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The term slow code refers to an intentional reduction in the pace or intensity of resuscitative efforts during a medical emergency. This can be understood as an intermediate level between full code (full resuscitation efforts) and no code (no resuscitation efforts) and serves as a symbolic gesture when intervention is considered medically futile. While some previous research acknowledges the slow code as an integral part of clinical practice, many ethicists have condemned the practice as dishonest and causing unnecessary pain for the patient. As the public's views on this issue have been largely absent from the discussion to date, two vignette experiments were performed to investigate their perceptions. The findings indicate that laypersons believe that slow codes are commonplace and often prefer them over a no code. While a full code was perceived as the standard approach and rated most ethical and least punishable, the present results do not support the widespread assumption that laypersons generally oppose slow codes, and this finding should inform ethical discussion and clinical practice. [ABSTRACT FROM AUTHOR]

The article explores the collaboration between ethicists and pediatric palliative care providers to enhance patient care. Topics discussed include the reasons for ethics consult requests by palliative care clinicians, the overlapping skill sets between bioethics and palliative care, and the importance of clear communication and role definition in family meetings to address ethical dilemmas and treatment preferences.

The article provides answers to questions concerning the ethical challenges of elder mistreatment, focusing on surrogate decision-making intervention, caregiver capability assessments, and balancing patient safety with preferences for home care.

While some countries are moving toward legalization, euthanasia is still criticized on various fronts. Most importantly, it is considered a violation of the medical ethics principle of non-maleficence, because it actively seeks a patient's death. But, medical ethicists should consider an ethical alternative to euthanasia. In this article, we defend cryocide as one such alternative. Under this procedure, with the consent of terminally-ill patients, their clinical death is induced, in order to prevent the further advance of their brain's deterioration. Their body is then cryogenically preserved, in the hope that in the future, there will be a technology to reanimate it. This prospect is ethically distinct from euthanasia if a different criterion of death is assumed. In the information-theoretic criterion of death, a person is not considered dead when brain and cardiopulmonary functions cease, but rather, when information constituting psychology and memory is lost. [ABSTRACT FROM AUTHOR]

Background: Despite continuous performance improvements, especially in clinical contexts, a major challenge of Artificial Intelligence based Decision Support Systems (AI-DSS) remains their degree of epistemic opacity. The conditions of and the solutions for the justified use of the occasionally unexplainable technology in healthcare are an active field of research. In March 2024, the European Union agreed upon the Artificial Intelligence Act (AIA), requiring medical AI-DSS to be ad-hoc explainable or to use post-hoc explainability methods. The ethical debate does not seem to settle on this requirement yet. This systematic review aims to outline and categorize the positions and arguments in the ethical debate. Methods: We conducted a literature search on PubMed, BASE, and Scopus for English-speaking scientific peer-reviewed publications from 2016 to 2024. The inclusion criterion was to give explicit requirements of explainability for AI-DSS in healthcare and reason for it. Non-domain-specific documents, as well as surveys, reviews, and meta-analyses were excluded. The ethical requirements for explainability outlined in the documents were qualitatively analyzed with respect to arguments for the requirement of explainability and the required level of explainability. Results: The literature search resulted in 1662 documents; 44 documents were included in the review after eligibility screening of the remaining full texts. Our analysis showed that 17 records argue in favor of the requirement of explainable AI methods (xAI) or ad-hoc explainable models, providing 9 categories of arguments. The other 27 records argued against a general requirement, providing 11 categories of arguments. Also, we found that 14 works advocate the need for context-dependent levels of explainability, as opposed to 30 documents, arguing for context-independent, absolute standards. Conclusions: The systematic review of reasons shows no clear agreement on the requirement of post-hoc explainability methods or ad-hoc explainable models for AI-DSS in healthcare. The arguments found in the debate were referenced and responded to from different perspectives, demonstrating an interactive discourse. Policymakers and researchers should watch the development of the debate closely. Conversely, ethicists should be well informed by empirical and technical research, given the frequency of advancements in the field. [ABSTRACT FROM AUTHOR]

In 1975, The New England Journal of Medicine published James Rachels' article ‘Active and Passive Euthanasia’. The argumentative method that Rachels introduced, the Bare Difference Argument (also known as the Contrast Strategy), became one of the most widely used tools in ethical reasoning. The argument, however, fails to show active euthanasia being morally permissible. It fails because Rachels takes the intuitions from the case where letting die is morally impermissible and applies the intuitions to cases where letting die is morally permissible. While it is possible to create thought‐experiments that are more analogous to euthanasia, in this respect, than Rachels' cases, they too are disanalogous to euthanasia with some of the relevant features. Creating the perfect analogy, however, would be a mistake too. Such a case would be too analogous; people would simply be divided on what kind of moral intuitions they would have. The problem thus highlights a methodological limit in philosophical bioethics and raises questions related to the roles of philosophical ethicists in the context of assisted dying. [ABSTRACT FROM AUTHOR]

In this paper, I attempt to articulate a version of qualitative hedonism, grounded in the value theory of the British Moralists. I argue that this view is novel, presents substantial advantages over alternative hedonisms (including rival approaches to qualitative hedonism and its quantitative cousin), and can avoid classic challenges to qualitative hedonism that emerged in the post‐Mill era. If I succeed, this is a significant result for substantive value theory, given the dismissiveness with which qualitative hedonism is generally treated in the literature on the good. [ABSTRACT FROM AUTHOR]

This article explores the profound sexualization of seventeenth-century English religious polemic by examining the history of the popular "holy sister" stereotype as it evolved during the English Revolution (1640–60) from a relatively tame element of contemporary religious satire into a regular feature of obscene antipuritan print by the 1660 Restoration. In particular, it argues that the erotic evolution of the sisterhood was primarily a function of the English civil wars, which witnessed an unprecedented crisis in post-Reformation politics and a concurrent explosion in partisan print. Together with the endemic misogyny enflamed by the transgressive activities of actual puritan women, those factors inspired a dramatic escalation in sexually explicit confessional polemic during the period—a process spurred on by the long-standing early modern association between lust and lechery as well as the commercial motivations of contemporary printers and publishers. Eventually, royalist writers during the early 1650s purposefully made graphic sexuality a staple of their antipuritan polemic, reasoning that godly moralists would find nothing more offensive than obscene depictions of human sexuality. The essay goes on to assert that this novel association between antipuritanism and explicit sexual description continued well into the Restoration, when its continued success may have encouraged London publishers to greenlight new erotic genres in print for the first time in English history. Not only, therefore, did the English Revolution spark an unprecedented sexualization in contemporary religious polemic; it may also have contributed to the much-studied erotic renaissance that characterized late Stuart culture after Charles II's accession. [ABSTRACT FROM AUTHOR]

The article focuses on addressing ableism within medical education and clinical practice. Topics include the need for disability-inclusive curricula in medical training, the impact of ableist biases on healthcare decisions and patient care, and the role of ethicists in challenging and correcting these biases in both educational and clinical settings.

AbstractBioethics has dedicated itself to exploring and defending both reasons for and against certain aspects of clinical care, biomedical research and health policy, including what decisions must be made, who should make them, and how they should be made. In pediatrics, it’s widely acknowledged that parents’ reasons may matter pragmatically; attending to parents’ reasons is important if we want to work with families. Yet the conventional view in pediatric ethics is that parents’ reasons are irrelevant to whether a decision is permissible or impermissible according to accepted ethical standards. In this paper, we explore whether parents’ reasons matter ethically and, if so, in what way and for whom. First, we clarify what we mean by ‘reasons.’ Second, we provide an overview of how reasons are typically treated in medical decision-making and pediatric ethics. Third, we analyze a hypothetical pediatric case to illustrate how changing reasons can transform ethical analyses, including by contributing to where and how clinicians and ethicists draw the boundaries intrinsic to common pediatric ethical frameworks. We push back against the conventional view and argue that parents’ reasons matter ethically in several ways. We call for further research on the role of parents’ reasons in clinical ethics deliberation. [ABSTRACT FROM AUTHOR]

Speciesism, broadly understood as the view that species membership is a morally relevant property, has been a central topic of debate within animal ethics for around 50 years. However, in all this time, animal ethicists have paid relatively scant attention to the nature of species membership itself. This seems potentially regrettable, since species membership's precise nature is presumably highly pertinent to the question of its exact moral relevance. Here, I advocate for a 'species‐focused' approach to assessing speciesism, arguing that, in debating the merits of speciesism, animal ethicists should (i) centre the nature of species membership, and (ii) consult philosophers of biology. Adherence to this second prescription appears necessary since a lot of what philosophers of biology believe regarding the nature of species membership appears contrary to what many animal ethicists have seemingly assumed. [ABSTRACT FROM AUTHOR]

The article focuses on the complex ethical issues that ethicists face in medical-aid-in-dying (MAID) cases. Topics include the role of the American Clinicians Academy on Medical Aid in Dying (ACAMAID) Ethics Consultation Service in addressing ethical dilemmas; challenges faced by clinicians with limited access to ethics support; and the ethical considerations surrounding specific MAID scenarios.

In this article, we consider the intersection of cognitive motor dissociation (CMD) and artificial intelligence (AI), hence when CMD meets AI. In covert consciousness, there is a discordance between the observed behavior, the traditional bedside mode of assessment, and the response to volitional commands as depicted by neuroimaging or EEG studies. This alphabet soup of acronyms represents both the promise and peril of nascent technology in covert consciousness. On the diagnostic side, there is the complexity and uncertainty of identifying the discordance between cognitive activity and overt behavior. On the therapeutic side, when AI is used to generate speech, there is the possibility of misrepresenting the thoughts and intentions of those who are otherwise voiceless. This concordance of factors makes the application of AI to CMD worthy of deeper consideration. We offer this analysis in the spirit of anticipatory governance, a prudential process by which one plans to prevent or mitigate unintended consequences of novel technology. We first consider the normative challenges posed by CMD for clinical practice, neuroethics, and the law. We then explore the history of covert consciousness and the relationship of severe brain injury to the right-to-die movement, before introducing three biographies of brain injury that highlight the potential impact of disability bias or ableism in clinical practice, assistive technology, and translational research. Subsequently, we explore how AI might give voice to conscious individuals who are unable to communicate and the ethical challenges that this technology must overcome to promote human flourishing drawing upon what Nussbaum and Sen have described as a "capabilities approach" to promote normative reasoning. [ABSTRACT FROM AUTHOR]

Practical wisdom is the sine qua non of good conduct for Aristotelian virtue ethicists. Aristotelians conceive it as the virtue responsible for the intellectual side of good conduct, which involves having the right goal and deliberating well about what fulfils that goal, among other tasks. But is there any such trait as practical wisdom? Given the diversity of jobs practical wisdom is asked to do (seven goals are often enumerated), there may be a cluster of traits corresponding to what Aristotelians are talking about, so there really isn't one trait. In this paper, I defend a traditional Aristotelian position on practical wisdom, arguing that it is one thing despite having different functions. Following Thomas Aquinas, we can see practical wisdom as having parts. Those parts may be psychological components (integral parts) of the trait, or they may be derivative functions (virtual parts), things that someone with practical wisdom is also able to do because they have practical wisdom. Still, practical wisdom is one because it is a trait that functions to enable us to pursue the good as good; it possesses what I will call here 'practical unity' as the master virtue of praxis or acting well full stop. [ABSTRACT FROM AUTHOR]

Clinical Ethics Consultation (CEC) aims to resolve ethical dilemmas at the bedside. Through a structured process, CEC allows practitioners and patients to consult ethicists at times of moral conflict or uncertainty. Over the past few decades, CEC has become an invaluable part of healthcare practice. In Saudi Arabia, however, CEC services remain inexplicably underutilized. This study attempts to understand the factors associated with Saudi physicians’ utilization of CEC to better meet the needs of practitioners and patients. Results indicate that although physicians routinely experience moral dilemmas, they seldom request a CEC. This is not due to unfamiliarity, lack of accessibility, or suspicion of ethical expertise. Rather, reluctance is likely due to an ingrained medical cultural stronghold that pressures practitioners to act heroically, and to resolve ethical dilemmas independently. Recommendations to improve the utilization of CEC services include wider availability, active collaborations with clinical practitioners, routine quality improvements, and managerial and national support. [ABSTRACT FROM AUTHOR]

The paper aims to trace the distinctive character of the talk of the soul and to disentangle it from the talk of the mind. The key context will be the way in which we talk about souls that are ailing. As a point of departure, I use the later Wittgenstein's notion of the soul as anti‐dualist and anti‐substantive, which brings it close to Dennett's or Davidson's philosophy of mind, but which Wittgensteinian ethicists have elaborated upon as concerned with matters of good and evil, and beauty. In relation to these concerns, the sense of the ailing soul is different from issues relating to mental health. I then discuss cases of ailments of the soul that would be misleading to analyse as matters of mental health (issues): addiction, racism, and environmental grief. I conclude with a plea for maintaining the talk of the soul as helpful for making sense of existential or beauty‐ or morality‐related ailments, yet as something that does not necessarily subscribe to any doctrine of the soul as a substance. In support, I also use arguments from the spheres of eco‐theology and public theology. [ABSTRACT FROM AUTHOR]

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Copyright of Annals of Philosophy / Roczniki Filozoficzne is the property of John Paul II Catholic University of Lublin, Faculty of Philosophy and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Filosofija, Sociologija is the property of Lithuanian Academy of Sciences Publishers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Kant is usually considered a cold moralist who does not give any importance to feeling and emotions. In this paper I show that Kant has a place for love although he uses this word in different meanings through his work. I will analyze the use and meaning of five different uses of the term love: self-love, practical love, love as affect, love as passion, and sexual love. I show that Kant has a place for love in his theory, in a plurality of shades and meanings, going from the practical love to romantic love. Some of their expressions are meaningful for the moral life, such as practical love, some are not. Kant portrait romantic love as a silly affect, sometimes as a dangerous passion who can even call for medication. And about sex, he claims that it is nothing but the use of the other as a means, which may obtain a higher juridical status if this use is reciprocal, in the case of marriage. [ABSTRACT FROM AUTHOR]

Environmental ethicists often make claims about the intrinsic value of nature or parts thereof. Advances in intrinsic value theory, most notably Ben Bradley's 'Two Concepts of Intrinsic Value,' successfully cleave the concept of intrinsic value into two: a Moorean and Kantian variety. This paper seeks to classify and organize different environmental theorists within a Bradley-inspired framework, helping to bring clarity and charity to the claims of older and newer environmental ethicists. These two types of intrinsic value help explain why different thinkers have differing intuitions on e.g., culling cases. As well as valuing nature suis generis, the paper considers the value that might accrue from other relational properties in nature, such as beauty, biodiversity, and rarity. [ABSTRACT FROM AUTHOR]

In recent decades, it has often been argued by environmental ethicists that human beings and the natural world ought to be considered as equals in some basic sense. The aim of this paper is to make sense of this view by examining what role, if any, the idea of equality ought to play in environmental ethics. Specifically, we have two aims: the first aim is to identify those environmental claims that are distinctively egalitarian. The second aim is to show these claims do not rest on a principled and convincing justification. Our main contention is therefore that equality has no place in environmental ethics. There are other promising ways to argue that our relationship with the natural environment must be fundamentally revised. By bringing clarity to this debate and dispelling the possibility of equality-based arguments, we hope to contribute to this endeavor. [ABSTRACT FROM AUTHOR]

This paper explores the question of whether clinical ethicists should engage in prayer with patients to establish a deeper connection and gain a better understanding of their perspectives. By examining the ethical considerations, potential benefits, and limitations associated with prayer in clinical settings, this paper aims to contribute to the ongoing discourse surrounding the role of spirituality in health care. [ABSTRACT FROM AUTHOR]

Public decision-makers incorporate algorithm decision aids, often developed by private businesses, into the policy process, in part, as a method for justifying difficult decisions. Ethicists have worried that over-trust in algorithm advice and concerns about punishment if departing from an algorithm's recommendation will result in over-reliance and harm democratic accountability. We test these concerns in a set of two pre-registered survey experiments in the judicial context conducted on three representative U.S. samples. The results show no support for the hypothesized blame dynamics, regardless of whether the judge agrees or disagrees with the algorithm. Algorithms, moreover, do not have a significant impact relative to other sources of advice. Respondents who are generally more trusting of elites assign greater blame to the decision-maker when they disagree with the algorithm, and they assign more blame when they think the decision-maker is abdicating their responsibility by agreeing with an algorithm. [ABSTRACT FROM AUTHOR]

Translational science is justified as advancing the public's interests but has no mechanism for determining these interests. Standard social science approaches would produce either unrepresentative descriptions or a cacophony of data not easily condensed into a concrete conclusion about moving forward with a translational-science project. Here, I propose that the simplifying and structuring ethics employed by institutional review boards (IRBs) be used to create social science reports of the four to six most prominent values or principles of the public regarding a biotechnology. A board of bioethicists would weigh and balance these values to conclude whether the public supports a given translational-science innovation.

The article focuses on the potential for bioethicists to leverage their unique institutional relationships to promote racial justice within healthcare systems and universities. Topics include the distinctive strengths and challenges of the bioethics field; the importance of self-education and long-term advocacy for marginalized populations; and the need for bioethicists to extend their influence beyond their discipline to effect meaningful change in broader medical and educational contexts.

The article examines the persistent ableist bias among bioethicists as revealed by the Views in Bioethics Survey, which shows a prevalent belief that blindness is inherently disadvantaging despite evidence to the contrary. Topics discussed include the discrepancy between bioethicists' views and the lived experiences of blind individuals, the persistent influence of the disability-as-deficit model, and the implications for addressing inequities in healthcare and telehealth accessibility.

The article examines the VIBeS project, which surveys the views and demographics of American bioethicists to understand their divergence from public opinions. Topics discussed include the implications of these divergences for bioethicists' practices, the philosophical debate on how to handle peer disagreement, and the potential need for bioethicists to adjust their views based on public sentiment.

The article highlights the disconnect between U.S. bioethicists' views and those of clinicians and the general public, noting that bioethicists are often less diverse and thus less representative of broader society. Topics discussed include the need for bioethicists to better align with public perspectives, the importance of increased diversity within the field, and the value of integrating real-world experiences into bioethical research.

The article compares two surveys on bioethicists' views, one focused on U.S. bioethicists, and another targeting a broader international audience. Topics discussed include the perception of disability (medical vs. social models), the ethics of abortion, and the differences in bioethical concerns between American and international scholars.

The article focuses on the need for ethicists' assistance in addressing moral distress among nursing leaders. It reports that nurse leaders often lack support from their organizations in navigating moral distress, and it highlights the scarcity of research on this topic and the potential effectiveness of ethicist-led training programs in mitigating moral distress.

The article discusses the responsibility of ethicists to report significant ethical violations by physicians to state medical boards, including instances of patient abuse or unnecessary procedures. It highlights the need for consistent practices and suggests that while state medical boards can revoke licenses, disciplinary actions vary. It emphasizes ethicists can use reporting mechanisms within hospitals or communicate directly with hospital leadership to address such violations.

The central thesis of this article is that by anchoring bioethics' core conceptual armamentarium in a four‐principled theory emphasizing autonomy and treating justice as a principle of allocation, theorists inadvertently biased 20th‐century bioethical scholarship against addressing such subjects as ableism, anti‐Black racism, classism, and other forms of discrimination, placing them outside of the scope of bioethics research and scholarship. It is also claimed that these scope limitations can be traced to the displacement of the nascent concept of respect for persons—a concept designed to address classist and racist discrimination—with the morally solipsistic concept of autonomy. [ABSTRACT FROM AUTHOR]

During our workshop at the 2023 CBS-SCB Workshop and Community Forum, we explored and problematized the concept of “improvement” of clinical ethicists, situated within the larger context of discussions about the professionalization of clinical ethics. This summary provides key insights on this topic by clinical ethicists from across Canada and includes suggestions for steps that we might want to take in the field to enable and support the improvement of clinical ethicists going forward. [ABSTRACT FROM AUTHOR]

During the 2023 Canadian Bioethics Society forum, 28 practicing healthcare ethicists (PHEs) and other attendees from across Canada, including bioethics students and fellows, gathered virtually for a collaborative workshop entitled “Towards Evaluating Clinical Ethics Consultation Effectiveness: Engagement in a Scoping Review of Reported Outcomes”. The workshop was open to all members of the bioethics community who registered for the forum but was designed primarily for PHEs. [ABSTRACT FROM AUTHOR]

This paper summarizes the presentation and stakeholder feedback gathered from the Canadian Bioethics Society Workshop and Community Forum in May 2023, in a session entitled, “Clinical Ethics Fellowship in Canada: Making the Move Towards Standardization”. This summary provides insight into the clinical ethics fellowship landscape across Canada, including current gaps in the training of Canadian healthcare ethicists and opportunities to advance the journey towards standardization. [ABSTRACT FROM AUTHOR]

Virtue ethics is frequently billed as a remedy to the problems of deontological and consequentialist ethics that Bernard Williams identified in his critique of "the morality system." But how far can virtue ethics be relied upon to avoid these problems? What does Williams's critique of the morality system mean for virtue ethics? To answer this question, we offer a more principled characterisation of the defining features of the morality system in terms of its organising ambition—to shelter life against luck. This reveals the system to be multiply realisable: the same function can be served by substantively different but functionally equivalent ideas. After identifying four requirements that ethical thought must meet to function as a morality system, we show that they can also be met by certain constellations of virtue-ethical ideas, including notably Stoicism. We thereby demonstrate the possibility of virtue-ethical morality systems raising problems analogous to those besetting their deontological and consequentialist counterparts. This not only widens the scope of Williams's critique and brings out the cautionary aspect of his legacy for virtue ethics; it also offers contemporary virtue ethicists a more principled understanding of the functional features that mark out morality systems and lie at the root of their problems, thereby helping them avoid or overcome these problems. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges facing ethics programs in healthcare, including potential budget cuts leading to decreased staff or even program elimination as well as strategies to make ethics consultation more efficient and cost-effective.

Pediatric intervention principles help clinicians and health-care institutions determine appropriate responses when parents' medical decisions place children at risk. Several intervention principles have been proposed and defended in the pediatric ethics literature. These principles may appear to provide conflicting guidance, but much of that conflict is superficial. First, seemingly different pediatric intervention principles sometimes converge on the same guidance. Second, these principles often aim to solve different problems in pediatrics or to operate in different background conditions. The potential for convergence between intervention principles—or at least an absence of conflict between them—matters for both the theory and practice of pediatric ethics. This article builds on the recent work of a diverse group of pediatric ethicists tasked with identifying consensus guidelines for pediatric decision-making. [End Page 277] [ABSTRACT FROM AUTHOR]

In this article I defend a new argument against moralist theories of legitimacy and in favour of realist theories. Moralist theories, I argue, are vulnerable to ideological and wishful thinking because they do not connect the demands of legitimacy with the interests of rulers. Realist theories, however, generally do manage to make this connection. This is because satisfying the usual realist criteria for legitimacy – the creation of a stable political order that transcends brute coercion – is usually necessary for rulers to preserve their rule. [ABSTRACT FROM AUTHOR]

Background: Whether patients' life-style should involve lower priority for treatment is a controversial question in bioethics. Less is known about clinicians' views. Aim: To study how clinical doctors' attitudes to questions of patient responsibility and priority vary over time. Method: Surveys of doctors in Norway in 2008, 2014, 2021. Questionnaires included statements about patients' lifestyle's significance for priority to care, and vignettes of priority cases (only in 2014). Results: Attitudes were fairly stable between 2008 and 2021. 17%/14% agreed that patients' lifestyle should count, while 19%/22% agreed that it should involve lower priority to scarce organs. 42/44% agreed that smokers should have lower priority. Substantially more agreed in 2014. Regression analyses showed that being male, working in hospital, and younger age increased the likelihood of agreeing. Conclusion: A substantial minority of doctors agreed that lifestyle should be a priority criterion, possibly contrary to Norwegian legislation and professional ethics. The finding might be explained by the unspecified meaning of priority, increased scarcity-awareness, or socio-cultural trends towards individualism. The 2014 results indicate a framing effect; the vignettes may have primed the respondents towards accepting lifestyle as a criterion. We conclude that attitudes to normative questions are unstable and depend on context. A substantial minority of doctors seems to be positive to deprioritizing patients allegedly responsible for their illness. However, what deprioritization implies in practice is not clear. [ABSTRACT FROM AUTHOR]

During a clinical ethics fellow's first week of independent supervised service, two unhoused patients on the same floor were resisting the medical team's recommendations to discharge. In the team's view, both were medically stable and no longer required hospitalization in an acute setting. The medical team suspected malingering for both. The social worker and case manager had employed their usual means of gentle persuasion and eliminating psychosocial barriers to no avail. Rather than call the police, the attending physician, social worker, and case manager decided to call ethics. These cases lead the fledgling fellow to consider the appropriate role for ethicists in difficult discharge cases. The article analyzes each case, evaluates their similarities and differences in the context of suspected malingering, and comments on ethical issues surrounding cases of suspected malingering. Finally, the authors reflect on the value and importance of developing and maintaining epistemic and professional independence. [ABSTRACT FROM AUTHOR]

Bernard Mandeville's theory of morality – 'private vices, public benefits' – provides a frame for comparing Adam Smith and David Hume on utility. Mandeville held that vice, not virtue, is useful for society. For him, the private and public good do not align. What is bad for individuals is often beneficial for society and vice versa. To counter Mandeville's rhetoric and show the attractiveness of virtue, Hume places the principle of utility at the center of his An Enquiry concerning the Principles of Morals (1751). This placement directs the reader's attention away from the lack of alignment between private and public advantage and enables Hume to 'dress' moral virtue in utility and pleasure. Smith, by contrast, places the principle of propriety at the center of The Theory of Moral Sentiments (1759). This is because he is closer in spirit to Mandeville than is Hume in acknowledging a gap between the private and public good. By directing the reader's attention to this gap in Part IV, Smith tries to show, contra Hume, that the principle of propriety, not utility, better explains and defends praiseworthy action and choice in an imperfect world. [ABSTRACT FROM AUTHOR]

The principle of clinical equipoise has been variously characterized by ethicists and clinicians as fundamentally flawed, a myth, and even a moral balm. Yet, the principle continues to be treated as the de facto gold standard for conducting randomized control trials in an ethical manner. Why do we hold on to clinical equipoise, despite its shortcomings being widely known and well-advertised? This paper reviews the most important arguments criticizing clinical equipoise as well as what the most prominent proposed alternatives are. In the process, it evaluates the justification for continuing to use clinical equipoise as the gold standard for randomized control trials. [ABSTRACT FROM AUTHOR]

This article provides an overview of William James's ethical writings, focusing on the concept of "responsible self-fashioning." The author argues that James's ethical framework involves the pursuit of a significant life through the strenuous pursuit of ideals, while also emphasizing ethical constraints such as tolerance, inclusivity, and efforts to overcome moral blindness. James's philosophy is seen as a balance between the perspectives of social moral philosophers, who aim to create an inclusive moral order, and existential moral philosophers, who help individuals find meaning in the face of suffering. The article also explores James's views on significant living, the moral self, and the connection between his ethics and his "will to believe" doctrine. The author concludes by extending James's ethics to include cognitively disabled humans and nonhuman animals, arguing for strong obligations towards nonrational conscious subjects and the need to overcome moral blindness to different perspectives. [Extracted from the article]

Well-functioning modern democracies depend largely on expert knowledge and expert arrangements, but this expertise reliance also causes severe problems for their legitimacy. Somewhat surprisingly, moral and political philosophers have come to play an increasing role as experts in contemporary policymaking. The paper discusses different epistemic and democratic worries raised by the presence of philosopher experts in contemporary governance, relying on a broad review of existing studies, and suggests measures to alleviate them. It is argued that biases philosophers are vulnerable to may contribute to reducing the quality of their advice, and that the characteristics of philosophers' expertise, and controversies around what their competences amount to, make it hard to distinguish proper from less proper philosopher experts. Reliance on philosopher experts may also intensify democratic worries not least due to the depoliticization pressures that the introduction of ethics expertise tends to give rise to. Still, philosophers have competences and orientations that policy discussions and democratic deliberations are likely to profit from. Worries about philosopher experts may moreover be mitigated by means of a proper design of expert arrangements. Confronted with the genuine epistemic risks and democratic challenges of contemporary governance any quick fix is obviously unavailable, but when institutionalized in the right way philosophers' involvement in present-day policymaking bears significant promise. [ABSTRACT FROM AUTHOR]

Whether or not there is such a thing as moral expertise, and, if so, what constitutes it, is much debated. Empirical expertise bestows epistemic authority over propositional content; that is not the case in moral domains, technical expertise notwithstanding. This article identifies three types of agencies with some authority over decisions in moral matters. It shows that the source of the authority wielded by such agencies, while varying across the three forms identified, is based on empirical and technical knowledge and does not derive solely from any moral expertise of its members. The article examines, and finds wanting, two recent arguments for giving others authority over moral content. [ABSTRACT FROM AUTHOR]

Ethics commissions are government advisory commissions mandated to give expert advice on contentious moral issues. As this requires making explicit value judgments, members with expert knowledge of ethics have a natural place as members of such commissions. Apart from these commissions being widespread, their recommendations assume a special normative authority within the legislative process. This raises many fundamental questions concerning the nature of moral expertise and how such commissions should deal with the political contexts in which they operate. Through a reading of the relevant discussions in the literature in which the underlying normative ideals are located, this article reconstructs four normative models of the proper role of ethics commissions. This reconstruction seeks to contribute to analytical clarity and to elucidate the underlying disagreements concerning our expectations of ethics commissions. The four models, labeled 'commission consensus model', 'society-proxy model', 'correctness model', and 'deep pluralism model', differ from one another in terms of two main dimensions: the expertise and the public/political dimensions. After describing the models, giving examples from the literature on how they can be explicated, and describing an empirical example of a commission that has approximated the ideals, the strengths and weaknesses of the four models are discussed before the article concludes by asking whether there is one correct model of ethics commissions. [ABSTRACT FROM AUTHOR]