We will next speak of Liberality. Now this is thought to be the mean state, having for its object-matter Wealth: I mean, the Liberal man is praised not in the circumstances of war, nor in those which constitute the character of perfected self-mastery, nor again in judicial decisions, but in respect of giving and receiving Wealth, chiefly the former. By the term Wealth I mean all those things whose worth is measured by money.

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)

Considering a growing nurse shortage and the need for qualified nurses to handle increasingly complex patient care situations, how ethical beliefs are influenced and the consequences that can occur when moral conflicts of right and wrong arise need to be explored. The aim of this study was to explore influencers identified by nurses as having the most impact on the development of their ethical beliefs and whether these influencers might impact levels of moral distress and the potential for conscientious objection. (...) Nurses whose ethical beliefs were most influenced by their religious beliefs scored higher in levels of moral distress and demonstrated greater differences in areas of conscientious objection than did nurses who developed their ethical beliefs from influencers such as family values, life and work experience, political views or the professional code of ethics. (shrink)

"First published in this translation 1955; second edition (revised) 1974; reprinted with additional revisions 1987; reissued with new Further Reading 2003; reissued with new introduction 2007"--T.p. verso.

The term body integrity identity disorder (BIID) describes the extremely rare phenomenon of persons who desire the amputation of one or more healthy limbs or who desire a paralysis. Some of these persons mutilate themselves; others ask surgeons for an amputation or for the transection of their spinal cord. Psychologists and physicians explain this phenomenon in quite different ways; but a successful psychotherapeutic or pharmaceutical therapy is not known. Lobbies of persons suffering from BIID explain the desire for amputation in (...) analogy to the desire of transsexuals for surgical sex reassignment. Medical ethicists discuss the controversy about elective amputations of healthy limbs: on the one hand the principle of autonomy is used to deduce the right for body modifications; on the other hand the autonomy of BIID patients is doubted. Neurological results suggest that BIID is a brain disorder producing a disruption of the body image, for which parallels for stroke patients are known. If BIID were a neuropsychological disturbance, which includes missing insight into the illness and a specific lack of autonomy, then amputations would be contraindicated and must be evaluated as bodily injuries of mentally disordered patients. Instead of only curing the symptom, a causal therapy should be developed to integrate the alien limb into the body image. (shrink)

Contemporary liberal societies are seeing increasing pressure on individuals to act against their consciences. Most of the pressure is directed at freedom of religion but it also affects ethical beliefs more generally, contrary to the recognition of freedom of religion and conscience as a basic human right. I propose that freedom of dissociation, as a corollary of freedom of association, could be a practical and ethically acceptable solution to the conscience problem. I examine freedom of association and explain how freedom (...) of dissociation follows from it, showing how dissociation protects freedom of religion and conscience. Extreme cases, such as the problem of the Satanist nurse, can be handled within a dissociationist framework, so it is reasonable to think less extreme cases can also be dealt with. The serious objection that dissociationism entails unjust discrimination is answered primarily by appeal to the need for ‘full and fair access’ to goods and services by all groups. I then allay important concerns about what kind of liberal society we should want to live in. Next, I refute the charge that a dissociationist society violates liberalism's ‘higher good’, arguing that liberalism strictly does not have a higher good. I conclude with some reflections on what a dissociationist society might look like. (shrink)