Background: There is growing interest in credentialing hospital ethicists. Consult volume is being incorporated into credentialing criteria, although few data supporting this approach are available...

IBERTARIANS hold that we have such duties as: not to directly and significantly harm others or their property, to keep agreements, to refrain from lying and certain other sorts of deception, and to compensate those whom we wrong. They also hold that we have a duty not to interfere with the liberty of others as long as they are fulfilling these duties. This duty of non-interference, they have thought, has protected the privacy of the home, and hence parental autonomy, for (...) it insures that others have no authority over or responsibility for (except in extreme circumstances) how parents raise or treat their children. (Why parental autonomy has been held to be protected by this duty of non—in_terference should be clear enough: for if (as is surely plausible) the main effect of that duty is to secure for adults the liberty (within limits) to live their private lives as they choose, then, on the natural assumption that the matter of how to raise one`s children falls within the domain of the private lives of adults, intervention by others, and in particular by the state, for the purpose of ensuring that children get raised in one way rather than another, would be impermissible.) More specifically to our purposes now, libertarians have supposed that the duty of non-interference leaves intact parents` perogative to decide if, and in what way, their children are to be educated. That this is crucial both to the degree and to the point of parental autonomy is clear enough. For it goes both to the matter of keeping out of the private home those who would provide education for children (if such is the wish of the parents), and to the matter of parents` entitlement to instill in their children the values that they (the parents) wish their children to have. Libertarians, however, have not had very much specific to say about the moral status of children. Are children owned by their parents? Do they have all the rights and duties that normal adults have'? Or is their status somewhere in between these extremes? Given that libertarians haven't said, there are different possible ways of extending traditional libertarian theory so as to cover children.. (shrink)

In a ‘Letter from Washington’ in The New Yorker, Elizabeth Drew reported some speculation regarding the mental processes of Ronald Reagan. In Drew’s words:The curious process Drew describes is clearly important in many ways -historically, politically, and perhaps legally. We contend that there is even some epistemological significance to Reagan’s method for the fixation of belief. We shall argue, in particular, that some of those curiously insulated beliefs which Reagan possesses qualify as knowledge under at least one leading causal reliabilist (...) theory of knowledge- that presented by F. Dretske in Knowledge and the Flow of Information. But, as we detail the structure of such beliefs, what is probably evident already will emerge quite clearly, viz., that these beliefs do not amount to knowledge. (shrink)

Medical ethics tends to focus on the content of patients' beliefs rather than concern itself with patients' ethical development. An ethics of attention investigates the psychological processes that are the prerequisite to moral action.

Suppose that in the Meditations Descartes thinks he needs to prove that his clear and distinct perceptions are true. There can be little doubt that if he does think he needs to do this, he thinks that the way to do it is to prove that ‘a non-deceiving God exists’ is true. Now suppose that Descartes does come up with such a proof. Presumably he clearly and distinctly perceives both the premisses and that ‘a non-deceiving God exists’ follows from them. (...) But that will not suffice to prove that ‘a non-deceiving God exists’ is true. For, if there is a problem about whether clear and distinct perceptions are true, then in advance of settling it, there is a problem about whether what is proved merely on the basis of clear and distinct perceptions is true. (shrink)

When a child is dying of AIDS, what can she understand, and what can her parents bear to tell her? The persons involved in the telling and the manner of disclosure will vary with each child and over time.

Child liberationism holds that children are entitled to more freedom from interference than we currently acknowledge socially or legally. It holds, for example, that "the law [should] grant and guarantee to the young the freedom that it now grants to adults to make certain kinds of choices, do certain kinds of things, and accept certain kinds of responsibilities. This means in turn that the law [should] take action against anyone who interferes with young people's rights to do such things".1 Call (...) an agent minimally rational just in case he/she is capable of basic means-ends reasoning and of basic reflection on his/her beliefs and desires. No plausible form of child liberationism advocates full freedom from interference (i.e., as much as normal adults) for children that are not yet minimally rational. Some child liberationists do, however, advocate full freedom from interference for all minimally rational children -- typically those over age 5, say. Call this position radical child libera tionism . Other child liberationists only advocate full freedom from interference for older children -- typically those over age 12, say. Call this position moderate child libera tionism .2 For the sake of argument we shall grant that even young minimally rational children (e.g., 5 year olds) have full rights of non-interference. We shall argue that there are nonetheless a wide range of paternalistic practices regarding such children that are legitimate. In short, even granting the radical child liberationist thesis that young children have the same formal rights to freedom as competent adults, it does not follow that young children should enjoy the same effective freedom. Indeed, there are good reasons for holding that they should enjoy less freedom. Or so we shall.. (shrink)