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

More than twenty years after its original publication, _The Case for Animal Rights _is an acknowledged classic of moral philosophy, and its author is recognized as the intellectual leader of the animal rights movement. In a new and fully considered preface, Regan responds to his critics and defends the book's revolutionary position.

Emerging infectious diseases such as Ebola, Hendra, SARS, West Nile, Hepatitis E and avian influenza have led to a renewed recognition of how diseases in human beings, wildlife and livestock are interlinked. The changing prevalence and spread of such infections are largely determined by human activities and changes in environment and climate—where the latter are often also caused by human activities. Since the beginning of the 21st century, these insights have been brought together under the heading of OneHealth—a concept that (...) calls for interdisciplinary collaboration between various sciences as well as professional practices to promote and protect the health of human and non-human animals and the natural environment. Just as insights from public health have led to a broadened focus for health policy and medical care, from treating individual patients to protecting and promoting population health, OneHealth calls for an even broader perspective, including a concern for the environment and animals, and for social-cultural factors that affect human, animal and environmental health. OneHealth not only covers collaborative work to understand and control zoonotic diseases, but also other ways in which interactions between animals, plants and humans may positively or negatively impact on each other’s health. Thus, studies in veterinary medicine and environmental sciences may lead to new insights in human medicine, and vice versa. Acknowledgment of the links between environmental, animal and social health is of course not a novel insight. Hippocrates already pointed to the importance of a clean environment as a requirement for good health; the early public health movements emphasized hygienic living conditions including good-quality housing, sewage systems and clean air and water; and the founders of modern medicine such as William Osler and Rudolf Virchow promoted …. (shrink)

What is at the basis of moral action? An altruism acquired by the application of rule and principle? Or, as Noddings asserts, caring and the memory of being cared for? With numerous examples to supplement her rich theoretical discussion, Noddings builds a compelling philosophical argument for an ethics based on natural caring, as in the care of a mother for her child. The ethical behavior that grows out of natural caring, and has as its core care-filled receptivity to those involved (...) in any moral situation, leaves behind the rigidity of rule and principle to focus on what is particular and unique in human relations. Noddings's discussion is wide-ranging, as she considers whether organizations, which operate at a remove from the caring relationship, can truly be called ethical. She discusses the extent to which we may truly care for plants, animals, or ideas. Finally, she proposes a realignment of education to encourage and reward not just rationality and trained intelligence, but also enhanced sensitivity in moral matters. (shrink)

Ethics has been discussed largely in the language of the father, Nel Noddings believes: in principles and propostions, in terms such as _justification,_ _fairness,_ and _equity._ The mother's voice has been silent. The view of ethics Noddings offers in this book is a feminine view. "This does not imply," she writes, "that all women will accept it or that most men will reject it; indeed there is no reason why men should not embrace it. It is feminine in the deep (...) classical sense—rooted in receptivity, relatedness, and responsiveness. It does not imply either that logic is to be discarded or that logic is alien to women. It represents an aternative to present views, one that begins with the moral attitude or longing for goodness and not with moral reasoning." What is at the basis of moral action? An altruism acquired by the application of rule and principle? Or, as Noddings asserts, caring and the memory of being cared for? With numerous examples to supplement her rich theoretical discussion, Noddings builds a compelling philosophical argument for an ethics based on natural caring, as in the care of a mother for her child. The ethical behavior that grows out of natural caring has at its core as care-filled receptivity to those involved in any moral situation, and leaves behind the rigidity of rule and principle to focus on what is particular and unique in human relations. "The hand that steadied us as we learned to ride our first bicycle did not provide propositional knowledge, but it guided and supported us all the same, and we finished up 'knowing how.'" Noddings's discussion is far-ranging, as she considers whether organizations, which operate at a remove from the caring relationship, can truly be called ethical. She discusses the extent to which we may truly care for plants, animals, or ideas. Finally, she proposes a realignment of education to encourage and reward not just rationality and trained intelligence, but also enhanced sensitivity in moral matters. (shrink)

The predominant view of moral virtue can be traced back to Aristotle. He believed that moral virtue must involve intellectual excellence. To have moral virtue one must have practical wisdom - the ability to deliberate well and to see what is morally relevant in a given context. Julia Driver challenges this classical theory of virtue, arguing that it fails to take into account virtues which do seem to involve ignorance or epistemic defect. Some 'virtues of ignorance' are counterexamples to accounts (...) of virtue which hold that moral virtue must involve practical wisdom. Modesty, for example, is generally considered to be a virtue even though the modest person may be making an inaccurate assessment of his or her accomplishments. Driver argues that we should abandon the highly intellectualist view of virtue and instead adopt a consequentialist perspective which holds that virtue is simply a character trait which systematically produces good consequences. (shrink)

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. (...) The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary. (shrink)

Environmental Health Ethics illuminates the conflicts between protecting the environment and promoting human health. In this study, David B. Resnik develops a method for making ethical decisions on environmental health issues. He applies this method to various issues, including pesticide use, antibiotic resistance, nutrition policy, vegetarianism, urban development, occupational safety, disaster preparedness and global climate change. Resnik provides readers with the scientific and technical background necessary to understand these issues. He explains that environmental health controversies cannot simply be reduced to (...) humanity versus environment and explores the ways in which human values and concerns - health, economic development, rights and justice - interact with environmental protection. (shrink)

ACKNOWLEDGMENTS. Among Those Who helped greatly in the initial stages of this project by making constructive suggestions on my first "caring" papers are Nick Burbules, William Doll, Bruce Fuller, Brian Hill, William Pinar, Mary Anne ...

The peculiar features of the climate change problem pose substantial obstacles to our ability to make the hard choices necessary to address it. Climate change involves the convergence of a set of global, intergenerational and theoretical problems. This convergence justifies calling it a 'perfect moral storm'. One consequence of this storm is that, even if the other difficult ethical questions surrounding climate change could be answered, we might still find it difficult to act. For the storm makes us extremely vulnerable (...) to moral corruption. (shrink)

Many philosophers have objected to Kant’s account of duties regarding non-human nature, arguing that it does not ground adequate moral concern for non-human natural entities. However, the traditional interpretation of Kant on this issue is mistaken, because it takes him to be arguing merely that humans should abstain from animal cruelty and wanton destruction of flora solely because such actions could make one more likely to violate one’s duties to human beings. Instead, I argue, Kant’s account of duties regarding nature (...) grounds much stronger limitations on how humans may treat non-human animals and flora, since such duties are rooted in the imperfect duty to increase one’s own moral perfection. This duty proscribes actions affecting non-human nature that decrease one’s moral perfection, such as those that cause organisms unnecessary harm. Moreover, the duty to moral perfection prescribes (but does not strictly require) actions affecting non-human nature that increase one’s moral perfection, such as those that benefit organisms. Given this interpretation, I show that, contrary to a widely held view, Kant’s moral philosophy can ground a coherent and robust approach to environmental ethics. (shrink)

In 1970 Van Rensselaer Potter was the first to use the term "bioethics" in a publication to advocate the development of a new discipline to address the basic problems of human flourishing. This article analyzes Potter's notion of bioethics in order to understand its origins, sources, and substance. In early publications, Potter conceptualized bioethics as a bridge: between present and future, nature and culture, science and values, and finally between humankind and nature. In later publications, disappointed by a predominant focus (...) on individual and medical issues, and with a wish to underscore the need for a broader perspective, Potter introduced the new term "global bioethics," meant to transcend ethics specialties and integrate them into a new interdisciplinary endeavor to address global problems. A growing interest in global bioethics today means that Potter's original insights are more timely than ever. (shrink)

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. (...) The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary. (shrink)

Ecologically responsible policies are concerned only in part with pollution and resource depletion. There are deeper concerns which touch upon principles of diversity, complexity, autonomy, decentralization, symbiosis, egalitarianism, and classlessness.

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)

Ethical concepts are, or purport to be, normative. They make claims on us: they command, oblige, recommend, or guide. Or at least when we invoke them, we make claims on one another; but where does their authority over us - or ours over one another - come from? Christine Korsgaard identifies four accounts of the source of normativity that have been advocated by modern moral philosophers: voluntarism, realism, reflective endorsement, and the appeal to autonomy. She traces their history, showing how (...) each developed in response to the prior one and comparing their early versions with those on the contemporary philosophical scene. Kant's theory that normativity springs from our own autonomy emerges as a synthesis of the other three, and Korsgaard concludes with her own version of the Kantian account. Her discussion is followed by commentary from G. A. Cohen, Raymond Geuss, Thomas Nagel, and Bernard Williams, and a reply by Korsgaard. (shrink)

The contrast typically made between utilitarianism and virtue theory is overdrawn. Utilitarianism is a universal emulator: it implies that we should lie, cheat, steal, even appropriate Aristotle, when that is what brings about the best outcomes. In some cases and in some worlds it is best for us to focus as precisely as possible on individual acts. In other cases and worlds it is best for us to be concerned with character traits. Global environmental change leads to concerns about character (...) because the best results will be produced by generally uncoupling my behavior from that of others. Thus, in this case and in this world, utilitarians should be virtue theorists. (shrink)

Challenging, with several powerful arguments, some of our deepest beliefs about rationality, morality, and personal identity, Parfit claims that we have a false view about our own nature. It is often rational to act against our own best interersts, he argues, and most of us have moral views that are self-defeating. We often act wrongly, although we know there will be no one with serious grounds for complaint, and when we consider future generations it is very hard to avoid conclusions (...) that most of us will find very disturbing. (shrink)

Contemporary biomedical ethics and environmental ethics share a common ancestry in Aldo Leopold's and Van Rensselaer Potter's initial broad visions of a connected biosphere. Over the past five decades, the two fields have become strangers. Public health ethics, a new subfield of bioethics, emerged from the belly of contemporary biomedical ethics and has evolved over the past 25 years. It has moved from its traditional concern with the tension between individual autonomy and community health to a wider focus on social (...) justice and solidarity. Public health has a broad focus that includes individual, community, and environmental health. Public health ethics attends to these broad commitments reflected in the increasing concern with the connectedness of health of individuals to the health of populations, to the health of animals, to the health of the environment; it is well situated to reconnect all three “fields” of ethics to promote a healthier planet. (shrink)

Nel Noddings argues that hers is not an ethics of agape. I want to argue, on the contrary, that it is, and that this is a problem. My central thesis is that the unidirectional nature of the analysis of one-caring reinforces oppressive institutions.

An article by Warren Reich in the December 1994 issue of this journal concludes that the word "bioethics" and the field of study it names experienced a "bilocated birth" in 1970/1971 under Van Rensselaer Potter, at the University of Wisconsin, and André Hellegers, at Georgetown University. Further historical inquiry confirms (1) that there were, from the start, some major differences—even clashes—between the Potter and the Hellegers/Georgetown understandings of bioethics; and (2) that the Hellegers/Georgetown approach came to be the more widely (...) accepted meaning of the term, while Potter's idea of bioethics remained largely marginalized. However, this inquiry also results in a third, unanticipated, conclusion: that Hellegers (in contrast to the dominant model offered by the Georgetown scholars) actually proposed a global approach to bioethics, bringing his vision much closer to Potter's evolving view than previously has been acknowledged. (shrink)

Julia Annas offers a new account of virtue and happiness as central ethical ideas. She argues that exercising a virtue involves practical reasoning of the kind we find in someone exercising an everyday practical skill, such as farming, building, or playing the piano. This helps us to see virtue as part of an agent's happiness or flourishing.

A leading international expert on environmental issues, Shrader-Frechette brings a new standard of rigor to philosophical discussions of environmental justice in her latest work. Observing that environmental activists often value environmental concerns over basic human rights, she points out the importance of recognising that minority groups and the poor in general are frequently the biggest victims of environmental degradation, a phenomenon with serious social and political implications that the environmental movement has failed to adequately address. She argues for their equal (...) rights to 'environmental justice' and maintains that they should not have to bear most of the weight of the burdens of pollution and resource depletion. Advocating a greater awareness on the part of professionals in a position to help these victims, Shrader-Frechette proposes a more equitable distribution of environmental resources and, in doing so, makes an important contribution to the fields of environmental ethics and applied philosophy. (shrink)

I develop two different epistemic roles for emotion and desire. Caring for moral ends and people plays a pivotal though contingent role in ensuring reliable awareness of morally salient details; possession of various emotions and motives is a necessary condition for autonomous understanding of moral concepts themselves. Those who believe such connections compromise the "objective" status of morality tend to assume rather than argue for the bifurcated conception of reason and affect this essay challenges.

In this essay I will argue that, preconceptions notwithstanding, Immanuel Kant does have an environmental ethics which uniquely contributes to two current debates in the field. First, he transcends the controversy between individualistic and holistic approaches to nature with a theory that considers humanity in terms of the autonomy of moral individuals and nature in terms of the integrity of functional wholes. Second, he diminishes the gulf between Conservationism and Preservationism. He does this by constructing an ideal-regarding conception of the (...) former that values nature not as "merely" a thing to be used by human preferences and translated by markets, but as an essential component and prerequisite to the intrinsic autonomy of human beings. Simultaneously, he argues for a definition of preservation which places responsibility on humanity to harmonize moral agency with the functional integrity of natural systems. Here humanity and nature become the two unique and equally important components of what we might call the greater " Kantian ecosystem." In addition to the theoretical contributions of Kant's approach to our appreciation of the duties we owe to our natural environment, I will also suggest that Kantian Conservationism and Kantian Preservationism provide a sound moral basis for public policy arguments that wish to take the intrinsic value of humanity and nature into account. By requiring decision makers to consider citizens as ethical ends and nature as a functional end-in-itself, public choice becomes a process of restricting the use of the "kingdom of nature" to the essential requirements of the "kingdom of ends.". (shrink)

Environmental ethics in its modem classical expression by Aldo Leopold appears to fall afoul of Hume’s prohibition against deriving ought-statements from is-statements since it is presented as a logical consequence of the science of ecology. Hume’s is/ought dichotomy is reviewed in its historical theoretical context. A general formulation bridging is and ought, in Hume’s terms, meeting his own criteria for sound practical argument, is found. It is then shown that Aldo Leopold’s land ethic is expressible as a special case of (...) this general formulation. Hence Leopold’s land ethic, despite its direct passage from descriptive scientific premises to prescriptive normative conclusions, is not in violation of any logical strictures which Hume would impose upon axiological reasoning. (shrink)

The nature and role of the patient in biomedicine comprise issues central to bioethical inquiry. Given its developmental history grounded firmly in a backlash against 20th-century cases of egregious human subjects abuse, contemporary medical bioethics has come to rely on a fundamental assumption: the unit of care is the autonomous self-directing patient. In this article we examine first the structure of the feminist social critique of autonomy. Then we show that a parallel argument can be made against relational autonomy as (...) well, demonstrating how this second concept of autonomy fails to take sufficiently into account an array of biological determinants, particularly those from microbial biology. Finally, in light of this biological critique, we question whether or to what extent any relevant and meaningful view of autonomy can be recovered in the contemporary landscape of bioethics. (shrink)

Aldo Leopold's land ethic has been extremely influential among people working in conservation biology, environmental ethics, and related fields. Others have abandoned the land ethic for purportedly being outdated or ethically untenable. Yet, both acceptance of the land ethic and rejection of the land ethic are often based on misunderstandings of Leopold's original meaning – misunderstandings that have become so entrenched as to have the status of myths. This essay seeks to identify and then debunk six myths that have grown (...) up around the land ethic. These myths include misunderstandings about how we should understand key terms like “stability” and “biotic community” as well as the scope and main message of the land ethic. Properly understanding Leopold's original meaning, a meaning derived from ideas he developed after a lifetime of scientific theorizing and hands-on practical knowledge, prevents hasty rejection and provides a sounder basis for conservation policy. (shrink)