Background: Demand for organisational ethics capacity is growing in health organisations, particularly among managers. The role of clinical ethicists in, and perspective on, organisational ethics has not been well described or documented in the literature. Objective: To describe clinical ethicists’ perspectives on organisational ethics issues in their hospitals, their institutional role in relation to organisational ethics, and their perceived effectiveness in helping to address organisational ethics issues. Design and Setting: Qualitative case study involving semi-structured interviews with 18 clinical ethicists across (...) 13 health organisations in Toronto, Canada. Results: From the clinical ethicists’ perspective, the most pressing organisational ethics issues in their organisations are: resource allocation, staff moral distress linked to the organisation’s moral climate, conflicts of interest, and clinical issues with a significant organisational dimension. Clinical ethicists were consulted in particular on issues related to staff moral distress and clinical issues with an organisational dimension. Some ethicists described being increasingly consulted on resource allocation, conflicts of interest, and other corporate decisions. Many clinical ethicists felt they lacked sufficient knowledge and understanding of organisational decision-making processes, training in organisational ethics, and access to organisational ethics tools to deal effectively with the increasing demand for organisational ethics support. Conclusion: Growing demand for organisational ethics expertise in healthcare institutions is reshaping the role of clinical ethicists. Effectiveness in organisational ethics entails a re-evaluation of clinical ethics training to include capacity building in organisational ethics and organisational decision-making processes as a complement to traditional clinical ethics education. (shrink)

Nicholas Shackel (2011) has proposed a number of arguments to save the Dipert–Bird model of physical reality from the sorts of unpalatable consequence I identified in Oderberg 2011. Some consequences, he thinks, are only apparent; others are real but palatable. In neither case does he seem to me to have deflected the concerns I raised, leaving graph structuralism on Dipert–Bird lines as problematic as ever.

That Sallust owed a considerable debt to the writings of Cato the Censor was observed in antiquity, and the observation has often been discussed and expanded on by modern scholars. The ancient references to Sallust's employment of Cato are mainly in the context of his adoption of an archaic style, and specifically Catonian vocabulary. But the choice of Cato as a model had an obvious significance that went beyond the purely stylistic. Sallust's works articulate extreme pessimism at the moral state (...) of late-Republican Rome, and do so partly by contrasting the modern age with a prelapsarian time of near-untrammelled virtue, brought to an end only by the fall of Carthage and the consequent dominance of Roman power, which in turn led to moral corruption. Similarly, Cato famously stood in his own day for moral rectitude—and specifically appealed to past virtue as the standard to which he wished to hold his contemporaries. Sallust, by writing in a Catonian style, aligns himself with that tradition. (shrink)

Marking the 50th anniversary of one among this philosopher's most distinguished pieces, Blumenberg's Rhetoric proffers a decidedly dialogic and diversified interaction with the essay polyvalently entitled 'Anthropological Approach to the Actuality and Topicality (or Currency, Relevance) of Rhetoric' (Anthropologische Annäherung an die Aktualität der Rhetorik), first published in 1971. Following Blumenberg's lead, the contributors consider and tackle their topics rhetorically, 'in utramque partem vel in plures'--treating (inter alia) the variegated discourses of Phenomenology, the History of Philosophy, Anthropology, and the téchne (...) itself from a plurality of viewpoints. Quasi in actu--as a mise en abyme of this rhetorical method par excellence--said accent on approaching any matter polyperspectivally is reflected in the proceedings of the live(ly) discussions having taken place in preparation for the present volume. Along with the diachronically extensive, disciplinarily diverse essays, this publication of the actual academic interplay--notably in the current lingua franca--will facilitate, and is to conduce to, further scholarship with respect to Blumenberg and the art of rhetoric. (shrink)

Within the increasingly complex picture which has emerged in recent years of the manuscript tradition of Ovid's Amores the relationship of the two earliest MSS appears to remain firm: cod. P or Puteaneus of the 9th or early 10th century, which begins at Am. 1.2.51, was copied, probably directly, from the second half of the 9th-century cod. R or Regius , whose first half now ends at Am. 1.2.50. This view, which originates in S. Tafel's dissertation of 1910 and lies (...) behind the stemma constructed by E. J. Kenney for his OCT edition of 1961 , has come to be taken by Ovidian scholars to be the truth. My purpose in this first section is to show that this idea is unlikely to be the truth and, in the form in which it has most strongly been put forward, cannot be the truth. In the second section consequences for the manuscript tradition as a whole are explored. First we shall need some details. P, the slightly later manuscript, consists in all of 99 folia, of which 1–54 contain most, but not all, of the Heroides — not all, because they are in a lacunose state, a point to which we shall return in greater detail later. Foll. 55–6 are blank sheets of paper, not parchment, clearly inserted at a much later date during rebinding. (shrink)

Preimplantation genetic diagnosis (PID) is often seen as an improvement upon prenatal testing. I argue that PID may exacerbate the eugenic features of prenatal testing and make possible an expanded form of free-market eugenics. The current practice of prenatal testing is eugenic in that its aim is to reduce the numbers of people with genetic disorders. Due to social pressures and eugenic attitudes held by clinical geneticists in most countries, it results in eugenic outcomes even though no state coercion is (...) involved. I argue that technological advances may soon make PID widely accessible. Because abortion is not involved, and multiple embryos are available, PID is radically more effective as a tool of genetic selection. It will also make possible selection on the basis of non-pathological characteristics, leading, potentially, to a full-blown free-market eugenics. For these reasons, I argue that PID should be strictly regulated. (shrink)

Originally published in 1986. Both moral philosophers and philosophical psychologists need to answer the question ‘what is a virtue?’ and the best answer so far give is that of Aristotle. This book is a rigorous exposition of that answer. The elements of Aristotle’s doctrine of virtue are scattered throughout his writings; this book reconstructs his complex and comprehensive doctrine in one place. It also covers Aristotle’s views about choice, character, emotions and the role of pleasure and pain in virtue. The (...) celebrated function is considered carefully as well as the doctrine of virtue being related to Aristotle’s metaphysics and categories. (shrink)

The Intergovernmental Platform on Biodiversity and Ecosystem Services have recently launched themselves as the UN-sanctioned instrument for conserving nature. They seek to establish themselves as the authority in this field alongside the well-known Intergovernmental Panel on Climate Change in climate science. Quickly following or even before recent publication of their conceptual framework in two biology journals, they were already underway building upon it. This headlong push, we believe, is ill advised. We show how the framework is unsound as a foundation (...) for further work—in a number of ways and perhaps even by its authors’ own lights. It is therefore urgent that the IPBES thoroughly and thoughtfully reconsider their framework before too much effort is wasted. (shrink)

Indoor smoking bans in public places is usually held as a simple and straightforward example of the application of the harm principle in public health. However, implementing indoor smoking bans in mental health centres is difficult because of the potential neurological and social benefits of smoking for persons with schizophrenia, as suggested by some empirical studies. In this article, the ethical challenges related to smoking bans in mental health centres as justified by the harm principle are explored. Particular attention is (...) given to the case of R v. Nottinghamshire Healthcare NHS Trust . The article concludes by arguing that the possible benefits of smoking for persons with schizophrenia creates a rightful interest that cannot be ignored even if one applies the harm principle to protect others from the negative effects of second-hand smoke. Applying the harm principle in the case of smoking bans in mental health centres requires protecting the interest of persons with schizophrenia to smoke via the value of reciprocity. (shrink)

This paper provides a brief overview and critique of the dominant objectivist understanding and use of illness narrative in Enlightenment (scientific) medicine and ethics, as well as several revisionist accounts, which reflect the evolution of this approach. In light of certain limitations and difficulties endemic in the objectivist understanding of illness narrative, an alternative phronesis approach to medical ethics influenced by Charles Taylor’s account of the interpretive nature of human agency and language is examined. To this end, the account of (...) interpretive medical responsibility previously described by Schultz and Carnevale as "clinical phronesis" (based upon Taylor’s notion of "strong" or "radical evaluation") is reviewed and expanded. The thesis of this paper is that illness narrative has the ability to benefit patients as well as the potential to cause harm or iatrogenic effects. This benefit or harm is contingent upon how the story is told and understood. Consequently, these tales are not simply "nice stories," cathartic gestures, or mere supplements to scientific procedures and decision making, as suggested by the objectivist approach. Rather, they open the agent to meanings that provide a context for explanation and evaluation of illness episodes and therapeutic activities. This understanding provides indicators (guides) for right action. Hence, medical responsibility as clinical phronesis involves, first, the patient and provider’s coformulation and cointerpretation of what is going on in the patient’s illness narrative, and second, the patient and provider’s response to interpretation of the facts of illness and what they signify–not simply a response to the brute facts of illness, alone. The appeal to medical responsibility as clinical phronesis thus underscores the importance of getting the patient’s story of illness right. It is anticipated that further elaboration concerning the idea of clinical phronesis as interpretive illness narrative will provide a new foundation for medical ethics and decision making. (shrink)

This article traces the career path and personality of a chancery official or secretary in the service of the Gonzaga, the ruling dynasty of Mantua, in the middle years of the fifteenth century. It relates Giovanni Arrivabene to the contemporary social, political and cultural context of this secondary northern Italian power or signoria but touches the wider Italian world at many points, particularly the papal court, whether in Rome or other locations, where Giovanni’s talented younger brother served first as the (...) secretary of Cardinal Francesco Gonzaga and later as an apostolic secretary. The comparison between the two brothers and their interdependence as property owners is a recurring theme. Giovanni emerges with evident limitations which hampered the succession to his father’s superior role in the chancery, where other privileged families also tended to prevail. Humanist educated and efficient, he seems to have been a bureaucrat of routine abilities, not quite astute enough to outpace certain departmental rivals or to avoid being tainted by association with some possibly corrupt practice which caused loss of favour. His later rehabilitation, first as a provincial magistrate concerned with criminal jurisdiction and later as an estate management official, illustrates that private relationships within the narrow world of a civic quasi despotic government were all important. (shrink)

Guidelines around the world require children to provide assent for their participation in most research studies. Yet, little further guidance is provided on how review committees should implement this requirement, including which children are capable of providing assent and when the requirement for assent may be waived on the grounds that the research offers participating children the potential for important clinical benefit. The present paper argues that the assent requirement is supported by the importance of allowing children who are capable (...) to make their own decisions. This suggests children are capable of assent when they become able to understand the research in question. While development varies across individual children, existing data suggest most children develop this ability by approximately age 14. Until instruments are developed to assess the assent capacity of individual children, this age should be used as the threshold for assent. In addition, the importance of protecting children from harm suggests that the sustained dissent of all children, including those who are unable to provide assent, should be respected. While the assent requirement may be waived when research participation offers the potential for important medical benefit that is unavailable outside the research context, analysis suggests that children’s sustained dissent should be respected in all cases. (shrink)

Almost traditionally, it seems, accounts of the development of the concepts of work and energy have tended to describe them within the classical framework of Newtonian mechanics. They are seen as the end products of the celebratedvis-vivadispute in the eighteenth century: the outcome of a debate within the confines of the science of rational mechanics. I would like to suggest that this may be to take too narrow a view of the case. It is to project backwards our present specialist (...) arrangement of scientific knowledge, our present divisions between the sciences, and to assume that past development was strictly guided by these divisions. And this is to make questionable historical and sociological assumptions. (shrink)

An anthology of readings in panpsychism, spanning two millennia.

University Of California Publications In Philosophy, V35.