Adults who give proxy consent for medical treatment for adolescents must decide how much weight to give to adolescents' own preferences. There is evidence that some adolescents choose treatments different from what adults see as most reasonable. It is argued that adolescents choose according to age-specific values, i.e. values they hold, as adolescents, and which fulfil important developmental needs. Because not fulfilling these needs may do serious psychological damage, it is urged that proxies give weight to these values, up to (...) the limit where it would endanger or profoundly limit future life. (shrink)

The American Journal of Bioethics, Volume 11, Issue 11, Page 29-30, November 2011.

Despite the much-discussed court cases in the 1970s that permitted some sibling-to-sibling kidney donations from minors,1 principles that can guide parental, medical, or judicial decisionmaking are neither clearly articulated nor uncontroversial.

The American Journal of Bioethics, Volume 12, Issue 4, Page 21-22, April 2012.

Women wishing hospital admission for childbirth are asked to sign very general pre-admission consent forms. The use of such forms suggests that women in labor are considered incompetent to give informed consent. This paper explores some of the problems with advance directives and general consent, and argues that since women in labor are not generally incompetent, it is not appropriate to require this kind of consent of them.

Volume 19, Issue 12, December 2019, Page 73-74.

al treatment of episodic substance intoxicated states with or without self-inflicted injuries. Patients later can develop comorbid medical illnesses associated with nonadherence of treatment or iatrogenic conditions, both of which result in complex end-of-life-care decisions. Institutional familiarity of repeat patients often leaves healthcare providers feeling responsible for the patient despite having little influence over the patients' ultimate behavioral outcomes. This article describes a patient with chronic alcohol abuse, treatment noncompliance, severe personality disorder, recurrent suicidal ideation, self-injurious behavior, alcoholic cirrhosis, and (...) suicide attempt resulting in multisystem injuries leading to an ethical conflict regarding end-of-life care.... (shrink)

Rosalind Hursthouse took her undergraduate degree in New Zealand and her B. Phil. and D. Phil. at Oxford. She taught in Oxford for six years before joining the Open University in 1975. As part of her work for the O.U. she has published Beginning Lives (Blackwell, 1987) on the morality of abortion; this generated Virtue theory and abortion, Philosophy and Public Affairs, 1991) which has already been reprinted five times. She has published numerous other articles on virtue ethics, the (...) most recent of which is virtue ethics and the emotions, in: Virtue Ethics, A Critical Reader, Daniel Statman (ed.) Edinburgh University Press, 1997. (shrink)

The recent interest in systematic review methods in bioethics has highlighted the need for greater transparency in all literature review processes undertaken in bioethics projects. In this article, I articulate features of a good bioethics literature review that does not aim to be systematic, but rather to capture and analyse the key ideas relevant to a research question. I call this a critical interpretive literature review. I begin by sketching and comparing three different types of literature review conducted in bioethics (...) scholarship. Then, drawing on Dixon-Wood's concept of critical interpretive synthesis, I put forward six features of a good critical interpretive literature review in bioethics: answering a research question, capturing the key ideas relevant to the research question, analysing the literature as a whole, generating theory, not excluding papers based on rigid quality assessment criteria, and reporting the search strategy. (shrink)

Virtue ethics is perhaps the most important development within late twentieth-century moral philosophy. Rosalind Hursthouse, who has made notable contributions to this development, here presents a full exposition and defense of her neo-Aristotelian version of virtue ethics. She shows how virtue ethics can provide guidance for action, illuminate moral dilemmas, and bring out the moral significance of the emotions.

Machine learning-driven decision support systems (ML_CDSS) are poised for increasing presence and influence in clinical contexts. Salloch and Eriksen (2024) make two key arguments, that together bu...

From a clinical ethics perspective, I explore several traditional arguments that deem deception as morally unacceptable. For example, it is often argued that deception robs people of their autonomy. Deception also unfairly manipulates others and is a breach of important trust-relations. In these kinds of cases, I argue that the same reasons commonly used against deception can provide strong reasons why deception can be extremely beneficial for patients who lack mental capacity. For example, deception can enhance, rather than impair, autonomy (...) in certain cases. I argue that deception ought to only be used after considering several key morally relevant factors and provide a practical and morally justifiable framework for exploring these issues. (shrink)

In On Virtue Ethics I offered a criterion for a character trait's being a virtue according to which a virtuous character trait must conduce to, or at least not be inimical to, four ends, one of which is the continuance of the human species. I argue here that this does not commit me to homosexuality's being a vice, since homosexuality is not a character trait and hence not up for assessment as a virtue or a vice. Vegetarianism is not up (...) for such assessment either, for the same reason, but, as a practice, may well be required by the virtue of compassion, and sacrificing one's life for an animal or alien may be required by courage. The clause about the continuance of the human species in my criterion does not specify a foundational value, because, following McDowell, I reject foundationalism. (shrink)

First published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

Given advances in the science of fertility preservation and the link between fertility choices and wellbeing, it is time to reframe our ethical thinking around fertility preservation procedures for children and young people with cancer. The current framing of fertility preservation as a possible offer may no longer be universally appropriate. There is an increasingly pressing need to discuss the ethics of failing to preserve fertility, particularly for patient groups for whom established techniques exist. I argue that the starting point (...) for deliberating about a particular patient should be a rebuttable presumption that fertility preservation ought to be attempted. Consideration of the harms applicable to that specific patient may then override this presumption. I outline the benefits of attempting fertility preservation; these justify a presumption in favour of the treatment. I then discuss the potential harms associated with fertility preservation procedures, which may justify failing to attempt fertility preservation in an individual patient's particular case. Moving from a framework of offer to one of rebuttable presumption in favour of fertility preservation would have significant implications for medical practice, healthcare organizations and the state. (shrink)

The idea that an individual has a ‘right not to know’ genetic information about himself or herself is entrenched in both the policy sphere and the genetic counselling ethos. In this paper, I interrogate this idea of a ‘right not to know’, questioning particularly its status as a right. I identify the conception of rights that seems to underlie the posited ‘right not to know’ as a conception of rights in which they are prioritised non-outweighable interests. Turning to a series (...) of hypothetical situations in which the ‘right not to know’ is invoked, I argue that the ‘right not to know’ is not a right consistent with such a conception. The ‘right not to know’ can only exist in a framework of rights in which they lack significant moral weight. Thus, considering the gravity of rights in popular understanding, I suggest caution in the continuing use of the phrase ‘right not to know’ in the context of genetic testing. This investigation suggests that structuring the debate around genetic ignorance in terms of the ‘right not to know’ is not conducive to moving forward ethical thinking in this area. (shrink)

Adversities in pregnancy, including poor diet and stress, are associated with increased risk of developing both metabolic and mental health disorders later in life, a phenomenon described as fetal programming or developmental origins of disease. Predominant hypotheses proposed to explain this relationship suggest that the adversity imposes direct changes to the developing fetus which are maintained after birth resulting in an increased susceptibility to ill health. However, during pregnancy the mother, the developing fetus, and the placenta are all exposed to (...) the adversity. The same adversities linked to altered offspring outcome can also result in suboptimal maternal care, which is considered an independent adverse exposure for the offspring. Recent key experiments in mice reveal the potential of prenatal adversity to drive alterations in maternal care through abnormal maternal–pup interactions and via alterations in placental signaling. Together, these data highlight the critical importance of viewing fetal programming holistically paying attention to the intimate, bidirectional, and reiterative relationship between mothers and their offspring. (shrink)

Rosalind Hursthouse; IV*—A False Doctrine of the Mean, Proceedings of the Aristotelian Society, Volume 81, Issue 1, 1 June 1981, Pages 57–72, https://doi.org/10.

Most interpreters hold that Kant rejects actually infinite tota synthetica as conceptually impossible. This view is attributed to Kant to relieve him of the charge that the first antinomy’s thesis argument presupposes transcendental idealism. I argue that important textual evidence speaks against this view, and Kant in fact affirms the conceptual possibility of actually infinite tota synthetica. While this means the first antinomy may not be decisive as an indirect argument for idealism, it gives us a better account of how (...) our ideas of the unconditioned generate the antinomies, and it allows us to see important and often overlooked elements in Kant’s account of the infinite. (shrink)

Models for clinical ethics case consultation often make reference to ‘balancing’ or ‘weighing’ moral considerations, without further detail. In this paper, we investigate balancing in clinical ethics case consultation. We suggest that, while clinical ethics services cannot resolve ongoing deep philosophical debates about the nature of ethical reasoning, clinical ethicists can and should be more systematic and transparent when balancing considerations in case consultations. We conceptualise balancing on a spectrum from intuitive to deliberative, and argue that good balancing in case (...) consultation involves articulating reasons for giving something more or less weight. We develop a framework of four practical strategies for better balancing in clinical ethics case consultation: intuitions as a launchpad, drilling down, pairwise comparison and group deliberation. (shrink)

From accounts of migration and stories of personal alienation, through the fragmented memories of former incarnations, to fable-like tales of half-breeds and species metamorphosis, Ying Chen's fiction evolves as it revolves around questions of difference, otherness and identity, which is never fixed or singular. While presenting the narrators' inner preoccupations and, in some cases, unreliable nature, the increasingly complex texts of this francophone-Chinese writer (1961-) also reveal larger concerns about dominant discourses, the limitations of social realities, survival, and the relationship (...) between beings, all framed within an aesthetics of non-belonging. Intriguingly, the author achieves this by consciously distancing her works, from 1998 onwards, from any categorisation by ethnicity. This engaging study considers Chen's writing from the contemporary perspective of the breakdown of traditional spatiotemporal experiences, the homogenization of places, the erasure of cultural differences, and the resulting tendency towards universalism. Rosalind Silvester is Senior Lecturer in French Studies and Director of Education in the School of Arts, English and Languages at Queen's University Belfast. (shrink)