This book provides answers to both normative and metaethical questions in a way that shows the interconnection of both types of questions, and also shows how a complete theory of reasons can be developed by moving back and forth between the two types of questions. It offers an account of the nature of intimate relationships and of the nature of the reasons that intimacy provides, and then uses that account to defend a traditional intuitionist metaethics. The book thus combines attention (...) to the details of the lived moral life – the context in which many of our most pressing moral questions arise, how we deliberate and make moral decisions, the complexities that plague our attempts to know what we ought to do – with theoretical rigor in offering an account of the nature of reasons, how we come to have moral knowledge, and how we can adjudicate between competing positions. (shrink)

The two dominant contemporary moral theories, Kantianism and utilitarianism, have difficulty accommodating our commonsense understanding of friendship as a relationship with significant moral implications. The difficulty seems to arise from their underlying commitment to impartiality, to the claim that all persons are equally worthy of concern. Aristotelian accounts of friendship are partialist in so far as they defend certain types of friendship by appeal to the claim that some persons, the virtuous, are in fact more worthy of concern than are (...) other persons. This article argues that we can preserve the underlying impartiality of Kantianism and utilitarianism, while also preserving a certain partiality with respect to our friends: the partiality of commonsense only seems objectionable if we fail to understand the true grounds, nature, and implications of such partiality. Neo-Aristotelian partiality should be rejected in favor of commonsense partiality. (shrink)

Most of us accept that we have special obligations to our family members: to, e.g., our parents, our siblings, and our grandparents. But it is extremely difficult to offer a plausible grounding for such obligations, given the apparent fact that familial relationships are not voluntarily entered. I did not choose to be my mother's daughter or my brother's sister, so why suppose that such facts about me are morally significant? Why suppose that I owe more to my mother or to (...) my brother than natural duty requires that I do for all and any persons? Special obligations appear more problematic the less the relationships that supposedly generate them are akin to the relationship between promiser and promisee, a voluntarily assumed relationship. Thus, for example, special obligations to friends might appear less problematic than do those to family members, because it seems that we voluntarily choose our friends, and, thus, voluntarily choose to bear more for them than natural duty requires. (shrink)

A significant amount of discussion in the bioethics community has been devoted to the question of whether individuals performing ethics consultations in healthcare institutions have any special expertise. In addition, articles in the lay press have questioned the “added value” that bioethicists bring to ethical dilemmas. Those at the forefront of the bioethics community have argued repeatedly that those doing ethics consults cannot simply be well-intentioned individuals, that some training in bioethics, group process, and facilitation is necessary to competently execute (...) a consult. As one bioethicist commented:if you approach any endeavor as an amateur activity, you will get, in the end, an amateurish version of the activity. Without a sufficient commitment of personnel, time, support, and financial resources, a healthcare organization will get the ‘ethics’ program … it set out to create: an inept, unskilled, inefficient, and highly risky ‘program’ in healthcare ethics and bioethics. (shrink)

Samuel Scheffler has identified two important objections to associative obligations, the voluntarist objection and the distributivist objection. The voluntarist is concerned about protecting the autonomy of the agent who is supposed to have associative obligations. However, the appropriate account of the source of associative obligations reveals that they pose no threat to autonomy, if we understand autonomy in a weak rather than a strong sense. The distributivist is worried about the claims of outsiders being ignored as the result of insiders (...) having associative obligations to one another. This objection loses much of its force when we understand the genuine implications of associative obligations. (shrink)

Reasons of intimacy, i.e. reasons to care for friends and other intimates, resist categorization as either subjective Humean reasons or as objective consequentialist reasons. Reasons of intimacy are grounded in the friendship relation itself, not in the psychological attitudes of the agent or in the objective intrinsic value of the friend or the friendship. So reasons of intimacy are objective and agent-relative and can be understood by analogy with reasons of fidelity and reasons of prudence. Such an analogy can help (...) us to understand which objective agent-relative reasons we have and which, such as deontological constraints, we do not have. (shrink)

Shift work is a fixture of our 24-hour economy, with approximately 18 per cent of workers in the USA engaging in shift work, many overnight. Since shift work has been linked to an increased risk for an array of serious maladies, including cardiometabolic disorders and cancer, and is done disproportionately by the poor and by minorities, shift work is a highly prevalent economic and occupational health disparity. Here we draw primarily on the state of science around shift work and breast (...) cancer to argue that shift work represents a public health threat serious enough to warrant a precautionary stance. We use the precautionary principle to advance our case and view it as a moral compass for shift work research, empowering public health to cast shift work within the domain of health disparities deserving action despite scientific uncertainty. With the precautionary principle, we call for a deliberative decision-making process and formation of a broad shift work research collaboration to protect the health of many millions who work at night. (shrink)

BackgroundCerebral Visual Impairment is a very common finding in children affected by Cerebral Palsy. In this paper we studied the characteristics of CVI of a large group of children with CP and CVI, describing their neurovisual profiles according to three different age subgroups.MethodsWe enrolled 180 subjects with CP and CVI for the study. We carried out a demographic and clinical data collection, neurological examination, developmental or cognitive assessment, and a video-recorded visual function assessment including an evaluation of ophthalmological characteristics, oculomotor (...) functions, and basic visual functions. In school-aged children, we also performed an evaluation of their cognitive-visual profiles.ResultsThere were signs of CVI in all the three subgroups. Subgroup 1 and subgroup 2 were different for fixation, visual acuity and contrast sensitivity, being more frequently impaired in younger children. Comparing subgroup 2 with subgroup 3, the older children presented more frequently myopia while the younger ones esotropia and alteration in smooth pursuit and saccades. Furthermore, fixation, smooth pursuit, visual acuity, contrast sensitivity and visual filed were more frequently impaired in younger children compared to the older ones. Multiple correspondence analysis confirmed the different neurovisual profiles according to age: younger children with CP showed more signs of CVI compared to the older ones. 34 out of 68 children belonging to subgroup 3 underwent the cognitive visual evaluation; an impairment of cognitive visual skills was detected in 21 subjects.ConclusionYounger children with CP showed more signs of CVI compared to the older ones, likely for the physiological maturation of visual system and mechanisms of neuroplasticity. In this direction, we suggest an early neurovisual evaluation to detect any weak visual functions. (shrink)

Uncertainty regarding potential disciplinary action may give physicians pause when considering whether to accept a chronic pain patient or how to treat a patient who may require long-term or high doses of opioids. Surveys have shown that physicians fear potential disciplinary acrion for prescribing controlled substances and that physicians will, in some cases, inadequately prescribe opioids due to fear of regulatory scrutiny. Prescribing opioids for long-term pain management, particularly noncancer pain management, has been controversial; and boards have investigated and, in (...) some cases, disciplined physicians for such prescribing. While in virtually all of these cases the disciplinary actions were successfully appealed, news of the success was not often as well-publicized as news of the disciplinary actions, leaving some physicians confused about their potential liability when prescribing opioids for pain. The confusion has perhaps increased as a result of two relatively recent cases, one where a physician was successfully disciplined by a state medical board for undertreatment of his patients’ pain, and another where the physician was successfully sued for inadequate pain treatment. (shrink)

Philosophers who, in the light of these attacks, have attempted to vindicate the motive of duty have done so in a half-hearted way, by stressing the motive of duty’s function as a secondary or limiting motivation, or by denying “that acting from duty primarily concerns isolated actions.” I will defend duty as a primary motive with respect to isolated actions. Critics of acting from duty and philosophers who have attempted to respond to them have done little work spelling out exactly (...) what it is for an agent to act from duty. To act explicitly on moral principle is to act from a type of concern for persons that is no less morally good than concern expressed in direct emotional responses. Concern mediated by moral principles is, in certain ways, morally superior to that expressed in direct emotional responses, even when the object of concern is an intimate such as a friend or loved one. (shrink)

_Kant Trouble_ offers a highly original and incisive reading of some of the lesser known aspects of Kantian thought. Throughout Morgan challenges the widely held view of Kant as the exponent of concrete and rigid rationality and argues that his airtight 'architectonic' mode of reasoning overlooks certain topics which destabilise it. These include temporary forms of architecture, such as landscape gardening; examples which undermine the autonomy of the Kantian subject, for example, freemasonry; and the concept of radical evil, all of (...) which suggest that Kant's thought was capable of accommodating troubling and subversive themes. Morgan's compelling discussion arrives at a fresh and ground breaking perspective on Kant whereby he is no longer to be regarded as a concrete rationalist, but as a daring thinker, not afraid to entertain ideas highly threatening to his own system and to the humanistic legacy of the enlightenment. (shrink)

The purpose of this research was to understand institutional review board (IRB) challenges regarding youth-focused research submissions and to present advice from administrators. Semistructured self-report questionnaires were sent via e-mail to administrators identified using published lists of universities and hospitals and Internet searches. Of 183 eligible institutions, 49 responded. One half indicated they never granted parental waivers. Among those considering waivers, decision factors included research risks, survey content, and feasibility. Smoking and substance abuse research among children was generally considered more (...) than minimal risk. These findings are consistent with those from a study conducted by Mammel and Kaplan (1995), which investigated IRB practices concerning protocols involving adolescent participants. IRBs and investigators need to become aware of regulations' flexibility to ensure adequate participant protection. Investigators need to limit jargon and assumptions about participants' understanding of research objectives. (shrink)

What did wittgenstein mean when he said that 'ethics and aesthetics are one', Since these are generally contrasted than amalgamated? his "1914-1916 notebooks", The "tractatus", And the "lecture on ethics", Show that he regarded them as one because they shared a "sub specie aeternitatis" attitude. Study of his remarks reveals the implications of his account and shows that wittgenstein, In this phase of development, Belonged in the mainstream of ethical and aesthetic philosophy.

In this essay, I examine the arguments against physician-assisted suicide Susan Wolf offers in her essay, “Gender, Feminism, and Death: Physician-Assisted Suicide and Euthanasia.” I argue that Wolf's analysis of PAS, while timely and instructive in many ways, does not require that feminists reject policy approaches that might permit PAS. The essay concludes with reflections on the relationship between feminism and questions of agency, especially women's agency.

Friendship and other intimate relationships have created difficulties for moral philosophers. While morality seems to require us to remain impartial between persons, friendship seems to generate demands or obligations of partiality toward our intimates. But the difficulty can be removed once we cease to focus on categorizing reasons as moral or non-moral. This tendency to divide reasons into categories of moral vs. non-moral leads us to give those that we label ‘moral’ pride of place and to assume that the category (...) must be uniform. If we abandon these assumptions, then reasons of intimacy or friendship will no longer be so puzzling. We will then be able to see that all reasons, in the end, are importantly egocentric, and that deliberation must always proceed from an egocentric perspective. (shrink)

Garrett Hardin's 'lifeboat ethics' is examined in the light of historical evidence which may be applied in part and with moderation to avoid both Hardin's predicted catastrophe and the inevitable guilt for survivors. If the metaphor of the lifeboat is re-examined, and slightly modified by including examples of real open boat passages, a scheme for implementing lifeboat ethics may be supported. In a case where some or all of the victims outside the lifeboat may be safely rescued, it is the (...) moral obligation of those in the boat to do so. The goal of any lifeboat situation, actual or metaphorical, is to secure the rescue of the greatest number of victims. The wrecks of both Endurance, on an exploratory voyage to Antarctica, and Essex, a whaling voyage, give insight into the application of lifeboat ethics. (shrink)

Background Individuals who were maltreated during childhood are faced with increased risks for developing various psychological symptoms that are particularly resistant to traditional treatments. This pilot study investigated the effects of a mindfulness based behavioral intervention for young adults with a childhood maltreatment history. Methods This study looked at self-report psychological questionnaires from 20 subjects (5 males) before and after a mindfulness-based behavioral intervention, compared to 18 subjects (6 males) in the waiting list control group (age range 22–29); all subjects (...) experienced mild-to-moderate childhood maltreatment. We analyzed changes in stress, anxiety, depression, mindfulness and self-compassion related to the intervention with linear mixed effects models; we also analyzed the relationships among questionnaire score changes with partial correlation analyses and mediation analysis. Results Linear mixed effects model analyses revealed significant group by time interaction on stress ( p p p p p p r = 0.578, p = 0.001), which negatively correlated with changes in depression ( r = −0.374, p = 0.05) and anxiety ( r = −0.395, p p r = −0.674, p r = −0.580, p r = −0.544, p Conclusion Our results suggest that, to some extent, the mindfulness-based intervention can be helpful for improving self-compassion and psychological health among young adults with a childhood maltreatment history. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT02447744. (shrink)

But my real cat is not Alice’s little cat … because I am certainly not about to conclude hurriedly, upon waking, as Alice did, that one cannot speak with a cat on the pretext that it doesn’t reply or that it always replies the same thing. Everything that I am about to entrust to you no doubt comes back to asking you to respond to me, you, to me, reply to me concerning what it is to respond. If you can. (...) The said question of the said animal in its entirety comes down to knowing not whether the animal speaks but whether one can know what respond means. And how to distinguish the response from a reaction.A response that does not respond to a question is a response that is not the solution to a problem or the .. (shrink)

Bioethical decision‐making in pediatrics diverges from similar decisions in other medical domains because the young child is not an autonomous decision‐maker, while the teen is developing—and should be encouraged to develop—autonomy and decisional capacity. Thus the balance between autonomy and beneficence is fundamentally different in pediatrics than in adult medicine. While ethical dilemmas that reflect these fundamental issues are common, many pediatric physician and nursing training programs do not delve into the issues or offer specific training about how to deal (...) with borderline cases.To meet this need, the Children's Mercy Bioethics Center in Kansas City, Missouri, created a program specifically dedicated to serving practicing, experienced pediatric health professionals. Our students come from various professional disciplines: they are doctors, nurses, social workers, chaplains, lawyers, psychologists, counselors, and hospital administrators practicing in pediatrics. (shrink)

The book is an introduction to oriental philosophy via individual consideration of the ideas of thirty-five major figures drawn from six traditions. Commentaries on each philosopher are accompanied by overviews of these traditions.

This paper considers the arguments put forward for the closure of small schools in rural areas. The debate, which is firmly rooted in the Plowden Report, has involved both educational and economic arguments. The research on which this paper draws examines these arguments in the light of the implementation of the Local Management of Schools in three local authorities in the UK since 1988 and discusses the impact which this policy has had on resource provision, on the changing role of (...) staff and on the daily functioning of small rural schools. (shrink)

On standard accounts of responsibility, one is thought to be responsible for one's own actions or affairs. Levinas' philosophy speaks of a responsibility that goes beyond my actions and their consequences to an infinite, irrecusable, asymmetrical responsibility for the other human. In the dissertation, I present a defense of Levinasian responsibility and argue that distinctive of Levinas' thought as an ethics is the manner in which it maintains the absolute and unexceptionable character of responsibility, while simultaneously putting into question every (...) possible ground or justification for this claim. The central chapters of the dissertation consider the connection between the formal structure of transcendence and the deformalization of this notion as responsibility. After discussing the notions of transcendence employed in the phenomenology of Husserl and Heidegger, I examine Levinas' criticism that transcendence in their sense remains an immanence insofar it continues to tie the conditions of intelligibility to modes of understanding and comprehension. Levinas' reconception of transcendence as a relation to exteriority and absolute alterity is then examined as it is developed first in his early writings , and then in Totality and Infinity through the tropes of the idea of infinity, metaphysical desire, and the face. The aim of these chapters is not only to elucidate in detail the conception of transcendence, but to examine why Levinas thinks that transcendence is already an ethical event. While commentators have sometimes claimed that ethics in Levinas' sense is neither normative nor descriptive, I show that the question of normativity--of how ethical claims are binding on us--is central to the problematic of responsibility, though in a way which ultimately forces us to revise our understanding of both normativity and ethics. Levinas contests the possibility of decisive evidence that would prove the truth of our ethical obligations. What I show is how the call for proof or justification always already distorts and passes over the meaning of responsibility. (shrink)