of the framework has been discussed and analyzed extensively. The role of tools such as the Ethical Matrix in public policy decision-making has received increasing attention. In order to further develop the methodological aspects of the Ethical Matrix method, work was carried out to (...) study the potential role of the Ethical Matrix as a decision support framework. When considering which frameworks to apply when analyzing the ethical dimensions of the application of agri-food biotechnologies, it is important to clarify the substantive nature of any prospective framework. In order to further investigate this issue, reflections on the neologism “ethical soundness” of an ethical framework are presented here. This concept is introduced in order to provide more structured evaluations of a range of ethical tools, including ethical frameworks such as the Ethical Matrix. As well as examining the philosophical dimensions of the method, theoretical analysis and literature studies were combined with stakeholder engagement exercises and consultations in order to review the Ethical Matrix from a user perspective. This work resulted in the development of an Ethical Matrix Manual, which is intended to act as a guide for potential user groups. (shrink)

We present a novel procedure to engage the public in ethical deliberations on the potential impacts of brain machine interface technology. We call this procedure a convergence seminar, a form of scenario-based group discussion that is founded on the idea of hypothetical retrospection. The theoretical background of this procedure and the results of five seminars are presented.

In this paper we describe and explore a management tool called the Caux Round Table Self-Assessment and Improvement Process (SAIP). Based upon the Caux Round Table Principles for Business — a stakeholder-based, transcultural statement of business values — the SAIP assists executives with the task of shaping their firm’s conscience through an organizational self-appraisal process. This process is modeled after the self-assessment methodology pioneered by the Malcolm Baldrige National Quality Award Program. After briefly describing the SAIP, we address three topics. (...) First, we examine similarities and differences between the Baldrige approach to corporate self-assessment and the self-assessment process utilized within the SAIP. Second, we report initial findings from two beta tests of the tool. These illustrate both the SAIP’s ability to help organizations strengthen their commitment to ethically responsible conduct, and some of the tool’s limitations. Third, we briefly analyze various dimensions of the business scandals of 2001–2002 (Enron, WorldCom, Tyco, etc.) in light of the ethical requirements articulated with the SAIP. This analysis suggests that the SAIP can help link the current concerns of stakeholders — for example, investors and the general public — to organizational practice, by providing companies with a practical way to incorporate critical lessons from these unfortunate events. (shrink)

In order to explore public views on nanobiotechnology (NBT), convergence seminars were held in four places in Europe; namely in Visby (Sweden), Sheffield (UK), Lublin (Poland), and Porto (Portugal). A convergence seminar is a new form of public participatory activity that can be used to deal systematically with the uncertainty associated for instance with the development of an emerging technology like nanobiotechnology. In its first phase, the participants are divided into three “scenario groups” that discuss different future scenarios. In the (...) second phase, the participants are regrouped into three “convergence groups”, each of which contains representatives from each of the three groups from the first phase. In the final third phase, all participants meet for a summary discussion. This pilot project had two aims: (1) to develop and assess the new methodology and (2) to gather advice and recommendations from the public that may be useful for future decisions on nanobiotechnology (NBT). Participants emphasized that they wanted the technology to focus on solutions to environmental and medical problems and to meet the needs of developing countries. The need for further public participation and deliberation on NBT issues seemed to be acknowledged by all participants. Many of them also raised equality concerns. Views on the means by which NBT should be steered into socially useful directions were more divided. In particular, different views were expressed on how much regulation of company activities is needed to curb unwanted developments. The participants’ responses in a questionnaire indicate that the methodology of the convergence seminars was successful for decision-making under uncertainty. In particular, the participants stated that their advice was influenced both by access to different possible future developments and by the points of view of their co-participants, which is what the method is specifically intended to achieve. (shrink)

There is a growing call for greater public involvement in establishing science and technology policy, in line with democratic ideals. A variety of public participation procedures exist that aim to consult and involve the public, ranging from the public hearing to the consensus conference. Unfortunately, a general lack of empirical consideration of the quality of these methods arises from confusion as to the appropriate benchmarks for evaluation. Given that the quality of the output of any participation exercise is difficult to (...) determine, the authors suggest the need to consider which aspects of the process are desirable and then to measure the presence or quality of these process aspects. To this end, a number of theoretical evaluation criteria that are essential for effective public participation are specified. These comprise two types: acceptance criteria, which concern features of a method that make it acceptable to the wider public, and process criteria, which concern features of the process that are liable to ensure that it takes place in an effective manner. Future research needs to develop instruments to measure these criteria more precisely and identify the contextual and environmental factors that will mediate the effectiveness of the different participation methods. (shrink)

The concept of “public participation” is currently one of great interest to researchers and policy makers. In response to a perceived need for greater public involvement in decision making and policy formation processes on the part of both policymakers and the general public, a variety of novel mechanisms have been developed, such as the consensus conference and citizens jury, to complement traditional mechanisms, such as the public meeting. However, the relative effectiveness of the various mechanisms is unclear, as efforts at (...) evaluation have been sparse. In this article, the authors describe an evaluation of a two-day “deliberative conference” on the topic of radiation dose assessment. The authors detail the evaluation framework that they adopt and describe the instruments that they have developed to determine the attainment of the evaluationcriteria stipulated in that framework. They then describe the participation exercise that they have evaluated. Finally, they apply the instruments to assess the effectiveness of the exercise, and discuss the results and their implications for the conduct of evaluations and the use of this particular participation mechanism. (shrink)

Imprecise definition of key terms in the “public participation” domain have hindered the conduct of good research and militated against the development and implementation of effective participation practices. In this article, we define key concepts in the domain: public communication, public consultation, and public participation. These concepts are differentiated according to the nature and flow of information between exercise sponsors and participants. According to such an information flow perspective, an exercise’s effectiveness may be ascertained by the efficiency with which full, (...) relevant information is elicited from all appropriate sources, transferred to all appropriate recipients, and combined to give an aggregate/consensual response. Key variables that may theoretically affect effectiveness—and on which engagement mechanisms differ—are identified and used to develop a typology of mechanisms. The resultant typology reveals four communication, six consultation, and four participation mechanism classes. Limitations to the typology are discussed, and future research needs identified. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

In Intricate Ethics, Kamm questions the moral importance of some non-consequentialist distinctions and then introduces and argues for the moral importance of ...

Case methods of reasoning are persuasive, but we need to address problems of bias in order to use them to reach morally justifiable conclusions. A bias is an unwarranted inclination or a special perspective that disposes us to mistaken or one-sided judgments. The potential for bias arises at each stage of a case method of reasoning including in describing, framing, selecting and comparing of cases and paradigms. A problem of bias occurs because to identify the relevant features for such purposes, (...) we must use general views about what is relevant; but some of our general views are biased, both in the sense of being unwarranted inclinations and in the sense that they are one of many viable perspectives. This reliance upon general views to determine relevancy creates additional difficulties for defenders who maintain that case methods of moral reasoning are not only useful, but more basic, reliable or prior to other forms of moral reasoning. If we cannot identify the case's relevant features and issues independently of our general views or biases, we need further explanation about why a case method or casuistry should be viewed as prior to or more basic or reliable than other forms of moral reasoning. Problems of bias also arise for other methods of reasoning. In medical science, case reviews are regarded as an unreliable way to form generalizations, and methods such as clinical trials are used to address bias. (shrink)