Friendship, Altruism, and Morality, originally published in 1980, gives an account of "altruistic emotions" and friendship that brings out their moral value. Blum argues that moral theories centered on rationality, universal principle, obligation, and impersonality cannot capture this moral importance. This was one of the first books in contemporary moral philosophy to emphasize the moral significance of emotions, to deal with friendship as a moral phenomenon, and to challenge the rationalism of standard interpretations of Kant, although Blum’s "sentimentalism" owes more (...) to Schopenhauer than to Hume. It was a forerunner to care ethics, and feminist ethics more generally; to virtue ethics; and to subsequent influential interpretations of Kant that attempted to room for altruistic emotion and friendship, and other forms of particularism and partialism. In addition, the work has been widely influential in religious studies, political theory, bioethics, and feminist ethics. (shrink)

Scholars have debated the role that altruistic considerations play—and should play—in recruitment and decision-making processes for clinical trials. Little empirical data are available to support their various perspectives. We analyzed 140 audiotaped pediatric informed consent sessions, of which 95 (68%) included at least one discussion of how participation in a cancer clinical trial might benefit: 1) the pursuit of scientific knowledge generally; 2) other children with cancer specifically; and 3) “the future” and other vaguely defined recipients. Clinicians initiated most (80%) (...) of these discussions of altruism. The enrollment rate of children in the clinical trial was high (83%) overall, but not higher among children whose parents were involved in an altruism-oriented discussion. These findings suggest that: (1) clinicians invoke a spectrum of altruistic considerations rather than a single monothematic notion of altruism, and (2) the effect of altruistic considerations on subsequent enrollment decisions is marginal. While further research on this topic is warranted, bioethical debate should strive to reflect the diversity of altruistic discourse in clinical research encounters and to place this discourse in the context of other, including nonaltruistic, considerations. (shrink)

In this paper, we respond to Andrew Avins's recent review of methods whose use he advocates in clinical trials, to make them more ethical. He recommends in particular, “unbalanced randomisation”. However, we argue that, before such a recommendation can be made, it is important to establish why unequal randomisation might offer ethical advantages over equal randomisation, other things being equal. It is important to make a pragmatic distinction between trials of treatments that are already routinely available and trials of restricted (...) treatments. We conclude that unequal randomisation could, indeed, be an ethical compromise between protecting the interests of participants and those of society. (shrink)