Volume 25, Issue 3, March 2025, Page 73-76.

In lieu of an abstract, here is a brief excerpt of the content:Extramarital Contraception in the Catholic Faith:A Call to Action from a Physician and EthicistCara BuskmillerIntroductionDefinitionsBefore proceeding to a discussion of extramarital contraception, it is relevant to lay a foundation of definitions and limitations of this essay. Here, "sex" and "sexual act" will refer to acts of penile–vaginal intercourse and acts meant to lead to such intercourse, respectively. Other acts which are rightly called "sexual" are not relevant to this (...) essay, as the focus here is on encounters that could result in fertilization.The traditional natural law theory with its analysis of object, intention, and circumstances is at play in this essay, with a hylomorphic understanding of nature and ethics. In this understanding of ethics, the names of many acts include not only an object but an intention and circumstances (e.g., murder specifies an illegal type of killing with premeditation). Likewise, "contraception" here refers to the use of any drug or device which temporarily lowers fertility (object), to prevent fertilization (intention) due to presumed-fertile sex (circumstance). Such drugs or devices are called "contraceptives" in this essay. In this essay, "contraception" is not committed solely by intending to avoid fertilization, so acts such as trying to avoid fertilization by timing sex during infertile parts of a menstrual cycle are not contraception, and the pastoral term "contraceptive mindset" does not apply. "Contraception" is also not solely defined by the use of particular medical products, since the intention to avoid fertilization is part of the definition in this essay. Thus, [End Page 1245] prescribing or taking a birth control pill for polycystic ovarian syndrome, in the words of Pope St. Paul VI in his 1968 landmark encyclical Humanae Vitae (HV), is not at all illicit, here because such treatment is not contraception, and the problems of contraception do not apply (§15)."Marriage" in this essay refers principally to sacramental matrimony, made by the consent of a baptized man and a baptized woman.1 Civil marriage, cohabitation, long-term affairs, sex in dating, short-term hookups, prostitution, and sexual assault represent a spectrum of falling away from matrimony. This essay assumes that matrimony is God's one true plan for sex, fertilization, and childrearing. This essay also makes heavy use of the Scholastic-personalist perspective of HV on the unitive and procreative dimensions of sex. As sexual relationships "fall away" from matrimony, they lose resemblance to these dimensions."Consent" is here defined as a free act in which a person agrees to do, accept, or reject something.2 Consent is an act of the will, and it may be partial or total. Only when consent is total is a person held fully responsible for his or her actions; for example, only when consent is total can a person commit a mortal sin. Consent is different from assent, which is not of the will, but of the mind.3 In this paper, sex without consent is termed "sexual assault"—the status of the act as an assault is solely determined by consent. These definitions allow for a sexual assault in which a victim withholds consent and yet does not resist an attack,4 which is different from past legal and colloquial definitions.5 This definition also allows for assault victims that have positive emotional responses to or physical arousal from an attack. These responses from a victim do not make the assault consensual or desired, [End Page 1246] and in fact make post-traumatic recovery more difficult.6 Simply put, consent is of the will, and this is not diminished by whether the body follows suit; this differs from some legal definitions of consent in canon law, where the will of the person agreeing to a contract is signified by externals, even if there was no intention to fulfill the duties of the contract.7 Consent will be central to this essay, since it helps make the spectrum of relationships that "fall away" from marriage intelligible in two sets: one with consent, and one without."Intellectual disability" in medical and ethical literature refers to a large spectrum of differences in mental and behavioral performance, but this essay is only considering intellectually disabled persons who would be unable to... (shrink)

A correct understanding of Hume's sentimentalism cleared away the alleged difficulties of his sentimentalism; this chapter shows how a correct understanding of Nietzsche's attacks on “morality” and altruism removes the difficulties of his egoism. The chapter investigates what it is to affirm one's own life, and what is involved in self‐sacrificing altruism. It also shows how affirming one's own life can be compatible with “working for one's fellow men”. One has seen that virtuous egoism is consistent with “overflowing” “gift‐giving” but (...) the overflowing nature of giving is not sufficient for virtuous egoism. Full virtue requires the social feeling of the “collective‐individual.” Finally, one should recall that consequentialism for Nietzsche is the most shallow and “immature” of all the major types of moral theory, simply because it assesses states and actions solely in terms of their consequences, rather than in terms of the depth psychological states of individuals. (shrink)

Xunzi (c. 313–238 BC), original name Xun Kuang, honorary name Xun Qing, or Sun Qingzi, was a native of the Zhao Kingdom in the late Warring States period. He was one of the Jixia scholars (Ji, the capital city of Qi, Linzi, now part of Zibo, Shandong Province) in the Qi Kingdom and was repeatedly elected as the “Ji Jiu” (leader) of the school. As one of the most outstanding materialist thinkers of the pre-Qin dynasty, Xunzi was revered by scholars (...) of the time. (shrink)

Contemporary literature investigating the significant impact of technology on our lives leads many to conclude that ethics must be a part of the discussion at an earlier stage in the design process i.e., before a commercial product is developed and introduced. The problem, however, is the question regarding how ethics can be incorporated into an earlier stage of technological development and it is this question that we argue has not yet been answered adequately. There is no consensus amongst scholars as (...) to the kind of ethics that should be practiced, nor the individual selected to perform this ethical analysis. One school of thought holds that ethics should have pragmatic value in research and design and that it should be implemented by the engineers and/or scientists themselves, while another school of thought holds that ethics need not be so pragmatic. For the latter, the ethical reflection can aim at a variety of goals, and be carried out by an ethicist. None of the approaches resulting from these lines of thinking have been adopted on a wide-scale basis. To that end, the approach presented here is intended to bridge the gap between these schools of thought. It is our contention that ethics ought to be pragmatic and to provide utility for the design process and we maintain that adequate ethical reflection, and all that it entails, ought to be conducted by an ethicist. Thus, we propose a novel role for the ethicist—the ethicist as designer—who subscribes to a pragmatic view of ethics in order to bring ethics into the research and design of artifacts—no matter the stage of development. In this paper we outline the series of steps that a pragmatic value analysis entails: uncovering relevant values, scrutinizing these values and, working towards the translation of values into technical content. In conclusion, we present a list of tasks for the ethicist in his/her role as designer on the interdisciplinary team. (shrink)

Do bioethicists have an obligation to speak out against such atrocities as Hamas' terrorism and Israel's war crimes? I will argue that they do have such an obligation, but not because they are bioethicists or even ethicists. Before driving home this conclusion, I will highlight some crucial facts in applying criteria for ethical engagement in warfare. Although I maintain that Hamas' terrorist attack of October 7 involved crimes against humanity that deserve condemnation, here I will focus on Israel's subsequent conduct, (...) the ethical significance of which has been insufficiently appreciated among those who embrace a highly prevalent double standard. (shrink)

Ethicists are experts in ethics such as academic scholars who mainly focus on research and the teaching of ethical theories (philosophers specialized in ethics) and practitioners engaged in the application of ethics to different realms of social and professional activity (advisors or consultants in codes of ethics and professional ethics dilemmas).

In recent years, there have been growing calls for nurses to have a formal advanced practice role as nurse ethicists in hospital contexts. Initially proposed in the cultural context of the USA where nurse ethicists have long been recognised, the idea is being advocated in other judications outside of the USA such as the UK, Australia and elsewhere. Such calls are not without controversy, however. Underpinning this controversy are ongoing debates about the theoretical, methodological and political dimensions of clinical ethics (...) support services generally, and more recently where nurses might ‘fit’ within such a service. In considering whether nurse ethicists ought to have a place in clinical ethics support services, a number of questions arise such as: Is such a role warranted? If so, what credentials should nurses assuming the title of ‘nurse ethicist’ be required to have? What standards of practice ought nurse ethicists be required to uphold? What is the ultimate role and function of nurse ethicists in hospital contexts? And in what contexts might a nurse ethicist be most useful? In this essay, brief attention will be given to addressing these questions. It will be concluded that, as a minimum, nurses wishing to assume an advanced nursing practice role as a nurse ethicist must have substantive grounding in the foundational knowledge of the disciplines of both moral philosophy and nursing ethics. They must also not lose sight of the ultimate goal of nursing ethics, notably, to promote and advance ethical nursing practice and the provision of ‘good’ nursing care. (shrink)

If explicit cognition about morality promotes moral behavior then one might expect ethics professors to behave particularly well. However, professional ethicists' behavior has never been empirically studied. The present research examined the rates at which ethics books are missing from leading academic libraries, compared to other philosophy books similar in age and popularity. Study 1 found that relatively obscure, contemporary ethics books of the sort likely to be borrowed mainly by professors and advanced students of philosophy were actually about 50% (...) more likely to be missing than non-ethics books. Study 2 found that classic (pre-1900) ethics books were about twice as likely to be missing. (shrink)

In this article, we explore how to engage with the work of ethicists facing public allegations of professional sexual misconduct. Rather than disengaging or proceeding as usual, we propose citing their work alongside impartial information about credible allegations. We choose to isolate the work of ethicists as the target of this proposal because ethicists are distinct on two fronts: they are distinct among philosophers because they have moral authority, and distinct among others with moral authority, such as religious leaders and (...) civil rights activists, because their power is reproduced in part through citations. Our approach offers a nuanced perspective on the power conferred through citations. We argue that individual scholars have a moral and intellectual responsibility to cite using this practice, especially when institutional enforcement of justice is lacking. (shrink)

Assisted dying (AD) presents a range of challenges for clinical ethicists (CEs) and healthcare institutions seeking to involve them in its provision. Questions regarding the legitimacy, scope, and nature of CE involvement remain underexplored in the literature. This article addresses this gap by first outlining the professional standards that guide CE practice and presenting arguments for the value of ethics expertise in AD contexts. We then examine the Canadian MAiD landscape and draw on the experiences of CEs—particularly within a healthcare (...) institution in Quebec—to propose a typology of roles that CEs have occupied at various moments and levels throughout the emergence and institutionalization of AD. These roles span micro to macro levels of involvement and reflect both practical contributions and normative considerations. In the final section, we return to the foundational normative questions raised at the outset—not to offer definitive answers, but to contribute meaningfully to ongoing reflection about CE involvement in AD. By analyzing professional standards alongside the diverse roles CEs have played, we assess the benefits and challenges of their participation in this ethically complex domain and offer guidance for institutions seeking to engage ethics expertise in AD policy and practice. (shrink)

If philosophical moral reflection improves moral behavior, one might expect ethics professors to behave morally better than socially similar non-ethicists. Under the assumption that forms of political engagement such as voting have moral worth, we looked at the rate at which a sample of professional ethicists—and political philosophers as a subgroup of ethicists—voted in eight years’ worth of elections. We compared ethicists’ and political philosophers’ voting rates with the voting rates of three other groups: philosophers not specializing in ethics, political (...) scientists, and a comparison group of professors specializing in neither philosophy nor political science. All groups voted at about the same rate, except for the political scientists, who voted about 10–15% more often. On the face of it, this finding conflicts with the expectation that ethicists will behave more responsibly than non-ethicists. (shrink)

Do professional ethicists behave any morally better than other professors do? Do they show any greater consistency between their normative attitudes and their behavior? In response to a survey question, a large majority of professors (83 percent of ethicists, 83 percent of nonethicist philosophers, and 85 percent of nonphilosophers) expressed the view that “not consistently responding to student e-mails” is morally bad. A similarly large majority of professors claimed to respond to at least 95 percent of student e-mails. These professors, (...) and others, were sent three e-mails designed to look like queries from students. Ethicists’ e-mail response rates were not significantly different from the other two groups’. Expressed normative view correlated with self-estimated rate of e-mail responsiveness, especially among the ethicists. Empirically measured e-mail responsiveness, however, was at best weakly correlated with self-estimated e-mail responsiveness; and professors’ expressed normative attitude was not significantly correlated with empirically measured e-mail responsiveness for any of the three groups. (shrink)

Because the United States has failed to provide a pathway to citizenship for its long-term undocumented population, clinical ethicists have more than 20 years of addressing issues that arise in caring for this population. I illustrate that these challenges fall into two sets of issues. First-generation issues involve finding ethical ways to treat and discharge patients who are uninsured and ineligible for safety-net resources. More recently, ethicists have been invited to help address second-generation issues that involve facilitating the presentation for (...) care of undocumented patients. In the current environment of widespread fear of deportation in the immigrant community, ethicists are working with health care providers to address patient concerns that prevent them from seeking care. I illustrate that in both generations of issues, values implicit within health care, namely, caring, efficiency, and promotion of public health, guide the strategies that are acceptable and recommended. (shrink)

If philosophical moral reflection tends to promote moral behavior, one might think that professional ethicists would behave morally better than do socially comparable non-ethicists. We examined three types of courteous and discourteous behavior at American Philosophical Association conferences: talking audibly while the speaker is talking (versus remaining silent), allowing the door to slam shut while entering or exiting mid-session (versus attempting to close the door quietly), and leaving behind clutter at the end of a session (versus leaving one's seat tidy). (...) By these three measures, audiences in ethics sessions did not appear to behave any more courteously than did audiences in non-ethics sessions. However, audiences in environmental ethics sessions did appear to leave behind less trash. (shrink)

Ethicist assumptions about the causes and solutions of environmental problems are widely held within environmental philosophy. It is typically assumed that an important cause of problems are the attitudes towards the natural environment held by individuals and that problems can be solved by getting people to adopt a more ethical orientation towards the environment. This article analyses and criticises these claims. Both the highly mediated nature of the relationship between individuals and the natural environment and the pervasive pressure on (...) firms in market economies to reduce their costs provide reasons to question the ethicist assumptions. (shrink)

Ethics has been central to the nursing profession. Challenges in patient care have arisen through advances in medicine through science and technology. These advances have led to patients being sustained in ethically difficult situations. Nurses have uniquely witnessed both the suffering of patients and rendered care for extended periods of time at the bedside. Through these caring relationships nurses have developed expertise in advocating for their patients. Many nurses have also returned to graduate school to develop their nursing science and (...) ethical reasoning. Recently, the field of nursing has developed the role of the nurse ethicist. Nurse ethicists often also work as clinical ethics consultants. Additionally, nursing has advanced to include nurse practitioners as advanced practice nurses. Nurse practitioners have also obtained additional education in ethical reasoning and are working in roles similar to nurse ethicists and clinical ethicists. Given the science and nature of the nurse practitioner there may be unique facets to nurse practitioners who are ethicists. To date there are no proposals for nurse practitioner ethicists. Let this be the first proposal addressing the distinctions of the nurse practitioner ethicist. (shrink)

Background: Demand for organisational ethics capacity is growing in health organisations, particularly among managers. The role of clinical ethicists in, and perspective on, organisational ethics has not been well described or documented in the literature. Objective: To describe clinical ethicists’ perspectives on organisational ethics issues in their hospitals, their institutional role in relation to organisational ethics, and their perceived effectiveness in helping to address organisational ethics issues. Design and Setting: Qualitative case study involving semi-structured interviews with 18 clinical ethicists across (...) 13 health organisations in Toronto, Canada. Results: From the clinical ethicists’ perspective, the most pressing organisational ethics issues in their organisations are: resource allocation, staff moral distress linked to the organisation’s moral climate, conflicts of interest, and clinical issues with a significant organisational dimension. Clinical ethicists were consulted in particular on issues related to staff moral distress and clinical issues with an organisational dimension. Some ethicists described being increasingly consulted on resource allocation, conflicts of interest, and other corporate decisions. Many clinical ethicists felt they lacked sufficient knowledge and understanding of organisational decision-making processes, training in organisational ethics, and access to organisational ethics tools to deal effectively with the increasing demand for organisational ethics support. Conclusion: Growing demand for organisational ethics expertise in healthcare institutions is reshaping the role of clinical ethicists. Effectiveness in organisational ethics entails a re-evaluation of clinical ethics training to include capacity building in organisational ethics and organisational decision-making processes as a complement to traditional clinical ethics education. (shrink)

Lists of paid registrants at Pacific Division meetings of the American Philosophical Association from 2006–2008 were compared with lists of people appearing as presenters, commentators or chairs on the meeting programme those same years. These were years in which fee payment depended primarily on an honour system rather than on enforcement. Seventy-four per cent of ethicist participants and 76% of non-ethicist participants appear to have paid their meeting registration fees: not a statistically significant difference. This finding of no (...) difference survives scrutiny for several possible confounds. Thus, professional ethicists seem no less likely to free-ride in this context than do philosophers not specializing in ethics. These data fit with other recent findings suggesting that on average professional ethicists behave no morally better than do professors not specializing in ethics. (shrink)

Medical ethicists have assumed a role in justifying public voyeurism of human "curiosities." This role has precedent in how scientists and natural philosophers once legitimized the marketing of museums of "human curiosities." At the beginning of the twentieth century, physicians dissociated themselves from entrepreneurial displays of persons with anomalies, and such commercial exhibits went into decline. Today, news media, principally on television, promote news features about persons that closely resemble the nineteenth century exhibits of human curiosities. Reporters solicit medical ethicists (...) for soundbites to affirm the newsworthiness and propriety of public voyeurism of these medical stories. Ethicists' soundbites are usually ambiguous or self-evident and rarely enable viewers to morally engage the issues. The precedent of early twentieth century physicians disengaging from such exploitive public shows is a useful example for medical ethics. (shrink)

Although clinical ethics scholarship and practice has largely avoided assuming an activist stance, the many health care crises of the last eighteen months motivated a distinct change: On listserves, in blog postings, and in published essays, activist language has permeated conversations over such issues as the impact of triage policies on persons with disabilities and of color, and how the health care system has historically failed African Americans. In this paper, I defend this turn, arguing that clinical ethicists should embrace (...) activism—generally, and with particular emphasis on institutional, mesolevel concerns. Ethicists are often uniquely situated to understand the structural factors that regularly motivate clinical ethics cases, and they are often in a privileged position to be effective change agents. In making this case, I also stress the need not to overstep one's skills and to be acutely cognizant of the political risks associated with such work. (shrink)

John H. Evans’s views on the multiple roles of healthcare ethics consultants are based on his claim that bioethics is a “distinct profession” that has a “system of abstract knowledge.” This response to Professor Evans disputes both of his claims. It is argued that clinical ethicists are consultants but not professionals. Their roles as consultants require more than one abstract form of knowledge (principlism). Instead, clinical ethicists rely upon a variety of ethical perspectives and other skills to help resolve conflicts (...) and facilitate healthcare decisions and policy making, whether it is in clinical, research, policy, or organizational contexts. The credibility and effectiveness of clinical ethicists depend upon their knowledge of ethics, their practical experience, and personal abilities, not one form of abstract knowledge. (shrink)

This article discusses the transition that business ethics has undergone since its start essentially as a philosophical sub-discipline of applied ethics. Today, business ethics—as demonstrated by four examples of gatekeepers—is a well-established field in general management, and increasingly business scholars without a “formal” background in philosophy are entering the scene. I take this transition to examine an updated positioning of business ethics and offer a proposal to redefine what makes a business ethicist. I suggest taking critical thinking as the (...) common denominator of all business ethics activities beyond the academic silos of various disciplines. In conclusion, by borrowing from the post-colonial theorist Edward Said, this article offers a definition of what makes a business ethicist in the broadest possible sense. Implications are discussed, including the consequences suggesting that if critical thinking is the common denominator, business ethics-as-business-case logic is not considered a part of business ethics publications, but should be addressed within more instrumental publication outlets of business. (shrink)

In some sense, argues Christopher Meyers in the lead article in this, the July‐August 2021, issue of the Hastings Center Report, to be a good ethicist is to be an activist. The question for the ethicist, and for Meyers, is about how hard and far to push: how much personal risk to shoulder, how much to tick off colleagues, how much institutional disruption to create, how much to look like an angry protester. Meyers argues for aiming at the (...) middle, in two senses. In a time of anger and activism about relentless, pervasive, overwhelming wrongs, the question of balance is increasingly front of mind. A set of commentaries we solicited both welcome Meyers's call for activism and push for more. (shrink)

In this paper we respectfully present a counter argument to Jesse Michael Kay’s thesis, as we understand it, in his article titled, “The Nurse Practitioner Ethicist: Distinct from a Nurse Ethicist?” Foundational to our analysis is that we take the distinction between nursing as a discipline and a practice profession, and clinical ethics as an emerging discipline seriously. The distinctions between them are well described in the literature. The two have different reasons for existence. While we agree that (...) one’s professional background can inform a secondary endeavor such as clinical ethics the goals are incommensurable. Moreover, we present an expanded definition of nursing ethics to explain the historical development of nursing goals and perspectives and its codes of ethics or conduct. Importantly, we provide support for the assertion that nurse practitioners are nurses in expanded roles but still accountable to nursing codes of ethics. Additionally, nurses who are working in the role of clinical ethicist are accountable to the goals of clinical ethics. (shrink)

In the United States, disturbing concerns pertaining to both how putative bioethicists are perceived and the potential for the abuse of their power in connection with these perceptions compel close examination. This paper addresses these caveats by examining two fundamental and interrelated components in the image-construction of the ethicist: definitional and contextual. Definitional features reveal that perceptions and images of the ethicist are especially subject to distortion due to a lack of clarity as to the nature and qualifications (...) of the ethicist. Furthermore, the clinical, professional, political, academic, and linguistic contexts in which these ethicists are engaged are contexts of disquieting degrees of power. I argue that the lack of definitional clarity as to what constitutes an ethicist combined with the above volatile contexts together set the stage for the abuse of power on the part of ethicists. Throughout, I question the extent of self-critical analyses among ethicists, and, in view of these components in image-construction and their relationship to power, I challenge the degree of integrity within the field. In conclusion, I propose some areas for further investigation. (shrink)

Animal welfare policy presents complex ethical challenges, requiring the careful balancing of diverse perspectives on issues such as animal housing, transport, and slaughter. As a policy domain shaped by societal pluralism, it demands reasoned debate and informed decision-making. Ethicists contribute to these discussions in different ways, assuming distinct professional roles in public policy-making. Building on Roger Pielke’s _The Honest Broker_ (The honest broker: Making sense of science in policy and politics, Cambridge University Press, 2007), four roles for ethicists are developed: (...) _The Pure Philosopher_, who develops ethical theory without direct policy engagement; _The Ethics Advocate_, who aligns with a specific position based on a foundational ethical theory; _The Ethics Facilitator_, who clarifies ethical disagreements to enable reasoned debate; and _The Engaged Philosopher_, who reframes discussions to expand policy options. Ethical advising in public policy depends on a democratic public ethos, where debates remain reasonable and open to reflection. This ethos is increasingly threatened by populism, which portrays politics as an antagonistic struggle rather than a deliberative process. In such a polarized context, ethicists face the risk of having their work instrumentalized in divisive narratives, potentially undermining meaningful engagement. The case of ritual slaughter highlights these challenges, demonstrating how ethics advice can become entangled in contentious debates. To uphold democratic pluralism, ethicists must ensure that their contributions to policy-making foster an open, inclusive, and reflective deliberative process. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Clinical Ethicists: Can They Help Families in Their Times of Need?Tracy R. WilsonI am a doctorally-prepared nurse practitioner with over 20 years in healthcare, and I am currently pursuing my MS in Bioethics and Medical Humanities at Tulane University, with an anticipated graduation of May 2023. In the fall of 2022, I had the pleasure of taking a Clinical Ethics course. As part of that course, I shadowed a (...) Clinical Ethicist for a week. It was a valuable experience, and I gained some insights about a role I didn’t know about previously. The last two years have been difficult for my family and me. I lost my dad in November 2020 and then a “sister cousin” in May 2021. In both instances, we had the team involved in their care and helping with the decision-making process.The role of the Clinical Ethicist Consultant (CEC) service is to help families process medical decisions—most of those decisions deal with endof-life care. The CEC works as the mediator between the family and the medical team. This is how I saw the CEC role play out in my experience.During my shadowing experience, my preceptor was phenomenal at his role because 1) he listened to the patient and the family, and 2) he consulted with the appropriate team members. My shadowing experience was virtual due to the restrictions of the healthcare facility. However, I was able to attend ethical team meetings. I was able to listen to multiple family calls and consultations. During my experience, my clinical ethicist was very conscientious of taking inventory of the feelings of everyone involved. Before he provided an opinion on a case, he did a deep dive into the patient’s chart to gain the patient’s historical context. He always asked for my opinion while we discussed a case, which made me feel included even as a student. It made me feel like my opinion had some weight, and it did in one of the cases. When I returned the next day, the feelings I had about a patient and her family using her for financial gain turned out to be true. Elder abuse was taking place.My personal experiences were more complicated, in which we didn’t always have a medical team that always heard what we needed for our loved ones. In the case of my sister cousin, she entered the hospital and was diagnosed with COVID-19. Our family never thought she would die from it, so it was shocking to us when she was placed on a ventilator and never came off. When the critical care MD stated that “there was nothing else he could do for her,” I could not understand how that could be when lung transplants were being done all over the US and even less than 100 miles away.We needed a CEC team then. I was the medical expert for my family, and I felt the medical team was not listening to what we wanted. The medical team believed that to continue treatment would be futile and their belief about this exceeded their need to continue treating my sister cousin. However, having a CEC mediate by first understanding the clinical team’s perspective, explaining those considerations to us, and then helping our family relay back our [End Page 23] wants, needs, and values to the clinical team could have helped. Unfortunately, my cousin never got this option. There was a palliative care team implemented but never a Clinical Ethicist. Having faced both, from a student perspective and from a personal experience, I would say that having a CEC present allows a family to have an advocate in the room, someone who knows the medical language and can explain to you and will explain to the medical team your perspective, which can sometimes be lost in translation or not heard.When my father passed away, he did not have a Clinical Ethicist as a part of his medical team either. My dad was a Vietnam Vet and a very prideful man. So, when my dad became ill in 2018 with vascular dementia, it took a toll on me and my sisters. To... (shrink)

Much has been written about the rights of health-care professionals to conscientiously object. Ironically, there has been no formal discussion as to whether clinical ethicists have the same right. Given that ethicists routinely deal with the same situations and questions that other health-care professionals find morally discomforting, the question as to whether they have the same right is a critical one. We conclude that ethicists should not have the same right to conscientious objection. The role of an ethicist is (...) to competently manage those situations and cases that cause moral discomfort and confusion. By conscientiously objecting, an ethicist would be failing to fulfil their primary function. The same cannot be said as forcefully about other professionals who object. Moreover, ethicists retain the right to conscientious objection to the joining of the discipline in the first place, and also retain the right to exit if they so choose. (shrink)

The Clinton Administration stated that the list of values and moral principles generated by the Ethics group reflects "fundamental national beliefs about community, equality, and liberty" and that "these convictions anchor health reform in shared moral traditions." However, these statements are difficult to justify. There is not a moral consensus in America that would justify thorough-going health care reform. In such a context of pluralism, ethicists should seek to move society in the direction of solidarity. The participation of ethicists on (...) the Clinton Task Force was valuable because it showed that health reform is an exercise in social ethics, disseminated the work of ethicists to the entire Task Force, and expanded the experience of the ethicists involved. It may also have accelerated the moral transformation of Americans, which is needed before radical reform can take place. Keywords: American values, Clinton health plan, health care reform CiteULike Connotea Del.icio.us What's this? (shrink)

A minority of countries around the world have taken steps to legalize the practice of physician-assisted suicide and/or euthanasia (PAS/E). Proponents frame PAS/E as a means to enhance patient autonomy, reduce suffering, alleviate the burden of illness, and respect patient dignity. Critics of PAS/E, on the other hand, assert that it reflects a distortion of autonomy, mistakes the source of patient suffering, and dangerously affirms to people that their dignity and worth are contingent on not requiring burdensome caregiving. This has (...) the potential to create uncertainty for how clinicians and institutions should provide ethical guidance to patients on morally controversial matters such as PAS/E. Although ethicists have a duty to explain the range of ethical arguments, they also have an obligation to reinforce ethical boundaries and provide decisive guidance when an intervention is irreconcilable with the practice of medicine. In their clinical role, ethicists can explain why PAS/E is not a healing act and why it violates the principles of beneficence and nonmaleficence. This article outlines three roles for clinical ethicists to provide education, consultation, and develop policies designed to respond to patient suffering in a manner that preserves the integrity of medicine. (shrink)

We report here an emerging dispute in Italy concerning triage criteria for critically ill covid-19 patients, and how best to support doctors having to make difficult decisions in a context of insufficient life saving resources. The dispute we present is particularly significant as it juxtaposes two opposite views of who should make triage decisions, and how doctors should best be supported. There are both empirical and normative questions at stake here. The empirical questions pertain to the available level of evidence (...) that healthcare professionals would rather not be left alone with their ‘clinical judgments’ to make triage decisions, and to the accounts of distributive justice that doctors and healthcare professionals rely on, when making triage decisions. The normative questions pertain to how this empirical evidence should inform guidelines on how prioritisation decisions are made in a context of emergency, and who gets to have the authority to do so. This debate goes beyond the discussion of the care of critically ill patients with COVID-19 and has broader implications beyond the national context for the discussion of how to relieve moral distress in contexts of imbalances between healthcare resources and clinical needs of a population. (shrink)

If philosophical moral reflection tends to improve moral behaviour, one might expect that professional ethicists will, on average, behave morally better than non-ethicists. One potential source of insight into the moral behaviour of ethicists is philosophers' opinions about ethicists' behaviour. At the 2007 Pacific Division meeting of the American Philosophical Association, we used chocolate to entice 277 passers-by to complete anonymous questionnaires without their knowing the topic of those questionnaires in advance. Version I of the questionnaire asked respondents to compare, (...) in general, the moral behaviour of ethicists to that of philosophers not specializing in ethics and to non-academics of similar social background. Version II asked respondents similar questions about the moral behaviour of the ethics specialist in their department whose name comes next in alphabetical order after their own. Both versions asked control questions about specialists in metaphysics and epistemology. The majority of respondents expressed the view that ethicists do not, on average, behave better than non-ethicists. Whereas ethicists tended to avoid saying that ethicists behave worse than non-ethicists, non-ethicists expressed that pessimistic view about as often as they expressed the view that ethicists behave better. (shrink)

For many years, there has been debate among bioethicists regarding the role of professional standards. Experts have debated whether the field should have a code of ethics, whether we should develop...

This chapter argues that the differences between Nietzsche and Aristotle are easily exaggerated. It discusses Nietzsche's “perspectivism.” The chapter focuses on three central basic universal virtues which the author argues Nietzsche both endorses and describes: forgetfulness, justice, and wisdom. In order for a genuine virtue of justice to be strong and tempered by grace, a strong “forgetfulness” is necessary. Virtues are described as “overflowing,” have extreme enthusiasm and passion at their core, and practical wisdom is nowhere or hardly to be (...) seen. The chapter describes the universal virtues as basic virtues and also discusses the issue of their differentiation. Two more forms of differentiation apparently create problems for understanding Nietzsche as a virtue ethicist: his idea that virtues are “individual” and his idea that there are virtues of the “convalescent” by contrast with virtues of the strong. (shrink)

We review and present a new meta‐analysis of research suggesting that ethicists in the United States appear to behave no morally better overall than do non‐ethicist professors. Measures include: returning library books, peer evaluation of overall moral behavior, voting participation, courteous and discourteous behavior at conferences, replying to student emails, paying conference registration fees and disciplinary society dues, staying in touch with one's mother, charitable giving, organ and blood donation, vegetarianism, and honesty in responding to survey questions. One multi‐measure (...) study found ethicists tending to embrace more stringent moral views, especially about meat eating and charitable donation. The same multi‐measure study found ethicists and other professors to show similarly small‐to‐medium correlations between their expressed normative attitudes and their self‐reported or directly measured behavior. (shrink)

Ethics in the modern context is under the dual pressure of scientific-technological rationality and market commercialization, which has led to breakthroughs in the original boundaries of knowledge and academic methodology. The gradual separation of the domain of public life and that of private life in modern society and the former's increasing pressure on the latter, in addition to the above dual pressure on ethics, is causing a dramatic transformation of the structure of ethical knowledge itself. All of these raise new (...) theoretical problems for ethics and ethicists in the modern context. Answering and solving these problems makes sense for the future development of ethics as one of the classic humanities, and tests modern ethicists' ability to realize their moral and theoretical duties. /// 现代语境中的伦理学面临着科技理性主义和市场商业化的双重挤压，致使伦 理学原有的知识边界和学理方法均被突破。现代社会之公共生活领域与私人生活领 域的日趋分化以及前者对后者日益增强的压迫，又使得伦理学在不得不承受双重挤 压的同时，还经历着自身知识结构的急剧转型。凡此种种都给现代社会的伦理学和 伦理学家提出了诸多新的理论课题，如何应对和处理这些课题，将不仅关系到作为 一门经典人文科学的伦理学之未来发展，而且也将考验当代伦理学家承诺自身学术 道义和理论责任的能力。. (shrink)

Environmental ethicists have been arguing for decades that swift action to protect our natural environment is morally paramount, and that our concern for the environment should go beyond its importance for human welfare. It might be thought that the widespread acceptance of moral anti-realism would undermine the aims of environmental ethicists. One reason is that recent empirical studies purport to show that moral realists are more likely to act on the basis of their ethical convictions than anti-realists. In addition, it (...) is sometimes argued that only moral realists can countenance the claim that nature is intrinsically valuable. Against this, we argue that the acceptance of moral anti-realism is no threat to the environmentalist cause. We argue, further, that the acceptance of moral realism is potentially an obstacle to delivering on a third core environmental ethicist demand: namely, that successful action on climate change and environmental destruction requires us to change some of our commonly-held ethical views and to achieve a workable consensus. (shrink)

Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effectDesign, subjects and setting–A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on “Death and Dying” was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on “Decisions near the End of Life”.Results–Practitioners accept the relevance of concepts widely (...) disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/ withdrawing treatment. Within the UK nurses' group a “rationalist” axis of respondents who describe themselves as having “no religion” are closer to the bioethics consensus on withholding and withdrawing treatment.Conclusions—Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners. (shrink)

A project featuring scholars in nursing ethics was planned in 2005. The goal was to document the contributions of some 24 selected American nurse ethicists to bioethics, and to discuss and explore the future trajectory of that work through a two-day working seminar. This article outlines the beginnings of bioethics in the USA and the specific contribution of nurse scholars to the debate, the preparation for the seminar, the results of the project, and the possible application of such a model (...) for teaching and archiving in the future. Documentation of the work carried out at the seminar resulted in the publication of a book. Short biographies of the participants at the seminar are included in Appendix 1. (shrink)

Ethics in the modern context is under the dual pressure of scientific-technological rationality and market commercialization, which has led to breakthroughs in the original boundaries of knowledge and academic methodology. The gradual separation of the domain of public life and that of private life in modern society and the former’s increasing pressure on the latter, in addition to the above dual pressure on ethics, is causing a dramatic transformation of the structure of ethical knowledge itself. All of these raise new (...) theoretical problems for ethics and ethicists in the modern context. Answering and solving these problems makes sense for the future development of ethics as one of the classic humanities, and tests modern ethicists’ ability to realize their moral and theoretical duties. (shrink)

In his last two books and in the essays and interviews associated with them, Foucault develops a new mode of ethical thought he describes as an aesthetics of existence. I argue that this new ethics bears a striking resemblance to the virtue ethics that has become prominent in Anglo-American moral philosophy over the past three decades, in its classical sources, in its opposition to rule-based systems and its positive emphasis upon what Foucault called the care for the self. I suggest (...) that seeing Foucault and virtue ethicists as engaged in a convergent project sheds light on a number of obscurities in Foucault's thought, and provides us with a historical narrative in which to situate his claims about the development of Western moral thought. (shrink)

BackgroundAlthough clinical ethicists are becoming more prevalent in healthcare settings, their required training and education have not been clearly delineated. Most agree that training and education are important, but their nature and delivery remain topics of debate. One option is through completion of a clinical ethics fellowship.MethodIn this paper, the first four fellows to complete a newly developed fellowship program discuss their experiences. They describe the goals, structure, participants and activities of the fellowship. They identify key elements for succeeding as (...) a clinical ethicist and sustaining a clinical ethics program. They critically reflect upon the challenges faced in the program.ResultsThe one-year fellowship provided real-time clinical opportunities that helped them to develop the necessary knowledge and skills, gain insight into the role and scope of practice of clinical ethicists and hone valuable character traits.ConclusionThe fellowship enabled each of the fellows to assume confidently and competently a position as a clinical ethicist upon completion. (shrink)

Debates regarding clinical ethicists’ scope of practice are not novel and will continue to evolve. Rapid changes in healthcare delivery, outcomes, and expectations have necessitated flexibility in clinical ethicists’ roles whereby hospital-based clinical ethicists are expected to be woven into the institutional fabric in a way that did not exist in more traditional relationships. In this article we discuss three emerging roles: the ethicist embedded in the interdisciplinary team, the ethicist with an expanded educational mandate, and the (...) class='Hi'>ethicist as a therapeutic presence in the patient care space. Such expanded capacities offer more robust, positive contributions to institutional culture, stakeholders’ relationships, and patient-centered care. (shrink)