Introduction to one of the most important, controversial, and suggestive works of moral philosophy ever written.

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

Two essays on utilitarianism, written from opposite points of view, by J. J. C. Smart and Bernard Williams. In the first part of the book Professor Smart advocates a modern and sophisticated version of classical utilitarianism; he tries to formulate a consistent and persuasive elaboration of the doctrine that the rightness and wrongness of actions is determined solely by their consequences, and in particular their consequences for the sum total of human happiness. In Part II Bernard Williams offers a sustained (...) and vigorous critique of utilitarian assumptions, arguments and ideals. He finds inadequate the theory of action implied by utilitarianism, and he argues that utilitarianism fails to engage at a serious level with the real problems of moral and political philosophy, and fails to make sense of notions such as integrity, or even human happiness itself. This book should be of interest to welfare economists, political scientists and decision-theorists. (shrink)

While this paper does not explicitly define the concept of autonomy, the way Ubel et al describe clinicians’ failures to enhance their patients’ autonomy reflects a broader understanding of autonomy than the default account as free and informed choice. In this OPC I would demonstrate that the communication strategies the authors recommend reflects a more sophisticated conception of autonomy than the understanding that typically prevails in bioethics. I will also distinguish between weak and strong forms of paternalism, and argue that (...) a weak paternalistic approach is not only defensible but also aligns with the strategies the authors propose. Thus, by clarifying the concept of autonomy we can show how it can be enhanced in practice. (shrink)

When we applied for the editorship of the JME 7 years ago, we said that we considered the JME to be the most important journal in medicine. The most profound questions that health professionals face are not scientific or technical, but ethical. Our enormous scientific and medical progress already outstrips our capability to provide treatment. Life can be prolonged at enormous cost, sometimes far beyond the point that the individual appears to be gaining a net benefit from that life. Science (...) can tell us how to achieve something, but it cannot tell us whether we should achieve that end—whether it is good. For that, we need ethics. Ethics grows in importance as our technology creates new possibilities. Where there are no options, there are no ethical questions. However, once there are options, there arise pressing questions about whether to pursue them. We require values and principles to decide how to use medicine and science. During the last 7 years, issues like the creation of brain organoids, human non-human chimeras, mitochondrial transfer, gene editing of embryos and in vitro gametogenesis have grown in prominence. These raise deep questions about moral status and how it should be determined, the limits of modification of humans, and what is good in life. As editors of the JME, we are proud of our small contribution to thinking about these challenges. We are grateful to the hard work of our associate editors and administrative staff, but there is still much more to do. During our term as editors, we have published papers from diverse perspectives, on a wide range of topics. We have seen vigorous debate within the pages of the journal and have often sought to deliberately encourage that debate …. (shrink)

Background: Although family caregivers play an important role in end-of-life care decisions, few studies have examined the communication between family caregivers and patients at the end of life. Objective: The objective was to describe family caregivers’ attitudes toward death, hospice, and truth disclosure. Research design: A quantitative method was used, and a closed-ended survey of 140 family caregivers was conducted in China. The subjects included 140 primary family caregivers of elders with terminal cancer enrolled at a hospice center from April (...) to August 2017. Participants: 140 primary family caregivers of elders with terminal cancer participated the study. Research Context: A high proportion of cancer patients continue to receive inadequate information about their illness. Family caregivers’ inhibitions about disclosing information to cancer patients have not yet been the objects of research in China. Ethical considerations: This study was reported to and approved by the Regional Ethics Committee in Shenzhen, China. Findings: A questionnaire survey collected information on family caregivers’ background information, emotional state, personal needs, death attitudes, and truth-disclosure opinions. The results revealed that family caregivers’ death attitudes and truth-disclosure opinions played an important role in the process of caring for elders with terminal cancer. Discussion: By adopting a quantitative method, the author revealed not only the general patterns of family caregivers’ attitudes toward cancer diagnosis disclosure but also the reasons for their actions and the practices of family disclosure. Conclusion: The findings suggested that ineffective communication concerning end-of-life issues resulted from family caregivers’ lack of discussion and difficulty in hearing the news. Future studies should examine strategies for optimal communication between family caregivers and patients, especially with regard to breaking the bad news. Professional training in breaking bad news is important and is associated with self-reported truth-disclosure practices among family caregivers. (shrink)

This collection of classic and contemporary readings in ethics presents sharp, competing views on a wide range of fundamentally important topics: moral relativism and objectivism, ethical egoism, value theory, utilitarianism, deontological ethics, virtue ethics, ethics and religion, and applied ethics. The Fourth Edition dramatically increases the volume’s utility by expanding and updating the selections and introductions while retaining the structure that has made previous editions so successful.

Everyday practice is steeped in ethical considerations for nursing and healthcare professionals, but the theory behind ethics is removed from day to day care. This concise book shows how ethics implicates your work in a straightforward way. All the essential knowledge of ethics you need for passing your course is covered, including the principles of bioethics, rights and moral philosophy.

Book reviewed in this article: Case Studies in Nursing Ethics. By Robert M. Veatch and Sara T. Fry.

In this project, we aimed to revise the medical ethics curriculum at the School of Medicine, Tehran University of Medical Sciences, in order to promote the level of students' ethical awareness and enable them to make ethical decisions.Ideal and long term educational objectives were set to determine directions for future reforms and to provide a baseline for future evaluation of the project. However, based on limited available recourses, the first stage of the reform was planned and implemented with a 3 (...) years scope. In revising the curriculum, which was done according to the Harden's ten questions, we focused on moral attitude and ethical reasoning skill in addition to academic knowledge base by using methods such as case discussions, portfolio, and clinical ethics rounds. The revised curriculum was implemented during the first semester of the 2006-2007 academic year for the first time.The student feedback indicated that the new curriculum was successful in increasing the students' awareness of ethical issues and enabled them to understand and accept their professional obligations.Revising the curriculum and its evaluation should be considered as an ongoing process. The present project was a successful experience that motivated faculty members to pursue the next steps of improving the curriculum on medical ethics and proved to be convincing for the authorities and policy makers to support it. (shrink)