The placebo drug reactions from controlled trials were studied for the first time systematically for efficacy and the safety in drug data pooled from randomized, placebo-controlled, multicentre studies. Results: The efficacy of placebo on clinical symptoms and outcome varied between the therapeutic indications. However, no placebo effects on laboratory values, as e.g. blood glucose or Hb1c in diabetics, were noted. The frequency and type of placebo-induced adverse reactions also varied between indication groups. The placebo side effect profile was largely similar (...) to the side effect profile of the active treatment. The mechanisms of placebo effects are manyfold and varied (e.g. endorphin release, conditioning), much lacks explanation. Conclusion: Since the prescription of non-evidence based medicines (= pseudoplacebos) may clearly also result in serious adverse effects, such practice may not only be non-beneficial but may even be harmful. In clinical research, the judicious use of placebo remains essential to establish the efficacy and safety, safeguarding that patients receiving placebo will not be subject to harm and are fully informed. (shrink)

Two profound atrocities in the history of Western culture form the subject of this moving philosophical exploration: American Slavery and the Holocaust. An African American and a Jew, Laurence Mordekhai Thomas denounces efforts to place the suffering of one group above the other. Rather, he pronounces these two defining historical experiences as profoundly evil in radically different ways and points to their logically incompatible aims. The author begins with a discussion of the nature of evil, exploring the fragility (...) of human beings and the phenomena of compartmentalizing, unquestioning obedience to authority, and moral drift. Citing compelling examples from history and contemporary life, he characterizes evil acts in terms of moral agency, magnitude, and intent. With moving testimony, Thomas depicts the moral pain of African Americans and Jews during their ordeals and describes how their past as victims has affected their future. Without invidious comparison, he distinguishes between extermination and domination, death and natal alienation, physical and mental cruelty, and between being viewed as irredeemable evil and as a moral simpleton. Thomas also considers the role of blacks and Jews in the Christian narrative. _In Vessels of Evil_, Thomas also considers the ways Jews and blacks have gone on to survive. He analyzes the relative flourishing of Jews and the languishing of blacks in this country and examines the implications of their dissimilar tragedies on any future relationship between these two minorities. (shrink)

Having children is the most common aim among human beings. The Family and the Political Self aims to capture the insights that can be gleaned from taking this truth seriously. One truth is that human beings may not be as self-interested as is commonly supposed. In this book Laurence Thomas argues that the best construal of the political self reflects this truth.

BackgroundGiven that advances in research continuously raise new ethical issues, a multidisciplinary working group of investigators involved in biomedical research has gathered to discuss and compare ethical viewpoints in their daily practice.MethodsThe working group has drafted a Charter for Ethics in Biomedical Research that encompasses all the steps in the research process, i.e. from the initial idea to analysis and publication of the results.ResultsBased on key principles for ethically responsible research, the Charter may serve as a tool for performing research, (...) discussing research issues and training researchers.ConclusionsThe Charter should stimulate researchers to think about their responsibility for research in a progressive, caring society. (shrink)

Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one’s moral knowledge about what one (...) ought to do. We begin by unpacking the philosophical components of Andrew Jameton’s original formulation from his landmark 1984 work and identify two key respects in which that formulation remains unclear: the origins of moral knowledge and impediments to acting on that moral knowledge. We then selectively review subsequent literature that shows that there is more than one concept of moral distress and that explores the origin of the values implicated in moral distress and impediments to acting on those values. This review sets the stage for identifying the elements of a philosophical taxonomy of ethically significant moral distress. The taxonomy uses these elements to create six categories of ethically significant moral distress: challenges to, threats to, and violations of professional integrity; and challenges to, threats to, and violations of individual integrity. We close with suggestions about how the proposed philosophical taxonomy of ethically significant moral distress sheds light on the concepts of moral residue and crescendo effect of moral distress and how the proposed taxonomy might usefully guide prevention of and future qualitative and quantitative empirical research on ethically significant moral distress. (shrink)

UTONOMY IS VERY HIGHLY PRAISED as something that it is always good to have, and always good to have more of rather than less of.1 The idea seems to be that persons should be autonomous whatever else they might be, and that should act autonomously whatever else it is that they might do. Kantians are fond of saying that a person is autonomous if she or he chooses to live in accordance with the dictates of reason. This, in turn, directly (...) links autonomy to morality, which for Kantians is an ineliminable aspect of reason. I shall discuss this view in Section II. Of course, it is also the case that autonomy is widely heralded as a good by those who do not accept Kant’s philosophical moorings. For instance, to say that women should be more autonomous is not thereby to say that they should be more embracing of this or that moral set of principles. In fact, it is not clear that this assertion pertains to acting morally at all. Autonomy, like liberty, seems to be regarded as a good whatever the philosophical leanings of people might be. In either case, the more the better. (shrink)

In this paper, I have assessed Marx's criticism of capitalism, and the practice of divided labor, from the standpoint of two important senses of worth which persons can have, namely self-respect and self-esteem. I have tried to show that in either case, Communism, as Marx envisioned it, is not the superior to capitalism he might have supposed. Along the way, I hope to have also shown the importance of distinguishing between two concepts, namely self-respect and self-esteem.

This essay is a discussion of the radio talk show host Dr. Laura Schlessinger. It is an assessment of the moral advice that she dispenses her radio show, and kinds of criticisms to which she has been subjected.

This work has a most resounding virtue: It is an essay in moral philosophy written about the ordinary life. Care’s point of departure is a life that is flawed and troubled—one that is dulled to numerous moral considerations, one that is far from capable of just willing itself back on any track, moral or otherwise. And as the book’s title suggests, the question that he is concerned to answer is, How does that kind of person get on with living a (...) morally respectable life? How is it possible for that person to have what Care calls Hume-Falk peace of mind, since that person’s life will never, in view of the damage caused to others, pass satisfactory review. (shrink)

The terrorists will win because they have nothing to lose if they try and fail, whereas we here in the West have become so concerned with the amenities of life (such as our gas-guzzling SUVs) that, lest we should have to forgo them, we would rather appease evil itself.

The essay discuss the issue of comparing the American Slavery and the Holocaust, and the extent to which the ideology of the American dream has fueled invidious comparisons between the two peoples. Just as murder and rape are wrongs to be understood in their own right, I argue that a like claim holds for American Slavery and the Holocuast. The essay further points out that we should be weary of supposing that wrongdoing is the sort of the thing for which (...) compensation is at all possible. (shrink)

In this article, the focus is on developing a governance concept built on integrating the ISO 26000 Social Responsibility standard with an “employee social responsibility” concept developed by the authors. To this end. The authors propose to compliment the voluntary, organizationally adaptable, ISO 26000 SR standard for the organization/firm with a seamlessly integrated—and equally adaptable—ESR concept for the individual/employee of that organization/firm. An SR/ESR governance concept emerges, with an emphasis on implementing a SR-based business enterprise code of conduct and ESR-related (...) functional-level codes of conduct, the latter firmly ensconced in an organization's ethical climate. The conclusion section discusses the strengths and weaknesses of our proposed SR/ESR governance concept. (shrink)

In this important and engaging volume, international scholars present opposing viewpoints to debate ten of the most important issues in contemporary social philosophy. Provides an original analysis of some of society’s most pressing issues Written by an outstanding cast of international scholars Issues covered include the nature of freedom, the limits of religious tolerance, affirmative action, parenting, the death penalty, privacy, violence, world hunger, social diversity, homosexuality, and abortion Invites the reader to participate in the exchange of arguments.

There is a way of doing moral philosophy which goes something like this: If it can be shown that it is rational for perfectly selfish people to accept the constraints of morality, then it will follow, a fortiori, that it is rational for people capable of affective bonds, and thus less selfish, to do so. On this way of proceeding the real argument – that is, the argument for the actual constraints to be adopted – proceeds with only fully rational (...) individuals who have no other concern than to maximize their nontuistic preferences. Then it is noted that the affective capacities of human beings actually make quite palatable the constraints that the fully rational persons with wholly nontuistic preferences have agreed upon. (shrink)

CHAPTER ONE Moral Character and Moral Theories Social interaction is the thread from which the fabric of moral character is woven.1 For it is social ...

Speciesism is the wrong of not acknowledging the moral qualities that non-human animals possess that are similar or equivalent or even superior to the moral qualities that human beings possess. However, since it is manifestly clear that no one thinks that apes are in any way obligated to human beings, it clearly cannot be a form of speciesism to be mindful of the differences on the basis of which that is so. In opposition to the advocates of the Great Ape (...) Project, my aim in this essay is to establish the quite minimal claim that apes should not have the same moral status as human beings because human beings have a far greater capacity for moral responsibility than do apes. The claim that I wish to establish is quite compatible with the claim that apes should be treated in a much more morally wholesome manner. (shrink)

What rights govern heterosexual and homosexual behaviors? Two distinguished philosophers debate this important issue in Sexual Orientation and Human Rights. Laurence M. Thomas argues that a society which has the constitutional resources to protect hate groups can protect homosexuals without valorizing the homosexual life-style. He defends the view that the Bible cannot warrant the venom that, in the name of religion, is often expressed against homosexuals. Michael E. Levin defends the unorthodox view that the aversion some people experience (...) toward homosexuality deserves respect. He further argues that while homosexuals enjoy the same rights as others to be free of violence and discrimination, they do not have more extensive rights. (shrink)

In this commentary on Carse and Rushton’s call for reorientation of moral distress, we state agreement with the authors that the discourse of moral distress should refocus on the moral components of integrity. We then explain how our philosophical taxonomy of moral distress, mentioned by the authors, appeals to moral integrity. In this process, we clarify our taxonomy’s appeal to Aristotle’s concept of akrasia. We conclude by offering support of Carse and Rushton’s challenge to organizations to strengthen moral integrity by (...) fostering resilience. (shrink)

This essay discusss (1) the differences and commonalities between romantic love and friendship and (2) the differences and commonalities between parental love of friendship.

It is generally agreed that Kant went too far in his claim that it is wrong to lie even if doing so will save an individual's life. The question remains whether it is morally permissible to tell a lie even if this does not involve saving the life of another individual. In this essay, I seek to answer this question affirmatively while at the same time setting strong constraints for when a lie (not involving saving a life) is morally permissible. (...) I argue that lying is morally permissible in the face of what I call an egregious morally infelicitous question. Further, in some cases, lying is not only morally permissible but even reflects an unmistakable instance of considerable self-sacrifice. Needless to say, lies that constitute an instance of self-sacrifice are extremely rare. However, this possibility brings into sharp relief the truth that a lie need not stem from unsavory moral motives; it is upon this truth that the argument that it is morally permissible to lie in the face of an egregious morally infelicitous question relies. This essay ends with the quite poignant observation that there is nothing stable about out a society in which, owing to an unfailing duty to tell the truth, a person can obtain the truth merely by asking an egregious morally infelicitous question. (shrink)

Ethical egoism and Kantian ethics constitute radically different and incompatible moral traditions. Speaking rather broadly, one might go so far as to say that each tradition is a source of inspiration for criticisms of the other, each tradition reminding us of the limitations of the other. For Kantian ethics, with its extreme other-regarding and abstract approach to morality, would sometimes seem to lose sight of the self, leaving a self that seems somewhat eviscerated. Ethical egosim, by contrast, with its extreme (...) self-centered conception, would seem to lose sight of the importance of others, positing a self that can only give instrumental value to others. Though both traditions have been criticized, these criticisms have travelled independently of one another—no line of argument being at once a criticism of both. Perhaps no such argument is to be had. However, when two traditions trade off of one another this suggests an underlying text or theme. That theme, I suggest, is about the metaphysics of the moral self—that is, the way in which the self is morally constituted. I want to offer an account of the way in which the self is morally constituted which is at once a criticism of both ethical egoism and Kantian ethics. (shrink)

Moral philosophy is at its best when it takes human psychology seriously. Such are the instincts of Thomas Wren. His engaging book Caring About Morality is an attempt to offer an account of human motivation that is true to human psychology, but which captures the spirit of Kantian morality without Kantian metaphysics. I argue that there are some fundamental psychological considerations which Wren does not take into account, and which are an obstacle to the success of his project. Moral (...) motivation, 1 suggest, is much more tied to the psychological histories of persons than Wren allows. (shrink)