The author defends the ancient claim that justice is at bottom a body of social conventions. Recent analytical and empirical concepts and results from the social sciences together with insights and arguments of past masters of moral and political philosophy are integrated into a new game-theoretic conventionalist analysis of justice.

In this essay we discuss an ethical dilemma that recently arose in our institution, involving healthcare workers who lamented the requirement to shave their facial hair as a condition to care for COVID-19 patients. The essay represents a genuine attempt to grapple with the dilemma sensibly and vigorously. We first provide a brief introduction, focusing on the tension between religious tolerance and the institutional obligation to optimize patient care and public health in the age of COVID-19. We then discuss the (...) complex relationship between facial hair and cultural as well as religious factors throughout history. Next, we make a case, based on several principles in Islam jurisprudence, that Muslim healthcare professionals in our institution should be expected to shave their facial hair so they could care for COVID patients. We end with considering two alternative solutions that were offered in the literature. (shrink)

Abstract:What makes a leader ethical? This paper critically examines the answer given by developmental theory, which argues that individuals can develop through cumulative stages of ethical orientation and behavior (e.g. Hobbesian, Kantian, Rawlsian), such that leaders at later developmental stages (of whom there are empirically very few today) are more ethical. By contrast to a simple progressive model of ethical development, this paper shows that each developmental stage has both positive (light) and negative (shadow) aspects, which affect the ethical behaviors (...) of leaders at that stage. It also explores an unexpected result: later stage leaders can have more significantly negative effects than earlier stage leadership. (shrink)

Ob im Fitnessstudio, in der Mode oder bei der Ernährung – heute wird ständig Körperoptimierung betrieben. Durch neue technologische Entwicklungen wie Neuroimplantate und Brain-Computer-Interfaces (neurologisches Enhancement) wird die Körperoptimierung auf eine neue Ebene gehoben. Mittels Pharmazeutika sollen Kognition (kognitives Enhancement) oder moralische Verhaltensweisen (moralisches Enhancement) verbessert werden, Prothesen werden in den Körper integriert und es werden ästhetisch-chirurgische Eingriffe vorgenommen. 2019 wurden insgesamt 983.432 ästhetische Eingriffe in Deutschland unternommen.1 Im Alltag sind Wearables wie Smartwatches mit ihren Fitnessprogrammen und vielfältige Smartphone-Apps zur (...) Körperoptimierung allgegenwärtig. Technologische Körperoptimierung spielt eine wichtige Rolle im menschlichen Leben und bedarf einer ethischen Auseinandersetzung. Der Beitrag behandelt die Frage, wie die gegenwärtigen technologischen Körperoptimierungen ethisch bewertet werden können und stellt dabei die Autonomie ins Zentrum der ethischen Überlegungen. Inwiefern kann die Entscheidung für eine Körperoptimierung autonom getroffen werden? Welche ethischen Aspekte spielen eine Rolle und wie wirken sich die Optimierungen auf das Selbstverständnis des Individuums aus? -/- Die Fülle an Optimierungsmaßnahmen macht es notwendig, in Kap. 1 zunächst in den Begriff, die Formen und Ziele der Körperoptimierung einzuführen und Differenzierungen vorzunehmen. In Kap. 2 wird die Autonomie in den Fokus gerückt und mit Rückgriff auf Foucaults Konzepte der „Bio-Macht“ und „Technologien des Selbst“ untersucht, wie die Optimierungsentscheidungen zwischen individueller Selbstbestimmung und gesellschaftlicher Fremdbestimmung verortet werden können. Daran anknüpfend wird in Kap. 3 nach einer ethischen Bewertung der Optimierungsmaßnahmen gefragt. Der Aufsatz sucht nach einer ethischen Einordnung der Körperoptimierungen und gelangt letztlich zu wichtigen Erkenntnissen über den Zusammenhang von Identität/ Körper, Gesellschaft und Technik. Kap. 4 führt dazu die These aus, dass Technik mithervorbringt, was Körper bedeutet und zeigt auf, wie Technologien auf diese Weise eine Chance sein können, das Menschenund Körperverständnis neu und inklusiv auszuhandeln. Aus den Untersuchungsergebnissen werden letztlich in Kap. 5 Schlüsse für die Theologie abgeleitet und Wege dargestellt, wie die Theologie einen Beitrag zu den Optimierungen leisten kann. Abschließend wird in Kapitel 6 ein Fazit gezogen und ein Ausblick für die zukünftige ethische Forschung eröffnet. (shrink)

Mentalities like scientism and relativism idealise or belittle science respectively, and thus hurt science education and our literacy. However, it seems very hard to avoid the former mentality without sliding to the latter, and vise versa. I will suggest that part of what makes balancing between the two so difficult, is a representational account of meaning that science educators, like most of us really, usually endorse. Scientism then, arises from the assumption that ​there is such a thing called science​. (...) Relativism, on the other hand, assumes that ​there is no such thing called science,t​hereisnorealmeaningattachedtotheterm​.Wittgenstein'sremarksonrule-following then, could help us escape this twofold danger. Addressing scientism, Wittgensteinian writings remind us that, in order to understand the sciences, we do not need to point to some mental referendum of what science is. We rather need to grasp a matrix of overlapping, often implicit, always evolving rules that govern scientific practices. Addressing relativism, Wittgenstein's comments help us realise that there are always certain criteria about what kinds of things we call by a name; there are rules governing scientific practices, rules that even though they may be context dependent or evolving, are always in play. (shrink)

This article analyses the rationality of the principle of proportionality as a justificatory method for solving cases involving conflicts of constitutional principles. It addresses the “problem of comparability”: a set of arguments claiming that proportionalists fail to understand what happens when constitutional principles collide. The problem of comparability suggests that balancing cannot be done if some conflicts of constitutional principles are, in reality, cases of noncomparability, incommensurability, incomparability, or vagueness. In this article, I challenge the views of both proportionalists (...) and their skeptics. Against the skeptics, I argue that proportionality can survive the challenge posed by the problem of comparability. Against the proportionalists, I submit that proportionality cannot be understood as a system of tradeoffs between degrees of satisfaction of principles. If comparison among constitutional principles is to be rational, we need a different approach to normativity—one that allows for the possibility of parity. (shrink)

Researchers have frequently complained that the NHS ethical review system stifles good research. At last measures are being put in place to address this criticism, but will they undermine the protection of research participants? The Declaration of Helsinki recognizes that medicine will not progress without good quality research, but also demands that the well-being of research participants takes precedence over the interests of science and society. This article examines the implications of the ongoing reform of the NHS research ethics review (...) system for researchers, ethics committees and research participants. (shrink)

Certain realist critics of U.S. foreign policy put forth an alternative model of “offshore balancing” as a definitively rational alternative to what they regard as the current, and utterly disastrous, policy of “liberal hegemony.” They predict that the public will eventually recognize the hollowness of liberalism and demand a foreign policy rooted in hardnosed realism. They also promise that this rational outline will also be a positive good, maximizing national interests and moral values with no tradeoffs between them. I (...) argue that offshore balancing packages realist arguments in an idealist framework, whereby the good is both self-evident and bound to triumph. This inhibits the actual realist task of revealing the harsh facts of politics, which inevitably interfere with preferences. Offshore balancing traps itself between its claim of inevitability, which undercuts the need for advocacy, and desirability, which pushes against its inevitability. The only way they can resolve this contradiction is with an increasingly caustic account of liberalism as so utterly wrong and immoral that its opponents earn the mark of reason and goodness by sheer virtue of their opposition. Offshore balancing subordinates its account of the world as it is to a demand of how the world must not be. (shrink)

Developments in the provision of care and support services for disabled and older people across developed welfare states have led to the expansion of personalisation (sometimes called cash-for-care, direct payments, care payments, etc.) schemes, whereby cash is paid in substitute for care services and support. Although these schemes vary considerably in their scope and operation (sometimes paying carers directly, sometimes enabling disabled and older people to act as direct employers, sometimes mixing paid and unpaid care), they share the characteristics of (...) commodifying care and support services and will have a potentially profound impact on the relationship between individuals, families, communities and the welfare state. Although the schemes have been evaluated within their own national contexts, little work has been done so far to explore the theoretical implications of their development and extension, particularly from an ethics of care perspective. This paper intends to fill that theoretical gap by drawing on comparative evidence from several schemes across different national contexts to develop an analysis which draws on feminist theory and an ethics of care approach to examine (a) the gendered policy outcomes and impact of such schemes; (b) a feminist analysis of the governance implications of personalisation; (c) the implications for the gendered division of work, particularly between paid and unpaid care work and between different groups of paid and unpaid carers; (d) an ethics of care analysis of the impact of personalisation over the lifecourse of disabled and older people, and carers; and (e) a discussion of the relationship between commodification, empowerment, citizenship and choice drawing on the work of care ethicists. It will draw conclusions about the outcomes of a range of types of personalisation schemes and thus have implications for theory, policy and practice. (shrink)

Within the ever-growing body of research on sickness presenteeism, studies of perceived consequences are scarce and equally rare are joint considerations of beneficial and harmful effects. This study examined how experienced and expected consequences of the behavior are related to presenteeism. Positive and negative effects were considered simultaneously and comprehensively. This approach allowed us to capture the trade-off process of individuals in deciding to work or call in sick when ill. In a cross-sectional online survey, 591 working adults in Germany (...) rated a thoroughly developed pool of specific experienced or potential consequences of working while sick and gave an overall judgment of effects. The results show that perceptions of effects are consistent with behavior. Individuals who exhibit presenteeism do so primarily because of work-related effects such as the completion of one’s work tasks and the meeting of deadlines. Few specific effects stand out and can largely explain attendance behavior and the overall assessment of effects. The findings are consistent with the assumptions of the health belief model and the expectancy value theory of work motivation and they relate to the health-performance framework. They demonstrated that benefits and costs of the behavior are simultaneously weighed in the decision to engage in presenteeism or not. (shrink)

This book explores how considerations of justice apply to procreative decision-making. -/- Despite its immense personal significance, procreation is an inherently other-regarding endeavor. By its very nature, the decision to procreate is the decision to bring into existence another morally considerable being, one who will be exposed to the full range of harms, benefits, and risks that accompany a typical human life, and one who cannot by its nature ever consent to being born. Moreover, when this decision is undertaken in (...) a community of persons, it is also a decision to affect the lives of others in a host of profound if often underappreciated ways, from its effects on population size and environmental sustainability to its consequences for a community’s distribution of resources. In many ways, of course, these interests coincide: adults need children for their parenting projects, societies need citizens for the maintenance of their institutions, and children themselves are often happy to have been brought into existence. However, as the book demonstrates, the various interests that are implicated by procreative decision-making can also come into conflict as well, and in ways that raise basic questions of justice. Through a systematic examination of six of these questions, the author argues that taking adequate stock of the conflicting interests at stake in procreative decision-making leads to a narrower view of the conditions under which it is morally permissible to procreate and a much more demanding conception of our procreative responsibilities. -/- Procreative Justice will be of interest to researchers and advanced students working on the morality of procreation and related areas of philosophy, including bioethics, intergenerational ethics, environmental ethics, population ethics, and the ethics of the family. (shrink)

Quinoa farmers in San Agustín, Bolivia face the dilemma of producing for a growing international market while defending their community interests and resources, meeting their basic household needs, and making a profit. Farmers responded to a changing market in the 1970s by creating committees in defense of quinoa and farmer cooperatives to represent their interests and maximize economic returns. Today farmer cooperatives offer high, stable prices, politically represent farmers, and are major quinoa exporters, but intermediaries continue to play an important (...) role in the local economy. Meanwhile, some farmers rebuff the national cooperatives and intermediaries in favor of a denomination of origin and closer association with local cooperatives. This article, based on 4 months of ethnographic research, explores the reasons for the continued presence of intermediaries on the market landscape and how farmers have worked to create a quinoa economy embedded with fair trade values. Farmers demand stable prices, flexible standards, provision of services, and promises of maintaining the distinctive qualities of San Agustín quinoa. They frame their trades in economic, utility, and solidarity terms to reflect their livelihood strategies, farming capabilities, and personal concepts of fair trade. Meanwhile cooperatives, development initiatives, and intermediaries each argue that their particular buying practices allow farmers to attain household goods, credit, and cash for food and economic security. (shrink)

Philosophers have often noted a contrast between practical and theoretical reasons when it comes to cases involving equally balanced reasons. When there are strong practical reasons for A-ing, and equally strong practical reasons for some incompatible option, B-ing, the agent is permitted to make an arbitrary choice between them, having sufficient reason to A and sufficient reason to B. But when there is strong evidence for P and equally strong evidence for ~ P, one isn’t permitted to simply believe one (...) or the other. Instead, one must withhold belief, neither believing that P nor believing that ~ P. This paper examines what explains this contrast, focusing in particular on a proposal recently developed by Mark Schroeder across several papers. Schroeder aims to explain the contrast by an appeal to non-evidential, epistemic reasons against belief. But, I argue, it’s not clear exactly what those reasons are, nor how those reasons are to be weighed against evidential reasons. Despite these challenges, I argue that there are grounds for optimism that the contrast can be explained within the broad framework Schroeder provides, and I aim to provide resources to meet the aforementioned challenges. (shrink)

In February 1997, the Committee on Bioethics of the American Academy of Pediatrics updated its position on religious exemptions to medical care. In its earlier statement, the committee noted that forty-four states have religious exemptions to the child abuse and neglect statutes, and they argued for the repeal of these exemptions. The committee did not indude in its statement a position on religious exemptions to childhood immunization requirements that exist in forty-eight states, although this issue was discussed in committee meetings. (...) In its revised statement, the committee concluded that “The AAP does not support the stringent application of medical neglect laws when children do not receive recommended immunizations.” In this paper, we consider whether failure to immunize one's child is a form of medical neglect and, if so, whether states should repeal their religious exemptions to the immunization statutes. We argue that failure to vaccinate a child properly is medical neglect. (shrink)

In the case described here, an often recurring and unresolved scenario is presented where communication issues are underpinned by pre-existing perceptions of mistrust between the caregivers and the surrogate family members in the intensive care unit. Racial factors play into this mistrust, when a family feel that their loved one is “yet again” not being treated in the best way possible. The perspectives of all stakeholders are considered in the discussion and relevant literature is cited.

I vindicate Hume’s argument against belief in miracle reports against a prevalent objection. Hume has us balance the probability of a miracle’s occurrence against the probability of its being falsely attested to, and argues that the latter must inevitably be the greater; thus, reason requires us to reject any miracle report. The "flaw" in this reasoning, according to Butler and many others, is that it proves too much--it counsels us to never believe historians, newspaper reports of lottery results, and so (...) on; and this is clearly absurd. I show that this objection is misguided: far from providing counterexamples to Hume’s "balancing principle", as I call it, these cases actually confirm it, as some simple calculations of probabilities show. (shrink)

A particle of molecular dimensions which can exist in two states is associated with a membrane pore through which molecules of a gas can pass. The gas molecules from two identical phases on either side of the membrane may pass only when the particle is in one particular state. If certain restrictions are imposed on the system, then the particle appears to act like a Maxwell's Demon(1) which “handles” the gas molecules during their passage through the pore.

Physicians expressing opinions on medical matters that run contrary to the consensus of experts pose a challenge to licensing bodies and regulatory authorities. While the right to express contrarian views feeds a robust marketplace of ideas that is essential for scientific progress, physicians advocating ineffective or dangerous cures, or actively opposing public health measures, pose a grave threat to societal welfare. Increasingly, a distinction has been made between professional speech that occurs during the physician-patient encounter and public speech that transpires (...) beyond the clinical setting, with physicians being afforded wide latitude to voice empirically false claims outside the context of patient care. This paper argues that such a bifurcated model does not sufficiently address the challenges of an age when mass communications and social media allow dissenting physicians to offer misleading medical advice to the general public on a mass scale. Instead, a three-tiered model that distinguishes between citizen speech, physician speech and clinical speech would best serve authorities when regulating physician expression. (shrink)

In this paper, we discuss how access to health-related data by private insurers, other than affecting the interests of prospective policy-holders, can also influence their propensity to make personal data available for research purposes. We take the case of national precision medicine initiatives as an illustrative example of this possible tendency. Precision medicine pools together unprecedented amounts of genetic as well as phenotypic data. The possibility that private insurers could claim access to such rapidly accumulating biomedical Big Data or to (...) health-related information derived from it would discourage people from enrolling in precision medicine studies. Should that be the case, the economic value of personal data for the insurance industry would end up affecting the public value of data as a scientific resource. In what follows we articulate three principles – trustworthiness, openness and evidence – to address this problem and tame its potentially harmful effects on the development of precision medicine and, more generally, on the advancement of medical science. (shrink)

Advance health care directives and informed consent remain the cornerstones of patients' right to self-determination regarding medical care and preferences at the end-of-life. However, the effectiveness and clinical applicability of advance health care directives to decision-making on the use of life support systems at the end-of-life is questionable. The Uniform Anatomical Gift Act (UAGA) has been revised in 2006 to permit the use of life support systems at or near death for the purpose of maximizing procurement opportunities of organs medically (...) suitable for transplantation. Some states have enacted the Revised UAGA (2006) and a few of those have included amendments while attempting to preserve the uniformity of the revised Act. Other states have introduced the Revised UAGA (2006) for legislation and remaining states are likely to follow soon. (shrink)

Obstetric ultrasound has become a significant tool in obstetric practice, however, it has been argued that its increasing use may have adverse implications for women’s reproductive freedom. This study aimed to explore Australian obstetricians’ experiences and views of the use of obstetric ultrasound both in relation to clinical management of complicated pregnancy, and in situations where maternal and fetal health interests conflict.

This article describes the results of qualitative research into the moral issues faced by social work professionals working in projects targeted at teenage mothers. The research is part of the tradition of empirical and practice-driven ethics. The main questions were: How does morality become visible in the social services for teenage mothers and how do social workers deal with the moral dimension of their work? (How) can education, training and peer review offer space for moral reflection? Interviews and group meetings (...) ('focus groups') were held to answer these questions. Nineteen professionals (front-line professionals as well as professionals in executive roles) participated in the research. The findings describe the moral issues and the moral actions of professionals and the organizational context respectively. The results reveal that the everyday practice of social work professionals can raise complex issues inherent to their work and that there is often no explicit reflection on the moral dimension of these issues. The authors argue that there needs to be greater focus on the complexity of moral issues and elaborate on three dimensions of this complexity. (shrink)

Lukas J. Meier et al. offer the promise of a pathway for resolving clinical bioethical problems using an artificial intelligence interface. The ultimate goal, we assume, is...

This scoping review maps research ethics and integrity challenges and best practices encountered by research actors in the DACH countries (Germany, Austria, and Switzerland), including researchers, funders, publishers, research ethics committees, and policymakers, during the COVID-19 pandemic. The COVID-19 pandemic brought research and, in turn, research ethics and integrity, into public focus. This review identified challenges related to changing research environments, diversity in research, publication and dissemination trends, scientific literacy and trust in science, recruitment, research redundancy and study termination, placebo (...) and human challenge studies, data management, and informed consent. These challenges are linked to two crucial factors: first, actors in the DACH research ecosystem lacked a sound knowledge base to assess the risks and benefits of research during the COVID-19 pandemic. Second, researchers in the DACH region faced pressure from policymakers, funders, and the public to generate relevant, timely, and consistent findings to mitigate the impacts of the COVID-19 pandemic. In addition, this review highlights best practices to mitigate the effects of future crises on research ethics and integrity, including enhanced cooperation among actors, continuous ethics assessments, and support for public scientific literacy. (shrink)

Functional MRI shows promise as a candidate prognostication method in acutely comatose patients following severe brain injury. However, further research is needed before this technique becomes appropriate for clinical practice. Drawing on a clinical case, we investigate the process of obtaining informed consent for this kind of research and identify four ethical issues. After describing each issue, we propose potential solutions which would make a patient’s participation in research compatible with her rights and interests. First, we defend the need for (...) traditional proxy consent against two alternative approaches. Second, we examine the impact of the intensive care unit environment on the informed consent process. Third, we discuss the therapeutic misconception and its potential influence on informed consent. Finally, we deal with issues of timing in recruiting participants and related factors which may affect the risks of participation. (shrink)

Distributed programming paradigms such as MapReduce and Spark have alleviated sequential bottleneck while mining of massive transaction databases. Of significant importance is mining High Utility Itemset that incorporates the revenue of the items purchased in a transaction. Although a few algorithms to mine HUIs in the distributed environment exist, workload skew and data transfer overhead due to shuffling operations remain major issues. In the current study, Parallel Utility Computation algorithm has been proposed with novel grouping and load balancing strategies (...) for an efficient mining of HUIs in a distributed environment. To group the items, Transaction Weighted Utility values as a degree of transaction similarity is employed. Subsequently, these groups are assigned to the nodes across the cluster by taking into account the mining load due to the items in the group. Experimental evaluation on real and synthetic datasets demonstrate that PUC with TWU grouping in conjunction with load balancing converges mining faster. Due to reduced data transfer, and load balancing-based assignment strategy, PUC outperforms different grouping strategies and random assignment of groups across the cluster. Also, PUC is shown to be faster than PHUI-Growth algorithm with a promising speedup. (shrink)

This study – the first to explore how infertility providers confront several critical dilemmas concerning sex selection of embryos for nonmedical, social reasons – highlights key challenges and questions. Clinicians struggle, for instance, with how to define “family balalancing”, when to offer it, and how to decide.

During the first outbreak of COVID-19, the F rench governmental advisory council on bioethics suggested the need to support healthcare providers with ad hoc “ethical support units.” Several units engaged in such endeavors across the country. This article outlines some methodological considerations made by the Cochin Hospital Clinical Ethics Center (the Cec). The Cec was founded in 2002 to provide clinical ethics support services. While its approach was inspired by North American models, it was shaped by and adapted to the (...) French context. This approach is called the “Commitment Model,” as it draws upon societal engagement in all phases of its service and places the perspectives of individual patients at its core. During the first outbreak of COVID-19 pandemic, the Cec received a greater number of requests about recurring care practices or ethical guidelines and recommendations than single clinical ethics dilemmas. Through the presentation of an illustrative consultation, this article describes how, while the Cec made some adjustments to its service for the emergency situation, it preserved its case-by-case approach rather than engaging in what it calls organizational and institutional ethics. Such an approach allowed the Cec to refocus attention to individual patients and their unique circumstances and to support decision makers by the use of case-by-case, problematized, ethical reflections. (shrink)

Parts I through III of this paper will examine several, increasingly comprehensive forms of aggregation, ranging from insurance reimbursement “lock-in” programs to PDMPs to completely unified electronic medical records. Each part will advocate for the adoption of these aggregation systems and provide suggestions for effective implementation in the fight against opioid misuse. All PDMPs are not made equal, however, and Part II will, therefore, focus on several elements — mandating prescriber usage, streamlining the user interface, ensuring timely data uploads, creating (...) a national data repository, mitigating privacy concerns, and training doctors on how to respond to perceived doctor-shopping — that can make these systems more effective. In each part, we will also discuss the privacy concerns of aggregating data, ranging from minimal to significant, and highlight the unique role of stigma in motivating these concerns. In Part IV, we will conclude by suggesting remedial steps to offset this loss of privacy and to combat the stigma around SUDs and mental health disorders in general. (shrink)

The American health care system long has been distinctive in its embrace of market forces. For-profit private insurers play a major role in providing coverage, though they operate alongside public insurance programs that cover over one-third of the population. Historically, federal and state governments’ regulation of insurance markets was limited, leaving insurers to set premiums and coverage rules largely as they saw fit.Government’s role in controlling health care spending has been even more circumscribed. Purchasing power is fragmented, with each insurer (...) negotiating its own rates with physicians and hospitals. A formidable medical-industrial complex of for-profit providers, from hospitals to home-health care agencies, dialysis facilities, pharmaceutical companies and much more, has arisen to sell services. (shrink)

After clarifying the outlines of Raz's interest theory of rights and its relationship to aspects of the principles theory of rights, I consider how his recent observations on human rights manage to fit into the interest theory. I then address two questions. First, I elaborate on Raz's definition of morally fundamental rights, arguing that he is right in claiming that there are no such rights. I then show that the interest theory accommodates the notion that rights may take qualitative precedence (...) over conflicting considerations—a question that has become increasingly relevant in light of recent writing on rights. (shrink)

The current study explores role retreatism in secondary social studies teachers who coach athletics. The purpose of this study was to determine the extent to which social studies teacher-coaches retreat towards coaching and reasons for such prioritization. A case study relying primarily on interview and document data was conducted which included three secondary social studies teachers who coach football in the southeastern United States. Results indicate that participants prioritized coaching over teaching to cope with role conflict. The study further highlights (...) the unequal rewards system in American schools, which promotes athletics over academics. (shrink)

For many rare diseases, the availability of effective interventions is limited or non-existent. In this context, clinical research evaluating emerging interventions may be the only potentially “the...

Person‐centred care is founded on ethics as a basis for organizing care. In spite of healthcare systems claiming that they have implemented person‐centred care, patients report less satisfaction with care. These contrasting results require clarification of how to practice person‐centred ethics using Paul Ricoeur's ‘Little ethics’, summarized as: ‘aiming for the good life, with and for others in just institutions’. In this ethic Kantian morality is at once subordinate and complementary to Aristotelian ethics because the ethical goal needs to be (...) critically assessed and passed through the examination of the norm in each care situation. This paper presents examples that describes a person‐centred care practice that balance a critical review of care activities based on a conviction of aiming for patients' wellbeing. In contrast to patients' experiences of person‐centred care in real life, research projects have shown that if the clinical performers comprehend and apply the practice of person‐centred ethics, patients report positive outcomes. The implementation of person‐centred care therefore demands that stakeholders and managers enables and requires that healthcare staff study ethics in the same way as studying for example pharmacology is required when handling patients' medicines. (shrink)