Search

This Commentary critiques an extremely relational view of robot moral status, drawing out its practical implications for ethics and law. It also suggests next steps for AI ethics if extremely relational reasoning is compelling. Section I introduces the topic, distinguishing an ‘extremely relational’ view from more moderate relational views. Section II illustrates extremely relational views using the example of embodiment. Section III explores practical implications of extremely relational views for ethics and law. Section IV offers possible responses to extreme relationism. Section V concludes by suggesting next steps for AI ethics. [ABSTRACT FROM AUTHOR]

This Commentary critiques Paul Showler’s combination view of robot moral status, which combines sophisticated cognitive capacities like consciousness with highly valued machine-human relationships. Showler holds that a combined approach carries the advantage of more fully accounting for ordinary folk psychology views about of what it means to have moral standing and be a person. This commentary paper is largely sympathetic to Showler, but argues for a stronger view: being a person is a cluster concept that can include a combination of different possible sufficient conditions, none of which is necessary. What must be constrained, then, is the strong claim that a quality is necessary for personhood. Since most approaches that appeal to sophisticated cognitive capacities make the strong claim, they require constraint. Since most approaches that appeal to highly valued relationships, do not make the stronger claim, they generally do not require constraint. [ABSTRACT FROM AUTHOR]

This paper opens a critical conversation about the ethics of international bioethics conferencing and proposes principles that commit to being anti-discriminatory, global, and inclusive. We launch this conversation in the Section, Case Study, with a case example involving the International Association of Bioethics' (IAB's) selection of Qatar to host the 2024 World Congress of Bioethics. IAB's choice of Qatar sparked controversy. We believe it also may reveal deeper issues of Islamophobia in bioethics. The Section, Principles for International Bioethics Conferencing, sets forth and defends proposed principles for international bioethics conferencing. The Section, Applying Principles to Site Selection applies the proposed principles to the case example. The Section, Applying Principles Beyond Site Selection addresses other applications of the proposed principles. The Section, Objections responds to objections. We close (in the Section, Conclusion) by calling for a wider discussion of our proposed principles. One-Sentence Capsule Summary: How should bioethicists navigate the ethics of global bioethics conferencing? [ABSTRACT FROM AUTHOR]

This paper addresses bioethics in the context of the coronavirus disease 2019 (COVID‐19) pandemic. The Introduction (Section 1) highlights that at the field's inception, infectiousness was not front and center. Instead, infectious disease was widely perceived as having been conquered. This made it possible for bioethicists to center values such as individual autonomy, informed consent, and a statist conception of justice. Section 2 urges shifting to values more fitting for the moment the world is in. To find these, it directs attention to the Global South, and in particular, Africa, and to the values of ubuntu, solidarity, dignity, kinship, and humility. The paper concludes (in Section 3) that 21st‐century challenges facing bioethics are increasingly global, and calls on bioethicists themselves to be more globally inclusive in their approaches. [ABSTRACT FROM AUTHOR]

The article presents the discussion on practical fields like bioethics. Topics include addressing cutting-edge challenges like human-brain organoids, artificial intelligence (AI), and interspecies chimeras; and concern arises specifically when individuals lack intellectual capacities that Western views deem necessary for personhood, such as sentience, consciousness, autonomy, and rationality.

Social isolation and loneliness are growing concerns around the globe that put people at increased risk of disease and early death. One much‐touted approach to addressing them is deploying artificially intelligent agents to serve as companions for socially isolated and lonely people. Focusing on digital humans, we consider evidence and ethical arguments for and against this approach. We set forth and defend public health policies that respond to concerns about replacing humans, establishing inferior relationships, algorithmic bias, distributive justice, and data privacy. [ABSTRACT FROM AUTHOR]

Social robots are increasingly being deployed to address social isolation and loneliness, particularly among older adults. Clips on social media attest that individuals availing themselves of this option are pleased with their robot companions. Yet, some people find the use of social robots to meet fundamental human emotional needs disturbing. This article clarifies and critically evaluates this response. It sets forth a framework for loneliness, which characterizes one kind of loneliness as involving an affective experience of lacking human relations that provide certain social goods. Next, the article discusses social robots and critically reviews the literature on the ethics of using them in light of this loneliness characterization. Third, we present a normative argument connecting the philosophical critique of loneliness-as-absence with the design and deployment of social robots. Finally, we draw out the implications of our analysis for public health and for interrogating the aims of commercial companies who make social robots. [ABSTRACT FROM AUTHOR]

This letter replies to the letter "Colonial and Neocolonial Barriers to Companion Digital Humans in Africa," by Luís Cordeiro‐Rodrigues, in the same, May‐June 2024, issue of the Hastings Center Report. [ABSTRACT FROM AUTHOR]

Previously, we introduced a capability approach to assess the responsible use of brain-computer interface. In this commentary, we say more about the ethical basis of our capability view and respond to three objections. The first objection holds that by stressing that capability lists are provisional and subject to change, we threaten the persistence of human dignity, which is tied to capabilities. The second objection states that we conflate capabilities and abilities. The third objection claims that the goal of using neuroenhancements should be preserving capabilities, not altering them. [ABSTRACT FROM AUTHOR]

Global scarcity of COVID‐19 vaccines raises ethical questions about their fair allocation between nations. Section I introduces the question and proposes that wealthy nations have a duty of justice to share globally scarce COVID‐19 vaccines. Section II distinguishes justice from charity and argues that beneficiaries of unjust structures incur duties of justice when they are systematically advantaged at others expense. Section III gives a case‐based argument describing three upstream structural injustices that systematically advantaged wealthy countries and disadvantaged poorer countries, contributing to global disparities of COVID‐19 vaccines. Section IV examines more closely the duties of justice owed, including a duty to relinquish holdings, restitute victims, and restore relationships. Section V concludes that wealthy nations have a duty of justice to share COVID‐19 vaccines with poor nations and to restore relationships damaged by injustice. All nations should take steps to transform unjust structures. [ABSTRACT FROM AUTHOR]

With the development of increasingly sophisticated sociable robots, robot-human relationships are being transformed. Not only can sociable robots furnish emotional support and companionship for humans, humans can also form relationships with robots that they value highly. It is natural to ask, do robots that stand in close relationships with us have any moral standing over and above their purely instrumental value as means to human ends. We might ask our question this way, 'Are there ways we can act towards robots that would be wrong to the robot?' To address this, Part I lays out standard approaches to moral standing: appealing to intrinsic properties, human responses, and values inhering in relationships. Part II explores the third, relational strategy in detail. Looking beyond Western analyses, it considers Eastern philosophy and the environmental philosophy of 'deep ecology' and extends these approaches to sociable robots. Part III examines practical implications for the case of Samantha, a sex robot that was allegedly raped. Part IV identifies and replies to objections. [ABSTRACT FROM AUTHOR]

Intelligent neurotechnology is an emerging field that combines neurotechnologies like brain-computer interface (BCI) with artificial intelligence. This paper introduces a capability framework to assess the responsible use of intelligent BCI systems and provide practical ethical guidance. It proposes two tests, the threshold and flourishing tests, that BCI applications must meet, and illustrates them in a series of cases. After a brief introduction (Section 1), Section 2 sets forth the capability view and the two tests. It illustrates the threshold test using examples from clinical medicine of BCI applications that enable patients with profound disabilities to function at a threshold level through computer mediation. Section 3 illustrates the flourishing test by exploring possible future applications of BCI involving neuroenhancements for healthy people, using examples adapted from research currently underway in the US military. Section 3 applies a capability lens to a complex case involving dual effects, both therapeutic and non-therapeutic, showing how the threshold and flourishing tests resolve the case. Section 4 replies to three objections: neurorights are the best tool for assessing BCI; the two tests are moving targets; and the analysis utilizes a capability view to do work it is not designed for. The paper concludes that a capability view offers unique advantages and gives practical guidance for evaluating the responsible use of present and future BCI applications. Extrapolating from our analysis may help guide other emerging technologies, such as germline gene editing, expected to impact central human capabilities. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has highlighted the question, 'What do we owe each other as members of a global community during a global health crisis?' In tandem, it has raised underlying concerns about how we should prepare for the next infectious disease outbreak and what we owe to people in other countries during normal times. While the prevailing bioethics literature addresses these questions drawing on values and concepts prominent in the global north, this paper articulates responses prominent in sub-Saharan Africa. The paper first introduces a figurative 'global health village' to orient readers to African traditional thought. Next, it considers ethical requirements for governing a global health village, drawing on the ethic of ubuntu to formulate African renderings of solidarity, relational justice and sufficiency. The final section of the paper uses these values to critique current approaches, including COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) accelerator, and a proposed international Pandemic Treaty. It proposes a path forward that better realizes ubuntu in global health. [ABSTRACT FROM AUTHOR]

In 2022, the International Association of Bioethics (IAB) announced that the 17th World Congress of Bioethics would be held in Doha, Qatar. In response to ethical concerns expressed about the Qatar selection, the IAB Board of Directors developed and posted to the IAB website a response using a Q&A format. In this Letter, we (the IAB President and Vice President) address concerns about the ethics of bioethics conferencing raised in a 2023 Letter to the Editor of Bioethics by Van der Graaf et al. We do not represent the Board of Directors, and this Letter expresses solely our own views. [ABSTRACT FROM AUTHOR]

Societies of the East are often contrasted with those of the West in their stances toward technology. This paper explores these perceived differences in the context of international ethics guidance for artificial intelligence (AI) and robotics. Japan serves as an example of the East, while Europe and North America serve as examples of the West. The paper's principal aim is to demonstrate that Western values predominate in international ethics guidance and that Japanese values serve as a much-needed corrective. We recommend a hybrid approach that is more inclusive and truly 'international'. Following an introduction, the paper examines distinct stances toward robots that emerged in the West and Japan, respectively, during the aftermath of the Second World War, reflecting history and popular culture, socio-economic conditions, and religious worldviews. It shows how international ethics guidelines reflect these disparate stances, drawing on a 2019 scoping review that examined 84 international AI ethics documents. These documents are heavily skewed toward precautionary values associated with the West and cite the optimistic values associated with Japan less frequently. Drawing insights from Japan's so-called 'moonshot goals', the paper fleshes out Japanese values in greater detail and shows how to incorporate them more effectively in international ethics guidelines for AI and robotics. [ABSTRACT FROM AUTHOR]

This paper argues for global sharing of COVID‐19 treatments during the COVID‐19 pandemic and beyond based on principles of global solidarity. It starts by distinguishing two types of COVID‐19 treatments and models sharing strategies for each in small‐group scenarios, contrasting groups that are solidaristic with those composed of self‐interest maximizers to show the appeal of solidaristic reasoning. It then extends the analysis, arguing that a similar logic should apply within and between nations. To further elaborate global solidarity, the paper distinguishes morally voluntary, sliding‐scale, and mandatory versions. It argues for an all‐hands‐on‐deck approach and gives examples to illustrate. The paper concludes that during the COVID‐19 crisis, global solidarity is a core value, and global sharing of COVID‐19 treatments should be considered a duty of justice, not of charity. [ABSTRACT FROM AUTHOR]

This paper replies to a commentary by John-Stewart Gordon on our paper, “The Moral Standing of Social Robots: Untapped Insights from Africa.” In the original paper, we set forth an African relational view of personhood and show its implications for the moral standing of social robots. This reply clarifies our position and answers three objections. The objections concern (1) the ethical significance of intelligence, (2) the meaning of ‘pro-social,' and (3) the justification for prioritizing humans over pro-social robots. [ABSTRACT FROM AUTHOR]

This paper presents an African relational view of social robots’ moral standing which draws on the philosophy of ubuntu (humanness). The introduction (Section 1) places the question of moral standing in historical and cultural contexts. Section 2 demonstrates an ubuntu framework by applying it to the fictional case of a social robot named Klara, taken from Ishiguro’s novel, Klara and the Sun. We argue that an ubuntu ethic assigns moral standing to Klara, based on her relational qualities and pro-social virtues. Section 3 introduces a second fictional case, taken from McKeown’s novel, Machines Like Me, in which a social robot named Adam displays intrinsic qualities, such as sentience, rationality, and deductive moral reasoning, yet lacks close social ties to particular people. We argue that Adam is not a person in the African sense; however, he qualifies as a person according to many standard Western views, such as Kantian and utilitarian ethics. Section 4 further elaborates the African relational view by comparing the moral standing of social robots and humans in a forced choice scenario. Section 5 replies to objections. We conclude that an African relational approach captures important insights about the moral standing of social robots that many Western accounts miss and should be better incorporated into global frameworks for designing and deploying social robots. [ABSTRACT FROM AUTHOR]

Across sub‐Saharan Africa, bioethics is an emerging field of scholarly inquiry, informed by contextual features distinct to the region. A cultural mix comprised of Euro‐American influences, indigenous traditions, Christian faiths and Muslim communities, a bioethics for the sub‐Saharan region must be responsive to this milieu. This paper asks, what values and methods can best promote the practice of bioethics in Africa? We set forth a strategy that leans one way or another in response to contextual features of a particular setting. Since our aim is to be responsive to context, we begin with a series of cases and develop values and methods in response to each case as we work through its ethical analysis. Section I introduces a case involving setting priorities for public funding of services that produce large benefits for a small group of people, using the example of dialysis in Ghana. Section II presents a situation involving determining the permissibility of a double standard of quality for healthcare devices in rich and poor nations, using the example of explanting pacemakers from deceased people in wealthy nations for use by people in low‐ and middle‐income nations. Section III describes a scenario where international groups clash with religious and spiritual healers over the chaining of people with severe mental illness at prayer camps and healing centers in Ghana. Section IV articulates a three‐pronged strategy for engaging in bioethics brought to light by the case analyses and defends it against objections. Throughout the paper, we tag certain views 'African' and others 'Western' to indicate ethical beliefs commonly found in these regions and less commonly found elsewhere. We do not mean to imply that all Africans hold a certain ethical stance or that all Westerners do; nor do we mean to suggest that people outside these regions do not hold the views in question. [ABSTRACT FROM AUTHOR]

Stigmatization and sharming of healthcare workers in Japan during the coronavirus 2019 (COVID-19) pandemic reveal uniquely Japanese features. Seken , usually translated as 'social appearance or appearance in the eyes of others,' is a deep undercurrent woven into the fabric of Japanese life. It has led to providers who become ill with the SARS-CoV-2 virus feeling ashamed, while concealing their conditions from coworkers and public health officials. It also has led to healthcare providers being perceived as polluted and their children being told they were not welcome in schools. Although such experiences are not isolated to Japan and have appeared in other parts of the world, the cultural forces driving them in Japan are unique. Overcoming stigmatization and shaming of Japanese healthcare providers will require concerted efforts to understand cultural barriers and to view such practices as raising human rights issues affecting the safety and well-being of all. [ABSTRACT FROM AUTHOR]

This paper argues that we can see our lives as a snapshot happening now or as a moving picture extending across time. These dual ways of seeing our lives inform how we conceive of the problem of age group justice. A snapshot view sees age group justice as an interpersonal problem between distinct age groups. A moving picture view sees age group justice as a first-person problem of prudential choice. This paper explores these different ways of thinking about age group justice and illustrates them using a principle of respect for human dignity, understood in terms of reasonable support for floor level central human capabilities at each stage of life. I argue that different frames are suitable for different kinds of decisions, and each provides a true, but partial, picture of aging and age group justice. [ABSTRACT FROM AUTHOR]

Controlled human infection (CHI) studies involve the deliberate exposure of healthy research participants to infectious agents to study early disease processes and evaluate interventions under controlled conditions with high efficiency. Although CHI studies expose participants to the risk of infection, they are designed to offer investigators unique advantages for studying the pathogenesis of infectious diseases and testing potential vaccines or treatments in humans. One of the central challenges facing investigators involves the fair selection of research subjects to participate in CHI studies. While there is widespread agreement that investigators have a duty to select research participants fairly, this principle also yields conflicting ethical imperatives, for example requiring investigators to both exclude potential participants with co‐morbidities since they face increased risks, but also to include them in order to ensure generalizability. In this paper we defend an account of fair subject selection that is tailored to the context of CHI studies. We identify the considerations of fairness that bear directly on selecting participants for CHI studies and provide investigators and members of IRBs and RECs with a principled way to navigate the conflicting imperatives to which these considerations give rise. [ABSTRACT FROM AUTHOR]

The article stresses the need to prioritize frontline workers during the COVID-19 pandemic. Topics discussed include the best way to manage pandemics such as COVID-19, difference between pandemics and typical mass casualty events like mass shootings or earthquakes, and ethical argument for priority to healthcare personnel on the frontlines.

This commentary focuses on 12 narratives written by caregivers of people living with Alzheimer's Disease and other types of dementia. While each narrative is distinctive and particular telling, common themes woven throughout the narratives include: embarking on a journey; I changed and they changed; feelings elicited; the hardest and best parts; understandings and acceptance; intersections; and what the future holds. This commentary shares these common themes and how they play out in the lives of people caring for loved ones with dementia. The last section connects the narrative themes to bioethical inquiry, with a focus on discerning moral boundaries. The boundaries touched on relate to justice within families, caregiver self-respect, and the persistence of persons and personal relationships over time. [ABSTRACT FROM AUTHOR]

Is age discrimination ethically objectionable? One puzzle is that we sometimes assume that the target of both age discrimination and ageism must be older people, yet in poorer nations, older people are generally shown more respect. This article explores the ethical question. It looks first at ethical arguments favoring age discrimination toward younger people in low‐income, less industrialized countries of the global South, using sub‐Saharan Africa as an illustration. It contrasts these with arguments favoring age discrimination toward older people in high‐income, more industrialized countries of the global North, particularly the United States and United Kingdom. Finally, it considers what role, if any, differences in life expectancy, infant and child mortality, and prospects for healthy lives should play in the moral embrace of a particular view by a community. It argues that there can be reasons to favor different types of discrimination in different parts of the world. [ABSTRACT FROM AUTHOR]

Growing demand for direct care workers to assist care-dependent elderly people has created an opening for migrant workers from low- income nations to sell their services to middle and high-income nations. Using Singapore as a case example, we draw on capability theory to make the case that receiving nations that import direct care workers should be held to global justice standards that protect workers' floor level human capabilities. Specifically, we (1) show that Singapore and other receiving nations fail to protect human capabilities at a threshold level required by dignity; (2) identify specific human capabilities placed at risk; and (3) recommend standards for receiving nations that support central capabilities. As populations in both developed and developing nations are rapidly aging, these concerns could not be timelier. [ABSTRACT FROM AUTHOR]

While people are still alive, we owe them respect. Yet what, if anything, do we owe the newly dead? This question is an urgent practical concern for aged societies, because older people die at higher rates than any other age group. One novel way in which Japan, the frontrunner of aged societies, meets its need to accommodate high numbers of newly dead is itai hoteru or corpse hotels. Itai hoteru offer families a way to wait for space in over‐crowded crematoriums while affording an environment conducive to grieving. Drawing on conversations with itai hoteru employees, we delineate the values this contemporary death practice expresses and show how these values comprise part of the broader idea of a good death. A good death implies duties on both sides of death's divide: to both the dying and the newly dead. [ABSTRACT FROM AUTHOR]

Health care reform to provide long-term care supportive services for growing numbers of older Americans presents ethical, cultural, and political challenges. This paper draws lessons from Japan, the world's oldest nation, to develop an ethical argument in support of enacting public long-term care in the U.S. Despite cultural and political challenges, the paper shows that the ethical case for reform is strong, with broad ethical support from a range of ethical perspectives. [ABSTRACT FROM AUTHOR]

The authors comment on the reopening of economies during the COVID-19 pandemic. Topics discussed include basis made by U.S. states such as Washington in reopening, strategies for weighing competing values, and implications of the ethical guidelines for the varied responses to the COVID-19 pandemic evident around the world.

The article focuses on the fair subject selection in terms of four sub principles including fair inclusion, fair burden sharing, fair opportunity, and fair distribution of third-party risks. It mentions a principle of fair reparations is diachronic, triggered by past injustices; at the same time; and also mentions the larger picture of clinical research includes the quotidian things.

How should healthcare systems prepare to care for growing numbers and proportions of older people? Older people generally suffer worse health than younger people do. Should societies take steps to reduce age-related health inequalities? Some express concern that doing so would increase age-related inequalities in healthcare. This paper addresses this debate by (1) presenting an argument in support of three principles for distributing scarce resources between age groups; (2) framing these principles of age group justice in terms of life stages; and (3) indicating policy implications that merit further attention in light of rapidly aging societies. [ABSTRACT FROM AUTHOR]

Our aims are to (1) set forth a multiprinciple system for selecting among clinical trials competing for limited space in an immunotherapy production facility that supplies products under investigation by scientific investigators; (2) defend this system by appealing to justice principles; and (3) illustrate our proposal by showing how it might be implemented. Our overarching aim is to assist manufacturers of immunotherapeutic products and other potentially breakthrough experimental therapies with the ethical task of prioritizing requests from scientific investigators when production capacity is limited. [ABSTRACT FROM AUTHOR]

Do neurosurgical procedures ever result in the patient prior to the procedure not being identical with the individual who wakes up postsurgery in the hospital bed? We address this question by offering an analysis of the persistence of persons that emphasizes narrative, rather than numerical, identity. We argue that a narrative analysis carries the advantage of highlighting what matters to patients in their ordinary lives, explaining the varying degrees of persistence of personal identity, and enhancing our understanding of patients' experiences. We illustrate these points in cases involving temporal lobectomy for treatment of refractory epilepsy and deep brain stimulation for refractory Parkinson's disease. [ABSTRACT FROM PUBLISHER]

Two recent policy statements by major providers of critical care have rejected the concept and language of "medical futility," on the ground that there is no universal consensus on a definition. They recommend using "potentially inappropriate" or "inappropriate" instead. We argue that their proposed terms are vague-- even misleading--in the ICU setting, where serious life-and-death decisions are made. Whatever specific meaning the exclusive world of critical caie might wish to give to the word inappropriate, in the lay world the term is so broad it trivializes the activity. We also point out that there is no universal consensus on the definition of death, the right to abortion, or the right to refuse blood products, yet medicine carries on. One advantage of the term "medical futility" is that it confirms unambiguously that human beings are mortal, and medicine's powers are limited. It leads more naturally to integrating palliative and comfort care into critical care decision-making and encourages health providers to think more deeply about their role in the inevitable ending of their patients' lives. [ABSTRACT FROM AUTHOR]

The conventional wisdom about advance care planning holds that the normative force of my prior wishes is simply that they are mine. It is their connection to me that matters. This paper challenges conventional thinking. I propose that the normative force of prior wishes does not depend exclusively on personal identity. Instead, it sometimes depends on a special relationship that exists between a prior, capacitated person and a now incapacitated person. I consider what normative guidance governs persons who stand in a special relationship, and contrast these with the standard model of respect for autonomy. My conclusion is that advance care planning for individuals who have lost decision-making capacity should incorporate the virtues of prudence and integrity, even when one and the same person ceases to exist, and respect for personal autonomy is no longer relevant. [ABSTRACT FROM AUTHOR]

The author conveys her views on whether for-profit groups like pharmaceutical firm Pfizer have reason to consider the distributive effects of their actions or they are beholden only to shareholders. The market failure approach to corporate responsibility is discussed. Practice guidelines was issued by the United Nations in 2018 to help businesses translate principles of corporate citizenship into practice. Corporate citizenship means that companies like Pfizer have also duties to rightsholders.

The article presents the discussion on monetary incentives increasing COVID-19 vaccinations including immigrants concerning about deportation or Catholics troubled by fetal cell lines used in vaccine development.

The article presents the author's proposed guidelines for the appropriate emergency response to areas affected by the Ebola virus disease and the ethical treatment of patients afflicted with the disease. Topics discussed include an overview of the proposed guidelines, the author's assessment of the proposed guidelines based on scientific and ethical principles, and the author's contention that the proposed guidelines can also be applied to other diseases that are similar to the Ebola virus.

The author offers a defense of the Texas Advance Directive Law (TADA). Topics covered include how TADA's approach achieves a balance that recognizes the physician's duty to provide competent and professional care that helps the patient and the value of respecting the preferences of patients and surrogates and how it offers a method for overriding futility judgments made by individual providers while leaving medical decisions to people who are trained and experienced at making them.

The author discusses the ethics of rescue medicine. The author states that in tragic situations, rescue medicine renews hope and has the power to restore faith in human beings. The author notes that despite strong positive emotions, rescue efforts provoke chaos. The author mentions that when rescue medicine prevents other values such as long-term care and universal access to health care, it becomes unjust and an irrational system for allocating health care.

The author comments on ethical issues concerning kidney commercialization. Topics covered include the views of people opposing human organ commercialization as well as harms associated with kidney sales. Also mentioned are the different approaches to address problems associated with the proliferation of kidney sales in some countries.

The author offers insights on the use and necessity of cardiopulmonary resuscitation (CPR), in response to the article "Irrational Exuberance: Cardiopulmonary Resuscitation as Fetish" by P. M. Rosoff and L. J. Schneiderman, published within the issue. Topics explored include the perception of healthcare providers, patients, and the media on CPR, the need to consider patient outcomes associated with the procedure, and the need to respect wishes and values of the patient before performing CPR.

Is there a rational and ethical basis for efforts to rescue individuals in dire straits? When does rescue have ethical support, and when does it reflect an irrational impulse? This paper defines a Rule of Rescue and shows its intuitive appeal. It then proceeds to argue that this rule lacks support from standard principles of justice and from ethical principles more broadly, and should be rejected in many situations. I distinguish between agent-relative and agent-neutral reasons, and argue that the Rule of Rescue qualifies only in a narrow range of cases where agent-relative considerations apply. I conclude that it would be wise to set aside the Rule of Rescue in many cases, especially those involving public policies, where it has only weak normative justification. The broader implications of this analysis are noted. [ABSTRACT FROM PUBLISHER]

Our response to death may differ depending on the patient's age. We may feel that death is a sad, but acceptable event in an elderly patient, yet feel that death in a very young patient is somehow unfair. This paper explores whether there is any ethical basis for our different responses. It examines in particular whether a patient's age should be relevant to the determination that an intervention is medically futile. It also considers the responsibilities of health professionals and the rights of family members in situations where an interventions is clearly futile. [ABSTRACT FROM AUTHOR]

Focuses on historical approaches to adult moral development from the ancient Greek thought to the modern era. Identification of two accounts of moral maturation traced from roots in Greek thoughts; Vision and voice concerning love and reason; Discussion of themes on love and reason; Development versus difference.

Analyzes how a caregiver from the dominant United States culture and a patient from an immigrant, refugee or ethnic minority can resolve cross-cultural disputes about medical treatment, not by compromising important values but by focusing on the patient's goals. A practical ethical approach; Meeting ethical constraints; Analysis of two cases involving Navajo patients; Requirements and justification for three levels of ethical analysis.

Looks at the social and ethical responsibilities that private health insurers bear in the wake of expanded genetic testing capabilities. Current and future medical testing; DNA testing; Health care reform; Comments on the 1990 American with Disabilities Act (ADA).

Argues that justice must be considered in the analysis of physician's duties to abused patients. Privacy beliefs as barrier to physician's response to domestic violence; Beneficence and nonmaleficence towards abused patients; Self-respect as requirement of justice; Requiring domestic violence training in medical education; Treatment plans and protocols to identify abuse and provide assistance.