The nocebo effect, a phenomenon whereby learning about the possible side effects of a medical treatment increases the likelihood that one will suffer these side effects, continues to challenge physicians and ethicists. If a physician fully informs her patient as to the potential side effects of a medicine that may produce nocebogenic effects, which is usually conceived of as being a requirement associated with the duty to respect autonomy, she risks increasing the likelihood that her patient will experience these side (...) effects and therefore suffer (unnecessary) harm, a violation of the duty of nonmaleficence. If, on the other hand, she intentionally withholds side effect information in an effort to protect her patient from suffering unnecessary harm from side effects, which is consistent with the duty of nonmaleficence, she violates the duty to respect patient autonomy. In this paper, the author discusses several previous attempts to deal with the nocebo effect and explains their weaknesses. He then proposes a means of managing the nocebo effect and argues that it does not share the weaknesses found in previous approaches. He concludes with a discussion of a simple, yet practical tool that might help clinicians manage the tension resulting from the nocebo effect. (shrink)

Richard Thaler and Cass Sunstein, in Nudge: Improving Decisions About Health, Wealth, and Happiness, assert that rejecting the use nudges is ‘pointless’ because ‘[i]n many cases, some kind of nudge is inevitable’. Schlomo Cohen makes a similar claim. He asserts that in certain situations surgeons cannot avoid nudging patients either toward or away from consenting to surgical interventions. Cohen concludes that in these situations, nudging patients toward consenting to surgical interventions is uncriticizable or morally permissible. I call this argument: The (...) Unavoidability Argument. In this essay, I will respond to Cohen's use of the unavoidability argument in support of using nudges during the process of informed consent. Specifically, I argue that many so-called ‘unavoidable nudges’ are, in fact, avoidable. Although my argument is directed toward Cohen's use of the unavoidability argument, it is applicable to the unavoidability argument more generally. (shrink)

In this essay I discuss a novel engineering ethics class that has the potential to significantly decrease the likelihood that students will inadvertently or unintentionally act unethically in the future. This class is different from standard engineering ethics classes in that it focuses on the issue of why people act unethically and how students can avoid a variety of hurdles to ethical behavior. I do not deny that it is important for students to develop cogent moral reasoning and ethical decision-making (...) as taught in traditional college-level ethics classes, but as an educator, I aim to help students apply moral reasoning in specific, real-life situations so they are able to make ethical decisions and act ethically in their academic careers and after they graduate. Research in moral psychology provides evidence that many seemingly irrelevant situational factors affect the moral judgment of most moral agents and frequently lead agents to unintentionally or inadvertently act wrongly. I argue that, in addition to teaching college students moral reasoning and ethical decision-making, it is important to: 1. Teach students about psychological and situational factors that affect people’s ethical judgments/behaviors in the sometimes stressful, emotion-laden environment of the workplace; 2. Guide students to engage in critical reflection about the sorts of situations they personally might find ethically challenging before they encounter those situations; and 3. Provide students with strategies to help them avoid future unethical behavior when they encounter these situations in school and in the workplace. (shrink)

In “Nudging, Bullshitting, and the Meta-Nudge”, the author responds to William Simkulet’s claim that nudging is bullshitting (according to Harry Frankfurt’s analysis of bullshit and bullshitting), and therefore nudging during the process of informed consent renders consent invalid. The author argues that nudging is not necessarily bullshitting and then explains that although this issue is philosophically interesting, practically speaking, even if nudging is bullshitting, it does not follow that nudging necessarily renders informed consent invalid. This is obviously true in those (...) situations in which nudging during the process of informed consent is unavoidable. The author concludes with a discussion of the meta-nudge and suggests that physicians can use the meta-nudge to eliminate or decrease the power of inappropriate, problematic, or undesirable nudges. (shrink)

In this essay, I suggest that a slightly modified version of Freedman’s formulation of the clinical equipoise requirement is justified. I begin this essay with a brief discussion of the equipoise r...

In his influential 1987 essay, “Equipoise and The Ethics of Randomized Clinical Research,” Benjamin Freedman argued that Charles Fried’s theoretical equipoise requirement threatened clinical research because it was overwhelmingly fragile and rendered unethical too many randomized clinical trials. Freedman, therefore, proposed an alternative requirement, the clinical equipoise requirement, which is now considered to be the fundamental or guiding principle concerning the ethics of enrolling patients in randomized clinical trials. In this essay I argue that Freedman’s clinical equipoise requirement is ambiguous (...) and can be interpreted in (at least) two different ways. I furthermore claim that, ironically, the best interpretation of the clinical equipoise requirement opens Freedman to the same objection that he leveled against Fried twenty-five years ago; namely, that it (Freedman’s clinical equipoise requirement) renders unethical too many randomized clinical trials. (shrink)

This book raises many moral, legal, social, and political, questions related to possible development, in the near future, of an artificial womb for human use. Is ectogenesis ever morally permissible? If so, under what circumstances? Will ectogenesis enhance or diminish women's reproductive rights and/or their economic opportunities? These are some of the difficult and crucial questions this anthology addresses and attempts to answer.

Volume 20, Issue 3, March 2020, Page 83-85.

Francis Hutcheson's moral sense theory is the inspiration for both act utilitarianism and a contemporary virtue ethics approach that Michael Slote calls agent‐based virtue ethics. In this essay, I look at other possibilities for ethical theory that spring from Hutcheson's writings and conclude that the landscape of sentimentalist inspired ethics is richer than many realize. I begin this article with a short explanation of Hutcheson's moral sense theory. I explain that Hutcheson proposes and embraces three distinct criteria of moral evaluation, (...) one of which is concerned with the evaluation of motives and two of which are concerned with the evaluation of acts. Act utilitarianism adopts one of the criteria of act evaluation, and Slote's agent‐based virtue ethics adopts the remaining criterion of act evaluation and the criterion of motive evaluation. Then, after pointing out what I believe are shortcomings of Slote's agent‐based virtue ethics, I propose two Hutchesonian inspired theories, each of which is a compromise between act utilitarianism and agent‐based virtue ethics. The first, which I call hypothetical agent‐based virtue ethics, adopts two of Hutcheson's three criteria and is similar structurally to a virtue ethics theory articulated by Rosalind Hursthouse and Linda Zabzebski. The second, which, for lack of a better name, I call Hutchesonian hybridism, adopts all three of Hutcheson's criteria and is a hybrid combination of Slote's actualist agent‐based virtue ethics and hypothetical agent‐based virtue ethics. I argue that both hypothetical agent‐based virtue ethics and Hutchesonian hybridism overcome the shortcomings (pointed out earlier in this essay) of Slote's actualist agent‐based virtue ethics, and that both of these theories are, therefore, worthy of further consideration. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editorial StatementScott Gelfand, CoeditorOnce per year The Pluralist publishes an issue devoted exclusively to values. This year’s issue contains articles on a variety of related topics, including the difference between strong and weak pluralism in classroom communities; curing ills facing today’s college students with the aid of Aquinas’s ethical theory; the Golden Rule and virtue ethics; advance directives and psychological accounts of identity; Judith Butler, the personal, the political (...) and theological discourse; George Herbert Mead, social conceptions of self and moral reasoning; William James’s ideas about militarism applied to American foreign policy since 1945; and the philosophical roots of Martin Luther King, Jr.’s, important moral ideal of a beloved community. We hope you will find this selection provocative and informative. [End Page v]Scott Gelfand, CoeditorOklahoma State UniversityCopyright © 2009 Board of Trustees of the University of Illinois... (shrink)

This is a reply to Don Marquis’‘Why Abortion is Immoral.‘ Marquis, who asserts that abortion is morally wrong, bases his argument on the following premise: Killing a being is morally wrong if that being is the sort of being who has a valuable future. I argue that this premise is false. I then assert that if I am correct about this premise being false, Marquis is faced with a dilemma. If he does not alter the premise in a way that (...) makes it true, his argument is unsound. However, if he does make such an alteration, he must also alter a second premise in his argument, and this second change opens him to the charge of question begging. In addition, I conclude that such an alteration requires Marquis to adopt a position much like that taken by Judith J. Thompson in ‘A Defense of Abortion,‘ a position he initially states is indefensible. (shrink)

In “Two Minds, One Patient: Clearing Up Confusion About ‘Ambivalence,’” Moore and colleagues provide a sophisticated and subtle taxonomy of ambivalence. As they explain, clinical ethicists a...

We are currently developing a short, online ethics course that attempts to teach students why well-intentioned people act unethically and what students can do to decrease the likelihood that they will find themselves in the middle of an ethical crisis in the future. Most of the well-known case studies in professional ethics textbooks concern ethical failures that do not involve difficult ethical choices. When our students read these case studies, it is not difficult for them to determine what went wrong (...) or what the players in the cases ought to have done. And students don’t need to read Kant or Mill to make these determinations. Importantly, the agents who acted wrongly usually seem to be ethical people. Rarely do cases involve moral monsters. In a similar vein, most cases of research misconduct are cut-and-dry, and most of our students who plagiarize did not enroll in the course intending to plagiarize. Rather, something went wrong. Professional ethics classes neglect to address an important practical question: Why do well-intentioned people find themselves in the middle of ethical crises and how can our students decrease the likelihood that they will find themselves in an ethical crisis in the future? We are developing a course that answers this question. Our course is built around the findings of John Dorris and other situationists. After teaching our students about situationism, we teach them a two-level theory of cognition that may help them avoid acting unethically. (shrink)

Hospitals and businesses regularly utilize the services of ethics consultants—experts who help resolve ethical problems/dilemmas, provide guidance concerning ethical issues, and assist in the development of policies designed to increase the likelihood that ethically difficult or challenging situations that arise in the future will be resolved satisfactorily. Surprisingly, universities do not employ ethics consultants. In this essay, I will explore the idea of university ethics consultants.