This chapter discusses the prospects for logical, semantic, metaphysical, and epistemic characterisations of the autonomy of ethics.

My first paper on the Is/Ought issue. The young Arthur Prior endorsed the Autonomy of Ethics, in the form of Hume’s No-Ought-From-Is (NOFI) but the later Prior developed a seemingly devastating counter-argument. I defend Prior's earlier logical thesis (albeit in a modified form) against his later self. However it is important to distinguish between three versions of the Autonomy of Ethics: Ontological, Semantic and Ontological. Ontological Autonomy is the thesis that moral judgments, to be true, (...) must answer to a realm of sui generis non-natural PROPERTIES. Semantic autonomy insists on a realm of sui generis non-natural PREDICATES which do not mean the same as any natural counterparts. Logical Autonomy maintains that moral conclusions cannot be derived from non-moral premises.-moral premises with the aid of logic alone. Logical Autonomy does not entail Semantic Autonomy and Semantic Autonomy does not entail Ontological Autonomy. But, given some plausible assumptions Ontological Autonomy entails Semantic Autonomy and given the conservativeness of logic – the idea that in a valid argument you don’t get out what you haven’t put in – Semantic Autonomy entails Logical Autonomy. So if Logical Autonomy is false – as Prior appears to prove – then Semantic and Ontological Autonomy would appear to be false too! I develop a version of Logical Autonomy (or NOFI) and vindicate it against Prior’s counterexamples, which are also counterexamples to the conservativeness of logic as traditionally conceived. The key concept here is an idea derived in part from Quine - that of INFERENCE-RELATIVE VACUITY. I prove that you cannot derive conclusions in which the moral terms appear non-vacuously from premises from which they are absent. But this is because you cannot derive conclusions in which ANY (non-logical) terms appear non-vacuously from premises from which they are absent Thus NOFI or Logical Autonomy comes out as an instance of the conservativeness of logic. This means that the reverse entailment that I have suggested turns out to be a mistake. The falsehood of Logical Autonomy would not entail either the falsehood Semantic Autonomy or the falsehood of Ontological Autonomy, since Semantic Autonomy only entails Logical Autonomy with the aid of the conservativeness of logic of which Logical Autonomy is simply an instance. Thus NOFI or Logical Autonomy is vindicated, but it turns out to be a less world-shattering thesis than some have supposed. It provides no support for either non-cognitivism or non-naturalism. (shrink)

In the present paper, I attempt to provide a reconstructed Marxian response to the question of whether the social (and behavioral) sciences constitute a philosophical threat to the autonomy of ethics. I suggest that shedding light on some aspects of the Marxian work (especially the _Theses on Feuerbach_), from the standpoint of the debate on naturalism in contemporary analytic philosophy, can offer valuable philosophical insights against the framework of scientific naturalism. This framework is responsible for presenting the social (...) sciences as a philosophical threat to the autonomy of ethics. I argue that Marx detects and rejects three fundamental presuppositions of scientific naturalism: empiricism, ‘God’s point of view,’ and methodological individualism. I conclude that the Marxian view is a liberal naturalist perspective which allows both the scientific comprehension of the social world and the autonomy of ethics. (shrink)

There are various ways of characterising Hume’s dictum that ‘you can’t get an ought from an is.’ Contributors to the literature directly addressing this question focus on logical characterisations of autonomy theses. Such theses maintain that certain logical relations do not obtain between ethical and non-ethical sentences, for instance that no non-ethical sentences logically entail an ethical sentence. I argue that this focus on logical autonomy is a mistake. The thesis so important to our metaethicists is not a (...) logical thesis but a metaphysical one. The relevant metaphysical autonomy thesis maintains that ethical facts are not fully grounded just in non-ethical facts. I defend this characterization. I also defend the converse thesis that all facts partly grounded in ethical facts are ethical facts. I then argue that this pair of theses can help with debates about the plausibility of nihilism and the classification of revisionary metaethical theses. (shrink)

Thomas Reid has the unusual distinction of arriving at a metaethical position very much like G. E. Moore’s via a route very similar to that employed by the Kantians. That is, Reid embraces a version of nonnaturalist moral realism by appeal not to open question-style considerations but to a particular account of agency. In this essay, we reconstruct Reid’s agency-centered argument for his constitutivist version of moral nonnaturalism, highlighting its commitments. Having presented Reid’s argument, we close by considering a prominent (...) contemporary Kantian view, namely, Christine Korsgaard’s, and identifying where, despite their common commitments, Reid and Korsgaard part company. The comparison, we suggest, is instructive because it allows us to see more clearly why the link between agency-centered approaches to ethical theorizing and nonrealist, constitutivist views of morality, such as Korsgaard’s, is deeply contingent. (shrink)

This article considers the value of adopting a code of professional ethics for teachers. After having underlined how a code of ethics stands to benefits a community of educators – namely, by providing a mechanism for regulating autonomy and promoting a shared professional ethic – the article examines the principal arguments against codes of ethics. Three arguments are presented and analyzed in light of the codes of teacher ethics in place elsewhere in Canada. We conclude (...) that a code of ethics must meet three conditions in order for it to be favorable to autonomous judgment rather than blind adhesion to pre-established norms: openness of meaning, space for dissidence, and avoidance of moralistic language. (shrink)

There has recently been a revival of interest in ‘naturalizing’ ethics. A naturalization seeks to vindicate ethical realism — the idea that ethical judgments can be true reflections of a moral reality — without violating the naturalist constraint that science sets the limits of ontology. The recent revival has been prompted by examples of successful scientific reduction (e.g. temperature, water), and by the emergence of new, nonreductive naturalist strategies (e.g. for biological and mental properties). In this paper, I argue (...) against such naturalist approaches to ethics. My argument builds on the traditional one offered by G.E. Moore, namely that a naturalization would fail to respect an existing difference between the meanings of moral and naturalistic terms. I defend this line of argument against the common claim that it cannot block ‘synthetic’ property identities, ones grounded not in meaning equivalences but in empirical discoveries (as in the cases of temperature and water). I then go on to show that the Moorean argument can make trouble even for recent revisionist and nonreductive naturalist approaches. (shrink)

Are there good arguments from Is to Ought? Toomas Karmo has claimed that there are trivially valid arguments from Is to Ought, but no sound ones. I call into question some key elements of Karmo’s argument for the “logical autonomy of ethics”, and show that attempts to use it as part of an overall case for moral skepticism would be self-defeating.

Toomas Karmo claims that his taxonomy of ethical sentences has the result that there does not exist a sound argument with all non-ethical premises and an ethical conclusion. In a recent paper, Mark T. Nelson argues against this claim. Nelson presents a sound argument that he takes to be such that (i) Karmo’s taxonomy classifies that argument’s single premise as non-ethical and (ii) Karmo’s taxonomy classifies that argument’s conclusion as ethical. I attempt to show that Nelson is mistaken about (ii). (...) For any possible world at which the premise of Nelson’s argument is true, Karmo’s taxonomy classifies the conclusion of Nelson’s argument as non-ethical. (shrink)

In Ethics and the Autonomy of Philosophy, Bernard Walker sets out with two objectives. First, Walker argues that ethics is autonomous as a discipline. Oftentimes ethics books, from a Christian perspective, lean toward grounding ethics in theology or in biblical proof texting. Walker departs from this tradition. Ethics grounded in theology entails a limited scope for those doing ethics in that the Christian God must be assumed for both Christian and non-Christian when at (...) the table of ethical dialogue. For the non-Christian, this loads the dice and shuts down ethical consensus and dialogue, if not ethical truth. With that said, this book does not depart from Christian ethical views on such issues as the sanctity of life, antiracism, the death penalty, the objectivity of ethics, and the importance of integrating faith into ethics; however, Walker does so from a common denominator of philosophy rather than theology. Second, Walker ventures into the streets and engages the man/woman on the streets approach to ethics and ethical decision-making. He points out the shortcomings of the ubiquitous views of the man/woman on the streets, viz., cultural relativism, skepticism, and the attitude that ethics is merely a matter of personal choice. (shrink)

Algorithms influence every facet of modern life: criminal justice, education, housing, entertainment, elections, social media, news feeds, work… the list goes on. Delegating important decisions to machines, however, gives rise to deep moral concerns about responsibility, transparency, freedom, fairness, and democracy. Algorithms and Autonomy connects these concerns to the core human value of autonomy in the contexts of algorithmic teacher evaluation, risk assessment in criminal sentencing, predictive policing, background checks, news feeds, ride-sharing platforms, social media, and election interference. (...) Using these case studies, the authors provide a better understanding of machine fairness and algorithmic transparency. They explain why interventions in algorithmic systems are necessary to ensure that algorithms are not used to control citizens' participation in politics and undercut democracy. This title is also available as Open Access on Cambridge Core. (shrink)

This paper formulates a kind of divine command ethical theory intended to comport with two major views: that basic moral principles are necessary truths and that necessary truths are not determined by divine will. The theory is based on the possibility that obligatoriness can be a theological property even if its grounds are such that the content of our obligations has a priori limits. As developed in the paper, the proposed divine command theory is compatible with the centrality of God (...) in practical ethics; it provides an account of a divine command morality as a set of internalized moral standards; and it is consistent with the autonomy of ethics conceived as a domain in which knowledge is possible independently of reliance on theology or religion. (shrink)

The bioethical principle of respect for a person’s bodily autonomy is central to biomedical and healthcare ethics. In this article, we argue that this concept of autonomy is often annulled in the maternity field, due to the maternal two-in-one body (and the obstetric focus on the foetus over the woman) and the history of medical paternalism in Western medicine and obstetrics. The principle of respect for autonomy has therefore become largely rhetorical, yet can hide all manner (...) of unethical practice. We propose that large institutions that prioritize a midwife–institution relationship over a midwife–woman relationship are in themselves unethical and inimical to the midwifery philosophy of care. We suggest that a focus on care ethics has the potential to remedy these problems, by making power relationships visible and by prioritizing the relationship above abstract ethical principles. (shrink)

In The Autonomy of Morality Charles Larmore challenges two ideas that have shaped the modern mind. The world, he argues, is not a realm of value-neutral fact, nor does human freedom consist in imposing principles of our own devising on an alien reality. Rather, reason consists in being responsive to reasons for thought and action that arise from the world itself. Larmore shows that the moral good has an authority that speaks for itself. Only in this light does the (...) true basis of a liberal political order come into view, as well as the role of unexpected goods in the makeup of a life lived well. (shrink)

Background: Moral distress is a major problem in nursing profession. Researchers identified that the stronger the ethical basis of the organization, the less moral distress is reported. However, different ethical climates may have different impacts on moral distress. Moreover, conceptualization of moral distress and ethical climate as well as their relationship may change according to the cultural context. Objectives: The main aim of the study is to investigate the relationship between different types of ethical climate as described in Victor and (...) Cullen’s framework, and moral distress intensity among nurses in Turkish healthcare settings. Research design: An online survey was administrated to collect data. Questionnaires included moral distress and ethical climate scales in addition to demographic questions. Participants and research context: Data were collected from registered nurses in Turkey. In all, 201 of 279 nurses completed questionnaires, resulting in a response rate of 72%. Ethical considerations: Ethical approval was obtained from the university to which the authors were affiliated, after a detailed investigation of the content and data collection method. Findings: Factor analyses showed that moral distress had three dimensions, namely, organizational constraints, misinformed and over-treated patients, and lack of time and resources, while ethical climate had four types, namely, rules, well-being of stakeholders, individualism, and organizational interests. Positive correlations were identified between certain types of ethical climate (rules, individualism, or organizational interests) and moral distress intensity. Discussion: Factor distribution of the scales shows some commonalities with the findings of previous research. However, context-specific dimensions and types were also detected. No particular ethical climate type was found to have a negative correlation with moral distress. Conclusion: Recommendations were made for reducing the negative impact of ethical climate on moral distress. These include solving the nursing-shortage problem, increasing autonomy, and improving physical conditions. (shrink)

In this paper, I summarize the medical evidence regarding the auditory and non-auditory effects of noise and analyse the ethics of noise and personal autonomy in the social environment using a variety of case studies. Key to this discussion is the fact that, contrary to the traditional definition of noise, sound can be noise without being annoying, as the evidence shows that some sounds can harm without being perceived. Ultimately, I develop a theory of ‘noisy autonomy’ with (...) which to guide us in discussing the public health ethics of noise and other sounds. (shrink)

This book explores, in rich and rigorous ways, the possibilities and limitations of “thick” autonomy in light of contemporary debates in philosophy, ethics, and bioethics. Many standard ethical theories and practices, particularly in domains such as biomedical ethics, incorporate minimal, formal, procedural concepts of personal autonomy and autonomous decisions and actions. Over the last three decades, concerns about the problems and limitations of these “thin” concepts have led to the formulation of “thick” concepts that highlight the (...) mental, corporeal, biographical and social conditions of what it means to be a human person and that enrich concepts of autonomy, with direct implications for the ethical requirement to respect autonomy. The chapters in this book offer a wide range of perspectives on both the elements of and the relations between “thin” and “thick” concepts of autonomy as well as their relative roles and importance in ethics and bioethics. This book offers valuable and illuminating examinations of autonomy and respect for autonomy, relevant for audiences in philosophy, ethics, and bioethics. (shrink)

In this article, I consider recent debates on the notion of procreative liberty, to argue that reproductive freedom can be understood as a form of positive freedom—that is, the freedom to make oneself according to various ethical and aesthetic principles or values. To make this argument, I draw on Michel Foucault’s later work on ethics. Both adopting and adapting Foucault’s notion of ethics as a practice of the self and of liberty, I argue that reproductive autonomy requires (...) enactment to gain meaning within the life contexts of prospective parents. Thus, I propose a shift away from the standard negative model of freedom that sees it solely as a matter of noninterference or nonimpedance, a view advocated by major commentators such as John Harris and John Robertson. Instead, reproduction should be understood as a deeply personal project of self-making that integrates both negative and positive freedom. (shrink)

The development of modern science, as everybody knows, has come largely through naturalizing domains of inquiry that were traditionally parts of philosophy – a process that philosophers have, by and large, applauded. But could this worthwhile endeavor now move on to include critical thinking? Here we argue that critical thinking, a discipline devoted principally to the study of the normative aspects of reasoning, cannot be assimilated to purely naturalistic, descriptive studies of reasoning of the sort now prevalent in the social (...) sciences and in what is now called „experimental philosophy.‟ Critical thinking, on our view, is a discipline whose central task is not that of constructing a catalogue of common patterns of reasoning, but instead of accounting for the normative worth of such patterns. Plainly, it is an enterprise that raises philosophical questions about the nature of such normativity and requires an evaluation of possible answers. The normativity issues at stake in critical thinking are parallel in significant ways to those arising in normative ethics and traditional epistemology. And this is why successful arguments offered against attempts at eliminating or reducing the latter disciplines to the sciences could be adapted to support the philosophical autonomy of critical thinking. A glance at the naturalistic approaches to reasoning currently on offer reveals that there is so far no naturalistic account of the normativity of reasoning in the offing. Not surprisingly, naturalistic studies of reasoning concerned with such normativity either fail to account for it or simply rehash traditional philosophical accounts. In a recent study, Sripada and Stich (2005) 1 seem to assume that all there is to explaining what moral judgments are can be captured by some results of experimental tests about what people standardly make of moral norms in general (e.g., Turiel‟s moral/conventional task experiments) – perhaps together with some psychological account of the role of emotions and motivation in normative judgment.. (shrink)

Accounting professionals play an important role in the generation and auditing of financial statements and, given their understanding of business processes, may be relied upon in the development of organizations’ ethical infrastructures (i.e., the formal aspects of an organization’s ethical environment that are explicitly under the control of the organization). Thus, understanding and improving the work environments of accounting professionals is crucial to improving organizational ethical culture and reducing fraud. In this study, we extend prior research that documents the prevalence (...) of ethical infrastructure programs by assessing how accounting professionals, a key employee group, perceive their organizations’ ethical infrastructures. In addition, we examine whether perceptions of the effectiveness of the ethical infrastructure and professional autonomy influence accountants’ ethical judgments. Based on the responses of 378 CPAs in the United States, we find the perceived state of the ethical infrastructure across accounting work environments—both public accounting firms and other organization types—is relatively strong. However, of the five ethical infrastructure components we examine (i.e., ethics code, ethics training, ethics-based punishments and incentives, ethics reporting system, and ethics review system), only 35% of respondents indicate that their organizations have more than three of these components. Importantly, we find that perceived ethical infrastructure effectiveness and professional autonomy influence both perceptions of the ethical culture and the ethical judgments of accounting professionals. We also contribute to practice by highlighting opportunities for improvement in ethics training formats, ethics-based incentives, and ethics review systems. (shrink)

Due to the domain characteristics of business ethics, a contractarian theory for business ethics will need to be essentially different from the contract model as it is applied to other domains. Much of the current criticism of contractarian business ethics (CBE) can be traced back to autonomy, one of its three boundary conditions. After explaining why autonomy is so important, this article considers the notion carefully vis à vis the contracting partners in the contractarian approaches (...) in business ethics. Autonomy is too demanding a condition for the realm of CBE. But a less stringent version of the contract may be possible, a version which uses the contract as a heuristic device, which merely requires moral responsibility. Furthermore, it is argued that views of (human) agency and the moral subject should be made explicit in such a theory. (shrink)

The purpose of this study was to test a causal model of ethical conflict in practice and autonomy in a sample of 254 nurse practitioners working in the primary care areas of family health, pediatrics, adult health and obstetrics/gynecology in the state of Maryland. A test of the model was conducted using a path analytic approach with LISREL 8.30 hypothesizing individual, organizational and societal/market factors influencing ethical conflict in practice and autonomy. Maximum likelihood estimation was used to estimate (...) the parameters most likely to have generated the data. Forty-five percent of the total variance in ethical conflict was explained by the variables of ethical environment and ethical concern. Ethical concern, idealistic philosophy, ethics education in continuing education, percentage of client population enrolled in managed care, and market penetration explained 15% of the total variance in autonomy. The findings of this study indicate that the causal model of ethical conflict in practice and autonomy is consistent with the data and contributed to a fuller understanding of clinical decision making associated with practicing in a managed care environment. The final model supported a conceptual framework that is inclusive of three domains: individual, organizational and societal/market variables. (shrink)

J. B. Schneewind's "The Invention of Autonomy" has been hailed as a major interpretation of modern moral thought. Schneewind's narrative, however, elides several serious interpretive issues, particularly in the transition from late medieval to early modern thought. This results in potentially distorted accounts of Thomas Aquinas, Hugo Grotius, and G. W. Leibniz. Since these thinkers play a crucial role in Schneewind's argument, uncertainty over their work calls into question at least some of Schneewind's larger agenda for the history of (...) ethics. (shrink)

Antidepressant medication and evidence-based psychotherapy have largely equivalent efficacy in the management of the common, less severe grades of depression. As a result, several national guidelines recommend that either can be used in the treatment of this disorder. Psychotherapy, however, differs in that it assists insight into how the depressed person appraises and manages the stressors that frequently trigger depressive episodes. I argue that the self-knowledge achieved through psychotherapy has moral value in that it promotes the autonomy of stressor-related (...) decisions. I further argue that such an effect comprises a compelling moral reason for doctors to see evidence-based psychotherapy not as merely optional, but as a necessary treatment for their patients with depression. (shrink)

This contribution deals with the issue of the professional autonomy ofthe medical doctor. Worldwide, the physician's autonomy is guaranteedand limited, first of all, by Codes of Medical Ethics. InItaly, the latest version of the national Code of MedicalEthics (Code 1998) was published in 1998 by the Federation ofprovincial Medical Associations (FnomCeO). The Code 1998acknowledges the physician's autonomy regarding the scheduling, thechoice and application of diagnostic and therapeutic means, within theprinciples of professional responsibility. This responsibility has tomake (...) reference to the following fundamental ethical principles:(1) the protection of human life; (2) the protection of thephysical and psychological health of the human being; (3) therelief from pain; (4) the respect for the freedom and the dignityof the human person, without discrimination; (5) an up-to-datescientific qualification (Art. 5). The authors underline that autonomyis an anthropological – and consequently ethical –characteristic of the human person. Different positions on autonomy inbioethics (individualistic, evolutionistic, utilitarian andpersonalistic models) are explained. The relation between theprofessional autonomy of the physician and the autonomy of the patientand of colleagues is discussed. In fact, the medical doctor isobliged: (1) to respect the fundamental rights of the person,first of all his/her life; (2) to ensure the continuity of thecare, even if he can only relieve the patient's suffering; (3) tomaintain, except under certain circumstances, professional secrecy andconfidentiality regarding patients and their medical records. Moreover,the physician cannot deny the patient correct and appropriateinformation. He/she should not perform any diagnostic or therapeuticactivity without the informed consent of the patient and the medicaldoctor must give up medical treatment in case of documented refusal ofthe individual. Furthermore, the medical doctor has the right to raiseconscientious objections if he/she is requested to perform medicalactions that are contrary to his/her conscience or medical opinion,unless this attitude would seriously and immediately harm the patient.Regarding the relationships with colleagues, the physician is obliged tosolidarity, mutual respect, and care of sick colleagues. Finally, theauthors discuss the Italian legislation affecting the physician'sprofessional autonomy: (1) the SSN health care Acts; (2) theso-called Charter for Public Health Care Services; (3) the Acts onprivacy; (4) Good Clinical Practice. (shrink)

The theist thesis that any true ethics must be a religious one is criticized from two different angles; it is shown that: (i) in order to avoid divine voluntarism, theism uses a supposition the acceptance of which makes arguments against autonomous ethics un- acceptable, for they inevitably beg the question; (ii) it assumes a kind of moral foun- dationalism which is, according to some Wittgensteinean arguments, utterly superfluous; the idea that any authoritative ethics needs the absolute authority (...) of God can thus be shown to be unjustified. (shrink)

This article questions the validity of the recent suggestion made by donald sherburne that the 'naturalization' of whiteheadian philosophy through the deletion of the concept of God leads to the reduction of whitehead's theory of religion to an ethical theory. Against this thesis, The author of this article attempts to establish the validity of two propositions: (1) that the discussion of religion from whiteheadian perspective can proceed productively without explicit reference to the doctrine of God and (2) religion and morality (...) are autonomous cultural interests neither of which depends for its content or presuppositions upon the other. From the arguments supporting the two above-Stated propositions the author concludes that the deletion of the concept of 'god' from whiteheadian philosophy cannot in any valid manner lead to the interpretation of whitehead's theory of religion in terms of ethical concepts. (edited). (shrink)

Patient autonomy is one of the four pillars of modern medical ethics. In some cases, however, its value is not absolute and autonomy may be overridden by sufficiently important matters of public interest. Coroner’s autopsies represent an example of when the wishes of the deceased and their family may come in conflict with the benefits of knowledge gained from understanding the cause of death. Current legislation governing coroner’s autopsies relies on the assumption of their obvious public benefit, (...) hence consent for them need not be sought. This interpretation has attracted controversy, as exemplified by the case of Rotsztein vs HM Senior Coroner and a recent study questioning the prevalent use of invasive autopsy. However, this issue has received little recent attention in ethical literature. In this essay, the ethical nature of coroner’s autopsies in cases of natural deaths with unexplained causes is examined as a balance between patient autonomy and the value of knowledge gained from them. This is done by analysing a case which under current legislation warrants coroner’s autopsy, however, its ethical justification remains contentious. This discussion is expanded by discussion of non-invasive alternatives and comparison to another situation which balances individual autonomy with public benefits—organ donation. The conclusion of this analysis is a moral middle ground in which objection to invasive autopsy could be respected once issues of overriding public interest are excluded, or at least non-invasive alternatives should be considered, with coroners left responsible for demonstrating specific public needs that could override objection. (shrink)

Autonomy has been central to moral and political philosophy for millenia, and has been positioned as a critical aspect of both justice and wellbeing. Research in psychology supports this position, providing empirical evidence that autonomy is critical to motivation, personal growth and psychological wellness. Responsible AI will require an understanding of, and ability to effectively design for, human autonomy (rather than just machine autonomy) if it is to genuinely benefit humanity. Yet the effects on human (...) class='Hi'>autonomy of digital experiences are neither straightforward nor consistent, and are complicated by commercial interests and tensions around compulsive overuse. This multi-layered reality requires an analysis that is itself multidimensional and that takes into account human experience at various levels of resolution. We borrow from HCI and psychological research to apply a model (“METUX”) that identifies six distinct spheres of technology experience. We demonstrate the value of the model for understanding human autonomy in a technology ethics context at multiple levels by applying it to the real-world case study of an AI-enhanced video recommender system. In the process we argue for the following three claims: 1) There are autonomy-related consequences to algorithms representing the interests of third parties, and they are not impartial and rational extensions of the self, as is often perceived; 2) Designing for autonomy is an ethical imperative critical to the future design of responsible AI; and 3) Autonomy-support must be analysed from at least six spheres of experience in order to approriately capture contradictory and downstream effects. (shrink)

Background Respect for patients’ autonomy is usually considered to be an important ethical principle in Western countries; privacy is one of the implications of such respect. Healthcare professionals frequently encounter ethical dilemmas during their practice. The past few decades have seen an increased use of courts to resolve intractable ethical dilemmas across both the developed and the developing world. However, Chinese and American bioethics differ largely due to the influence of Chinese Confucianism and Western religions, respectively, and there is (...) a dearth of comparative studies that explore cases of ethical dilemmas between China and the United States. Methods This paper discusses four typical cases with significant social impact. First, it compares two cases concerning patient privacy: the “Shihezi University Hospital Case”, in which a patient was used as a clinical teaching object without her permission, and the “New York-Presbyterian Hospital Case”, in which the hospital allowed the filming of a patient’s treatment without his consent. Second, it compares two cases regarding patient autonomy and potentially life-saving medical procedures: the “Case of Ms. L”, concerning a cohabitant’s refusal to sign a consent form for a pregnant woman’s caesarean, and the “Case of Mrs. V”, concerning a hospital’s insistence upon a blood transfusion for a dissenting patient. This paper introduces the supporting and opposing views for each case and discusses their social impact. It then compares and analyses the differences between China and the United States from cultural and legislative perspectives. Conclusions Ethical dilemmas have often occurred in China due to the late development of bioethics. However, the presence of bioethics earlier in the US than in China has not spared the US of ethical dilemmas. This paper highlights lessons and inspiration from the cases for healthcare professionals and introduces readers to the role and weight of privacy and autonomy in China and in the US from the perspectives of different cultures, religions and laws. (shrink)

Children's autonomy includes, as far as possible, self-determination, bodily integrity and the right to influence outcomes. Limits to bodily integrity, which involves no touching without the child's consent or tacit agreement, are discussed. The clinical, legal and ethics literature tends to agree that children may give valid consent to major recommended treatment from around 12 years but may not refuse it until they are legal adults. Research shows that young children are more aware of their bodily integrity and (...) autonomy, of morality and decision making, than was assumed in the past. Adults therefore need to inform children and respect their initially instinctive efforts to protect their bodily integrity. Unlike assent, consent involves patients being adequately informed and being able to accept or refuse proposed treatment. Reasons are given for adults’ need to consult with children when determining their best interests. Beyond words, giving or withholding consent also involves emotions of fear, trust and courage, besides embodied reactions of cooperating with treatment or resisting it, in which young children actively engage. Some clinicians work with the informed cooperation of young children who need lifesaving treatment, and at times accept their refusal. Reasons for differences between mainstream experts’ views and clinical practices are considered. (shrink)

Since the first version of this classic work was published in 1974, major events in which American journalism has played a decisive role have cast the reporter increasingly as the subject for public examination. The newsman has become news. Though there are more serious, responsible journalists today than at any time in America, the less serious, less responsible also have great exposure. The loss of credibility of the mass media is widely acknowledged, and is a considerable concern to serious journalists. (...) For not only is American policy-making hampered by sensational journalism, but also weakened is the philosophical foundation of a free society; a society committed to maximize the freedom of well-informed choice for individual citizens in a period of massification. This book presents a philosophy of journalism that not only relates to a journalist's everyday activities, but also deals with a broad Weltanschauung for journalism which is built largely on the ideas coming out of the Age of Reason. Areas of philosophy are political philosophy and its relationship to journalism, epistemological concerns primarily journalistic objectivity and truth-seeking, and journalistic ethics. (shrink)

Background Even though we are now well into the 21st century and notwithstanding all the abuse to individuals involved in clinical studies that has been documented throughout History, fundamental ethical principles continue to be violated in one way or another. Discussion Here are some of the main factors that contribute to the abuse of subjects participating in clinical trials: paternalism, improper use of informed consent, lack of strict ethical supervision, pressure exerted by health institutions to increase the production of scientific (...) material, and the absence of legislation regarding ethics in terms of health care and research. Are researchers ready to respect fundamental ethical principles in light of the ample window of information provided by individual genomes, while defending the rights of the subjects participating in clinical studies as a major priority? Summary As one of the possible solutions to this problem, education regarding fundamental ethical principles is suggested for participants in research studies as an initial method of cognitive training in ethics, together with the promotion of ethical behavior in order to encourage the adoption of reasonable policies in the field of values, attitudes and behavior. (shrink)

More and more researchers argue that online technologies manipulate human users and, therefore, undermine their autonomy. We call this the MAL view on online technology because it argues from Manipulation to Autonomy-Loss. MAL enjoys public visibility and will shape the academic discussion to come. This view of online technology, however, fails conceptually. MAL presupposes that manipulation equals autonomy loss, and that autonomy is the absence of manipulation. That is mistaken. In short, an individual can be manipulated (...) while being fully personally autonomous. Internet policy researchers should be aware of this point to avoid looking in the wrong place in future research on manipulative and harmful online technology. (shrink)

Why has autonomy been a leading idea in philosophical writing on bioethics, and why has trust been marginal? In this important book, Onora O'Neill suggests that the conceptions of individual autonomy so widely relied on in bioethics are philosophically and ethically inadequate, and that they undermine rather than support relations of trust. She shows how Kant's non-individualistic view of autonomy provides a stronger basis for an approach to medicine, science and biotechnology, and does not marginalize untrustworthiness, while (...) also explaining why trustworthy individuals and institutions are often undeservingly mistrusted. Her arguments are illustrated with issues raised by practices such as the use of genetic information by the police or insurers, research using human tissues, uses of new reproductive technologies, and media practices for reporting on medicine, science and technology. Autonomy and Trust in Bioethics will appeal to a wide range of readers in ethics, bioethics and related disciplines. (shrink)

Nudging is considered a promising approach for behavioural change. At the same time, nudging has raised ethical concerns, specifically in relation to the impact of nudges on autonomous choice. A complexity is that in this debate authors may appeal to different understandings or dimensions of autonomy. Clarifying the different conceptualisations of autonomy in ethical debates around nudging would help to advance our understanding of the ethics of nudging. A literature review of these considerations was conducted in order (...) to identify and differentiate between the conceptualisations of autonomy. In 33 articles on the ethics of nudging, we identified 280 autonomy considerations, which we labelled with 790 unique autonomy codes and grouped under 61 unique super-codes. Finally, we formulated three general conceptualisations of autonomy. Freedom of choice refers to the availability of options and the environment in which individuals have to make choices. Agency involves an individual's capacity to deliberate and determine what to choose. Self-constitution relates to someone's identity and self-chosen goals. In the debate about the ethics of nudging, authors refer to different senses of autonomy. Clarifying these conceptualisations contributes to a better understanding of how nudges can undermine or, on the other hand, strengthen autonomy. (shrink)

The topics of ethical conduct and governance in academic research in the business field have attracted scientific and public attention. The concern is that research misconduct in organizations such as business schools and universities might result in practitioners, policymakers, and researchers grounding their decisions on biased research results. This study addresses ethical research misconduct by investigating whether the ethical orientation of business researchers is related to the likelihood of research misconduct, such as selective reporting of research findings. We distinguish between (...) deontological and consequentialist ethical orientations and the competition between researchers and investigate the moderating role of their perceived autonomy. Based on global data collected from 1031 business scholars, we find that researchers with a strong deontological ethical orientation are less prone to misconduct. This effect is robust against different levels of perceived autonomy and competition. In contrast, researchers having a consequentialist ethical orientation is positively associated with misconduct in business research. High levels of competition in the research environment reinforce this effect. Our results reveal a potentially toxic combination comprising researchers with a strong consequentialist orientation who are embedded in highly competitive research environments. Our research calls for the development of ethical orientations grounded on maxims rather than anticipated consequences among researchers. We conclude that measures for ethical governance in business schools should consider the ethical orientation that underlies researchers’ decision-making and the organizational and institutional environment in which business researchers are embedded. (shrink)