In lieu of an abstract, here is a brief excerpt of the content:Morality in Flux: Medical Ethics Dilemmas in the People's Republic of ChinaRen-Zong Qiu (bio)IntroductionModern China is undergoing a fundamental change from a monolithic society to a rather pluralistic one. It is a long and winding road. Marxism is facing various challenges as the influence of Western culture increases. Confucianism is still deeply entrenched in the Chinese mind but various religions, including Buddhism, Islam, and Christianity are experiencing a revival. (...) Almost fifty minorities coexist in the country in addition to the majority Han people. Tension and conflict are inevitable as diverse—and sometimes incompatible—values come to the fore at this historic juncture. Many fields, including medicine, face new challenges, and in this environment the field of bioethics is flourishing.Like many countries, China is groping with the effects of new medical technology and skyrocketing health care costs. But in the context of the Chinese sociocultural environment, some unique—as well as more familiar—issues arise. None of the classic texts provide ready-made answers to these dilemmas; we must find the answers ourselves. The only reasonable way to resolve the conflicts between opposing values is through dialogue, consultation, and negotiation among the various social and cultural groups.The bioethical dilemmas receiving the most attention in China now relate to the two ends of life: birth and death. On one end are issues relating to reproductive technology, especially birth control and family planning; at the other end is euthanasia.Dilemmas Surrounding Reproductive TechnologyAccording to traditional Chinese belief, not having a child results from not having virtue. In fact, the most serious violation of the Confucian [End Page 16]principle of filial piety is to be without offspring. A Chinese man without a child experiences heavy psychological pressure, and the burden is especially onerous for women because infertility is always blamed on the wife. Wives who do not bear a child are stigmatized and mistreated—even abused—in families that stick to traditional values.In China today, this widely held belief is colliding with another reality: an apparent increase in infertility among newly-married couples. The rate may be about 5 percent. These couples turn to doctors for help.Artificial insemination by donor (AID) and by husband is now widely practiced. Eleven provinces have established sperm banks, and private doctors are performing AID for considerable fees. But procedures to address legal and ethical problems associated with the procedure have lagged behind. With the exception of a few centers in large cities, AID is undertaken without established procedures or policies relating to the selection of donors and recipients, records about those involved, or clarification of the status of the child. The legal status of the child remains unresolved.The status of the child within the community is also unresolved as traditional values clash with the application of modern technology to childbearing. The case of "The Child Who Did Not Belong" (see box), illustrates how an AID child is not accepted by the family that embraces traditional values because he is not the husband's biological child.In vitro fertilization (IVF) is another alternative. Two IVF centers are in operation, one in Beijing and the other in Changsha, and both have succeeded in producing live births. This technology has received considerable media attention and is generally accepted even among those with traditional views.But much of this medical technology is not widely accessible—especially in rural areas—and so some infertile couples resort to surrogate motherhood to ensure an heir. An infertile couple enters into a contract with a woman who has intercourse with the husband in order to bear a child for the couple. This practice is called "borrowing a wife." In some villages, the "borrowed wife" receives as much as 10,000 yuan (five times a professor's monthly salary or about $250) for a girl and double that for a boy.But the more common and thorny problems involved with the beginning of life relate to birth control, family planning, and the "one couple, one child" policy that the Chinese government instituted to curb overpopulation. The goal of that policy is to prevent China's population from exceeding 1.2 billion in the year 2000... (shrink)

Considering the lack of substantive scientific or theoretical studies about ethics in small and medium sized enterprises (SMEs) in Latin America, this paper examines the context of an existent paradox, based upon the perspective of experts and academicians of Latin America and the Caribbean. These countries live different realities, due to their respective European cultural influences, as well as to racial and economic issues. Such facts impact the size and characteristics of their industries. On the other hand, the SMEs face (...) more similarities in the region, so they will be treated as a group in the discussion of ethics and corporate social responsibility (CSR) in Latin American SMEs. As this topic has not been sufficiently investigated in this geographic area, the objective of this exploratory study is to offer a contribution for future research. It raises the main dilemmas and intends to explain how legislation and common practices enable and perhaps lead SMEs to choose unethical strategies to survive and compete in the market. These enterprises are growing in number and in job creation, but do not participate in the Gross National Product in the same proportion. Informality, tax evasion and corruption are gradually caused or erode morality in business, but can contribute to corporate social responsibility in the region. The paper tries to show positive and negative aspects of apparently unethical practices and discusses challenging ways to solve complex problems that are common in most Latin America. (shrink)

Background: Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty. Objectives: The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi. Methodology: A cross-sectional survey was conducted in four selected hospitals (...) in Malawi with a sample of 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0. Ethical consideration: The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi. Results: The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings. Conclusion: The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision-making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real-life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we attempt (...) to capture a comprehensive overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement-based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)

Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision‐making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real‐life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we attempt (...) to capture a comprehensive overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement‐based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)

Definition of the problem Death and suicide wishes of older people represent a relevant and morally challenging issue for nurses. Especially in the context of wishes for assisted suicide, the risk for the development of moral uncertainty or even moral distress grows. As suicide rates and requests for assisted suicide are particularly high among people 65 years of age or older, the topic proves to be particularly relevant to the settings of long-term community and nursing home care. At the same (...) time, this fact underlines the importance of suicide prevention, which has recently been strengthened by the federal government, with the intention of launching a national strategy and a corresponding law. Arguments According to our hypothesis, the situational confrontation of nursing professionals with death and suicide wishes may cause an ethical field of tension between an unprejudiced, open, empathetic and respectful acceptance of death and suicide wishes on the one hand and the goal of suicide prevention on the other. The legal uncertainties in regards to the practice of assisted suicide, which currently prevails in practice, may intensify this risk. International studies point to the potential of moral distress of nurses when confronted with death and suicide wishes. Conclusion These findings and the reference to the current legal uncertainties and framework conditions in the national (German) context underpin the importance of the professional discussion about the topic, the need to sensitise (future) nursing professionals to potential ethical tensions and to enable them to deal with the accompanying moral uncertainty in a professional and competent manner. (shrink)

This paper develops a typology of moral problems in business. The cross-classification of two fundamental dimensions of ethical conduct: judgment and motivation, is employed to distinguish four types of moral problems: genuine dilemmas, compliance problems, moral laxity, and no-problem problems. Actual cases are brought to illustrate each type of problem, and corresponding coping strategies are presented. The paper highlights the need to design a dynamic strategy that will take into account the relationships among different types of ethical problems. (...) In its capacities as both an analytical tool for identifying and clarifying an ethical problem and a strategic tool for handling it, the typology has direct implications for developing ethical awareness, assigning accountability, and unfolding typical rationalizations in business activity. (shrink)

Background and aim Child and adolescent forensic psychiatry is fraught with complex medical, legal, and social tensions. The ethical challenges this entails for inhospital treatment have hardly been investigated, and specific support for health care professionals is lacking. This study identifies ethical issues and problems in this area and develops a tool for early detection and intervention of ethical problems in clinical practice. Methods A systematic literature search and an observational study in adolescent forensics at the University (...) Psychiatric Clinics Basel are conducted. The observation data are evaluated using a qualitative content analysis. The instrument is developed based on the results using a new method. Results In the literature search, 14 valid publications were identified that mainly address ethical conflicts in legal psychiatry, such as professional role conflicts, ethical problems in diagnostics and assessment, or confidentiality issues. Empirical or empirical–normative studies are missing. In the observational study, 24 ethical issues and specific conflicts were identified. Ethical questions about moral competencies of the adolescents, the quality of treatment, the handling of rules and sanctions, and freedom and privacy are particularly common. The Instrument for Early Detection and Intervention of Ethical Problems (FIEP) contains the four core elements risk factors, indicators, intervention planning and decision-making. Conclusions Inhospital treatment in forensic child and adolescent psychiatry reveals a broad spectrum of ethical issues with specific ethical problems, which are hardly investigated in literature so far. The FIEP instrument developed here supports health care practitioners in recognizing ethical problems at an early stage and addressing them efficiently. (shrink)

Photo ID 222412412 © US Navy Medicine | Dreamstime.com ABSTRACT In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. INTRODUCTION Medical resources in an austere environment without quick recourse for resupply or casualty evacuation are often (...) limited. The shortage extends not only to supplies like blood products and drugs, but physicians and other medical personnel. In the midst of a mass casualty scenario, such as a battle that includes intense ground fighting, the medical staff will stretch scarce resources and triage casualties according to specific criteria. Typically, they proceed by providing care for the most severely wounded first, referred to here as conventional triage. At times, though, the staff may reverse the triage so that soldiers with minor wounds can return to the fight. In a mass casualty situation, when medical personnel apply conventional triage and treat casualties from opposing forces, a dilemma may arise. We argue that it can be permissible for military physicians to prioritize their own soldiers over enemy combatants in a mass casualty triage, where reverse triage does not apply. The case we will focus on is as follows: Battlefield Triage: During combat operations on a remote island in the Pacific Ocean, a compatriot soldier and an enemy combatant arrive at the compatriot soldier country’s medical treatment facility. Both have similar gunshot wounds to the abdomen, and they arrive with similar conditions. Both have low oxygen saturation and excessive blood loss. The sole physician only has enough time to stabilize one person. The scenario is brief, and we are aware that medical rules of eligibility will most often dictate how the physician proceeds,[1] but this scenario is useful in setting up the question we focus on in this paper: would it be wrong to favor the stabilization of a soldier just because the soldier is the physician’s compatriot? In other words, can nationality serve as an ethically justified tiebreaker in a situation such as Battlefield Triage?[2] In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. The AMA’s Code of Medical Ethics asserts that physicians have “ethical obligations to place patients’ welfare above their self-interest and above obligations to other groups.”[3] The World Medical Association’s Declaration of Tokyo affirms that “no motive, whether personal, collective or political, shall prevail against this higher purpose” of alleviating distress.[4] Physicians are taught early on that triage decisions must be medically indicated and made without consideration of factors such as race, ethnicity, religion, social status, and nationality. They are taught that public trust and obligations of justice grounded in equality demand that only medical indications be considered. But military physicians in a military setting are beholden to obligations, duties, and responsibilities as members of the military, and when these obligations, duties, and responsibilities conflict, as they do in Battlefield Triage, which loyalties win out and why?[5] Critics of partiality on national grounds argue that partiality undermines public trust in medicine and justice because everyone should be treated equally regardless of nationality.[6] Proponents of partiality argue that military obligations supersede equality and that justice requires partiality in such cases.[7] Despite the critics’ disagreement, both agree that there is a morally right, perhaps even blameless, course of action. Drawing on insights from virtue ethics, we argue that Battlefield Triage is a moral tragedy in which justice is unattainable and there is no action without moral cost. The assumption that there is a morally right choice is flawed. We argue that while no decision in this scenario is free from moral blame, there are reasons to favor treating one’s soldiers over enemy combatants. I. The Case Against Partiality There is a common assumption that there is a morally right or just decision in Battlefield Triage. A number of organizations and scholars claim that it is wrong for military physicians to favor their own soldiers on the grounds of nationality or some form of ‘group membership.’ (In a conflict involving service members from multiple nations working as a coalition, a soldier from an allied country may receive the same priority as the US service member due to ‘group membership.’) The World Medical Association’s WMA Declaration of Lisbon on the Rights of the Patient, which was reaffirmed in 2015, posits that, “[i]n circumstances where a choice must be made between potential patients for a particular treatment that is in limited supply, all such patients are entitled to a fair selection procedure for that treatment. That choice must be based on medical criteria and made without discrimination.”[8] This echoes what was set forth in Article 12 of the Geneva Conventions, which states that “[o]nly urgent medical reasons will authorize priority in the order of treatment to be administered.”[9] The argument for impartiality in Battlefield Triage is that every person is morally equal, and equality entails that medical distribution is, “based on a combination of medical need and urgency.”[10] This is in keeping with the bioethical principles that are generally applied.[11] II. The Case for Partiality On the other side, there are arguments that favoritism is the ethically right decision in Battlefield Triage.[12] The argument asserts that members of the military form a morally significant community of friends and participation in these relationships demands partiality. Just as parents have strong ethical duties to their children and not just any children, military personnel have ethical duties to their group, a group that involves an affirmation of mutual aid and support. Some have termed these ‘associative duties. According to Michael Gross, obligations of friendship, care, and solidarity “leave very little room for generally applicable principles of justice that would obligate a medic to treat enemy or non-compatriot wounded ahead of their compatriots.”[13] This is true in Battlefield Triage, but it may also be true even if the enemy’s soldier were more seriously wounded: “the ethics of small group cohesion, largely an ethics of care, mostly replaces the demands of impartial justice.”[14] In a more recent article, Gross explains that preferential treatment is ethically justified based on fighting capability and “the special obligations people owe friends, family, and, no less, comrades-in-arms.”[15] To not show partiality to the US soldier would be morally wrong on the grounds of friendship and mutual care.[16] III. The Moral Tragedy of Battlefield Triage Defenders and critics of Battlefield Triage favoritism based on nationality both frame their position as just or fair. For example, Justin List argues that physicians are “bound to practice medical neutrality,”[17] Marcus Adams denies that physicians “possess special ethical obligations” to enemy combatants because of their profession.[18] These perspectives assume that there is a morally right decision and that justice is attainable. The assumption that there is or can be a morally right Battlefield Triage decision, and we need to put our heads together to figure it out, remains strongly entrenched. However, the facts of the situation should give us pause; there are too many people and too few resources, and this demands a decision-making process that determines who will receive scarce resources. By its very nature, a battlefield triage decision has to be made based on some characteristic or value, a characteristic or value that will inevitably favor some at the expense of others. This is precisely why competing analyses “in the military context struggle to resolve these conflicts satisfactorily.”[19] Drawing on the insights of virtue ethics, we suggest that Battlefield Triage is a moral tragedy. Virtue ethics suggests that morality is about acting virtuously, which is to say that we should do what a virtuous person would do in the situation. Ethics is about figuring out how a just, wise, compassionate, loving, and fair person would act, and then doing that, as one grows in virtue. But life is not always clear cut, and it is possible that virtuous people may find themselves in a moral tragedy, a situation in which, through no fault of one’s own, a person must make a morally objectionable decision. After the action the virtuous person “emerges having done a terrible thing, the very sort of thing that the callous, dishonest, unjust, or in general vicious agent would characteristically do.”[20] Stated differently, a moral tragedy presents a virtuous person with two or more courses of action, all of which have a moral cost.[21] In Battlefield Triage, no matter how the physician goes about deciding, there is going to be defensible concern from those not saved. The fact that there are more people than can be helped fosters competing values in battlefield triage: maximize lives saved, treat people equally, treat the worse off, and support the war effort. Treating people equally may create tension between treating the worse off, maximizing lives saved, and supporting the war effort. Reverse triage is a case in point, as supporting the war effort conflicts with treating the worse off first, as is a fair lottery system since deploying a lottery may not maximize lives saved or support the war effort. There can be reasons why one person is selected over another, to be sure. Yet, there are reasons for making a decision, and that the decision is subject to legitimate moral concern is another. To recognize the moral tragedy of Battlefield Triage is to recognize the impossibility of acting blamelessly in the situation. In this situation, the virtuous military physician is going to have to sacrifice important values such as justice, compassion, and respect for others, even with a defensible criterion in hand. The physician will grieve this sacrifice accordingly. The physician may find her decision difficult or stressful, and rightly so, because of what her circumstances require of her. This kind of moral tragedy results “in actions which betray and violate the rights of persons to whom there may be a strong duty of care. When this happens, it properly triggers an appropriate moral emotion since our moral integrity has been violated and this affects how we think of ourselves and what we have become.”[22] Rather than view her triage decision as the morally superior choice, the virtuous military physician will view her decisions in these circumstances in a different light: it is the least bad option in a terrible situation, and she did something ethically problematic, something that is contrary to her moral character. She deeply regrets the circumstances in which she had to act. IV. Virtue Ethics A virtue ethicist has insight into how one should go about deciding what to do in a moral tragedy, although virtue ethics may not be as helpful as one may hope. The goal of the virtuous military physician in Battlefield Triage is to adopt the best course of action or the action that she feels she ought to do, all things considered. This does not make her choice devoid of serious wrongdoing—a decision must be made, but that does not make it just. The virtuous military physician will approach the situation with courage, responsibility, and insight. She will think about the decision carefully, wisely, and conscientiously; she will weigh the goods and harms of the choices before her, in conjunction with a proper conception of the good life, human worth, and understanding of her obligations to others—including chain of command, fellow soldiers, and the medical community. She is attuned to the value of human life and has a reasonable idea of the various ways her decisions will affect others. She recognizes that she is in this non-ideal situation through no fault of her own: she is not the one fighting in battles; she is serving her country as a physician, whose job it is to save lives, treat everyone justly, and promote military objectives. She regrets the decision she is forced to make in battlefield triage, acting “with immense regret and pain,” Hursthouse explains, “instead of indifferently or gladly.”[23] This is because, no matter what decision is made, the virtuous military physician “does something terrible or horrible,” something she otherwise would not do and is contrary to her values.[24] V. A Resolvable Moral Tragedy Instead of asking whether there is a morally right decision, in which a decision is morally blameless and above reproach, the virtue ethicist asks whether there is a decision with a convincing rationale, knowing that a decision can have a clear rationale but still be morally tragic. It is perfectly reasonable to think that different virtuous persons will arrive at different courses of action: “two virtuous agents, in the same situation,” Hursthouse writes, “may act differently” in irresolvable moral tragedies, in cases in which there is no clear course of action.[25] Because a person must act in a moral tragedy, one goal is to identify reasons for choosing the chosen action. Some decisions are clearly indefensible—treating neither the compatriot soldier nor the enemy combatant in Battlefield Triage would be wrong—and some decisions are more problematic than others. If the military physician selects to treat the soldier because she does not like the enemy combatant’s skin color, such a reason would be deeply problematic. But much of the debate over how to act in a moral tragedy is not over clearly indefensible or problematic criteria. Instead, the literature is largely about different standards or implementations of justice. Some scholars defend nation-impartial triage as right, while others defend nation-aware triage as right, and each argues that the other side is promoting an unjust or otherwise wrong solution to Battlefield Triage. We suggest that Battlefield Triage is a resolvable moral tragedy and that virtue ethics offers convincing reasons to prefer the treatment of the compatriot soldier rather than the enemy combatant on the grounds of national identity. Virtues are integral to living a good life, a flourishing life, but as Aristotle observed long ago, human beings are inherently social, interdependent and interconnected in profound ways.[26] This goes beyond the obvious fact that we need each other to survive day to day (one person makes clothes, another farms, and another makes tools); the claim is that a good or flourishing life depends in large part on one’s social network or community. This is why many of Aristotle’s moral virtues are other facing: justice, friendship, generosity, and magnanimity, to name a few. Courage, a typically self-facing virtue, is understood by Aristotle to be the virtue that regards one’s fear of death in battle, a battle fought on behalf of one’s city.[27] All of this remains true today. Namely, there is an important sense in which our community matters to our lives: it is easier to live a good, flourishing life if one is part of a good, flourishing community. Our community is made up of smaller groups, and it is more accurate to say that we are simultaneous members of different groups within a broader community. A person may be part of a family, friend group, research team, large state university, city, state, and nation. Groups can function well or not, as we all have experienced, and this suggests that there are virtues or excellences that groups can instantiate. Good groups are unified in purpose, with each member doing their duty alongside others for the attainment of that purpose. Good groups manifest solidarity among their members. Although Aristotle does not list solidarity as a virtue, a number of modern-day virtue ethicists have begun examining how group solidarity can be a virtue that contributes to a good or flourishing life.[28] Solidarity is not conceptualized as an individual virtue, a virtue possessed by a person in isolation of others; instead, it is a collective virtue, a virtue that is shared among members of a defined group with particular ends.[29] “A group has solidarity to the extent that its members are disposed to: (1) share values, aims, or goals; (2) care about those values, aims, or goals; (3) act in accordance with those values, aims, or goals; (4) trust the testimony of other group members with respect to those values, aims, and goals; and (5) feel a sense of belonging to the group.”[30] The virtue of collective or group solidarity involves individuals having special concern for each other, shared aims and values, trust, loyalty, and a sense of belonging with these specific others. There is a oneness to the group in the pursuit of a definite goal or purpose, involving mutual support and affirmation of each member. As such, the group has ends and goods above and beyond the good of each individual person. Sometimes solidarity requires personal sacrifice for the collective (for example, a father sacrificing food so his child can eat). The virtue of collective or group solidarity is important to the military and medical community at every level, and for clear reasons. In the military, there is a clear hierarchy of command, unity of purpose and end, mutual trust and support in complex settings, and so on. Soldiers need to know they can count on one another, and solidarity grounds a soldier’s ability to trust others and be assured of mutual aid. In medicine, solidarity maintains self-regulation of the profession, shared values and goals, as well as public support, not to mention that day-to-day operations require physician trust, engagement, and effort toward the ends of clinical care. Physicians need to work together, along with others, in pursuit of health, and disunity is sowed when there is mistrust, selfishness, or disengagement among the healthcare team and organization. Importantly, just as we are all members of various groups and hence may manifest group solidarity in different settings, the virtuous military physician instantiates collective solidarity with both the medical profession and the military. Her dual loyalty contributes to the moral difficulty of acting in Battlefield Triage. The military physician has competing obligations to distinct groups and cannot satisfy all obligations in Battlefield Triage. Solidarity with the military supports the consideration of favoring the soldier for reasons of national identity, whereas solidarity with the medical community does not. Something has to give, which is why it is a moral tragedy. The virtuous military physician, therefore, must weigh the costs of each course of action. To fulfill her obligations to the medical community would require that she does not use nationality and other non-medical considerations in Battlefield Triage. Since the soldier and enemy combatant are equally injured, justice would demand a random process, perhaps a flip of the coin. Although this may satisfy obligations the military physician has to the medical community, this would be costly to the physician’s military group. If word gets out that the physician decides who to treat based on a coin toss, soldiers, families, and citizens may become frustrated and angry. Soldier morale may go down if it becomes known that a coin flip led to the preventable death of a soldier and the saving of an enemy combatant who had killed (or attempted to kill) other soldiers. As Gross highlights, military solidarity involves a mutual aid promise that military personnel promise to help one another.[31] A military physician is part of the military and, as such, is part of the mutual aid promise, which would appear to be violated if the physician flips a coin. Treating a member of one’s own team may be psychologically more beneficial than treating an enemy combatant and may lead to less moral distress.[32] Finally, treating soldiers rather than enemy combatants promotes broader military and social aims, including returning soldiers to health, maintaining unity of purpose, and minimizing community suffering from a soldier’s death. Favoring members of one’s group, that is, triage based on nationality in Battlefield Triage, would fulfill obligations of military group loyalty, which is contrary to the values and duties of medicine. It does not seem as though showing favoritism in this particular situation is very costly to the medical community or general public, but this is because there is recognition that the physician is in the military. Medicine is impartial to non-medical indications partly because of fairness and to promote public trust in medicine. However, Battlefield Triage is unique, as medicine is being practiced in a non-public, wartime setting. In ordinary circumstances, a patient’s identity is irrelevant, and physicians ought not play favorites. Since Battlefield Triage is not an ordinary circumstance, decisions based on patient identity may not undermine public trust in medicine. In addition, it is contestable that fairness in Battlefield Triage requires that no consideration be paid to one’s nationality. Fairness is about giving each person their due, what is owed to them, and the case can be made that soldiers who place themselves in danger for the sake of the common good or a just cause are owed special attention when they suffer harm in the line of duty. In other words, soldiers voluntarily undergo risk to themselves for the greater good, and society owes them for this sacrifice. This plausibly includes preferential treatment in a situation such as Battlefield Triage. So, while the medical community affirms justice demands non-preferential treatment, the military community can affirm the opposite. The demands of fairness are unclear at best or in conflict in this situation: demands of physician justice decry favoritism, while demands of military justice support favoritism. Triage not based on nationality is arguably unfair and triage based on nationality may not undermine public trust, after all. All things considered, there is a clear rationale for favoring nationality-based preferential treatment in Battlefield Triage. Adopting a nationality-based preference in this situation is more defensible than not. This does not make such a decision ethically right or just. Preference based on nationality is the least bad decision, but it is not morally blameless. It involves one in a serious moral wrong, a wrong otherwise avoided and contrary to one’s character. The virtuous military physician is in a situation in which obligations conflict, and we disagree with Gross, who posits that care of fellow soldiers “is important to the near exclusion of all else.”[33] Gross fails to appreciate the collective virtue of solidarity as applied to those in medicine. The military physician has duties to fellow soldiers but also to fellow physicians, to the medical community, and humanity. To favor a soldier on grounds of nationality violates her duties and responsibilities to this latter group. She is involved in a moral tragedy and can only seek the most just action given the circumstances, yet, at least in virtue ethics, the action remains far from blameless. CONCLUSION We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. As such, the virtuous military physician incurs a moral cost to acting as she does—there is a moral residue. However, despite being a moral tragedy, there are clear reasons to act in favor of treating one’s own, considering group solidarity. As such, these kinds of tragedies are resolvable: virtuous military physicians should favor treatment of their own, although they would do so with sorrow. - [1] Militaries set forth medical rules of eligibility or guidelines used to determine whether a person qualifies for specific medical interventions or treatments in certain circumstances, and these guidelines are binding for a military physician. For example, despite opposition from medical organizations, militaries have adopted reverse triage guidelines for military physicians to follow. For ethical discussion, see Falzone, Elisabeth, P. Pasquier, C. Hoffmann, O. Barbier, M. Boutonnet, A. Salvadori, A. Jarrassier, J. Renner, B. Malgras, and S. Mérat. "Triage in military settings." Anaesthesia Critical Care & Pain Medicine 36, no. 1 (2017): 43-51. https://doi.org/10.1016/j.accpm.2016.05.004 [2] There are issues that are related to this, including the triage of civilians and allied soldiers. We set related issues aside for purposes of this paper [3] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [4] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [5] This is termed the “dual loyalty” dilemma in military medicine and has been described at length elsewhere: Institute of Medicine (US) Board on Health Sciences Policy. Military Medical Ethics: Issues regarding Dual Loyalties: Workshop Summary. Washington (DC): National Academies Press (US); 2008. Toward a Framework for Resolving Dual Loyalties. Available from: https://www.ncbi.nlm.nih.gov/books/NBK214853/ [6] See Kenneth G. Swan and K.G. Swan, Jr., “Triage: The Past Revisited,” Military Medicine 161:8 (1996): 448–452. https://doi.org/10.1093/milmed/161.8.448; Jerome A. Singh, “American Physicians and dual loyalty obligations in the ‘war on terror,’” BMC Medical Ethics 4.4 (2003): 1–10. https://doi.org/10.1186/1472-6939-4-4; Beam, Thomas E. "Medical Ethics on the Battlefield." Military Medical Ethics: Sect. IV. Medical ethics in the military. Medical ethics on the battlefield: the crucible of military medical ethics 2 (2003): 369-402; Hereth, Blake. "Health justice for unjust combatants." Journal of Military Ethics 20, no. 1 (2021): 67-81. https://doi.org/10.1080/15027570.2021.1949782. [7] See Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. Gross, Michael L. "Comradery, community, and care in military medical ethics." Theoretical medicine and bioethics 32 (2011): 337-350. https://doi.org/10.1007/s11017-011-9189-6. Gross, Michael L. "The limits of impartial medical treatment during armed conflict." In Military medical ethics for the 21st century, pp. 71-84. Routledge, 2016. [8] World Medical Association, WMA Declaration of Lisbon on the Rights of the Patient. 5 December 2022, https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient/ [9] Geneva Convention for the Amelioration of the Condition of Wounded, Sick in Armed Forces in the Field. 12 August 1949. https://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.30_GC-I-EN.pdf. [10] List, Justin M. "Medical neutrality and political activism: physicians' roles in conflict situations." In Physicians at war: The dual-loyalties challenge, pp. 237-253. Dordrecht: Springer Netherlands, 2008. 240 [11] Beauchamp, T., and J. Childress. 2013. Principles of Biomedical Ethics, 7th ed. Oxford, United Kingdom: Oxford University Press. [12] Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. [13] Gross, "Comradery, community, and care in military medical ethics," 347. [14] Gross, “Comradery, community, and care in military medical ethics,” 349. [15] Gross, Michael L. "When medical ethics and military ethics collide." Narrative inquiry in bioethics 13, no. 3 (2023): 199-204. 202 https://dx.doi.org/10.1353/nib.2023.a924191 [16] Our argument draws on virtue ethics, from which care ethics derives, and it is worth clarifying how our argument relates to Gross’s. We do not think that the virtue of friendship grounds triage decisions, for we think it is unlikely that the physician and wounded soldier are friends. Instead, as explained below, we think the collective virtue of group solidarity better captures the moral significance of group loyalty and that Gross would agree with us. But since military physicians are part of distinct groups, with competing obligations, the military physician will be forced to sacrifice a value in battlefield triage cases. In other words, we think Gross downplays the dual group membership of a military physician. [17] List,”Medical neutrality and political activism,” 250. [18] Adams,”Triage priorities and military physicians,” 235. [19] London, Leslie, Leonard S. Rubenstein, Laurel Baldwin-Ragaven, and Adriaan Van Es. "Dual loyalty among military health professionals: human rights and ethics in times of armed conflict." Cambridge Quarterly of Healthcare Ethics 15, no. 4 (2006): 381-391. 383. [20] Hursthouse, R. On Virtue Ethics. OUP 1999. 74 [21] Nussbaum, Martha C. "The costs of tragedy: Some moral limits of cost-benefit analysis." The Journal of Legal Studies 29, no. S2 (2000): 1005-1036, 1007. [22] De Wijze, S. (2005). Tragic-remorse–the anguish of dirty hands. Ethical theory and moral practice, 7(5), 453-471, 457. https://doi.org/10.1007/s10677-005-6836-x [23] Hursthouse, 73 [24] Hursthouse, 81 [25] Hursthouse, 72 [26] Aristotle, Politics 1253a8. Reeve, C. D. C., Indianapolis: Hackett Publishing Co., 2017 [27] Aristotle, Nicomachean Ethics. III.6.114a, 34-35. 2002, Nicomachean Ethics, Christopher Rowe (trans.), Oxford: Oxford University Press [28] Byerly, T. Ryan, and Meghan Byerly. "Collective virtue." The Journal of Value Inquiry 50, no. 1 (2016): 33-50. https://doi.org/10.1007/s10790-015-9484-y; Federico, Veronica. "Conclusion: solidarity as a public virtue." Solidarity as a Public Virtue (2018): 495-542. https://doi.org/10.5771/9783845290058. Rehg, William. "Solidarity and the common good: An analytic framework." Journal of Social Philosophy 38, no. 1 (2007): 7-21. https://doi.org/10.1111/j.1467-9833.2007.00363.x [29] Byerly and Byerly. "Collective virtue." 43 [30] Battaly, Heather. "Solidarity: Virtue or vice?." In Social virtue epistemology, pp. 303-324. Routledge, 2022. 304 [31] Ibid., 2011: 341 [32] It might be thought that displaying altruism by helping an enemy combatant at the expense of one’s fellow soldier may be psychologically satisfiying. For evidence that military physicians find it difficult to treat enemy combatants, see Lundberg, Kristina, Sofia Kjellström, Anders Jonsson, and Lars Sandman. "Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties." Military medicine 179, no. 8 (2014): 821-826. https://doi.org/10.7205/MILMED-D-14-00038. Lamblin, Antoine, Clément Derkenne, Marion Trousselard, and Marie-Ange Einaudi. "Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study." BMC Medical Ethics 22 (2021): 1-13. https://doi.org/10.1186/s12910-021-00723-2 [33] Ibid., 2011: 344. (shrink)

This book discusses the ethical dilemmas of migration in the era of globalization. Centered on the recent influx of large numbers of migrants and refugees to the United States and Europe and viewed through the lens of the 2016 World Humanitarian Summit and the United Nations Summit on Refugees and Migrants, this book focuses on the problems posed by globalized migration and analyzes proposed responses. Using prominent ethical theories and moral principles, such as Utilitarianism, duty, justice, and integrity, (...) the book proposes a framework for analyzing decision-making by migrants and policymakers and formulating equitable policies to address the migration crisis. Drawing attention to the ethical dilemmas that migrants and policymakers experience, this book fills a gap in the literature and enriches it, adding to the economic, political, and human rights issues that are traditionally part of the migration discussion. Appropriate for students and scholars of ethics, policy, and political science, this book is also meant to be of use to practitioners and decision-makers faced with similar decisions. (shrink)

BackgroundVerbal autopsy is a pragmatic approach for generating cause-of-death data in contexts without well-functioning civil registration and vital statistics systems. It has primarily been conducted in health and demographic surveillance systems (HDSS) in Africa and Asia. Although significant resources have been invested to develop the technical aspects of verbal autopsy, ethical issues have received little attention. We explored the benefits and burdens of verbal autopsy in HDSS settings and identified potential strategies to respond to the ethical issues identified.MethodsThis (...) research was based on a case study approach centred on two contrasting HDSS in Kenya and followed the Mapping-Framing-Shaping Framework for empirical bioethics research. Data were collected through individual interviews, focus group discussions, document reviews and non-participant observations. 115 participants were involved, including 86 community members (HDSS residents and community representatives), and 29 research staff (HDSS managers, researchers, census field workers and verbal autopsy interviewers).ResultsThe use of verbal autopsy data for research and public health was described as the most common potential benefit of verbal autopsy in HDSS. Community members mentioned the potential uses of verbal autopsy data in addressing immediate public health problems for the local population while research staff emphasized the benefits of verbal autopsy to research and the wider public. The most prominent burden associated with the verbal autopsy was emotional distress for verbal autopsy interviewers and respondents. Moral events linked to the interview, such as being unsure of the right thing to do (moral uncertainty) or knowing the right thing to do and being constrained from acting (moral constraint), emerged as key causes of emotional distress for verbal autopsy interviewers.ConclusionsThe collection of cause-of-death data through verbal autopsy in HDSS settings presents important ethical and emotional challenges for verbal autopsy interviewers and respondents. These challenges include emotional distress for respondents and moral distress for interviewers. This empirical ethics study provides detailed accounts of the distress caused by verbal autopsy and highlights ethical tensions between potential population benefits and risks to individuals. It includes recommendations for policy and practice to address emotional and moral distress in verbal autopsy. (shrink)

Background: The professional values presented in ethical guidelines of the Norwegian Nurses Organisation and International Council of Nurses describe nurses’ professional ethics and the obligations that pertain to good nursing practice. The foundation of all nursing shall be respect for life and the inherent dignity of the individual. Research proposes that nurses lack insight in ethical competence and that ethical issues are rarely discussed on the wards. Furthermore, research has for some time confirmed that nurses experience moral (...) distress in their daily work and that this has become a major problem for the nursing profession. Objectives: The purpose of this article is to obtain a deeper understanding of the ethical challenges that nurses face in daily practice. The chosen research questions are “What ethical challenges do nurses experience in their daily practice?” Research design: We conducted a qualitative interview study using a hermeneutical approach to analyzing data describing nurses’ experiences. Ethical considerations: The Norwegian Social Science Data services approved the study. Furthermore, the head of the hospital gave permission to conduct the investigation. The requirement of anonymity and proper data storage in accordance with the World Medical Association Declaration of Helsinki was met. Method and results: The context for the study comprised three different clinical wards at a university hospital in Norway. Nine qualified nurses were interviewed. The results were obtained through a systematic development beginning with the discovery of busyness as a painful phenomenon that can lead to conflicts in terms of ethical values. Furthermore, the consequences compromising professional principles in nursing care emerged and ended in moral blindness and emotional immunization of the healthcare providers. Emotional immunization occurred as a new dimension involving moral blindness and immunity in relation to being emotionally touched. (shrink)

Ethics reflects the moral aspects of any kind of challenge and especially of complex problems. Ethics asks, ’What should be?’ given the facts, dilemmas and normative claims. It is always worth analyzing complex problems through a normative-ethical lens since many, if not all, complex problems incorporate moral issues. The five-step model allows decision-making in situations in which our moral intuitions do not provide convincing guidance. Ethical analysis is not only a means to clarify your individual moral position but (...) also to analyze the challenge you face from a moral point of view. Using the five-step model allows you to identify the ethical challenges, acquire a more encompassing understanding of them and make a well-reflected ethical decision. (shrink)

The task of media ethicists is not only to shine a light on the dilemmas facing our field, but also to point out what the moral issues of the day are. Why is it that some cases and issues appear on our radar, in our textbooks, web sites and journals? Using the example of how the problematic nature of the Apu character in The Simpsons escaped the attention of this author and other media ethicists, this essay explores how media ethicists (...) can be better aware of their own blind spots. Given our limited cognitive abilities and unconscious biases, I will argue that media ethicists could potentially benefit from the help of a theoretical media ethics moral machine (MeMorMach), especially in instances where they are unaware of the potential violation of an established norm. But when normative change occurs, such a device would be less useful in tracking this change and alerting them, especially to those adhering to a constructivist meta-ethical framework. The essay concludes with a call for media ethicists to pay attention to and assist so-called moral enquirers, advocates who, through personal engagement, enact normative change. (shrink)

The book reconstructs the history of Western ethics. The approach chosen focuses the endless dialectic of moral codes, or different kinds of ethos, moral doctrines that are preached in order to bring about a reform of existing ethos, and ethical theories that have taken shape in the context of controversies about the ethos and moral doctrines as means of justifying or reforming moral doctrines. Such dialectic is what is meant here by the phrase ‘moral traditions’, taken as a name (...) for threads of moral discourse, made in turn of other interwoven threads, including transmission of shared codes, appeals to reform of prevailing custom, rational argument about the justification of some precept on the basis of some shared general teaching or principle, and rational argument about the ultimate basis for principles and justification of authoritative teaching. That is, the approach adopted to the reading of ethical texts depends on a firm belief in the fact that philosophers hardly created any ethical doctrine out of nothing. The main point this book tries to highlight is how different philosophical theories emerged and followed each other as a result of attempts at accounting for what was going on in the world of moral traditions. Changes were propelled by controversies between different schools, and highly abstract arguments were the unintended effects of moves made by controversialists forced to transform (and occasionally to turn upside down) their own doctrines in order to face the challenge posed by other arguments. This is the reason why the book examines not only texts that already enjoy pride of place in the history of philosophy (Aristotle, Kant, Hegel), but also other texts usually treated in the histories of religions (the Bible, the Talmud, the Quran), and others considered to be much less philosophical (Plutarchus, Pufendorf). -/- 1. Plato and a response to ethical scepticism. Two different traditions of morality in VI-V century Greece are described. The birth of philosophical questioning of traditional morality and temporal and spatial variation of custom is described within the context of the v century crisis, the demise of traditional aristocratic and tyrannical rule and the birth of democracy. Two conflicting answers to the challenge are reconstructed, namely conventionalist or immoralist theories formulated by the Sophists and the eudemonist and intellectualist Socratic theory. Plato’s own reformulation of Socrates answer to the Sophists is reconstructed. His psychological views, his classification of the four cardinal virtues and his political theory are described as parts of a unitary system, culminating in an extremely realist moral ontology identifying the idea of the good with the essence of the (moral and extra-moral) world itself. -/- 2. Aristotle and the invention of practical philosophy. Aristotle’s invention of practical philosophy as a field separated from first philosophy is shown to be an implication of his break with Plato moral ultra-realism. Aristotle’s agenda in his moral works is arguably dependent on a polemical intention, namely dismantling Socratic intellectualism. The semi-inductive or virtuously circular method of practical philosophy is illustrated, starting with the received opinions of the better and wiser individuals and trying dialectically to sift what is left of mistake and inconsistence in such opinions, finally trying to correct mistakes and make the overall practical science more consistent. The chapter illustrates then the relationship of individual ethics, or ‘monastics’, with the art and the science of the pater familias, or ‘economics’, and the science of the ruler and citizen, or politics. The nature of virtues, or better, excellences of character, is discussed, highlighting the basic role of hexis, or ‘disposition’. Prudence, or better practical wisdom, is the focus of the chapter. Its relationship with bouleusis or deliberation is examined, and its autonomous status vis-à-vis theoretical knowledge is stressed. -/- 3. Diogenes and philosophy as a way of life. The chapter provides an overview of Hellenistic ethics, which almost amounts to Hellenistic schools of philosophy, in so far as ‘philosophy’ became in these centuries primarily the name for a way of life. The typical character of the Cynical movement is highlighted, that of a school of life, not a school aimed at providing any kind of intellectual training was to be provided. -/- 4. Epicurus and ethics as self-care. The peculiar character of the Epicurean school is described, a combination of a science of well-being aiming, more than at pleasure as in the popular view, at reduction of useless suffering, of unnecessary needs, and at a balanced selection of pleasures of the best and most durable kind. -/- 5. Epictetus and ethics as therapy of the passions. The various phases of Stoicism are described, and the shifting place given to ethics in the Stoic system of idea, culminating in the paradoxical view of ethics, its impossibility in principle notwithstanding, as the only truly significant and necessary part of philosophy. Cicero is treated, showing how his own synthesis of various Hellenistic trends is as a truly philosophical enterprise, deserving serious consideration after one or two centuries when he was confined to the role of literate. Epictetus is chosen as the best example of what the Stoic tradition could yield, an art of living based on sophisticated introspection, in turn aimed at making a kind of cognitive therapy possible, dismantling obnoxious passions at their root by systematically correcting false representations. -/- 6. Philo and the reconciliation of Torah and Platonism. A reconstruction of basic ideas from a few books of the Hebrew Bible is provided, starting with the Prophetic tradition and the focus on God’s mercy as the source of motivation and standard for human behaviour. Then a comparative analysis is undertaken of a parallel tradition, namely the three codifications of the Torā (Law or, better, Instruction), highlighting how a core of moral ideas may be recognized as a basis and preamble of codification of civil law, cultural practice, and regulation of ritual purity. The importance of Leviticus is stressed as the turning point when emphasis mercy, typical of the Prophetic tradition, is combined with the legal tradition, yielding the change in sensibility of the Second Temple time. Philo of Alexandria is described as one of the three leading figures – together with Rabbi Hillel and Rabbi Yeshua – at the apex the emergence of the mentioned new sensibility, gradually including mercy as an essential part of justice and establishing the starting point of both the Rabbinic and the Christian tradition. This consists precisely in the precept of one’s neighbour’s love or of the golden rule, two eventually identical precepts whose meaning is arguably more sober and sensible than the long-lasting Christian tradition deriving from John and Augustine has made us believe and no novelty vis-à-vis so-called Ancient-Testament teachings. -/- 7. Augustine and Christianity as Neo-Platonism. The first section examines the moral doctrines of so-called 'ethical Treaties' from the Talmud, a group of treaties, among which the best known is Pirqé Avot, that were left out of the six "orders" of the canon as they did not fit in any of the six groups of issues ritual or legal on which the division was based. According to Maimonides, their peculiar theme is provided by the Deòt, 'opinions', i.e., mental dispositions, that is, the translation of the Greek term hexeis and Arab akhlak (in turn providing in this language the name for ethics as such). The three topics I reconstruct are: i) the notion of Torah: The Torah is understood as the world order itself, or as the ‘Wisdom’ that existed even before creation and was ‘the tool by which the world was built’; however, the Torah is an earthly and human entity, as it was "received" by humans, and from that very moment belongs to them; ii) the relationship between love of God and love of neighbour; the treaties require us to study and practice the Torah ‘for its own sake’, that is, require us to act out of love, not out of fear or hope of reward; iii) the idea of sanctification of daily life: having disappeared with the destruction of the Temple the possibility of any conflict between liturgical service and everyday life, the latter is assumed to be in itself divine service: to give food to the poor has the same value as sacrifices in the Temple, and as an implication, the insistence become recurrent on the goodness of created things in themselves along with a polemic against ascetic currents. The conclusions drawn are: i) the moral teachings of the Talmud and those of Yeshua are, rather than similar, virtually identical; one may safely say that the precept of love and the golden rule are central ones for all Talmudic rabbis, that mercy plays an indispensable role alongside with justice, and the latter is not a different thing from one’s neighbour’s love; ii) a peculiarity of Talmud rabbis facing Yeshua is the idea of study as worship, and knowledge as a source of justice; but this is an idea of Judaism after the Temple's destruction that cannot be attributed to the Pharisees of Yeshua’s time; iii) the relation of study and practice in the Talmud parallels that between faith and deeds in Paul's epistles, that is, respectively faith or learning are a necessary and sufficient condition to be recognized as righteous , but deeds are the inevitable effect of either faith or learning. The sayings ascribed to Yeshua are examined first, yielding the conclusion that a close equivalent may be found for every saying in Talmudic literature and yet the whole is ascribed to one rabbi, with rather consistent stress on God’s mercy and unconditional forgiving as the mark of true imitation of God. Thus, Yeshua’s teaching is pure Judaism. The third section describes briefly the galaxy of Gnostic currents and Manichaeism, trying to sketch the profile of moral teachings resulting from an encounter of Asian spiritual traditions, Hellenistic lore and sparks of teachings from apocalyptic Jewish currents. The last section summarizes the turbulent history of several encounters between Christian currents and Hellenistic philosophical schools. The first one was with late Cynicism. Recent, rather controversial, literature discovered the jargon and a few topics from the Stoic-Cynical popular philosophy in a few books from the New Testament itself. This, far from proving that Rabbi Yeshua had been influenced by cynic preachers, is a proof of the necessity felt by Christian preachers to translate the original ‘Christian’ teaching into a Greek lexicon deeply impregnated with cynic terminology. The second was with Platonism, yielding the mild and temperate moral teaching of Clemens of Alexandria, teaching the sanctity of nature and the human body, the joy of moderate fruition of ‘natural’ kinds of pleasures, and the beauty of the marital life – in short, the opposite of the standard picture of Medieval Christianity. Ambrose of Milan brings about a different kind of synthesis, namely with Middle Platonism, where Stoic themes prevail. The most shocking case is Augustine, where an early Manichean education is overcome in a former phase by a synthesis of Plotinian Neo-Platonism and Christian preaching, yielding a sustained polemic with the Manicheans and rather optimistic views on life and Creation, the body and sexuality, and Hebrew-Judaic tradition not far from Clemens of Alexandria. In a later phase, occasioned by controversy on the opposite front, with such Christian currents as the Pelagians and Donatists, Augustine comes back to heavily anti-Judaic and world-denying ascetic attitudes where is earlier Manichean upbringing seems to emerge again. The tragedy of medieval Christianity will be the later Augustine’s overwhelming influence. A final section is dedicated to the monastic tradition where a curious mixture of world-denying asceticism with an astonishingly penetrating ‘science’ of introspection emerges. -/- 8. Al Farabi and the reconciliation of Islam and Platonism. The Qurān and the qadit, that is, collections of sayings ascribed to the prophet Muhammad contain a wealth of precepts and catalogues of virtues mirroring moral contents from the Jewish and the Christian traditions, among them the basic notion of imitation of the Deity, where mercy is assumed to be its basic trait. An important tradition within Islam, namely Sufism, stressed to the utmost degree the role of mercy, turning Islam into a mystic doctrine centred on retreat from the world, abandonment to God’s will, and a peaceful and fraternal attitude to our fellow-beings. A secular literary tradition originating in the Sassanid Empire, the literature of advice to the Prince had for a time a widespread influence in the newly constituted Arabic-Islamic commonwealth. In a later phase, the legacy of Hellenic philosophy made its way into the intellectual elite of the Islamic world. The first important legacy was Platonic, and the Republic became the main text for Islamic Platonism. Al-Farabi wrote an enjoyable remake of the Platonic Republic, arguing that the citizen’s virtues were the basis on which the political building needs to rest. The secular lawgiver is enlightened by the light of reason in his everyday practice of governance, but room is made for the Prophet as the voice of revealed truth that confirms and completes the rational truth that philosophy may afford. In a second phase also Aristotelian and Stoic influence were assimilated. Miskawayh’s treatise was the masterwork at the time Arabic philosophy reached its Zenith. It is a treatment of the soul’s diseases and their remedies, combining the Aristotelian doctrine of the golden mean with the Stoic doctrine of the passions and elements of Galenic medicine. Towards the eleventh-twelve centuries a war raged among theologians and philosophers, finally won by the former with disappearance of philosophy as such. The newly established mainstream, yet, was no kind of intolerant fanaticism. It drew from the work of mystic theologian Al-Ghazālī, the best heir of Sufism, teaching a tolerant and peaceful attitude to our fellow-beings and a passive attitude to destiny as an expression of the Divine will. -/- 9. Moshe ben Maimon and the reconciliation of Torah and Aristotelian ethics. The encounter between the Talmudic tradition and Hellenic philosophy had taken place a first time in Alexandria at the time of Philo but the two traditions had parted way again. In fact, the kind of Platonic Judaism founded by Philo survived only within Christianity, in the fourth Gospel and then in writings by Clemens of Alexandria. The Talmudic literature had absorbed just less striking traits from the Hellenic Philosophy, namely an idea of ethics as care of the self and a role for the education of character as propaedeutic to theoretical knowledge. In the Arabic-Islamic world, a second round started when Jewish authors writing in Arabic undertook the task to prove the full compatibility of the tradition deriving from Torah and Platonic philosophy. The culmination of this attempt is provided by Moshe ben Maimon who tried to use Aristotelian ethics as a language into which the teaching from the Pirké Avot could be translated. -/- 10. Thomas Aquinas and the reconciliation of Christian morality and Aristotelian ethics. In the first section the fresh start is described of philosophical ethics in Latin Europe at the turn of the Millennium. In a first phase, Anselm and Peter Abelard built on a Platonic and Augustinian legacy. In this phase. remarkable innovations are introduced, including Abelard’s claim of the obliging character of erring consciousness. In a second phase, the rediscovery of Nicomachean Ethics thanks to Latin translation of Arabic versions gives birth to a new wave of ethical studies, recovering the very idea of Aristotelian practical philosophy, with the potential implication of full legitimization of natural morality, i.e. ethics without Revelation. Aquinas’s ethics is a theological ethics out of which it would be vain to try to extract a self-contained philosophical ethics. His treatment of topics in philosophical ethics, yet, does not boil down to repetition of Aristotelian arguments but is rather a creative reshaping of such arguments. For example, he introduces also in the practical philosophy a first principle parallel to the principle of non-contradiction; and he also carries out a synthesis of Aristotelianism, Stoicism, and neo-Platonism. Even though it is essentially moral theology, Aquinas’s doctrine - unlike Augustine – grants full citizenship to "natural" morality, firstly by rejecting the claim that the corruption of human nature due to the original sin is so radical as to leave "pure nature" incapable of moral goodness. The doctrine is presented in a more sophisticated formulation in a few of the Quaestiones, such as De Malo and De Veritate, in the Summa contra Gentes and in the commentaries to Aristotle than in the famous Summa Theologica, but the latter work includes the only or the largest exposition of some decisive part of the theory. Thus, the Summa Theologica should be read for what it is more than criticized for not being what it was not meant to be. It was not meant to be the brilliant synthesis of all that Reason he had been able to produce with what Revelation had added about which the Neo-Thomists used to dream, but rather a manual for the training of preachers and confessors, where theoretical claims are not too demanding and a few serious tensions are left. Besides a jump between the Prima Secundae and the Secunda Secundae, being the former an essay in virtue theory and the latter a handbook for confessors, the most serious tension is perhaps the one between the ethics of right reason presented in most of Ia-IIae and the eudemonistic ethics developed in quaestiones 1-5 of the same part; the alternative ethical theory which also may be found in Augustine, the Stoic view of a cosmic reason eventually coincident with the moral law, was believed by Anselm (followed by John Duns Scotus and William of Ockham) to be incompatible with eudemonism. It is questionable whether Thomas could reduce the tension proving that it is just an apparent tension, in so far as the right reason and bliss derived from knowledge of God tend to coincide, but this is just a conjecture. Thomas’s ethics is a virtue ethic, not a law-based one, and moral judgment focuses on the virtues, particularly charity, not on the commandments and even less on absolute prohibitions; Thomas, however, would not have considered a drastic alternative between law and the virtues such as the one which has been advanced in late twentieth-century philosophy to be justified. Nonetheless, when it discusses ‘special’ virtues, it ceases to be an ethics of virtue and becomes a disappointing and often contradictory discussion of legal and illegal acts. Such a discussion takes most of the time ‘reasonable’ middle positions on controversial issues but not the alternative approach that Aristotelianism would have made possible; even when some occasional Aristotelian claim shows up, such as money’s barrenness as a reason against usury, this seems to be made by an author who apparently ignores the Aristotelian Thomas of the Prima Secundae. It is an ethic of human autonomy which recognizes the binding character of the individual conscience and, potentially, even a duty to disobey unjust laws. It is true that what Thomas writes in his discussion of death penalty and persecution of heretics is simply disgusting, and yet we should blame Thomas the man, not Thomist ethical theory. Finally, Thomas’s ethics is not ethical ‘absolutism’, as both traditionalist Catholic theologians and secularist enemies of dogmatic morality tend to believe. It is instead an ethic of prudential judgment. Exceptions to this approach – or better results of logical fallacies – are such claims as the absolute character of negative precepts and of the existence of "intrinsically evil acts", claims that simply cease to make sense in the light of Thomas’s own distinction between human act and natural act, carrying consequences Thomas did not live long enough to draw or was not consistent enough to dare to draw. -/- 11. Francisco de Vitoria and casuistry. The first topic illustrated is the discussion about the notion of pura natura, namely the human condition after the original sin and before divine revelation. The core notion was already there in Aquinas but was later developed by Caietanus (Thomas de Vio) with a number of interesting implications: firstly a view of human nature as such much more positive than Augustine’s and his followers’ view, including both Calvinists and Jansenists; secondly, the implication that the philosopher’s morality, as opposed to the Christian’s morality, is a quite respectable kind of morality; thirdly, that theocracy and prosecution of the unfaithful lacked justification, with more far-fetching consequences than Aquinas himself had dared to draw. The second topic is casuistry, a new name for a comparatively older way of thinking, which was already there in late Stoicism and Cicero as well as in the Talmudic literature. This is an approach aimed at yielding probable enough solutions for doubtful cases even in absence of completely safe staring points. The genre developed from medieval reference books for confessors and became by the sixteenth-century a sophisticated tool-box for dealing with various fields of applied ethics. Francisco Vitoria, the main authority of Baroque Scholasticism, was a controversial figure, among the proponents of the new discipline of casuistry and a consistent proponent of more separation between the religious and the civil authority, stricter limits to the legitimacy of war, innate rights of non-Christian nations in the New World based on the notion of pura natura, providing a standard of ‘natural’ goodness, previous to revelation, on which the Indian nations were judged to live in a naturally good condition, provided with the institutions of family, justice, and religion had accordingly a right to full respect by Christian sovereigns. Bartolomé de Las Casas, arguing along similar lines, was the leader of a historical battle in defence of the rights of the Indios. -/- 12. Michel de Montaigne and the art of living. A short description of one of the Renaissance Phyrronism, one of the classical philosophies revived in the fifteenth and sixteenth century. Montaigne combines the sceptical epistemology with an understanding of ethics – indeed of philosophy as a whole – in terms of an art of living inspired by two basic ideas, sagesse, that is, practical wisdom as the only kind of rationality available after theology, science, and tradition have declared bankrupt, and an aesthetic ideal of self-transformation through the art of writing and introspection. -/- 13. Pierre Nicole and neo-Augustinianism. The chapter illustrates first the vicissitudes of Augustinianism newly born after the late medieval triumph of Thomist Aristotelianism in the alternative Protestant and Catholic versions processed by the Calvinists and the Jansenists. Then it illustrates the doctrines of Pierre Nicole, Blaise Pascal’s best disciple, on the impossibility of introspection, on the ubiquity of self-deception, on the incurably evil character of the passion of love, and on the two moralities, the one of the man of the world, the morality of honesty which is indispensable for granting peace and order but devoid of any true value for eternal salvation, since the same external behaviour may be prompted by opposite motivations, and the morality of charity, the only true one but also useless to society. The third topic is Pierre Malebranche’s view of self-deception as a ubiquitous phenomenon accounting for human action and responsibility and his reformulated theory of self-love, no less ubiquitous than for Nicole and yet not as incurably evil, given the distinction between morally indifferent and even necessary amour de soi and vicious amour proper, a distinction on which the whole of Rousseau’s moral and political theory rests. -/- 14. Samuel von Pufendorf and the new science of morality. The chapter is dedicated to the discovery of the idea of a ‘new moral science’. Hugo Grotius is discussed first highlighting the real character of his project, much closer to the Thomist idea of a natural law accessible to non-corrupted human reason when human beings are living in a state of pura natura. Then Hobbes’s combination of scepticism, voluntarism, and conventionalism is described and both the continuity with Grotius’s new science, in the search for non-revealed rational morality, and the break with him, in the adoption of voluntarism and refusal of an intellectualist view of natural law, are illustrated. Pufendorf’s work is illustrated as a synthesis of the two previous attempts and the – up to Schneewind underestimated – paradigmatic example of the new science of morality. -/- 15. Richard Cumberland and consequentialist voluntarism. The chapter gives an overview of eighteenth-century Anglican ethics, noticing how the Cambridge tradition gave special weight to natural theology as opposed to positive or revealed theology – and how two Cambridge fellows, John Gay and Thomas Brown, elaborated on Cumberland’s (and Malebranche’s, as well as Leibniz’s) strategy for finding a third way between intellectualist view and voluntarist view of the laws of nature. The result of their elaboration was a kind of a rational-choice account of the origins of natural laws, where a law-giver God chooses among a number possible sets of laws on a maximizing criterion, and God’s maximandum is happiness for his creatures. The chapter notices also how such a solution aimed at solving at once the problem of evil and that of the foundation of moral obligation by proving how God’s choice was justified as far as it was the one minimising the amount of suffering in the world. 16. Richard Price and intuitionism. The chapter describes first the doctrines of the Cambridge Platonists, an example of hyper-rationalist reaction to Calvinism. Secondly it describes the sophisticated and universally ignored – from Sidgwick to Anscombe –version of what was later labelled ‘ethical intuitionism’ – showing how it escapes familiar objections and misrepresentations of intuitionism – from Mill to Rawls – in grounding its argument on transcendental arguments while carefully avoiding recourse to introspection and psychological evidence, which has been taken as a too easy target by critics of intuitionism. Thirdly, the chapter discusses Whewell’s ‘philosophy of morality’, as opposed to ‘systematic morality’, not unlike Kant’s distinction between a pure and an empirical moral philosophy. Whewell worked out a systematization of traditional normative ethics as a first step before its rational justification; he believed that the point in the philosophy of morality is justifying a few rational truths about the structure of morality such as to rule hedonism, eudemonism, and consequentialism; yet a system of positive morality cannot be derived solely from such rational truths but requires consideration of the ongoing dialectics between idea and fact in historically given moralities. Whewell’s intuitionism turns out closer to Kantian ethics than commentators have made us believe until now, and quite different from what Sidgwick meant by intuitionism. -/- 17. Adam Smith and the morality of role-switch. The chapter describes first, Hutcheson’s attempt at basing the ‘new science’ of natural law on different bedrock than Pufendorf and the English Platonists, namely a moral sense, a faculty whose existence is assumed to be proved on an empirical basis. The second step is a reconstruction of Hume’s rejoinder in terms of a new science of man including morality on an ‘experimental’ basis, that is, a ‘Newtonian’ hypothetical-deductive approach, distinguished from Hutcheson’s allegedly uncritical descriptive approach to human nature. The third step is a reconstruction of Adam Smith theory of morality understood as emerging from a spontaneous interplay of exchanges of situations (the most basic meaning of the word ‘sympathy’ as construed by this author). -/- 18. Jeremy Bentham and utilitarianism. The bulk of the chapter is dedicated to the doctrines of Jeremy Bentham. The Enlightenment spirit that suggested the idea of a new morality, free from religion, is illustrated. The notion of utility is illustrated as well as the subsequent formulations of the principle of utility. The idea of felicific calculus is discussed, showing how its inner difficulties prompted several reformulations of the principle of utility in order to avoid undesirable implications of proposed formulations. The role of the thesis of spontaneous convergence between interest and duty is discussed, showing how it left numberless questions open, and the distinction between the virtues of prudence, justice and beneficence is described as a way out of the deadlocks of classical utilitarianism. After Bentham, Mill’s reformed utilitarianism is reconstructed, showing how it is a kind of mixed system – as closer to common sense as it gives up Bentham’s claims to consistency and simplicity – resulting as unintended consequences from the controversies in which Mill was too keen to engage. The hidden agenda of the controversy between Utilitarianism and Intuitionism, going beyond the image of the battle between Prejudice and Reason, is described, showing how both competing philosophical outlooks turn out to be more research programs than self-contained doctrinal bodies, and such programs appear to be implemented, and indeed radically transformed while in progress thanks to their enemies no less than to their supporters. -/- 19. Immanuel Kant, practical reason and judgment. The chapter argues that Kant took from Moses Mendelssohn the idea of a distinction between geometry of morals and a practical ethic. He was drastically misunderstood by his followers precisely on this point. He had learned from the sceptics and the Jansenists the lesson that men are prompted to act by deceptive ends, and he was aware that human actions are also empirical phenomena, where laws like the laws of Nature may be detected. His practical ethics made room for judgment as a holistic procedure for assessing the saliency of relevant moral qualities in one given situation; this procedure yields the same results as the geometry of morals does for abstract cases but does so immediately and without balancing conflicting duties with each other, since what makes for the salient quality of a situation is perceived from the very beginning. Kant's practical philosophy is richer than the received image, making room for an ‘empirical moral philosophy’ or moral anthropology including treatment of commerce, needs, value and price, happiness and well-being; the overall social theory and philosophy of history is less different from Adam Smith's than the received image makes believe; the paradox of happiness is central to Kant's philosophy; a distinction between happiness and well-being is clearly drawn; the distinction plays a basic role in establishing a link between the economic and the moral life. -/- 20. Georg Wilhelm Friedrich Hegel and the critique of abstract universalism. The chapter describes first the Romantic movement and the implications some of its concerns, rescuing passions, community, tradition, the individual as the bearer of a unique destiny, and the longing for organic unity between the individual, mankind and nature. Hegel’s contribution is discussed then, highlighting how, on the one hand, he shared a number of these concerns and on the other he had more rationalist leanings. The notion of morality is the pivotal point of the reconstruction, highlighting how Hegel construes this notion as a key to his own diagnosis of the malaise of modernity – the separation of individual and Gemeinschaft – and how his attack on Kant turns around this very idea. -/- 21. Friedrich Nietzsche against Christianity and the Enlightenment. The chapter illustrates first the idea of deconstruction of the back-world of values. Nietzsche claims to be legitimate heir of the French moralists, Leibniz, Kant and Hegel, in so far as he allegedly carries out to its deepest implications their discovery of what lies behind traditional naïve belief in the existence of an objective realm of values just waiting for description by the philosopher. The two exemplars form which genealogy draws inspiration are the classical philologist’s historical reconstructions of lost meanings and the chemist’s decomposition of elements. Then the genealogy of the notions of good and evil carried out in the first dissertation of Genealogy of morals is illustrated with its paradoxical conclusion that will to power is in fact the only ‘genuine’ kind of goodness. The third point illustrated is the dialectic of ascetism and self-realization with its ambiguous outcome. The suggested interpretation of such outcome is that Nietzsche’s normative ethics is a kind of virtue ethics taking an aesthetic ideal as a normative standard -/- 22. George Edward Moore and ideal utilitarianism. The chapter discusses the ideas of common sense and common-sense morality in Sidgwick. I argue that, far from aiming at overcoming common-sense morality, Sidgwick aimed purposely at grounding a consist code of morality by methods allegedly taken from the natural sciences to reach, also in ethics, the same kind of “mature” knowledge as in the natural sciences. His whole polemics with intuitionism was vitiated by the a priori assumption that the widespread ethos of the educated part of humankind, not the theories of the intuitionist philosophers, was what was worth considering as the expression of intuitionist ethics. In spite of a naïve positivist starting-point, Sidgwick was encouraged by his own approach in exploring the fruitfulness of coherentist methods for normative ethics. Thus, Sidgwick left an ambivalent legacy to twentieth-century ethics: the dogmatic idea of a “new” morality of a consequentialist kind, and the fruitful idea that we can argue rationally in normative ethics albeit without shared foundations. Then it reconstructs the background of ideas, concerns and intentions out of which Moore’s early essays, the preliminary version, and then the final version of Principia Ethica originated. I stress the role of religious concerns, as well as that of the Idealist legacy. I argue that PE is more a patchwork of rather diverging contributions than a unitary work, not to say the paradigm of a new school in Ethics. I add a comparison with Rashdall’s almost contemporary ethical work, suggesting that the latter defends the same general claims in a different way, one that manages to pave decisive objections in a more plausible way. I end by suggesting that the emergence of Analytic Ethics was a more ambiguous phenomenon than the received view would make us believe, and that the wheat (or some other gluten-free grain) of this tradition, that is, what logic can do for philosophy, should be separated from the chaff, that is, the confused and mutually incompatible legacies of Utilitarianism and Idealism. -/- 23. Edmund Husserl and the a-priori of action. The chapter illustrates first the idea of phenomenology and the Husserl’s project of a phenomenological ethic as illustrated in his 1908-1914 lectures. The key idea is dismissing psychology and trying to ground a new science of the a priori of action, within which a more restricted field of inquiry will be the science of right actions. Then the chapter illustrates the criticism of modern moral philosophy carried out in the 1920 lectures, where the main target is naturalism, understood in the Kantian meaning of primacy of common sense. The third point illustrate is Adolph Reinach’s theory of social acts as a key the grounding of norms, a view that basically sketches the very ideas ‘discovered’ later by Clarence I. Lewis, John Searle, Karl-Otto Apel and Jürgen Habermas. A final section is dedicated to Nicolai Hartman, who always refused to define himself a phenomenologist and yet developed a more articulated and detailed theory of ‘values’ – with surprising affinities with George E. Moore - than philosophers such as Max Scheler who claimed to Husserl’s legitimate heirs. -/- 24. Bertrand Russell and non-cognitivism. The chapter reconstructs first the discussion after Moore. The naturalistic-fallacy argument was widely accepted but twisted to prove instead that the intuitive character of the definition of ‘good’, its non-cognitive meaning, in a first phase identified with ‘emotive’ meaning. Alfred Julius Ayer is indicated as a typical proponent of such non-cognitivist meta-ethics. More detailed discussion is dedicated to Bertrand Russell’s ethics, a more nuanced and sophisticated doctrine, arguing that non-cognitivism does not condemn morality to arbitrariness and that the project of a rational normative ethics is still possible, heading finally to the justification of a kind of non-hedonist utilitarianism. Stevenson’s theory, another moderate version of emotivism is discussed at some length, showing how the author comes close to the discovery of the role of a pragmatic dimension of language as a basis for ethical argument. Last of all, the discussion from the Forties about Hume’s law is described, mentioning Karl Popper’s argument and Richard Hare’s early non-cognitivist but non-emotivist doctrine named prescriptivism. -/- 25. Elizabeth Anscombe and the revival of virtue ethics. The chapter discusses the three theses defended by Anscombe in 'Modern Moral Philosophy'. I argue that: a) her answer to the question "why should I be moral?" requires a solution of the problem of theodicy, and ignores any attempts to save the moral point of view without recourse to divine retribution; b) her notion of divine law is an odd one more neo-Augustinian than Biblical or Scholastic; c) her image of Kantian ethics and intuitionism is the impoverished image manufactured by consequentialist opponents for polemical purposes and that she seems strangely accept it; d) the difficulty of identifying the "relevant descriptions" of acts is not an argument in favour of an ethics of virtue and against consequentialism or Kantian ethics, and indeed the role of judgment in the latter is a response to the difficulties raised by the case of judgment concerning future action. A short look at further developments in the neo-naturalist current is given trough a reconstruction of Philippa Foot’s and Peter Geach’s critiques to the naturalist-fallacy argument and Alasdair MacIntyre’s grand reconstruction of the origins and allegedly unavoidable failure of the Enlightenment project of an autonomous ethic. -/- 26. Richard Hare and neo-Utilitarianism. The chapter addresses the issue of the complex process of self-transformation Utilitarianism underwent after Sidgwick’s and Moore’s fatal criticism and the unexpected Phoenix-like process of rebirth of a doctrine definitely refuted. A glimpse at this uproarious process is given through two examples. The first is Roy Harrod Wittgensteinian transformation of Utilitarianism in pure normative ethics depurated from hedonism as well as from whatsoever theory of the good. This results in preference utilitarianism combined with a ‘Kantian’ version of rule utilitarianism. The second is Richard Hare’s two-level preference utilitarianism where act utilitarianism plays the function of eventual rational justification of moral judgments and rule-utilitarianism that of action-guiding practical device. -/- 27. Hans-Georg Gadamer and rehabilitation of practical philosophy. The post-war rediscovery of ethics by many German thinkers and its culmination in the Sixties in the movement named ‘Rehabilitation of practical philosophy’ is described. Among the actors of such rehabilitation there were a few of Heidegger’s most brilliant disciples, and Hans-Georg Gadamer is chosen as a paradigmatic example. His reading of Aristotle’s lesson I reconstructed, starting with Heidegger’s lesson but then subtly subverting its outcome thanks to the recovery of the central role of the notion of phronesis. -/- 28. Karl-Otto Apel and the revival of Kantian ethics. Parallel to the neo-Aristotelian trend, there was in the Rehabilitation of practical philosophy a Kantian current. This started, instead than the rehabilitation of prudence, with the discovery of the pragmatic dimension of language carried out by Charles Peirce and the Oxford linguistic philosophy. On this basis, Karl-Otto Apel singled out as the decisive proponent of the linguistic and Kantian turn in German-speaking ethics, worked out the performative-contradiction argument while claiming that this was able to provide a new rational and universal basis for normative ethics. An examination of his argument is some detail is offered, followed by a more cursory reconstruction of Jürgen Habermas’s elaboration on Apel’s theory. -/- 29. John Rawls and public ethics as applied ethics. Rawls’s distinction between a “political” and a “metaphysical” approach to one central part of ethical theory, namely the theory of justice, is interpreted as a formulation of the same basic idea at the root of both the principles approach and neo-casuistry, both discussed in the following chapter, namely that it is possible to reach an agreement concerning positive moral judgments even though the discussion is still open – and in Rawls’ view never will be close – on the basic criteria for judgment. -/- 30. Beauchamp and Childress and bioethics as applied ethics. The chapter presents the revolution of applied ethics while stressing its methodological novelty, exemplified primarily by Beauchamp and Childress principles approach and then by Jonsen and Toulmin’s new casuistry. -/- . (shrink)

What should we do if climate change or global injustice require radical policy changes not supported by the majority of citizens? And what if science shows that the lacking support is largely due to shortcomings in citizens’ individual psychology such as cognitive biases that lead to temporal and geographical parochialism? Could then a plausible case for enhancing the morality of the electorate—even against their will –be made? But can a democratic government manipulate the will of the people without losing democratic (...) legitimacy? This paper explores the problems that governmental manipulation of voters pose for democratic legitimacy and the tensions between non-manipulated input and morally acceptable output. These venerable issues of political theory resurface in light of recent suggestions to tackle today’s global mega-problems by Ingmar Persson and Julian Savulescu. They suggest that to avert the looming catastrophe, governments should alter psychological traits of the citizenry through biomedical means, from pharmaceuticals to genetics. However, we argue that a government cannot rule with democratic legitimacy if elected by a will of the people it manipulated before. Normatively, conferring power from the governed onto governors is a one-directional relation that is incompatible with manipulation. But while it is tempting to rebut suggestions to morally enhance the people as antithetical to essential ideas of democracy, swift rebuttals tend to overlook the deeper challenge: Majoritarian decision-making may lead to inacceptable outcomes. The dilemma between input and output runs through major works in political theory. Rather than wishfully ignoring the dangers of democracy, democratic theory has to provide answers. (shrink)

In spite of the growing interest in nursing ethics, few studies have focused on ethical dilemmas experienced by nurses working with clinical studies as ‘research nurses’. The aim of the present study was to describe and explore ethical dilemmas that Swedish research nurses experience in their day-to-day work. In a qualitative study a purposeful sample of six research nurses from five wards of differing disciplines in four Swedish hospitals was interviewed. The analysis displayed several examples of ethical (...) dilemmas, primarily tensions between the nurses’ obligations to the study and to the patients involved. A guiding moral principle for the nurses was patient-centeredness, where the interest of research must not override the interest of the patient. In situations where tensions between research and patient interests occurred, and doctors and nurses disagreed upon the judgement, the nurses sometimes chose to follow the doctors’ advice, and thus acted against their own moral judgment. Such situations seemed to create feelings of moral distress among the nurses. They described their profession as being ‘invisible’ and as lacking opportunities for ethical competence building. The conclusion is that research nurses frequently experience severe and difficult ethical dilemmas in their daily work. They need to be acknowledged as a particular profession in the health care organisation and encouraged to develop their specific ethical competence. (shrink)

Background: Ascertaining the relationship between ethical ideology, moral judgment, and ethical decision among academic nurse educators at work appears to be a challenge particularly in situations when they are faced with a need to solve an ethical problem and make a moral decision. Purpose: This study aims to investigate the relationship between ethical ideology, moral judgment, and ethical decision as perceived by academic nurse educators. Methods: A descriptive correlational research design was conducted at Faculty of (...) Nursing, Alexandria University. All academic nurse educators were included in the study (N = 220). Ethical Position Questionnaire and Questionnaire of Moral Judgment and Ethical Decisions were proved reliable to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects’ informed consent. Findings: This study reveals a significant positive moderate correlation between idealism construct of ethical ideology and moral judgment in terms of recognition of the behavior as an ethical issue and the magnitude of emotional consequences of the ethical situation (p < 0.001; p = 0.031) respectively. Also, there is a positive significant moderate correlation between relativism construct of ethical ideology and overall moral judgment (p = 0.010). Approximately 3.5% of the explained variance of overall moral judgment is predicted by idealism together with relativism. Discussion: The findings suggest that variations in ethical position and ideology are associated with moral judgment and ethical decision. Conclusion: Organizations of academic nursing education should provide a supportive work environment to help their academic staff to develop their self-awareness and knowledge of their ethical position and promoting their ethical ideologies and, in turn, enhance their moral judgment as well as develop ethical reasoning and decision-making capability of nursing students. More emphasis in nursing curricula is needed on ethical concepts for developing nursing competencies. (shrink)

Accountants and auditors are often faced with ethical dilemmas, which they have to process using resources available to them. Although they may be sensitive to the ethicality of the issues and have the cognitive ability to work through a judgment process, the final action they take may be dependent on a number of motivational factors, endogenous to the issue. Agency issues are a continuing area of concern providing accountants with an ability to shirk their responsibilities and hide confidential information, (...) which may affect their career prospects if disclosed. This ongoing study explores these notions within a stakeholder context and uses a post test only field experiment to gain evidence to support the existence of an agency problem and that membership to one of a number of motivational typologies directly affects the way accountants respond to ethical issues. This association causes them to adopt informational heuristics that may result in less than optimal decisions. This study identified two specific endogenous constructs, namely social consensus and venal intent that discriminate between motivational types and which possibly provide psychological underpinnings explaining membership orientation. (shrink)

What should we do if climate change or global injustice require radical policy changes not supported by the majority of citizens? And what if science shows that the lacking support is largely due to shortcomings in citizens’ individual psychology such as cognitive biases that lead to temporal and geographical parochialism? Could then a plausible case for enhancing the morality of the electorate—even against their will –be made? But can a democratic government manipulate the will of the people without losing democratic (...) legitimacy? This paper explores the problems that governmental manipulation of voters pose for democratic legitimacy and the tensions between non-manipulated input and morally acceptable output. These venerable issues of political theory resurface in light of recent suggestions to tackle today’s global mega-problems by Ingmar Persson and Julian Savulescu. They suggest that to avert the looming catastrophe, governments should alter psychological traits of the citizenry through biomedical means, from pharmaceuticals to genetics. However, we argue that a government cannot rule with democratic legitimacy if elected by a will of the people it manipulated before. Normatively, conferring power from the governed onto governors is a one-directional relation that is incompatible with manipulation. But while it is tempting to rebut suggestions to morally enhance the people as antithetical to essential ideas of democracy, swift rebuttals tend to overlook the deeper challenge: Majoritarian decision-making may lead to inacceptable outcomes. The dilemma between input and output runs through major works in political theory. Rather than wishfully ignoring the dangers of democracy, democratic theory has to provide answers. (shrink)

This book offers a uniquely constructive set of tools for engaging complex and controversial ethical problems. Covering such practical methods as diversifying options, lateral thinking, reframing problems, approaching conflicts as creative opportunities, and many others, it shows how to find "room to move" inside even the most challenging ethical problems, and thereby discover new and productive ways to deal with them. The book features numerous exercises and applications that consider a wide range of familiar ethical issues--including the (...) moral status of animals, the death penalty, poverty, drug use, and many others--and ends with some of the toughest: abortion, assisted suicide, and environmental ethics. An ideal supplement for any general ethics course, Creative Problem-Solving in Ethics can also be used in more specific "applied" courses like bioethics, business ethics, and social ethics, as well as in critical thinking courses that emphasize ethics. In addition, it provides a concise and engaging introduction to creative thinking for workshop participants and general readers. From the very beginning of the book, readers will discover that creative thinking can offer imaginative and promising alternatives to seemingly intractable ethical dilemmas. (shrink)

This issue of The Journal of Medicine and Philosophy assesses the deep and abiding tensions that exist among the competing epistemic perspectives that bear on medicine and morality. Concepts of health and disease, as well as the theoretical framing of medical ethics and health care policy, intersect with an overlapping set of culturally situated communities, striving to understand and manipulate the world in ways that each finds explanatory, appropriate, or otherwise befitting. The articles explore the complexities of framing public health (...) care policy to guide bioethical decision making in the face of the plurality of ethical viewpoints and moral rationalities—including health enhancing supplements, continuous sedation until death, medical futility, the protection of vulnerable populations, and competing professional obligations. (shrink)

Background: The professional values presented in ethical guidelines of the Norwegian Nurses Organisation and International Council of Nurses describe nurses’ professional ethics and the obligations that pertain to good nursing practice. The foundation of all nursing shall be respect for life and the inherent dignity of the individual. Research proposes that nurses lack insight in ethical competence and that ethical issues are rarely discussed on the wards. Furthermore, research has for some time confirmed that nurses experience moral (...) distress in their daily work and that this has become a major problem for the nursing profession. Objectives: The purpose of this article is to obtain a deeper understanding of the ethical challenges that nurses face in daily practice. The chosen research questions are “What ethical challenges do nurses experience in their daily practice?” Research design: We conducted a qualitative interview study using a hermeneutical approach to analyzing data describing nurses’ experiences. Ethical considerations: The Norwegian Social Science Data services approved the study. Furthermore, the head of the hospital gave permission to conduct the investigation. The requirement of anonymity and proper data storage in accordance with the World Medical Association Declaration of Helsinki was met. Method and results: The context for the study comprised three different clinical wards at a university hospital in Norway. Nine qualified nurses were interviewed. The results were obtained through a systematic development beginning with the discovery of busyness as a painful phenomenon that can lead to conflicts in terms of ethical values. Furthermore, the consequences compromising professional principles in nursing care emerged and ended in moral blindness and emotional immunization of the healthcare providers. Emotional immunization occurred as a new dimension involving moral blindness and immunity in relation to being emotionally touched. (shrink)

Background Disaster scenarios challenge both novice and experienced nurses to navigate complex ethical dilemmas in resource-limited environments. Traditional nursing education often leaves new nurses unprepared for the ethical demands of disaster nursing. Utilitarianism must often guide triage ethics and decision-making. There is a critical need to equip nursing students with these ethical competencies. Research question/Aim This study explores nursing students’ lived experiences using introductory triage ethics in mass casualty incident simulation (MCIS). Research design A qualitative, interpretive phenomenological (...) approach was employed, analyzing reflective journal responses from senior nursing students following MCIS participation. Participants and research context Participants were senior-year nursing students from a private university in the U.S., engaging in MCIS as part of their curriculum, which simulated resource-limited disaster scenarios requiring real-time ethical decisions. Ethical considerations The study received Institutional Review Board (IRB) approval, and participants provided informed consent. Data were anonymized and did not affect academic evaluation. Findings Two major themes emerged: 1. Living in Ethical Dilemmas (subthemes: We Could Have Saved Them If…, Looking Past Obvious Suffering, How Can We Be Prepared?, We Can’t Abandon Them). 2. Development of Ethical Competency (subthemes: Knowing You’ve Done Enough, Finding New Perspectives, There Is No Right Answer). Students grew in moral reasoning and emotional resilience, transitioning from patient-centered care to utilitarian decision-making. Conclusions Participation in the mass casualty incident simulation allowed nursing students to confront and navigate complex ethical challenges in real time, fostering significant growth in moral reasoning and emotional resilience. Through immersion in simulated ethical dilemmas, students grappled with the tension between patient-centered care and the realities of utilitarian decision-making. This experience catalyzed a deeper understanding of ethical ambiguity and the development of moral clarity, equipping them with foundational skills for ethically navigating crises. Nursing curricula should recognize and incorporate opportunities that facilitate this ethical growth through experiential learning. (shrink)

Moral thinking and communication are critical competencies for confronting social dilemmas in a challenging world. We examined these moral competencies in 70 college students and graduates from Taiwan, the United Kingdom, and the United States. Participants were assessed through semi-structured written interviews, Facebook group discussions, and a questionnaire. In this paper, we describe the similarities and differences across cultural groupings in (1) the social issues of greatest importance to the participants; (2) the factors influencing their approaches to thinking about social (...) issues and communicating with others; and (3) the characteristics of their moral functioning in terms of moral awareness, moral judgment, moral discourse, and moral decision-making. (shrink)

This essay examines several ethical and epistemological issues that arise when philosophers conduct empirical research focused on, or in collaboration with, community groups seeking to bring about systemic change. This type of research can yield important policy lessons about effective community-driven reform and how to incorporate the voices of marginalized citizens in public policy debates. Community-based reform efforts are also particularly ripe for philosophical analysis since they can demonstrate the strengths and shortcomings of democratic and egalitarian ideals. This type (...) of research also raises unique ethical dilemmas that challenge central tenets of research ethics. We focus on two foundational questions: What does informed consent mean in the context of community-based research when CBR may dissolve differences between researcher and research participant, and its parameters can be hard to delineate? And what ethical, democratic, and epistemic issues arise when conducting research with and on community groups, given potentially competing commitments to respect the epistemological contributions of all participants while also meeting research norms to warrant findings and conclusions? Our examination has two aspects: we grapple with these issues through examples from our work to reveal their significance in our own philosophic practice, and more broadly, to reveal their significance as problems within traditional research ethics. We believe that this approach will demonstrate the utility of philosophic engagement with dilemmas in research ethics as a reflective matter, and in the course of empirical research itself. (shrink)

ART and, in particular, IVF and ICSI, are essentially a laboratory experiment, but which, due to its specificity, goes beyond the disciplinary boundaries, explicitly acquiring an ethical-axiological dimension in the interaction zone of the members of a particular community involved in child-bearing. At the same time, it is noted that the activity and choice of a way to solve problems with childbirth has a characteristic severity, due to the traditions and level of civil and social maturity of a country, (...) due, among other things, to the level and achievements of technical equipment in this industry of knowledge and practice. According to foreign studies, about half of all subfertile people in developed countries are trying to overcome their infertility with the help of medicine, and research data indicate that the proportion of such individuals is growing. The most difficult problems of reproduction are associated with low quality of oocytes or low ovarian reserve ; aspermia and deep teratozoospermia, can not give hope to a couple to have genetically related offspring. However, donor programs create additional opportunities for social motherhood / paternity. Donation of oocytes is found in ART programs at least 3 times more often than donation of spermatozoa. At the moment, donation of gametes and embryos raises a number of ethical, legal, medical and socio-psychological issues that require competent support from experts of a wide range of specialists, as well as competent, non-commercial, primarily due to the interaction between donors and recipients. The analysis of possible modifications of family and kinship ties is based on the idea of transforming social relations, in which assisted reproductive technologies play a fundamental role, building a system of “new kinship and new family.” By entering into the intimate process of the birth of life and acting as a regulator of the composition of participants in this process through the stimulation of responsibility to present and future relatives, reproductive technologies affect the initial moral requirements in the community, redefining universal values based on the specific situation. Scenarios of childbearing through ART with the involvement of additional participants are possible in the context of the legal field, but legally fixed anonymity of the donor leaves many unresolved issues related to the problems of hereditary diseases, genetic abnormalities and epigenetic changes; in addition, there is a problem associated with the possibility of unintentional incest, as well as the difficulties of the child’s self-identification and the closeness of his genealogy. Solutions to these issues are postponed until later, thereby initiating future dramatic situations, ethical conflicts and dilemmas with a poorly predictable positive outcome. (shrink)

The trend to centralization of the Mizrahi narrative has become an integral part of the nationalistic, ethnic, religious, and ideological-political dimensions of the emerging, complex Israeli identity. This trend includes several forms of opposition: strong opposition to "melting pot" policies and their ideological leaders; opposition to the view that ethnicity is a dimension of the tension and schisms that threaten Israeli society; and, direct repulsion of attempts to silence and to dismiss Mizrahim and so marginalize them hegemonically. The Mizrahi Democratic (...) Rainbow [The Keshet], the most prominent proponent and representative of this trend, was established in the 1990s with the intention of being a leading civic and political body in Israeli society. While it was the Mizrahi worldview that led to selection of the organization's name and aims, their vision was to be involved in social struggle on behalf of other groups in Israeli society. Since it was established, The Keshet has aimed to function as an assertive, long-term alternative coalition exerting influence, power, and pressure on the Israeli narrative network. And, indeed, the organization has succeeded in disrupting Israeli discourse, principally, by challenging the ideological foundations of the Zionist meta-narrative. Nearing the end of the first decade of the 21st century and nearly a decade since it was established, The Keshet not only represents the most current wave of Mizrahi discourse, it has changed it to such a great degree that it is impossible to ignore its influence. Further, this alternative narrative may have significant potential to advance the internal Jewish discourse so fundamental at this time given the changing Israeli situation and regional conditions. And, while it is possible to view The Keshet and this new narrative as a continuation of the Mizrahi struggle, as a narrative The Keshet's agenda represents a post-colonial perspective and multi-cultural alternative to Zionism as a social vehicle. Amidst all of this, The Keshet continues to offer concrete proposals to change the Jewish character of the state as well as its internal and external relations. One of the primary goals of this study was to examine the rise of the Mizrahi narrative over the last two decades and the new Mizrahi discourse in Israeli society. More specifically, the study sought to attain an in-depth understanding of the central narrative created and represented by The Keshet. An additional goal was to investigate the influence of The Keshet's activity and the narrative it constructed in regard to other narratives. In particular, the study focused on The Keshet's opposition to the central Zionist narrative that infuses civic, political, and academic frameworks in Israel. Accordingly, the primary research questions investigated in the study sought to determine: What has been the influence of the Mizrahi Democratic Rainbow on the Mizrahi narrative in Israel? And, what are implications of such influence for the central Zionist narrative? Methodologically, the study was based on narrative and comparative analyses of texts from different periods of the older and newer Mizrahi narratives. The corpus included two types of texts: First, academic texts and opinion pieces, both philosophical and programmatic in nature, published in magazines, journals, books, as well as position papers; second, all of the texts published by prominent and influential figures who charted the path of The Keshet or led it organizationally and/or intellectually over the last twenty years (e. g., Yehudah Shenhav, Yossi Yona, Moshe Krief among others). All texts were examined by means of philosophical, historical and critical hermeneutic tools. This analysis revealed different levels of Mizrahi and civic discourse in Israel as well as among The Keshet's founders and leading ideologues. The study was based on a three stage process model, developed for purposes of this study, for investigation and analysis of the new Mizrahi narrative as well as other oppositional narratives, in particular opposition to the hegemonic meta-narrative. The stages are: issuing the challenge, dissolution and, liberation; that is, liberation is the measure of the ultimate success of the struggle for narrative change. Such change is not based on success in the field, but rather on a radical, fundamental reversal of thought, discourse patterns, stylistic structures, as well as forms of questioning - in this case of taken-for-granted racist mechanisms. However, the principal change is in achieving a deep, inner de-legitimization of the signifiers, categories, and reproductions of all manner of mockery that are based on immoral colonialist processes that are reinforced by regimes of fear and intimidation whose self-destruction began upon their very creation. This three stage model charts the course of the oppositional Mizrahi narrative from: accounting for the past (passing judgment on the so-called historic colonialist Zionism) to writing a new (pure Mizrahi) history and creation of a Mizrahi-Arab identity separate from the Ashkenazic, identified as Zionist. Contemporary post-colonialist discourse is integral in these stages. Such a perspective has been transformed by transitions from - binarism to hybridity, Orientalism to Occidentalism, the politics of "liberation" to "constructive" politics, from the history of consciousness to the history of change, as well as from nationalist to post-nationalist questions. Fundamentally, according to this approach, political and other struggles for the emerging narrative of Mizrahi (or Arab) history seek to centralize it in society and weave it amidst the models of multiculturalism. Undertaken in parallel, the central characteristics of all these stages are borrowed from countries in which the need for national reconciliation led to renunciation of apartheid and racist policies and historical judgment of the hegemony supported by racist leaders. In addition, these three moves were undertaken in Keshet and its ideologues by means of substantive symbolic violence directed at the hegemonic Ashkenazic discourse, which included creation of hatred of it, use of stereotypes the opposite of oppressive discourse, and adoption of an arrogant point of view toward it. This stands in stark contrast to the claims of the self-proclaimed new Mizrahi stance of a discourse established on purely ethical grounds that sought to cleanse itself of these very same oppressive elements. The model developed for and demonstrated in this study allows for analysis of oppositional narratives in which the libratory stage evolves into a form of entrapment, as appears to be occurring to the new Mizrahi discourse. This conclusion is based on the observations shared by many Keshet proponents including leading intellectuals who worked on the manifestos that were the subject of criticism from the Zionist camp. The study identified and defined the following six interwoven strata, which for purposes of explication are each discussed in a separate chapter: The first chapter presents a general theoretical discussion of the issue of the narrative and the inter-narrative struggle that has become central and applicable in various ways in the latest generation (e. g., anthropologically, hermeneutically, and philosophically). The analysis surveys different discussions in the inter-narrative struggle and locates them in the contexts, relations, and meanings derived from, representing, and indeed reproducing the narrative of national identity. The second chapter includes a historical survey of the older Mizrahi struggle that existed prior to the ascendance of the new Mizrahi narrative. Initially, Mizrahi discourse focused on expressing the ethnic protest that grew in years to follow. These feelings of discrimination and social distancing of the immigrants from Islamic countries gave birth to expressions of protest, the most prominent of which were Wadi Salib and the Black Panther Movement's various activities. The research literature contains many explanations for the exacerbation of the ethnic problem and creation of a situation that could not be ignored. The consensus academic view reached at the end of the 1970s identified a number of primary factors for this situation: the existence and extensive numbers of different ethnic groups; the relative or absolute segregation of frameworks within which members of these ethnic groups lived and acted; and the significant overlap between socio-economic status and feelings of discrimination retained by members of the Mizrahi group due years of neglect by the Ashkenazic establishment, the strengthening of Mizrahi social, cultural, and political power, as well as the emergence of a Mizrahi elite that identified with Mizrahi problems. The severe consequences of feelings of discrimination were expressed in a long series of events, such as: rioting by residents of the Rehovot Sharayim neighborhood in 1956; events of Wadi Salib in Haifa in 1959; and a chain of activities involving the Black Panthers in the 1970s. Protest was also an aspect of the "tent movement" in the 1970s and 1980s. Political activities were advanced by the Tami Movement that competed in the election for the 10th Knesset in 1981 and the Shas Movement that has continued to garner political power since being found in 1984. The 1980s and 1990s were characterized as the era of radical consciousness of Mizrahi discourse as well as by the rise to power, in consecutive order, of the political parties – Tami, Shas, and the Mizrahim HaHadashim [the New Mizrahi]. The latter party laid the foundations of the new radical Mizrahi discourse from which emerged such cultural activities as: Iton Aher [A Different Newspaper]; Bimat Kivon Aher [Another Direction Forum]; Efir'yon journal; the Halah Organization for Education in Neighborhoods, Development Towns, and Villages; Kedma; the newspaper – Patish [Hammer]; and, eventually the establishment of Keshet. The third chapter presents an examination of the materialization of the inter-narrative struggle in the case of Israel, with a specific focus on The Keshet and the new Mizrahi narrative advanced by it and intellectuals. The Keshet ideology is examined in the context of its grounding in post-colonial thought, especially that of Edward Said; the directions proposed by Ella Shohat and her followers; the central thinkers of the narrative in Israel in the last decade; and the harsh critique leveled at the Ashkenazic-Zionist narrative. The practical steps proposed for implementation within the multicultural model are also examined. Here the effort to reduce the centrality of Zionism while revealing its oppressive mechanisms was undertaken in parallel with use of these mechanisms in order to create a Mizrahi space with broad margins inclusive of alternative forms of Israeli identity in the Middle East and in conjunction with Arabs within and beyond Israel. Mizrahi traditionalism is examined in the fourth chapter in two particular respects. First, the criticism of the new Mizrahi narrative leveled by the renewed view and, second, the implications of the alternative in terms of creating a Mizrahi space that does not oppose Zionism. Rather, in opposing the post-colonialist perspective, this renewed traditionalist perspective criticizes as well as values Zionism. This space seeks to be both Jewish and Mizrahi. It does not detach itself from nationalist Zionism but rather views itself as a continuation of this tradition and, accordingly, is an effort to develop a next stage in its development. For example, an essential dimension of the traditionalist perspective, "commitment," is considered in this stage to be a fertile basis for dialogue with the past and as an anchor for contemporary interpretation of Mizrahi and other Jews' identities in Israel. The fifth and sixth chapters deal with all of the vectors of criticism directed at the new Mizrahi narrative, including its ideological foundations, philosophical stance, as well as intellectual and practical basis in the Israeli sphere in the face of Palestinian nationalism. These vectors of criticism from within and beyond The Keshet deal with issues, such as, the meaning of the movement's activities and the narrative that it offers regarding questions of Israeli identity, Israeli collective memory, and Mizrahi self-perception. At the same time, it must confront the capitalist neo-liberal narrative in a global world and thrive in a context in which it must make itself manifest amidst oppositional narratives. The final chapter presents a comprehensive, critical analysis of the new Mizrahi narrative. It does so by means of a theoretical model that examines it as an oppositional narrative – one that seeks to challenge the hegemonic meta-narrative, to dissolve the boundaries of the narrative discourse, and to propose liberation and redemption that may led to entrapment amidst a changing, a-dichotomous realities (e. g., global economic development in the face of Zionist nationalisms that display ideological strength as well as development of the sense of being an Israeli that maintains its vitality and continuity while being constituted by sectors that challenge being a Mizrahi, such as co-ethnic subjects. The Keshet's influence is dramatic and extends in a number of central directions. Its political activity and non-entry into the domains of the Israeli parliament granted the movement significant power in civic discourse and contributed to changing the persona of the Mizrahi discourse; for example, from political-party struggles over budgets and obtaining shares of the regime to changing the face of Israeli society and the centrality of the Mizrahi narrative. This change included deconstructing the Ashkenazic narrative and constructing comprehensive Ashkenazic-Zionist guilt, as evident in the Ehud Barak's request for collective forgiveness. This was accomplished through the participation of leading members of Keshet who appeared in prominent intellectual forums and engaged in lively discourse - principally in academic, social, and media domains. Such participation gave new meaning to various aspects of Israeli society while establishing different models of multiculturalism. The rise of the new Mizrahi narrative is a significant marker in the inter-narrative struggle as it represents a desire for separate or hybrid identities. And, the deep probing of the narrative constructed by leaders of The Keshet and those who identify with the movement produced a number of clear ways to distinguish it from the old Mizrahi struggle, whose history was portrayed through social protests, in a manner similar to linear vectors marked with wars and elections. The old Mizrahi struggle selected the traditional tactical struggle identified usually with social and political movements that seek to change political, social, and economic reality - from the bottom up. Their primary demand was to change decisions as well as the division of social goods and resources. Hence, this older period of struggle was not aimed at opposing the ideological foundations of the hegemonic narrative nor did it seek to undermine in a radical manner the unique nature of the state of Israel as a revolutionary solution for the problems of the Jews according to the Zionist approach, as a national home for the Jewish people, and recognition of the right to an preferred and meta-definition of Jewish nationalism. In contrast, the top down struggle advanced by the new narrative is part of an ideological movement led by the educated that is assertive and ground in post-colonialist theory. Accordingly, it was critical of the techniques and mechanisms of oppression as well as sought to attack the Zionist ideological foundations and to reveal its racist operations and the regimes that have preserved it so efficiently for many years. The uniqueness of this narrative is the intellectual offensive that continues to be advanced and, in parallel, development of the discourse struggle in Israel concerning the justification for Zionism and the concrete political proposal that Jews reject the taken-for-granted status of it as an ideology. This new narrative recognizes the historic difficulties of subversion as an emancipatory and, principally, moral effort. In addition, the new Mizrahi narrative shares the foundations and narrative of Palestinian victimization. In its radical version, the new Mizrahi narrative seeks to connect to the Palestinian narrative in order to create a new space here. According to this version, this action will take place gradually. The first stage will be characterized by opposition to Western European, Ashkenazic Zionism. The Eurocentric Zionism will surrender in the second stage, to be followed in the last stage by creation of a coalition of Jews and Arabs that will be establish through concrete actualization of the refugee status and victimization that is shared by both Palestinians and Mizrahim (whether as Mizrahim or Jewish-Arab). Not a speculative academic exercise, the goal sought by this narrative is delineate and to achieve a multicultural model in which equality, liberty, and social justice will overcome the nationalism and colonialism of either side; that is it will be neither Zionist nor Jewish. Thus, this approach stresses what is shared (e.g., acceptance of the Arab space and not a rejection of it; the legitimacy of the Arab language and culture). This is part of detachment from and historic judgment of the colonialist Zionist enterprise. This possibility includes moral elements that remove the evil and harm caused by Zionism for many years as well as inner cleansing – primarily among Ashkenazim – of attitudes towards Jews and non-Jews. Though, in this regard, it should be noted that, to date, the new narrative has not made similar claims that Palestinians undergo a similar process. The assumption seems to be that this should be tested, that the coalition proposed is a possibility that will be recognized by the Palestinians, and that they are prepared to undergo a similar, shared moral process that involves negating the state of Israel as a Jewish, Western state, a state of the Jewish people, and not only for those who live within it. These Mizrahi thinkers conducted a significant move through deconstruction and substitution of the Eurocentric narrative with a multi-cultural proposal that is optimistic and even attractively naïve. Today, they acknowledge that they did not take into account Palestinian nationalist violence directed to citizens, the traditionalist alternative, and widespread opposition within the Mizrahi community toward what is perceived to be Mizrahi seclusion. They also did not take into account the harsh criticism rendered by young and educated Mizrahim who claim that they were born into a complex, multi-dimensional, multi-layered identity that includes internalization of the language of the West and rules of the game of this complex identity. And, though they are critical of some of its values, this makes it difficult to mount internal emotional opposition to the West and to the globalization contained within this world. Hence, this more familiar world is preferred over the values of the Mizrahi-Arab alternative, particularly in regard to problems in the domains of democratic citizenship, stance taken toward women, and freedom of speech. Further, educated Mizrachim reject the post-colonialist perspective and are stridently critical of its dichotomization. They claim that such a division is irrelevant in a world in which older ideologies have collapsed and new spheres – such as cyberspace and others – are open to them in which they can present themselves with an Israeli identity that is not categorized as necessarily Mizrahi. (shrink)

The global emergency caused by the spread of COVID-19 raises critical challenges for individuals and communities on many different levels. In particular, politicians, scientists, physicians, and other professionals may face new ethical dilemmas and cognitive constraints as they make critical decisions in extraordinary circumstances. Philosophers and cognitive scientists have long analyzed and discussed such issues. An example is the debate on moral decision making in imaginary scenarios, such as the famous “Trolley Problem”. Similarly, dramatic and consequential decisions are realized (...) daily in the current crisis. Focusing on Italy, we discuss the clinical ethical guidelines proposed by the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care, highlighting some crucial ethical and cognitive concerns surrounding emergency decision making in the current situation. (shrink)

As attention to the pervasiveness and severity of environmental challenges grows, technical universities are responding to the need to include environmental topics in engineering curricula and to equip engineering students, without training in ethics, to understand and respond to the complex social and normative demands of these issues. But as compared to other areas of engineering ethics education, environmental ethics has received very little attention. This article aims to address this lack and raises the question: How should we teach environmental (...) ethics to engineering students? We argue that one key aspect such teaching should address is the tendency of engineers towards technical framing of (social) problems. Drawing then on engineering ethics pedagogy we propose that the competencies of moral sensitivity and critical thinking can be developed to help engineering students with problem (re)framing. We conclude with an example from our teaching that operationalizes these competencies. (shrink)

This paper builds on a number of ideas concerning the nature, management and representation in case studies, of moral issues and dilemmas as experienced by people in organisations. Drawing on some cases used in teaching business ethics, and utilising a checklist of questions derived from the more general theoretical analysis, suggestions are offered regarding the contributions which such cases can make in developing students' understanding and potential for performative competence in real life situations. The distinction between issues and dilemmas is (...) emphasised, and different types of issue are identified. The status of self-interest as an issue, and as contributory to personal dilemmas, is given particular attention. The paper also addresses the distinction between cognitive and non-cognitive attributes required by individuals if they are to deal with such situations. Within the cognitive category attention is paid to the contribution of ethical and other theory, and to the need for moral imagination and judgement. (shrink)

Virtue ethics is now well established as a substantive, independent normative theory. It was not always so. The revival of virtue ethics was initially spurred by influential criticisms of other normative theories, especially those made by Elizabeth Anscombe, Philippa Foot, John McDowell, Alasdair MacIntyre, and Bernard Williams. 1 Because of this heritage, virtue ethics is often associated with anti-theory movements in ethics and more recently, moral particularism. There are, however, quite a few different approaches to ethics that can reasonably claim (...) to be versions of virtue ethics. The predominant strand of virtue ethics is broadly Aristotelian, although some accounts bear little resemblance to Aristotle's. In its most general form, virtue ethics is compatible with a wide range of meta-ethical and normative commitments. This diversity makes it difficult to compare virtue ethics as such with other normative theories. It can also be a challenge to see just what the various versions of virtue ethics have in common with each other. Three major types of virtue ethics are represented in the books by Rosalind Hursthouse, Michael Slote, and Christine Swanton, recommended in the following section. Each of these book sets forward a considerably self-standing form of virtue ethics. The authors differ on central issues such as the relationship between virtue and flourishing and the link between virtuous agents and right or virtuous actions. Unlike Swanton and Slote, Hursthouse defends a version of ethical naturalism that has affinities with theories recently defended by Philippa Foot and Alasdair MacIntyre. 2 Slote's theory is agent-based, meaning that his account derives judgments about the moral status of actions from moral features of agents. Hursthouse and Swanton defend theories according to which the moral status of an action depends on its broader relationship to human flourishing (Hursthouse) or whether it hits the target of a virtue (Swanton). Although these three books presently form the core of contemporary virtue ethics, there are other approaches that might reasonably be described as versions of virtue ethics, such as those presented by Julia Driver, Linda Zagzebski, and Robert Adams. 3 There are also, of course, a large number of articles in which authors defend or criticize tenets that are central to most versions of virtue ethics. Some recent articles on especially important topics are listed in the following section. Current 'hot topics' in virtue ethics include whether its account of right action is adequate and whether virtue ethics is at odds with empirical psychology. Articles on these debates and others are listed in the following section. Author Recommends: Books These three books are foundational works in contemporary virtue ethics, and represent quite different approaches to virtue ethics. For each book, I have also listed an article by the same author in which he or she articulates some similar themes. Those pressed for time or space on a syllabus might start by examining those articles. 1. Hursthouse, Rosalind. On Virtue Ethics. Oxford: Oxford University Press, 1999. Hursthouse defends a eudaimonistic version of virtue ethics with Aristotelian affinities. *See also Hursthouse, Rosalind. 'Normative Virtue Ethics.' How Should One Live? Ed. Roger Crisp. Oxford: Clarendon Press, 1996. 19–36. 2. Slote, Michael. Morals from Motives. Oxford: Oxford University Press, 2001. Slote defends a version of virtue ethics based on evaluations of motives, drawing on historical figures like Martineau, Hutcheson, and Hume. Note that this book represents a fairly significant departure from his first book in virtue ethics, From Morality to Virtue (New York: Oxford, 1992). *See also Slote, Michael. 'Agent-Based Virtue Ethics.' Virtue Ethics . Ed. Roger Crisp and Michael Slote. Oxford: Oxford University Press, 1997. 3. Swanton, Christine. Virtue Ethics: A Pluralistic View. Oxford: Oxford University Press, 2003. Swanton defends a pluralistic, non-eudaimonistic version of virtue ethics that draws on influences ranging from Aristotle to Nietzsche to contemporary psychoanalytic theory. *See also Swanton, Christine. 'A Virtue Ethical Account of Right Action.' Ethics 112 (2001): 32–52. Articles The following is a selection of articles that address some of the central and controversial topics within virtue ethics. 1. Annas, Julia. 'Being Virtuous and Doing the Right Thing.' Proceedings and Addresses of the American Philosophical Association 78.2 (2004): 61–75. This article addresses the problem of action guidance and the role that an account of right action should play in virtue ethics. 2. Conly, Sarah. 'Flourishing and the Failure of the Ethics of Virtue.' Midwest Studies in Philosophy Vol. XIII, Ethical Theory: Character and Virtue . Eds. P. French et al. South Bend: University of Notre Dame Press, 1988. 83–96. This article articulates the central problems faced by versions of virtue ethics that rely on a conception of human flourishing. 3. Das, Ramon. 'Virtue Ethics and Right Action.' Australasian Journal of Philosophy 81 (2003): 324–39. This article raises objections about insularity and circularity to accounts of right action presented by Hursthouse, Slote, and Swanton. 4. Doris, John M. 'Persons, Situations, and Virtue Ethics.' Nous 32 (1998): 504–30. This article argues that situationist psychology undermines the concept of a character trait on which virtue ethicists rely. An expanded version of this criticism can be found in Doris, Lack of Character, Cambridge: Cambridge University Press, 2002. 5. Hursthouse, Rosalind. 'Virtue Theory and Abortion.' Philosophy and Public Affairs 20.3 (1991): 223–46. This article argues that virtue ethics is capable of providing action guidance in the difficult problem of abortion. 6. Johnson, Robert N. 'Virtue and Right.' Ethics 113 (2003): 810–34. This article raises several objections against the accounts of right action in virtue ethics, one of which is that they cannot make sense of the rightness of self-improving actions. The criticism is directly primarily at Hursthouse's theory, but Swanton and Slote are discussed as well. 7. Kamtekar, Rachana. 'Situationism and Virtue Ethics on the Content of Our Character.' Ethics 114 (2004): 458–91. This article argues that situationist critiques of virtue ethics rely on a mistaken understanding of virtuous character. 8. Kawall, Jason. 'Virtue Theory and Ideal Observers.' Philosophical Studies 109 (2002): 197– 222. This article argues for an ideal observer-style account of right action in virtue ethics. 9. Nussbaum, Martha. 'Non-Relative Virtues: An Aristotelian Approach.' Midwest Studies in Philosophy, Vol. XIII, Ethical Theory: Character and Virtue . Ed. P. French et al. South Bend: University of Notre Dame Press, 1988. 32–53. This article presents a view of the virtues on which the virtues are excellences in spheres of activity. Although the spheres are common to all humans, the manifestation of excellence in a given sphere is subject to cultural variation. 10. Sreenivasan, Gopal. 'Errors about Errors: Virtue Theory and Trait Attribution.' Mind 111 (2002): 47–68. This article addresses the situationist critique of character traits by arguing that virtue ethics does not depend on the concept of a character trait as Doris and others understand it. 11. Stangl, Rebecca. 'A Dilemma for Particularist Virtue Ethics.' Philosophical Quarterly 58 (2008): 665–78. This article addresses the relationship between virtue ethics and radical moral particularism, arguing that the latter may have undesirable consequences for virtue ethicists unless they accept the unity of the virtues. 12. Stohr, Karen. 'Contemporary Virtue Ethics.' Philosophy Compass 1.1 (January 2006): 22–7. This article provides an overview and analysis of contemporary virtue ethics. It includes discussion of main problems and challenges for the future. 13. Stohr, Karen. 'Moral Cacophony: When Continence is a Virtue.' Journal of Ethics 7 (2003): 339–63. This article raises problems for the commonly accepted distinction between virtue and continence, arguing that the mixed emotions normally associated with continence are sometimes characteristic of virtue instead. 14. van Zyl, Liezl. 'Agent-Based Virtue Ethics and the Problem of Action Guidance.' Journal of Moral Philosophy 6 (2009): 50–69. This article defends agent-based virtue ethics against objections that it cannot distinguish agent-appraisal from act-appraisal and that it cannot provide adequate action guidance. Anthologies 1. Crisp, Roger, ed. How Should One Live? Essays on the Virtues. Oxford: Clarendon Press, 1996. This is one of the first virtue ethics anthologies published, and so reflects a correspondingly earlier picture of the field. The essays, however, are important and interesting in their own right, and cover a broad array of topics. 2. Crisp, Roger and Michael Slote, eds. Virtue Ethics . Oxford: Oxford University Press, 1997. This anthology was published over a decade ago and does not capture recent developments in the field. It is, however, an admirably thorough collection of the most influential essays from the early days of virtue ethics, both promoting and criticizing it. 3. Darwall, Stephen, ed. Virtue Ethics. Oxford: Blackwell, 2003. This anthology is distinctive in that it includes material from Aristotle, Hutcheson, and Hume, along with some central contemporary sources. 4. Walker, Rebecca L. and Philip J. Ivanhoe, eds. Working Virtue. Oxford: Oxford University Press, 2007. This recent anthology focuses on applied virtue ethics and has an excellent selection of essays by influential thinkers on topics including the environment, business, medicine, war, and poverty. Online Sources 'Virtue Ethics', Stanford Encyclopedia of Philosophy. http://plato.stanford.edu/entries/ethics-virtue/ Entry written by Rosalind Hursthouse and updated in 2007. 'Bibliography on Virtue Ethics', maintained by Jörg Schroth. http://www.ethikseite.de/bib/cvirtue.pdf Extensive list of work published in virtue ethics. Updated regularly, listed in both alphabetical and chronological order, and contains abstracts of papers. 'Janusblog', maintained by Guy Axtell. http://janusblog.squarespace.com/ Blog devoted to current work in virtue ethics and virtue epistemology, although with an emphasis on the latter. It contains spirited discussion among the many contributors, as well as a library of papers. Sample Syllabus This syllabus is for a graduate seminar or intense upper-level undergraduate course. Books for purchase for this course might include the Crisp and Slote anthology, the Walker and Ivanhoe anthology, and Hursthouse's On Virtue Ethics. Week 1: The Roots of Contemporary Virtue Ethics Anscombe, Elizabeth. 'Modern Moral Philosophy' (Crisp and Slote) Foot, Philippa. 'Virtues and Vices' (Crisp and Slote) MacIntyre, Alasdair. 'The Nature of the Virtues' (Crisp and Slote) Week 2: The Roots of Contemporary Virtue Ethics Stocker, Michael. 'The Schizophrenia of Modern Ethical Theories' (Crisp and Slote) Williams, Bernard. 'Morality, the Peculiar Institution' (Crisp and Slote) McDowell, John. 'Virtue and Reason' (Crisp and Slote) Week 3: Aristotelian Virtue Ethics Hursthouse, Rosalind. On Virtue Ethics, Part I Hursthouse, Rosalind. 'Practical Wisdom: A Mundane Account.' Proceedings of the Aristotelian Society 106.3 (2006): 283–307. Stangl, Rebecca. 'A Dilemma for Particularist Virtue Ethics' Week 4: Aristotelian Virtue Ethics Hursthouse, Rosalind. On Virtue Ethics, Part II Stark, Susan. 'Virtue and Emotion.' Nous 33.5 (2001): 440–55. Stohr, Karen. 'Moral Cacophony: When Continence is a Virtue' Week 5: Aristotelian Virtue Ethics Hursthouse, Rosalind. On Virtue Ethics, Part III Conly, Sarah. 'Flourishing and the Failure of an Ethics of Virtue' Nussbaum, Martha. 'Non-Relative Virtues: An Aristotelian Approach' MacIntyre, Alasdair. Dependent Rational Animals, chapter 10 Week 6: Agent-Based Virtue Ethics Slote, Michael 'Agent-Based Virtue Ethics' (Crisp and Slote) Slote, Michael, Morals from Motives, chapters 1 and 3 Week 7: Pluralistic Virtue Ethics Swanton, Christine. Virtue Ethics: A Pluralistic View , chapters 3, 4, and 11. Week 8: The Situationist Critique of Virtue Ethics Doris, John. 'Persons, Situations, and Virtue Ethics' Kamtekar, Rachana. 'Situationism and Virtue Ethics on the Content of Our Character' Sreenivasan, Gopal. 'Errors about Errors: Virtue Theory and Trait Attribution' Merritt, Maria. 'Aristotelian Virtue and the Interpersonal Aspect of Ethical Character.' Journal of Moral Philosophy 6 (2009): 23–49. Week 11: Right Action – Problems Johnson, Robert. 'Virtue and Right' Das, Ramon. 'Virtue Ethics and Right Action' Week 12: Right Action – Virtue Ethics Solutions Annas, Julia. 'Being Virtuous and Doing the Right Thing' van Zyl, Liezl. 'Agent-Based Virtue Ethics and the Problem of Action Guidance' Kawall, Jason. 'Virtue Theory and Ideal Observers' Week 13: Virtue Ethics and Professional Roles Pelligrino, Edmund. 'Professing Medicine, Virtue Based Ethics, and the Retrieval of Professionalism' (Walker and Ivanhoe) Swanton, Christine. 'Virtue Ethics, Role Ethics, and Business Ethics' (Walker and Ivanhoe) Sherman, Nancy. 'Virtue and a Warrier's Anger' (Walker and Ivanhoe) Week 14: Virtue Ethics and the Non-Human World Hursthouse, Rosalind. 'Environmental Virtue Ethics' (Walker and Ivanhoe) Walker, Rebecca. 'The Good Life for Non-Human Animals: What Virtue Requires of Humans' (Walker and Ivanhoe) Focus Questions 1. What is the relationship between virtue and flourishing? Are the virtues necessary for flourishing? Sufficient? 2. Can virtue ethics provide an adequate account of right action? 3. On what concept of a character trait does virtue ethics rely, and does situationist psychology undermine it? 4. Is the project of ethical naturalism a plausible one? To what extent does the success of Aristotelian virtue ethics depend on it? 5. How does virtue ethics affect the way that applied ethics is done? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:25 MORALITY AS A BACK-UP SYSTEM: HUME'S VIEW? The sense of duty is a useful device for helping men to do what a really good man would do without a sense of duty..... Nowell-Smith A certain picture of morality — arguably a Humean one — has come to have a prominent place in contemporary philosophy. On this picture, morality, as Richard Brandt asserts, is "a back-up system, which operates (...) when spontaneous personal caring fails 2 to motivate us to do as we ought." Morality — at least in the form of moral principles, whose force is felt through one's sense of duty — is, on this view, ideally superfluous. As a guide for one's own conduct it is needed only insofar as the agent's affective network is deficient. If one only spontaneously desired a, cared about b, cared for c, felt aversion towards d as, ideally, one should, moral principles and a sense of duty would be of no use. There are good reasons for supposing that this is Hume's view. After all, his characterization of acting from duty is more than a little disparaging: When any virtuous motive or principle is common in human nature, a person, who feels his heart devoid of that motive, may hate himself upon that account, and may perform the action without the motive, from a certain sense of duty, in order to acquire by practice, that virtuous principle, or at least, to disguise to himself,,as much as possible, his want of it. I will argue, however, that there is tension in Hume's ethics between two lines of thought. According to the first line of thought, and the one 26 usually associated with Hume, good conduct is conduct which is spontaneously prompted by virtuous desires. Unless our desires either are not what they should be or are motivationally weak, there is no need for mediation or tempering by a sense of duty or moral principles. According to the second line, the very good desires of a very good person may nonetheless need to be filtered, tempered, redirected or checked. This line is most evident in "Of the Origin of the Natural Virtues and Vices." Before arguing that these strains of thought are in tension in Hume's ethics, I need to clarify what is at issue and to develop the two competing pictures of moral motivation. First the issue. The issue is not 'Who is better: someone with a sense of duty but corrupt desires or someone with no sense of duty but ideal desires?' Nor is the issue one of the moral worth of actions ('Can an action have moral worth if it is not performed out of duty?') The issue, rather, is how to characterize morally good (or right) conduct. What role, if any, does a sense of duty or a Butlerian principle of reflection, i.e., an overarching, guiding conception of what is right or good which is 'juridically' supreme within the self, play in good conduct? Is morally good conduct ideally a matter of acting as one should from the proper desires? Or should the desires be governed and guided by moral principles? Consider two models of moral conduct. Model I: Morality as a Back-Up System On this picture, wrongness in conduct is traceable to an affective deficiency. The claim underlying this picture seems to be as follows: One 27 acts wrongly because one's passions are not quite what they should be. One person cheats in her business dealings because she cares too little about the welfare of others (and too much about her own); another is harsh and abrupt to a student because he cares too little about his students' concerns and is jealous and possessive when it comes to 'his time.' In each case the problem can be traced to an affective deficiency. Hume appears to be supporting this view when he asserts, "it may be establish'd as an undoubted maxim, that no act can be virtuous, or morally good, unless there be in human nature some motive to produce it, distinct from a sense of its morality' (T 479). A few pages later he writes, "[E]very immorality... (shrink)

The construction industry is typically characterized as a fragmented, multi-organizational setting in which members from different technical backgrounds and moral values join together to develop a particular business or project. The most challenging obstacle in the construction process is to achieve a successful practice and to identify and apply an ethical framework to manage the behavior of involved specialists and contractors and to ensure the quality of all completed construction activities. The framework should reflect a common moral ground for (...) myriad people involved in this process to survive and compete ethically in today’s turbulent construction market. This study establishes a framework for moral judgment of behavior and actions conducted in the construction process. The moral framework provides the basis of judging actions as “moral” or “immoral” based on three levels of moral accountability: personal, professional, and social. The social aspect of the proposed framework is developed primarily from the essential attributes of normative business decision-making models identified in the literature review and subsequently incorporates additional attributes related to professional and personal moral values. The normative decision-making models reviewed are based primarily on social attributes as related to moral theories. The professional and moral attributes are established by identifying a set of common moral values recognized by professionals in the construction industry and required to prevent common construction breaches. The moral framework presented here is the complementary part of the ethical framework developed in Part I of this article and is based primarily on the personal behavior or the moral aspect of professional responsibility. The framework can be implemented as a form of preventive personal ethics, which would help avoid ethical dilemmas and moral implications in the first place. Furthermore, the moral framework can be considered as a decision-making model to guide actions and improve the moral reasoning process, which would help individuals think through possible implications and the consequences of ethical and moral issues in the construction industry. (shrink)

A significant number of asylum seekers who largely survived torture live in the United States. Asylum seekers have complex social and medical problems with significant barriers to health care access. When evaluating and providing care for survivors, health providers face important challenges regarding medical ethics and professional codes. We review ethical concerns in regard to accountability, the patient–physician relationship, and moral responsibilities to offer health care irrespective of patient legal status; competing professional responsibility toward society and the judiciary system; (...) concerns about the consistency of asylum seekers’ claims; ethical concerns surrounding involving trainees and researching within the evaluation setting; and the implication of broader societal views towards rights and social justice. We discuss contributing factors, including inadequate and insufficient provider training, varying and inadequate institutional commitment, asylum seekers’ significant medical and social problems, and the broader health and social system issues. We review existing resources to address these concerns and offer suggestions. (shrink)

Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about (...) the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy. (shrink)

Graham Walker boldly recasts the debate over issues like constitutional interpretation and judicial review, and challenges contemporary thinking not only about specifically constitutional questions but also about liberalism, law, justice, and rights. Walker targets the "skeptical" moral nihilism of leading American judges and writers, on both the political left and right, charging that their premises undermine the authority of the Constitution, empty its moral words of any determinate meaning, and make nonsense of ostensibly normative theories. But he is even more (...) worried about those who desire to conduct constitutional government by direct recourse to an authoritative moral truth. Augustine's political ethics, Walker argues, offers a solution--a way to embrace substantive goodness while relativizing its embodiment in politics and law. Walker sees in Augustinian theory an understanding of the rule of law that prevents us from mistaking law for moral truth. Pointing out how the tensions in that theory resonate with the normative ambivalence of America's liberal constitutionalism, he shows that Augustine can provide successful but decidedly nonliberal grounds for the artifices and compromises characteristic of law in a liberal state. Originally published in 1990. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

In moral philosophy the problem of virtue has been neglected for a long time. The renaissance of the ethics of vitrues goes back to the 60ies. It had shad light on many problematic issues of the ethic of rules, i. e. of deontologism and utilitarism, and presented itself as an alternative approach. Instead of the question "How should we act?" it focused on the question of the moral subject, i. e. on the problem of moral chracter. The paper examnies some (...) of the problems of the ethics of virtues. It deals with various definitions of the concept of virtue, as well as with the question wether it is to compete with the ethics of rules, or it is more probable today, that the two will enrich one another. The author also asks, whether the ethics of virues is still a valid ethical theory in our times. (shrink)

Research ethics, once a platform for declaring intent, discussing moral issues and providing advice and guidance to researchers, has developed over time into an extra-legal regulatory system, complete with steering documents (ethics guidelines), overseeing bodies (research ethics committees) and formal procedures (informed consent). The process of institutionalizing distrust is usually motivated by reference to past atrocities committed in the name of research and the need to secure the trustworthiness of the research system. This article examines some limitations of this approach. (...) First, past atrocities cannot provide the necessary justification unless institutionalized distrust is a necessary or efficient means to prevent future ones – and there are several reasons to doubt this. Second, the efficacy of ethics review in safeguarding morally acceptable research depends on the moral competence and integrity of individual researchers – the very qualities that institutionalized distrust calls into question. Third, ethics guidelines cannot, as is sometimes assumed, educate or guide researchers in moral behaviour unless they already possess considerable capacity for moral judgment. Fourth, institutionalized distrust is a potential threat to the moral competence and integrity of researchers by encouraging a blinkered view of ethical issues, inducing moral heteronomy through incentives, and alienating them to research ethics. We conclude that the moral problem posed by inappropriate short-term behaviour on behalf of researchers is dwarfed by the potential long-term consequences if their moral competence is allowed to deteriorate. Measures must therefore be taken to ensure that researchers are equipped to take their individual responsibility and are not obstructed from so doing. (shrink)

Ethical questions have traditionally been approached through conceptual analysis. Inspired by the rapid advance of modern brain imaging techniques, however, some ethical questions appear in a new light. For example, hotly debated trolley dilemmas have recently been studied by psychologists and neuroscientists alike, arguing that their findings can support or debunk moral intuitions that underlie those dilemmas. Resulting from the wedding of philosophy and neuroscience, neuroethics has emerged as a novel interdisciplinary field that aims at drawing conclusive relationships (...) between neuroscientific observations and normative ethics. A major goal of neuroethics is to derive normative ethical conclusions from the investigation of neural and psychological mechanisms underlying ethical theories, as well as moral judgments and intuitions. The focus of this article is to shed light on the structure and functioning of neuroethical arguments of this sort, and to reveal particular methodological challenges that lie concealed therein. We discuss the methodological problem of how one can—or, as the case may be, cannot—validly infer normative conclusions from neuroscientific observations. Moreover, we raise the issue of how preexisting normative ethical convictions threaten to invalidate the interpretation of neuroscientific data, and thus arrive at question-begging conclusions. Nonetheless, this is not to deny that current neuroethics rightly presumes that moral considerations about actual human lives demand empirically substantiated answers. Therefore, in conclusion, we offer some preliminary reflections on how the discussed methodological challenges can be met. (shrink)

"Teaching College Students How to Solve Real-Life Moral Dilemmas" will speak to the sometimes confounding, real-life, moral challenges that quarterlife students actually face each and every day of their lives. It will spell out an original, all-inclusive approach to thinking about, and applying, ethical problem-solving that takes into consideration people's acts, intentions, circumstances, principles, background beliefs, religio-spiritualities, consequences, virtues and vices, narratives, communities, and the relevant institutional and political structures. This approach doesn't tell students exactly what to do as (...) much as it evokes important information in order to help them think more deeply and expansively about ethical issues in order to resolve actual ethical dilemmas. There is no text like it on the market today. "Teaching College Students How to Solve Real-Life Moral Dilemmas" can be used in a variety of ethics courses. (shrink)

Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about (...) the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy. (shrink)

Background Home-based care workers mainly work alone in the patient’s home. They encounter a diverse patient population with complex health issues. This inevitably leads to several ethical challenges. Aim The aim is to gain insight into ethical challenges related to patient autonomy in home-based care and how home-based care staff handle such challenges. Research design The study is based on a 9-month fieldwork, including participant observation and interviews in home-based care. Data were analysed with a thematic analysis approach. (...) Participants and research context The study took place within home-based care in three municipalities in Eastern Norway, with six staff members as key informants. Ethical considerations The Norwegian Agency for Shared Services in Education and Research evaluated the study. All participants were competent to consent and signed an informed consent form. Findings A main challenge was that staff found it difficult to respect the patient’s autonomy while at the same time practicing appropriate care. We found two main themes: Autonomy and risk in tension; and strategies to balance autonomy and risk. These were explicated in four sub-themes: Refusing and resisting care; when choosing to live at home becomes risky; sweet-talking and coaxing; and building trust over time. Staff’s threshold for considering the use of coercion appeared to be high. Conclusions Arguably, home-based care staff need improved knowledge of coercion and the legislation regulating it. There is also a need for arenas for ethics reflection and building of competence in balancing ethical values in recurrent ethical problems. (shrink)

Ethical challenges are traditionally described in a negative light, even though moral conflict can express the individual ability to perceive when something is not working and promote change. The true question, therefore, is not to how to silence moral conflict but how to educate it. Although the need for ethical support of health- and social-care professionals in elderly care is clearly perceived, there is no universal method for providing effective interventions. The authors hypothesize that adequate training sessions can (...) help care professionals enhance this skill, once clear goals and specific educational techniques are set. This research tests the hypothesis on twenty care professionals working in acute and residential care settings for the elderly, building on the ethics round method. Mixed methods drawn from literature and the experience of educators were adapted to meet different educational goals. Moral issues can hardly be removed from a context characterized by increasing demand and decreasing resources, but they can be recognized and addressed with common efforts, a critical attitude, and a growth mindset. Enhancing these skills in qualified workers can help them accept the reality of work, release pressure, and identify common team goals. Introducing these skills before graduation can help future workers avoid unreal expectations and reduce frustration and early job quit rates. (shrink)

In this study, it was examined whether the Professional Ethics and Legal Issues course given at the undergraduate level contributes to the professional ethical competencies of the counselor candidates. The study group of the research consists of 63 senior guidance and psychological counseling students who took the “Professional Ethics and Legal Issues” course at a university located in the Central Black Sea Region of Turkey. Students participating in the study, 46 (73%) were female and 17 (27%) were male. Descriptive (...) statistics were used while analyzing the data of the research. In addition, the internal consistency coefficient of the pre-test and post-test applications of the data collection tool used in the research was calculated. In the study, whether there was a significant difference between the pre-test and post-test scores after the application was analyzed with the dependent groups t-test. In addition, the _Cohen d_ effect size coefficient was calculated to determine the effect sizes of the results obtained after the pre-test and post-test. Psychological Counseling Professional Ethical Competencies Evaluation Questionnaire (PCPECEQ) developed by the researcher was used as data collection tool. As a result of the analysis, it was revealed that the professional ethics and legal problems course has a significant effect on the ethical competencies of the counselor candidates. This result reveals that the professional ethics course taken at the undergraduate level is an important course in terms of professional ethics competencies of counselor candidates. Considering that one of the important reasons for the ethical dilemmas of counselors working in the field is their lack of professional ethics, a professional ethics course to be given correctly at the undergraduate level will help counselor candidates to cope with possible ethical problems more effectively. (shrink)

This article strives to make a critical assessment of the claim of discourse ethics, as articulated by Jürgen Habermas, to meet with the challenges of moral consciousness and communicative action today. The article locates Habermas' theory of discourse ethics in the contemporary movement to remoralize institutions and to build a post-conventional moral theory. It describes Habermas' agenda and looks into incoherences in his project in accordance with his own norms. Beginning with an internal critique of Habermas, the article, however, is (...) engaged in an interrogation of the Habermasian agenda from outside its own frame of reference precisely because the issues that the discovered tensions raise, cannot be resolved within the rationalist framework of Habermas. The article argues that in order to realize the lofty agenda of transformation that discourse ethics sets for itself, it must now make a dialogue with critical and practical spir ituality. It gives a brief sketch of the agenda of spiritual transformations that can help discourse ethics solve some of its own stated problems such as the problems of anthropocentrism and cognitive distantiation and be a transformative agent in thinking through the theory and practice of moral consciousness and communicative action today. (shrink)

This new edition of Professionalism and Ethics: Q & A Self-Study Guide for Mental Health Professionals thoroughly updates the highly regarded and groundbreaking first edition, offering the contemporary reader clinical wisdom and ethical guidance for challenging times. As with its predecessor, the second edition features commentaries by leaders in psychiatric ethics, plus two foundational chapters on ethics and professionalism in the field of mental health. These commentaries and introductory chapters provide an overview of essential ethical principles and concepts, (...) the professional obligations of the mental health clinician, common ethical tensions found in practice, ethical aspects of caring for special populations, and ethical issues in professional training and research. The introductory chapters are followed by case-oriented questions and answers on core concepts and topics in clinical care, medical research, and interactions with colleagues and trainees. Topics explored in-depth include authorship, disclosure, and ethical peer review for scientific publications; assisted suicide and euthanasia; professional voyeurism versus patient privacy online and on social media; the appropriate process for reporting an impaired colleague; and problems of burnout, work-life balance, and professional well-being. Professionalism and Ethics: Q & A Self-Study Guide for Mental Health Professionals poses and plumbs critically important ethical dilemmas in a compelling, down-to-earth way for today's practitioners and learners. (shrink)

Providing ethically competent care requires nurses to reflect not only on nursing ethics, but also on their own ethical traditions. New challenges for nurse educators over the last decade have been the increasing globalization of the nursing workforce and the internationalization of nursing education. In New Zealand, there has been a large increase in numbers of Chinese students, both international and immigrant, already acculturated with ethical and cultural values derived from Chinese Confucian moral traditions. Recently, several incidents involving (...) Chinese nursing students in morally conflicting situations have led to one nursing faculty reflecting upon how moral philosophy is taught to non-European students and the support given to Chinese students in integrating the taught curriculum into real-life clinical practice settings. This article uses a case study involving a Chinese student to reflect on the challenges for both faculty members and students when encountering situations that present ethical dilemmas. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:164 BOOK REVIEWS the " causes and remedies " of homosexuality (this entails a guarded challenge to the notion of " constitutional " homosexuality) and a special outreach to people with AIDS; a long endnote undertakes to defend the thesis that AIDS can sometmies he, at least in a qualified sense, divine punishment for sexual sin (p. 110 n. 4). Ashley's essay concludes with an apology for any unintended (...) offense resulting from imprecise or otherwise infelicitous expressions of his position; and he suggests that such lapses on the part of the CDF letter itself were " inevitable in a document that had to he brief and directly to the point in order to clear up the ambiguities with which this complex question has been obscured" (p. 109). My personal assessment is that Ashley has succeeded much better than CDF in minimizing such problems; he might have been even more successful had he not been so intent on downplaying or excusing the letter's undeniable faults in this regard. Of course, Ashley is here engaging in debate with the Vatican's critics; were he instead directly addressing CDF, his approach might well have been different. Even in the present context, however, as a better gesture toward gay and lesbian people wounded by the letter's simplistic and harsh prescriptions, it would have been well for Ashley to repeat the observation he once addressed to U.S. and Canadian bishops assembled in Dallas for a sexuality workshop (Feb. 2-6, 1981): "Overfacile solutions to the tragic dilemmas of life which people are experiencing make the Church appear smug and silly." The debate over this issue will continue, as indeed it must. The participants in this hook, notwithstanding problems on either side, have contributed significantly to the ongoing conversation and have set a high standard which we must hope will he emulated by all who carry the conversation forward. Pontifical, University of St. Thomas Rome, Italy BRUCE WILLIAMS, O.P. Perplexity in the Moral Life: Philosophical and Theological Considerations. By EDMUND N. SANTURRI. Charlottesville, Va.: The University Press of Virginia, 1988. Pp. 256. $35.00. Edmund Santurri has written an important book about a central issue in moral theory and a fundamental problem in the moral life. On occasion, one feels on the horns of a dilemma. Whatever course of action might he taken, it appears as if wrong will he done in the process of doing right. Thus, we want to keep promises, but if we keep BOOK REVIEWS 165 this promise, we will cause or allow some great harm to come to an· other person. How ought this sort of dilemma to he understood? Santurri argues that there are within the traditions of moral philosophy and theology two ways of construing the problem. One can say either that moral dilemmas of the sort Santurri discusses are the re· sult of deficient knowledge and so in principle resolvable, or that they stem from the structure of the moral universe itself and are in consequence not resolvable. It is Santurri's contention that Christian ethics must hold to the former position and defend the view that in all dilemmatic contexts there is a way to dispel moral perplexity through more adequate moral knowledge. In order to establish this thesis he undertakes a review of typical philosophical and theological literature that addresses the problem he has identified. Santurri's review of the philosophical literature, though on occasion unnecessarily dense, is always competent and generally thorough. Among others, he reviews the work of David Lyons, Bernard Williams, and Thomas Nagel. His conclusion is that philosophical argument can establish neither of the two possible views of moral dilemma as superior to the other. Arguments designed to establish both points of view prove inconclusive in the end because they beg more fundamental ques· tions concerning the content, nature, and function of morality itself. Thus, Santurri argues that moral perplexity cannot he interpreted adequately apart from a discussion of " certain fundamental questions of moral ontology " (p. 4), and he quite successfully shows that these questions are passed over or inadequately treated in the philosophical literature. The fundamental questions he lists are these: Are moral codes simply systems of convention or do these... (shrink)

This Special Issue questions a basic assumption in thinking about morality: the idea that the explicit articulation of moral commitments that usually remain implicit is the basis par excellence for dialogue and rapprochement between people of opposing views. Nicholas Adams shows in the main article of this Special Issue that there is a paradox behind this assumption concerning ethics itself: articulating moral commitments may end up undermining them. It inherently stands in tension with forms of life as people actually inhabit (...) them. Adams associates this basic paradox of ethics with the problem of forced articulation in particular discursive regimes, such as interreligious dialogue. The practice of Scriptural Reasoning is introduced as an alternative mode of dialogue that is less vulnerable to the distortions of articulation. The five response articles (by Petruschka Schaafsma, Ariën Voogt, Rob Compaijen, Dominique Gosewisch, and Sophia Höff) address aspects of Adams’ challenge to articulation in relation to morality, rather than the setting of interreligious engagement. They point out the value of articulation in spite of its inherent imperfection, or constructively elaborate on how to deal with the paradox of ethics as analyzed by Adams. Finally, Adams responds by addressing the concerns of these replies. (shrink)