What proper role should considerations of risk, particularly to research subjects, play when it comes to conducting research on human enhancement in the military context? We introduce the currently visible military enhancement techniques (1) and the standard discussion of risk for these (2), in particular what we refer to as the ‘Assumption’, which states that the demands for risk-avoidance are higher for enhancement than for therapy. We challenge the Assumption through the introduction of three categories of enhancements (3): therapeutic, preventive, (...) and pure enhancements. This demands a revision of the Assumption (4), alongside which we propose some further general principles bearing on how to balance risks and benefits in the context of military enhancement research. We identify a particular type of therapeutic enhancements as providing a more responsible path to human trials of the relevant interventions than pure enhancement applications. Finally, we discuss some possible objections to our line of thought (5). While acknowledging their potential insights, we ultimately find them to be unpersuasive, at least provided that our proposal is understood as fully non-coercive towards the candidates for such therapeutic enhancement trials. (shrink)

What proper role should considerations of risk, particularly to research subjects, play when it comes to conducting research on human enhancement in the military context? We introduce the currently visible military enhancement techniques and the standard discussion of risk for these, in particular what we refer to as the ‘Assumption’, which states that the demands for risk-avoidance are higher for enhancement than for therapy. We challenge the Assumption through the introduction of three categories of enhancements : therapeutic, preventive, and pure (...) enhancements. This demands a revision of the Assumption, alongside which we propose some further general principles bearing on how to balance risks and benefits in the context of military enhancement research. We identify a particular type of therapeutic enhancements as providing a more responsible path to human trials of the relevant interventions than pure enhancement applications. Finally, we discuss some possible objections to our line of thought. While acknowledging their potential insights, we ultimately find them to be unpersuasive, at least provided that our proposal is understood as fully non-coercive towards the candidates for such therapeutic enhancement trials. (shrink)

Gender affirming hormone treatment is an important part of the care of trans adolescents which enables them to develop the secondary sexual characteristics congruent with their identified genders. There is an increasing amount of empirical evidence showing the benefits of gender affirming hormone treatment for psychological health and social well-being in this population. However, in several countries, access to gender affirming hormone treatment for trans adolescents has recently been severely restricted. While much of the opposition to gender affirming hormone treatment (...) for trans adolescents has in part been ideologically motivated, it also reflects a debate about whether there are harms that outweigh the benefits of the treatment. Accordingly, a systematic and comprehensive philosophical analysis of the ethics of gender affirming hormone treatment for trans adolescents is needed. Herein, I offer such an analysis that draws on the four principles of biomedical ethics by Tom Beauchamp and James Childress. Based on the considerations of beneficence, nonmaleficence, autonomy, and justice, I argue that the provision of access to gender affirming hormone treatment for consenting trans adolescents is ethically required and that the current restrictions to such treatment are ethically wrong. (shrink)

Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support (...) for gender diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

Background: Smart sensors have been developed as diagnostic tools for rehabilitation to cover an increasing number of geriatric patients. They promise to enable an objective assessment of complex movement patterns. -/- Objective: This research aimed to identify and analyze the conflicting ethical values associated with smart sensors in geriatric rehabilitation and provide ethical guidance on the best use of smart sensors to all stakeholders, including technology developers, health professionals, patients, and health authorities. -/- Methods: On the basis of a systematic (...) literature search of the scientific databases PubMed and ScienceDirect, we conducted a qualitative document analysis to identify evidence-based practical implications of ethical relevance. We included 33 articles in the analysis. The practical implications were extracted inductively. Finally, we carried out an ethical analysis based on the 4 principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice. The results are reported in categories based on these 4 principles. -/- Results: We identified 8 conflicting aims for using smart sensors. Gains in autonomy come at the cost of patient privacy. Smart sensors at home increase the independence of patients but may reduce social interactions. Independent measurements performed by patients may result in lower diagnostic accuracy. Although smart sensors could provide cost-effective and high-quality diagnostics for most patients, minorities could end up with suboptimal treatment owing to their underrepresentation in training data and studies. This could lead to algorithmic biases that would not be recognized by medical professionals when treating patients. -/- Conclusions: The application of smart sensors has the potential to improve the rehabilitation of geriatric patients in several ways. It is important that patients do not have to choose between autonomy and privacy and are well informed about the insights that can be gained from the data. Smart sensors should support and not replace interactions with medical professionals. Patients and medical professionals should be educated about the correct application and the limitations of smart sensors. Smart sensors should include an adequate representation of minorities in their training data and should be covered by health insurance to guarantee fair access. (shrink)

This is the text of a paper (along with appendixes) delivered at the 2019 annual meeting of the Minnesota Philosophical Society on Oct 26 in Cambridge, MN. -/- Beauchamp and Childress’s “Four Principles” (or “Principlism”) approach to bioethics has become something of a standard not only in bioethics classrooms and journals, but also within medicine itself. In this teaching-focused workshop, I’ll be doing the following: (1) Introducing the basics of the “Four Principles” approach, with a special focus on (...) its relation to the common morality and the importance to weighing and balancing of competing norms. (2) Comparing and contrasting this to other potential approaches, such as those provided by virtue ethics, act utilitarianism, casuistry, and competing versions of principles-based ethics. (3) Considering the ways in which the principles-based approach can best be implemented for lower-level, introductory bioethics classes, where the average student may have little background knowledge in either philosophy or medicine. I’ll be presenting sample activities, case studies, and lesson plans. There will be considerable time reserved for discussion at the end, so that participants can exchange ideas relating to the teaching of both bioethics and other varieties of applied ethics. (shrink)

Much of contemporary research ethics was developed in the latter half of the twentieth century as a response to the unethical treatment of human beings in biomedical research. Research ethical considerations have subsequently been extended to cover topics in the sciences and technology such as data handling, precautionary measures, engineering codes of conduct, and more. However, moral issues in the humanities have gained less attention from research ethicists. This article proposes an ethical principle for reading for research purposes: (...) Respect the author. (shrink)

Background: Use of patients’ medical data for secondary purposes such as health research, audit, and service planning is well established in the UK. However, the governance environment, as well as public understanding about this work, have lagged behind. We aimed to systematically review the literature on UK and Irish public views of patient data used in research, critically analysing such views though an established biomedical ethics framework, to draw out potential strategies for future good practice guidance and inform (...) ethical and privacy debates. Methods: We searched three databases using terms such as patient, public, opinion, and electronic health records. Empirical studies were eligible for inclusion if they surveyed healthcare users, patients or the public in UK and Ireland and examined attitudes, opinions or beliefs about the use of patient data for medical research. Results were synthesised into broad themes using a framework analysis. Results: Out of 13,492 papers and reports screened, 20 papers or reports were eligible. While there was a widespread willingness to share patient data for research for the common good, this very rarely led to unqualified support. The public expressed two generalised concerns about the potential risks to their privacy. The first of these concerns related to a party’s competence in keeping data secure, while the second was associated with the motivation a party might have to use the data. Conclusions: The public evaluates trustworthiness of research organisations by assessing their competence in data-handling and motivation for accessing the data. Public attitudes around data-sharing exemplified several principles which are also widely accepted in biomedical ethics. This provides a framework for understanding public attitudes, which should be considered in the development in any guidance for regulators and data custodians. We propose four salient questions which decision makers should address when evaluating proposals for the secondary use of data. (shrink)

It is widely believed that a conservative moral outlook is opposed to biomedical forms of human enhancement. In this paper, I argue that this widespread belief is incorrect. Using Cohen’s evaluative conservatism as my starting point, I argue that there are strong conservative reasons to prioritise the development of biomedical enhancements. In particular, I suggest that biomedical enhancement may be essential if we are to maintain our current evaluative equilibrium (i.e. the set of values that undergird and (...) permeate our current political, economic, and personal lives) against the threats to that equilibrium posed by external, non-biomedical forms of enhancement. I defend this view against modest conservatives who insist that biomedical enhancements pose a greater risk to our current evaluative equilibrium, and against those who see no principled distinction between the forms of human enhancement. (shrink)

Most current dental ethics curricula use a deontological approach to biomedical and dental ethics that emphasizes adherence to duties and principles as properties that determine whether an act is ethical. But the actual ethical orientation of students is typically unknown. The purpose of the current study was to determine the ethical orientation of dental students in resolving clinical ethical dilemmas. First-year students from one school were invited to participate in an electronic survey that included eight vignettes (...) featuring ethical conflicts common to the health care setting. The Multidimensional Ethics Scale was used to evaluate the students’ ethical judgments of these conflicts. Students rated each vignette along 13 ethically relevant items using a 7-point scale. Nine of the thirteen items were analyzed because they represent the dominant ethical theories, including deontology. One hundred sixteen dental students successfully completed the survey. Of the analyzed items, those associated with deontology had comparatively weak associations with whether students judged the action to be ethical and whether students judged themselves likely to perform the action. Whether an action was judged to be caring had the strongest association with whether the action was judged to be ethical and whether students judged themselves likely to perform the action. These results suggest that adherence to duties or principles has weaker association with students’ ethical judgments and behavior compared to caring, which was found to be more influential in their ethical judgments and behavior. Current dental school curricula with a primary focus on deontology may no. (shrink)

Background: Biomedical research nowadays is increasingly carried out in multinational and multicenter settings. Due to disparate national regulations on various ethical aspects, such as informed consent, there is the risk of ethical compromises when involving human subjects in research. Although the Declaration of Helsinki is the point of reference for ethical conduct of research on humans, national normative requirements may diverge from its provisions. The aim of this research is to examine requirements on informed consent in biomedical research (...) in Germany, Poland, and Russia to determine how each national regulatory framework relates to the provisions of the Declaration of Helsinki. Methods: For this analysis, we conducted a search of the legal databases “Gesetze im Internet” for Germany, “Internetowy System Aktow Prawnych” for Poland, and “ГAPAHT – Garant” for Russia. The search was complemented by a review of secondary literature contained in the databases Google Scholar, PubMed, Polish National Library, and eLibrary ru. We have identified 21 normative regulations containing provisions on informed consent in clinical research in all three countries. The content of these documents was systematically categorized and analyzed. Results: The normative framework in all three countries shows a strong commitment towards the core ethical principles of research envisaged in the Declaration of Helsinki. Nevertheless, provisions on informed consent vary between these three countries. The differences range from the method and language in which information should be provided, through the amount of information required to be disclosed, to the form of documenting consent or withdrawal. In the case of research on vulnerable groups, these differences are particularly visible. Conclusions: The identified differences can negatively impact the ethical conduct of international clinical studies. Attention needs to be paid that flexibilities within national regulations are not misused to undermine the protection of research subjects. Achieving global or regional legislative harmonization might prove impossible. Such lack of legal consensus reinforces the significance of the international ethical agreements. (shrink)

Background: Exposomics, the study of the exposome, is flourishing, but the field is not well defined. The term “exposome” refers to all environmental influences and associated biological responses throughout the lifespan. However, this definition is very similar to that of the term “environment”—the external elements and conditions that surround and affect the life and development of an organism. Consequently, the exposome seems to be nothing more than a synonym for the environment, and exposomics a synonym for environmental research. As a (...) result, some have rebranded their “standard” environmental health research with the neologistic exposome term, whereas others ignore or seek to abandon the seemingly redundant concept of the exposome. -/- Objectives: We argue that exposomics needs to sharpen its mission focus to counteract this apparent redundancy. Exposomics should be defined as a research program in environmental health aimed at enabling a comprehensive and discovery-driven approach to identifying environmental determinants of human health. Similar to the aim of the Human Genome Project, exposomics aims to analyze the complete complexity of exposures and their corresponding biological responses. Exposomics’ primary premise is that the existence of undiscovered, potentially interconnected, nongenetic (environmental) risk factors for health necessitates a comprehensive discovery-driven analysis approach. -/- Discussion: We argue that exposomics researchers should adopt our reconceptualization of exposomics and focus on the productiveness and integrity of their research program: its purpose and principles. We suggest that exposomics researchers should coordinate the writing of reviews that assess the program’s productiveness and integrity, as well as provide a platform for exposomics researchers to define their vision for the field. (shrink)

A new world has probably emerged through the progression of technology which has led to significant debates on social, cultural, legal, and ethical issues, especially in the biomedical field in this century. Application of physician-patient relationship, principles of pluralism, autonomy, democracy, human dignity, and human rights is being challenged within the medicine and health-care system of today. Development of technology-based remedies has fostered greater degrees of medicalization. Hence, the automatic application of such technologies risks distorting the nature of (...) medicine. To be sure, there is a cultural shift that is affecting the society that is increasingly unable to adapt to traditional legal systems. This cultural shift, perhaps, demands new ethics. This entry aims to evaluate the gap between traditional deontological nature of medicine and the emerging new ethics and assess why bioethical reflection is needed. (shrink)

The European project European and Latin American Systems of Ethics Regulation of Biomedical Research Project (EULABOR) has carried out the first comparative analysis of ethics regulation systems for biomedical research in seven countries in Europe and Latin America, evaluating their roles in the protection of human subjects. We developed a conceptual and methodological framework defining ‘ethics regulation system for biomedical research’ as a set of actors, institutions, codes and laws involved in overseeing the (...) class='Hi'>ethics of biomedical research on humans. This framework allowed us to develop comprehensive national reports by conducting semi-structured interviews to key informants. These reports were summarised and analysed in a comparative analysis. The study showed that the regulatory framework for clinical research in these countries differ in scope. It showed that despite the different political contexts, actors involved and motivations for creating the regulation, in most of the studied countries it was the government who took the lead in setting up the system. The study also showed that Europe and Latin America are similar regarding national bodies and research ethics committees, but the Brazilian system has strong and noteworthy specificities. (shrink)

The ethical Principle of Proportionality requires combatants not to cause collateral harm excessive in comparison to the anticipated military advantage of an attack. This principle is considered a major (and perhaps insurmountable) obstacle to ethical use of autonomous weapon systems (AWS). This article reviews three possible solutions to the problem of achieving Proportionality compliance in AWS. In doing so, I describe and discuss the three components Proportionality judgments, namely collateral damage estimation, assessment of anticipated military advantage, and judgment of “excessiveness”. (...) Some possible approaches to Proportionality compliance are then presented, such as restricting AWS operations to environments lacking civilian presence, using AWS in targeted strikes in which proportionality judgments are pre-made by human commanders, and a ‘price tag’ approach of pre-assigning acceptable collateral damage values to military hardware in conventional attritional warfare. The article argues that application of these three compliance methods would result in AWS’ achieving acceptable Proportionality compliance levels in many combat environments and scenarios, allowing AWS to perform most key tasks in conventional warfare. (shrink)

This paper proposes three principles for the ethical design of online social environments aiming to minimise the unintended harms caused by users while interacting online, specifically by enhancing the users’ awareness of the moral load of their interactions. Such principles would need to account for the strong mediation of the digital environment and the particular nature of user interactions: disembodied, asynchronous, and ambiguous intent about the target audience. I argue that, by contrast to face to face interactions, additional (...) factors make it more difficult for users to exercise moral sensitivity in an online environment. An ethics for social media user interactions is ultimately an ethics of human relations mediated by a particular environment; hence I look towards an enactive inspired ethics in formulating principles for human interactions online to enhance or at least do not hinder a user’s moral sensitivity. This enactive take on social media ethics supplements classical moral frameworks by asking us to focus on the relations established through the interactions and the environment created by those interactions. (shrink)

In biomedical ethics, there is widespread acceptance of moral realism, the view that moral claims express a proposition and that at least some of these propositions are true. Biomedical ethics is also in the business of attributing moral obligations, such as “S should do X.” The problem, as we argue, is that against the background of moral realism, most of these attributions are erroneous or inaccurate. The typical obligation attribution issued by a biomedical ethicist fails (...) to truly capture the person's actual obligations. We offer a novel argument for rife error in obligation attribution. The argument starts with the idea of an epistemic burden. Epistemic burdens are all of those epistemic obstacles one must surmount in order to achieve some aim. Epistemic burdens shape decision-making such that given two otherwise equal options, a person will choose the option that has the lesser of epistemic burdens. Epistemic burdens determine one's potential obligations and, conversely, their non-obligations. The problem for biomedical ethics is that ethicists have little to no access to others' epistemic burdens. Given this lack of access and the fact that epistemic burdens determine potential obligations, biomedical ethicists often can only attribute accurate obligations out of luck. This suggests that the practice of attributing obligations in biomedical ethics is rife with error. To resolve this widespread error, we argue that this practice should be abolished from the discourse of biomedical ethics. (shrink)

This paper is an examination of the ethical principles of effective altruism as they are articulated by Peter Singer in his book The Most Good You Can Do. It discusses the nature and the plausibility of the principles that he thinks both guide and ought to guide effective altruists. It argues in § II pace Singer that it is unclear that in charitable giving one ought always to aim to produce the most surplus benefit possible and in § (...) III that there is a more attractive set of principles than the ones Singer outlines that ought to guide effective altruists in their philanthropic practices and in their lives more generally. These principles fit better with his practical ambitions and with plausible attitudes about the limits of beneficence. (shrink)

abstract This article briefly examines Onora O'Neill's account of the relation between normative principles and practical ethical problems with an eye to suggesting that philosophers of practical ethics have reason to adopt fairly high moral ambitions to be edifying and instructive both as educators and as advisors on public policy debates.

The paper discusses the possibility that the benefits of pharmacogenomics will not be distributed equally and will create orphan populations. I argue that since these inequalities are not substantially different from those produced by ‘traditional’ drugs and are not generated with the intention to discriminate, their production needs not be unethical. Still, the final result is going against deep-seated moral feelings and intuitions, as well as broadly accepted principles of just distribution of health outcomes and healthcare. I thus propose (...) two provisos that would prevent the most offensive outcomes and moderate the scope of the produced inequalities. The first proviso rejects pharmacogenomics innovations that worsen existing group inequalities and aggravate the disadvantage of communities with a history of discrimination. The second proviso requires that there is a strategy in place to even out as much as possible the distribution of benefits in the future and that a system of compensations is in place for pharmacogenomic orphans. Given that only one moral problem generated by pharmacogenomics has been tackled, the list of provisos might be expanded when other issues are considered. (shrink)

When people share the same knowledge and culture, it is difficult to distinguish whether their ‎national speech is humanitarian or racist. Such things make it easy for people to accept ‎unhumanitarian speech just because it stems from their culture. Hence, the purpose of this ‎investigation is to give readers a tool to assist them in discriminating between discourses that ‎are racist and those that are humanitarian. It is called the principle of compliance. The principle ‎said that if all nations and (...) different cultures apply this discourse, what will be the overall ‎result in respect for people’s lives and plant resources? Does this discourse encourage ‎greater goodness or evil?. Goodness has been defined as preserving humanity and the Earth's ‎natural resources.‎. (shrink)

Andreas Follesdal,Victor Muñiz Fraticelli | : A Principle of Subsidiarity regulates the allocation and/or use of authority within a political order where authority is dispersed between a centre and various sub-units. Section 1 sketches the role of such principle of subsidiarity in the EU, and some of its significance in Canada. Section 2 presents some conceptions of subsidiarity that indicate the range of alternatives. Section 3 considers some areas where such conceptions might add value to constitutional and political deliberations in (...) Canada. Section 4 concludes with some reminders of crucial contested issues not fully resolved by appeals to subsidiarity alone, exemplified by the protection of human rights. | : Un principe de subsidiarité réglemente la répartition et/ou l’usage de l’autorité au sein d’un ordre politique où l’autorité est dispersée entre un centre et des sous-unités variées. La section 1 de cet article montre le rôle d’un tel principe de subsidiarité dans l’Union européenne, et certaines de ses implications au Canada. La section 2 présente des conceptions de la subsidiarité qui indiquent un éventail d’alternatives. La section 3 considère certains domaines où de telles conceptions pourraient ajouter de la valeur aux délibérations constitutionnelles et politiques au Canada. La section 4 conclut en rappelant certains problèmes cruciaux contestés, non entièrement résolus par les seuls appels à la subsidiarité, exemplifiés par la protection des droits humains. (shrink)

Ontologies describe reality in specific domains in ways that can bridge various disciplines and languages. They allow easier access and integration of information that is collected by different groups. Ontologies are currently used in the biomedical sciences, geography, and law. A Biomedical Ethics Ontology would benefit members of ethics committees who deal with protocols and consent forms spanning numerous fields of inquiry. There already exists the Ontology for Biomedical Investigations (OBI); the proposed BMEO would interoperate (...) with OBI, creating a powerful information tool. We define a domain ontology and begin to construct a BMEO, focused on the process of evaluating human research protocols. Finally, we show how our BMEO can have practical applications for ethics committees. This paper describes ongoing research and a strategy for its broader continuation and cooperation. (shrink)

Addressing the question in the form of Kant’s maxim, this paper moves on to a more controversial topic in biomedical ethics, physician-assisted suicide. However, my conclusion is tentative, and what is worse, negative: I partially approve suicide. It does not imply a moral hazard. The situation is opposite: in the present times, terminal patients seriously wish it. I, as an author, put an emphasis on this very respect. Now suicide is, for certain circles, nothing but justice. The arguments (...) of thinkers who approve suicide are also cited from this angle. (shrink)

Abstract: In Vacco v. Quill, 521 U.S. 793 (1997), the Supreme Court for the first time in American case law explicitly applied the principle of double effect to reject an equal protection claim to physician-assisted suicide. Double effect, traced historically to Thomas Aquinas, proposes that under certain circumstances it is permissible unintentionally to cause foreseen evil effects that would not be permissible to cause intentionally. The court rejected the constitutional claim on the basis of a distinction marked out by the (...) principle, i.e., between directly intending the death of a terminally ill patient as opposed to merely foreseeing that death as a consequence of medical treatment. The Court held that the distinction comports with fundamental legal principles of causation and intent. Id. at 802. -/- Critics allege that the principle itself is intrinsically flawed and that, in any event, its employment in Vacco is without legal precedent. I argue in response to contemporary objections that double effect is a valid principle of ethical reflection (Part II); claims to the contrary notwithstanding, double effect analysis is a pervasive, albeit generally unacknowledged principle employed regularly in American case law (Part III); and drawing on the preceding two sections, Vacco's application of the principle of double effect is appropriate (Part IV). -/- My conclusion is that [o]peration of some form of the principle, by whatever name, is inevitable. In an imperfect world where duties and interests collide, the possibility of choices of action foreseen to have both good and evil consequences cannot be avoided. In rare circumstances, ethics and the law require that a person refrain from acting altogether. More often, however, they provide that a determination of whether an actor may pursue a good effect although knowing it will or may unintentionally cause an harmful effect requires a more complex analysis - a double effect analysis. -/- Keywords: Equal protection, double effect, intention, physician-assisted suicide, Constitutional Law, Bioethics. (shrink)

During the eighteenth century, German philosophers wrote on a broad range of topics in moral philosophy: from meta-ethical issues such as the nature of obligation, to elaborate systems of normative ethics (often in the form of a doctrine of duties to self, others, and God), to topics in applied ethics such as the permissibility of the death penalty and censorship. Moral philosophy was also intimately related to the modern natural law tradition at the time, as well as to (...) discussions taking place in theology and psychology, to name only a few other disciplines. As a result, it is often hard to isolate eighteenth-century German moral philosophy without addressing a whole host of other philosophical subjects. There are nonetheless certain central topics that were discussed by nearly every major figure of the period and which therefore serve as a window into how German philosophers approached moral philosophy during the eighteenth century. In this chapter I illustrate that one such topic is the principle of morality; namely what philosophers took to be the supreme norm at the foundation of judging actions to be morally good or evil. As we will see, although several figures approached this principle in a broadly similar way by identifying “perfection” as the central concept at work, they differ considerably with respect to important details. Furthermore, certain common threads reveal themselves: philosophers differ not only with respect to the content of the principle, but also with respect to the way in which it can be derived, how particular duties can in turn be derived from the supreme principle, and how the principle can be formulated. I begin by outlining Christian Wolff’s influential principle of perfection (Section 1), followed by a consideration of Alexander Gottlieb Baumgarten’s subtle revision of this principle (Section 2) and Christian August Crusius’s theological alternative (Section 3). I then briefly consider the impact that the reception of eighteenth-century British philosophy had on German moral philosophy during the second half of the eighteenth century (Section 4), before considering Moses Mendelssohn’s and Immanuel Kant’s answers to the 1763 Prize Essay Question (Section 5) and Johann August Eberhard’s unique mixture of rationalism and empiricism from the early 1780s (Section 6). I conclude (Section 7) with a brief discussion of Kant’s approach to the principle of morality and the principle of happiness proposed against it by his early empiricist critics. (shrink)

After the terrorist attacks of September 11, 2001, most legacy airlines filed for bankruptcy protection as a way to cut costs drastically, with the exception of American Airlines. This article applies the Principle of Double-Effect to the act of filing for Chapter 11 bankruptcy protection for reasons of management strategy, in particular, cost-cutting. It argues that the Principle can be a useful tool for discerning the ethicality of the action, and demonstrates the usefulness by proposing three double-effect criteria that, when (...) fulfilled, argues for the ethical justifiability the action in question. (shrink)

Modern digital technologies—from web-based services to Artificial Intelligence (AI) solutions—increasingly affect the daily lives of billions of people. Such innovation brings huge opportunities, but also concerns about design, development, and deployment of digital technologies. This article identifies and discusses five clusters of risk in the international debate about digital ethics: ethics shopping; ethics bluewashing; ethics lobbying; ethics dumping; and ethics shirking.

The conjunction of wireless computing, ubiquitous Internet access, and the miniaturisation of sensors have opened the door for technological applications that can monitor health and well-being outside of formal healthcare systems. The health-related Internet of Things (H-IoT) increasingly plays a key role in health management by providing real-time tele-monitoring of patients, testing of treatments, actuation of medical devices, and fitness and well-being monitoring. Given its numerous applications and proposed benefits, adoption by medical and social care institutions and consumers may be (...) rapid. However, a host of ethical concerns are also raised that must be addressed. The inherent sensitivity of health-related data being generated and latent risks of Internet-enabled devices pose serious challenges. Users, already in a vulnerable position as patients, face a seemingly impossible task to retain control over their data due to the scale, scope and complexity of systems that create, aggregate, and analyse personal health data. In response, the H-IoT must be designed to be technologically robust and scientifically reliable, while also remaining ethically responsible, trustworthy, and respectful of user rights and interests. To assist developers of the H-IoT, this paper describes nine principles and nine guidelines for ethical design of H-IoT devices and data protocols. (shrink)

In the debates regarding the ethics of human enhancement, proponents have found it difficult to refute the concern, voiced by certain bioconservatives, that cognitive enhancement violates the autonomy of the enhanced. However, G. Owen Schaefer, Guy Kahane and Julian Savulescu have attempted not only to avoid autonomy-based bioconservative objections, but to argue that cognition-enhancing biomedical interventions can actually enhance autonomy. In response, this paper has two aims: firstly, to explore the limits of their argument; secondly, and more importantly, (...) to develop a more complete understanding of autonomy and its relation to cognitive enhancement. By drawing a distinction between the capacity for autonomy and the exercise and achievement of autonomy and by exploring the possible effects of cognitive enhancement on both competence and authenticity conditions for autonomy, the paper identifies and explains which dimensions of autonomy can and cannot, in principle, be enhanced via direct cognitive interventions. This allows us to draw conclusions regarding the limits of cognitive enhancement as a means for enhancing autonomy. (shrink)

In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle of policy equipoise. According to this principle, all arms of a policy RCT must be, at minimum, in a state of equipoise with the best proven policy that is also morally and practically attainable and sustainable. For all arms of a (...) policy RCT, policy experts must either reasonably disagree about whether the trial arms are more effective than this policy, or know that they are. (shrink)

The main purpose of this study is to introduce, analyze and propose the concept of Piety in Rousseau as a part of the ethical fundament of Positive Leadership Theory, also as a continuum of the original fundamental element of the Social Pact and its implication on the legitimization of organizational dynamics in the private sector (corporate ethics) and the impact on institutional efficiency. Given the theoretical nature of this research, the classic dialectic method has shown itself adequate once in (...) it there is a search for identification of an object (theory), its contradictions, and conflicts involved in the analyses of the problem. For that purpose, a vast bibliographical, documental e internet site research was conducted examining many of the main works about the themes studied. After presenting and dialectically analyzing the foundation of the Rousseaunian Social Pact, in convergence with the responsibility principle structure, this paper concludes by suggesting that these theoretical models can constitute the ethical basis of the management proposition of Positive Leadership as organization dynamics. (shrink)

Current advances in research, development and application of artificial intelligence systems have yielded a far-reaching discourse on AI ethics. In consequence, a number of ethics guidelines have been released in recent years. These guidelines comprise normative principles and recommendations aimed to harness the “disruptive” potentials of new AI technologies. Designed as a semi-systematic evaluation, this paper analyzes and compares 22 guidelines, highlighting overlaps but also omissions. As a result, I give a detailed overview of the field of (...) AI ethics. Finally, I also examine to what extent the respective ethical principles and values are implemented in the practice of research, development and application of AI systems—and how the effectiveness in the demands of AI ethics can be improved. (shrink)

Absolutist systems of ethics have come in for harsh criticism on a number of fronts. The Principle of Double Effect was formulated by Catholic ethicists to overcome such objections. In this essay, Leslie Allan addresses four of the most prominent problems faced by an absolutist ethic and evaluates the extent to which the Principle of Double Effect is successful in avoiding or mitigating these criticisms.

It is possible that the world contains infinitely many agents that have positive and negative levels of well-being. Theories have been developed to ethically rank such worlds based on the well-being levels of the agents in those worlds or other qualitative properties of the worlds in question, such as the distribution of agents across spacetime. In this thesis I argue that such ethical rankings ought to be consistent with the Pareto principle, which says that if two worlds contain the same (...) agents and some agents are better off in the first world than they are in the second and no agents are worse off than they are in the second, then the first world is better than the second. I show that if we accept four axioms – the Pareto principle, transitivity, an axiom stating that populations of worlds can be permuted, and the claim that if the ‘at least as good as’ relation holds between two worlds then it holds between qualitative duplicates of this world pair – then we must conclude that there is ubiquitous incomparability between infinite worlds. I show that this is true even if the populations of infinite worlds are disjoint or overlapping, and that we cannot use any qualitative properties of world pairs to rank these worlds. Finally, I argue that this incomparability result generates puzzles for both consequentialist and non-consequentialist theories of objective and subjective permissibility. (shrink)

To address some questions in global biomedical ethics, three problems about cultural moral differences and alleged differences in Eastern and Western cultures are addressed: The first is whether the East has fundamentally different moral traditions from those in the West. Concentrating on Japan and the United States, it is argued that theses of profound and fundamental East-West differences are dubious because of many forms of shared morality. The second is whether human rights theory is a Western invention with (...) no firm traditions in Eastern moral traditions. It is argued that this thesis is unsupported both historically and in contemporary bioethics. The third problem is whether multiculturalist theory casts doubt on claims of universal principles and rights. It is argued that the reverse is true: multiculturalism is a universalistic theory. The argument throughout supports common morality theory. (shrink)

As the Zika virus pandemic continues to bring worry and fear to health officials and medical scientists, Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have recommended that residents of the Zika-infected countries, e.g., Brazil, and those who have traveled to the area should delay having babies which may involve artificial contraceptive, particularly condom. This preventive policy, however, is seemingly at odds with the Roman Catholic Church’s position on the contraceptive. As least since the promulgation of (...) Paul VI’s 1968 encyclical, Humanae Vitae, the Church has explicitly condemned artificial birth control as intrinsic evil. However, the current pontiff, Pope Francis, during his recent visit to Latin America, remarked that the use of artificial contraception may not be in contradiction to the teaching of Humanae Vitae while drawing a parallel between the current Zika Crisis and the 1960’s Belgian Congo Nun Controversy. The pope mentioned that the traditional ethical principle of the lesser of two evils may be the doctrine that justified the exceptions. The authors of this paper attempt to expand the theological rationale of the pope’s suggestion. In so doing, the authors rely on casuistical reasoning as an analytic tool that compares the Belgian Congo Nun case and the given Zika case, and suggest that the former is highly similar to, if not the same as, the latter in terms of normative moral feature. That is, in both cases the use of artificial contraception is theologically justified in reference to the criteria that the doctrine of the lesser of two evils requires. The authors wish that the paper would provide a solid theological-ethical ground based on which condom-use as the most immediate and effective preventive measure can be recommended in numerous Catholic hospitals as well as among Catholic communities in the world, particularly the most Zika-affected and largest Catholic community in the world, Brazil – 123 million present Brazilian citizens are reported to be Roman Catholic. (shrink)

We present a novel methodology for calculating the improvements obtained in successive versions of biomedical ontologies. The theory takes into account changes both in reality itself and in our understanding of this reality. The successful application of the theory rests on the willingness of ontology authors to document changes they make by following a number of simple rules. The theory provides a pathway by which ontology authoring can become a science rather than an art, following principles analogous to (...) those that have fostered the growth of modern evidence-based medicine. Although in this paper we focus on ontologies, the methodology can be generalized to other sorts of terminology-based artifacts, including Electronic Patient Records. (shrink)

The ethical basis of trade unionism is the principle of solidarity, according to which “an injury to one is an injury to all.” The principle is analyzed in accordance with three competing interpretations: a “common-interest” interpretation, a “common-fate” interpretation, and a “common front” interpretation. The last of these interpretations, according to which the principle sets out “the terms of a mutually advantageous practice of reliable and reciprocal defence of one another, as if we were each defending ourselves,” is explained and (...) defended. (shrink)

Good governance, first appeared in the nineties within the United Nations, the World Bank and International Monetary Fund refers to describe how public organizations best conduct public affairs and deliver public goods and services. Today, about three decades later good governance seems to be still popular since there are still many challenges ahead for many governments especially in less-developed and developing countries. Hence the notion of good governance was emerged as a normative commencement of the principles, values and (...) class='Hi'>ethics to realise the acts of governance. Some thoughts on good governance and related topics advocated by three great ancient philosophers, who appear to be relevant at the present time are considered herein. One of the said philosophers is Kautilya (also known as Chanakya and Vishnugupta), who lived in India around 150AD. The others are the two great Greek philosophers Plato (427- 347BC) and Aristotle (384-322 BC), who stand with Socrates as the shapers of the whole intellectual tradition of the West. The thoughts are extracted from that detailed manual of state-craft and the science of living known as the Arthashastra written by one of classical India’s greatest minds Kautilya, Plato’s great work known as ‘The Republic’ and Aristotle’s treatise titled ‘The Politics”. The objective of this paper is to study the thoughts of ancient Greek philosophers who lived many centuries ago and their ideas are still relevant today. (shrink)

A current advance within the agricultural industry is the use of genetic engineering to produce novel crops for food production. This technology raises questions about how societies should position themselves with respect to genetically modified (GM) crop development and implementation; namely, how should the potentials and risks of this technology be evaluated? We argue that current methods to evaluate the risks and benefits of GM crops are inadequate and not conducive to the strategic development of this technology, where a way (...) to ameliorate technology assessments for GM crops is to include farmers in the research process of evaluating these crops prior to their commercialization. However, particularities concerning the ethical status of such research require special consideration and vigilance. For example, in such technology assessment initiatives, farmers would occupy both the roles of research participant and research investigator. Other particularities surface due to factors related to the nature of GM crops. These particularities are examined with reference to concepts drawn from the field of research ethics, namely informed consent, compensatory decisions, and issues of participant inclusion/exclusion. (shrink)

In the near future, our society may develop a vast array of medical enhancements. There is a large debate about enhancements, and that debate has identified many possible harms. This paper describes a harm that has so far been overlooked. Because of some particular features of enhancements, we could come to place more value on them than we actually should. This over-valuation would lead us to devote time, energy, and resources to enhancements that could be better spent somewhere else. That (...) mistake might not be trivial. By spending too much time, energy, and resources on enhancements, we could set back our pursuit of our deepest goals such as living happily and leading ethical lives. (shrink)

This article focuses on the ethical implications of so-called ‘collateral damage’. It develops a moral typology of collateral harm to innocents, which occurs as a side effect of military or quasi-military action. Distinguishing between accidental and incidental collateral damage, it introduces four categories of such damage: negligent, oblivious, knowing and reckless collateral damage. Objecting mainstream versions of the doctrine of double effect, the article argues that in order for any collateral damage to be morally permissible, violent agents must comply with (...) high standards of care. In order for incidental harm to be permissible, an agent must take pains to avoid such harm even at higher cost to him- or herself. It is argued that accidentally but negligently caused collateral damage may be just as difficult to excuse as incidental harm. Only if high precautionary standards of care are met, can unintended harm to innocents – incidental or accidental – be permissible. In practice, such a strong commitment to avoiding harm to civilians may well lead us to question more generally and rethink more radically how violent conflicts ought to be fought, how military violence ought to be used and whether there are better ways of achieving those aims that we think are legitimate than those we are currently using. (shrink)

One of the still unsolved problems in liberal anarchism is a definition of social constituency in positive terms. Partially, this had been solved by the advancements of liberal discourse ethics. These approaches, built on praxeology as a universal framework for social formation, are detached from the need of any previous or external authority or rule for the discursive partners. However, the relationship between action, personal identity, and liberty within the process of a community becoming solely generated from the praxeological (...) a priori remains largely disputed. In order to develop a testable constitutional model, this study revises how the “ontological turn” was introduced into liberal theories and redefines the concept of liberty. Liberty is usually understood as a moral goal or measurement for just actions, as the generative principle of all social existence - individual and interpersonal. For this purpose, the function of performative contradiction within the mechanism of interpersonal “encounter”, as part of the co-generative process of the individual becoming and social formation was explored through the production of a game-based narrative historiography grounded on 19th century life writings. This narrative historiography was developed in the context of Swiss history, with a “design-based” research approach, and resulted in a prototype for networked storytelling through which the transformative learning process could be visible and the negotiation of competing individual visions of the future could be re-enacted. (shrink)

We present a novel methodology for calculating the improvements obtained in successive versions of biomedical ontologies. The theory takes into account changes both in reality itself and in our understanding of this reality. The successful application of the theory rests on the willingness of ontology authors to document changes they make by following a number of simple rules. The theory provides a pathway by which ontology authoring can become a science rather than an art, following principles analogous to (...) those that have fostered the growth of modern evidence-based medicine. Although in this paper we focus on ontologies, the methodology can be generalized to other sorts of terminology-based artifacts, including Electronic Patient Records. (shrink)

According to the Thomistic tradition, the Principle of Totality (TPoT) articulates a secondary principle of natural law which guides the exercise of human ownership or dominium over creation. In its general signification, TPoT is a principle of distributive justice determining the right ordering of wholes to their parts. In the medical field it is traditionally understood as entailing an absolute prohibition of bodily mutilation as irrational and immoral, and an imperfect obligation to use the parts of one’s body for the (...) perfection of the bodily whole. TPoT is thus a key element of the system of principles within which an individual exercises her right to life: it helps specify the nature, scope and limits of those actions by which an agent permissibly acts in order to preserve her life. While the Thomistic tradition and the Catholic Church have drawn clear conclusions from the principle regarding, e.g., direct sterilization and non-therapeutic experimentation on human subjects, less attention has been given to the implications of TPoT for non-therapeutic procedures that may positively impact biological functioning or supra-biological goals–that is, for human “enhancement.” We will explore the degree to which TPoT non-univocally guides our use of both artifacts and bodies. We will argue that a careful analysis of these distinct kinds of totalities suggests that the application of TPoT to artifacts and bodies is strongly isomorphic, which is what tempts advocates of the Principle of Autonomy to invalidly infer the absolute dominium of the individual over her body. The inference is invalid because this isomorphism also includes a principle of intrinsic value whose function is to resist the instrumentalization of both artifacts and bodies in some contexts; we are not even related to artifacts as advocates of absolute autonomy believe we are, let alone to our bodies. Rather, the limits of human dominium are determined by the nature and finalities, inherent or acquired, of the objects in question, and it will be argued that articulating these limits raises important, understudied, and fascinating questions about the permissibility of various kinds of human enhancement. (shrink)

This is a defense of John Stuart Mill’s proof of the principle of utility in the fourth chapter of his Utilitarianism. The proof is notorious as a fallacious attempt by a prominent philosopher, who ought not to have made the elementary mistakes he is supposed to have made. This book shows that he did not. The aim is not to glorify utilitarianism, in a full sweep, as the best normative ethical theory, or even to vindicate, on a more specific level, (...) Mill’s universalistic ethical hedonism as the best form of utilitarianism. The book is concerned only with Mill’s utilitarianism, and primarily with his proof of the principle of utility. The purpose is to show that Mill proceeds intelligibly and systematically in pursuing a well-defined project in the fourth chapter of Utilitarianism, and that he successfully defends what he sets out to establish in his proof of the principle of utility. (shrink)

The principle of subsidiarity is a multi-layered and flexible principle that can be utilised to empower, inform, enhance and reform scholarship in a range of significant areas, however, it has been somewhat overlooked in recent scholarship. In order to highlight the continued relevance and potential applications of the principle, this, the first of two papers, will provide a detailed analysis of the meaning and application of the principle of subsidiarity in Catholic social teaching. In doing so, the interplay of the (...) principle of subsidiarity and other key principles of catholic social teaching such as dignity of the person, solidarity, and the common good will be highlighted. The second part of this paper discusses the political applications of the principle, including its ability to inform scholarship on the allocation of governmental powers (including federalism), democracy, and individual participation in government. This leads to a discussion in the second paper, of the Catholic aspects of subsidiarity in the governance of the European Union. (shrink)

Many nongovernmental forms of business regulation aim at reducing ethical violations in commerce. We argue that such nongovernmental ethics standards, while often laudable, raise their own ethical challenges. In particular, when such standards place burdens upon vulnerable market participants (often, though not always, SMEs), they do so without the backing of traditional legitimate political authority. We argue that this constitutes a structural analogy to wars of humanitarian intervention. Moreover, we show that, while some harms imposed by such standards are (...) desirable, others are best thought of as a form of collateral damage. We thus look at the well-developed literature on just war theory for inspiration and find that the principles of jus ad bellum and jus in bello contain many insights that can be fruitfully adapted to the case of nongovernmental standard-setting. Consequently, we propose the Ius ad Normam—a set of principles that should guide would-be standard-setters in assessing whether imposing those burdens is ethically justifiable in particular cases. We also discuss how powerful multinational businesses often act simultaneously as standard-takers and standard-setters and explore the normative implications of this dual role. (shrink)