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)

A strong tradition in philosophy denies the possibility of moral dilemmas. Recently, several philosophers reversed this tradition. In this dissertation, I clarify some fundamental issues in this debate, argue for the possibility of moral dilemmas, and determine some implications of this possibility. ;In chapter I, I define moral dilemmas roughly as situations where an agent morally ought to adopt each of two alternatives but cannot adopt both. Moral dilemmas are resolvable if and only if one of the moral oughts overrides (...) the other. ;In chapter II, I criticize several opponents of moral dilemmas, including utilitarians, Kant, Aquinas, and Ross. My main criticism is that no opponent of moral dilemmas can adequately justify moral residue . ;Chapters III and IV concern the two main arguments against the possibility of moral dilemmas. First, the argument for 'ought' implies 'can' runs as follows. If the agent cannot adopt both, then it is not the case that the agent ought to adopt both. But the agent ought to adopt both, since the agent ought to adopt each . Thus, the defining judgements of a moral dilemma seem to imply a contradiction. In response, I argue that the relation between 'ought' and 'can' is not a logical implication but a conversational implicature. ;Chapter IV concerns the argument from 'ought' implies 'permitted': If the agent ought to adopt one alternative, then the agent is permitted to adopt that alternative, which means that it is not the case that the agent ought not to adopt that alternative. But the agent ought not to adopt that alternative, since the agent ought to adopt the other alternative and cannot adopt both. I respond that 'ought' does not logically imply but conversationally implicates 'permitted'. ;In chapter V, I argue that, despite recent claims, both moral realism and anti-realism are compatible with the possibility of moral dilemmas. Thus, there are several reasons to accept and no reasons to deny the possibility of moral dilemmas. (shrink)

Biomedical ethics focuses on moral judgments applied to the delivery of health care. In this worktext, we have two goals: (1) improving your sensitivity to ethical issues in health care, and (2) developing your decision-making skills. Making decisions is never easy. The moral dilemmas outlined in this worktext, and those you encounter in your clinical experience, will never be easy to resolve. Solutions are seldom immediately obvious.-from Preface.

To an increasing extent ethical controversies affect and sometimes obstruct public health work and epidemiological research. In order to improve communication between the concerned parties a model for identification and analysis of ethical conflicts in individual-based research has been worked out in co-operation between epidemiologists and moral philosophers. The model has two dimensions. One dimension specifies relevant ethical principles (as beneficence, non-maleficence, autonomy and justice). The other dimension specifies the groups of persons involved in the conflict under consideration (for example: (...) the study-population, individuals who may benefit from the results, the researchers and their personnel, the community at large). The model has been applied to the problem of legitimacy of case-register research and to problems in psychiatric health services research as well as epidemiological research. (shrink)