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Evaluating readiness for discharge from the intensive care unit (ICU) is a critical aspect of patient care. Whereas evidence-based criteria for ICU admission have been established, practical criteria for discharge from the ICU are lacking. Often discharge guidelines simply state that a patient no longer meets ICU admission criteria. Such discharge criteria can be interpreted differently by different healthcare providers, leaving a clinical void where misunderstandings of patients' readiness can conflict with perceptions of what readiness means for patients, families, and healthcare providers. In considering ICU discharge readiness, the use and application of ethical principles may be helpful in mitigating such conflicts and achieving desired patient outcomes. Ethical principles propose different ways of understanding what readiness might mean and how clinicians might weigh these principles in their decision-making process. This article examines the concept of discharge readiness through the lens of the most widely cited ethical principles (autonomy [respect for persons], nonmaleficence/beneficence, and justice) and provides a discussion of their application in the critical care environment. Ongoing bioethics discourse and empirical research are needed to identify factors that help determine discharge readiness within critical care environments that will ultimately promote safe and effective ICU discharges for patients and their families. [ABSTRACT FROM AUTHOR]

This article provides a literature review on aesthetics and ethics, with a particular focus on how attention to aesthetics generates needed insights into ethical theory and the dynamics of moral practice. [ABSTRACT FROM AUTHOR]

This article discusses an approach to translational bioethics (TB) that is concerned with the adaptation—or 'translation'—of concepts, theories and methods from bioethics to practical contexts, in order to support 'non‐bioethicists', such as researchers and healthcare practitioners, in dealing with their ethical issues themselves. Specifically, it goes into the participatory development of clinical ethics support (CES) instruments that respond to the needs and wishes of healthcare practitioners and that are tailored to the specific care contexts in which they are to be used. The theoretical underpinnings of this participatory approach to TB are found in hermeneutic ethics and pragmatism. As an example, the development of CURA, a low‐threshold CES instrument for healthcare professionals in palliative care, is discussed. From this example, it becomes clear that TB is a two‐way street. Practice may be improved by means of CES that is effectively tailored to specific end users and care contexts. The other way around, ethical theory may be enriched by means of the insights gained from engaging with practice in developing CES in a process of co‐creation. TB is also a two‐way street in the sense that it requires collaboration and commitment of both bioethicists and practitioners, who engage in a process of mutual learning. However, substantial challenges remain. For instance, is there a limit to the extent to which a method of moral reasoning can be adapted in order to meet the constraints of a given healthcare setting? Who is to decide, the bioethicist or the practitioners? [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: to understand the bioethical perspectives on mobile tracking device use. Methods: theoretical study based on action research, carried out with eight graduate students from a public university. A focus group was used, with a thematic content analysis methodology with a codebook structure, approved by the Research Ethics Committee. Results: from the analysis, there was a concern about using devices after the pandemic ended. Using or not the device, rights inherent to humans, legislation and effectiveness of methods deepen interpretations, moving participants from a personalistic conception of the topic to a vision focused on professional implications about the methods. Final considerations: the debate on the impact of using technological devices on health, especially those that imply restriction of rights that refer to individuals’ private life, involves a discussion of a professional nature, in addition to requirement for clear rules on the topic.

Purpose – Qualitative research that involves the use of human participants calls for the need to protect those participants to give their honest view during data collection. This is an important part of every primary data collection in qualitative studies using interviews. This paper aims to investigate all available ethical considerations that need to be observed by the researcher when conducting primary data collection through interview and to explore the theories that underpin the ethics in qualitative studies. Design/methodology/approach – This paper systemically reviewed existing qualitative data on ethics and gathered information that were analysed and presented on the topic area. Findings – The findings show that ethical considerations deal with the various approaches adopted by the researcher to make the participants feel safe to participate in any given researcher. During an interview process in qualitative research, the findings show that anonymity, voluntary participation, privacy, confidentiality, option to opt out and avoiding misuse of findings are ethical considerations that must be observed by the researcher. The outcome of the investigation also shows that deontology and utilitarianism, rights and virtue are the main theories that underpin ethical considerations in research. Originality/value – The rights of the research participants need to be respected in qualitative research to assist in gathering accurate information to achieve the objectives of study. This and other ethical principles such as anonymity, privacy, confidentiality, voluntary participation and option to opt out guide the researcher to systematically adhere to data collection approaches that yield valid results in qualitative data collection using interviews.

It can be assumed that value judgements, which are needed to judge what is 'good' or 'better' and what is 'bad' or 'worse', are involved in every decision-making process. The theoretical understanding and analysis of value judgements is, therefore, important in the context of bioethics, for example, to be able to ethically assess real decision-making processes in biomedical practice and make recommendations for improvements. However, real decision-making processes and the value judgements inherent in them must first be investigated empirically ('empirical bioethics'). For this to succeed, what exactly a 'value judgement' is and of what components it might consist must initially be theoretically clarified. A corresponding conceptual model can then support or even enable empirical data collection and analysis and, above all, subsequent ethical analysis and evaluation. This paper, therefore, presents a value judgement model with its theoretical derivation. It also illustrates its application in an interview study of decision-making between animal experimentation and alternative methods in the context of biomedical research. Though the model itself can be theoretically deepened and extended, the application of the model works in general and helps to uncover what value judgements can enter into decision-making. However, the empirical methods, for example, qualitative interviews, can also be better oriented towards eliciting value judgements (as understood according to the model). Further applications of the model to other topics or by means of other empirical methods are conceivable. [ABSTRACT FROM AUTHOR]

The emergence of the 'child‐safe' organization requires close attention to practices that contribute to children's wellbeing and safety. Based on data collected in schools, residential care and disability services, this article argues for a more nuanced understanding of the ethical frameworks informing practice in these settings. Findings suggest both young people and adults predominantly describe ethical practice in terms of intersubjective relations. This ethical relationality is understood, less in terms of vertical responsibilities of care (largely the domain of adults and shaped by institutional norms), and more in terms of vertical and horizontal (interpersonal) relations, giving way to more empowered inclusion. [ABSTRACT FROM AUTHOR]

Clinical research is essential to modern evidence-based medicine. The potential for human harm must be minimized and balanced against the greater utility to society. With a multitude of clinical, governmental, and regulatory actors now working to ensure clinical research is ethically robust, it is important that we reflect on the current paradigm of clinical research in the UK, to safeguard participant safety. We also discuss ethical principles of clinical trials, according to different bioethical models. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic poses many real-world moral dilemmas, which can pit the needs and rights of the many against the needs and rights of the few. We investigated moral judgments in the context of the contemporary global crisis among older adults, who are at greatest personal risk from the pandemic. We hypothesized that during this pandemic, individuals would give fewer utilitarian responses to hypothetical dilemmas, accompanied by higher levels of confidence and emotion elicitation. Our pre-registered analysis (https://osf.io/g2wtp) involved two waves of data collection, before (2014) and during (2020) the COVID-19 pandemic, regarding three categories of moral dilemmas (personal rights, agent-centered permissions, and special obligations). While utilitarian responses considered across all categories of dilemma did not differ, participants during the 2020 wave gave fewer utilitarian responses to dilemmas involving personal rights; that is, they were less willing to violate the personal rights of others to produce the best overall outcomes.

Efficiency as quantified and promoted by cost-effectiveness analysis sometimes conflicts with equity and other ethical values, such as the "rule of rescue" or rights-based ethical values. We describe the utilitarian foundations of cost-effectiveness analysis and compare it with alternative ethical principles. We find that while fallible, utilitarianism is usually superior to the alternatives. This is primarily because efficiency - the maximization of health benefits under a budget constraint - is itself an important ethical value. Other ethical frames may be irrelevant, incompatible with each other, or have unacceptable implications. When alternatives to efficiency are considered for precedence, we propose that it is critical to quantify the trade-offs, in particular, the lost health benefits associated with divergence from strict efficiency criteria. Using an example from HIV prevention in a high-prevalence African country, we show that favoring a rights-based decision could result in 92-118 added HIV infections per $100,000 of spending, compared to one based on cost-effectiveness.

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina 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.)

The biggest research programme within business ethics is arguably Corporate Social Responsibility and all its related streams (Corporate Citizenship, Social Justice, etc.) While there seems to be widespread agreement that business ethics is situated between the amoral or even immoral view of Milton Friedman as explicated in his 1970 New York Times paper, and the moral view expounded by R. Edward Freeman, this essay challenges that view. Friedman, maybe owed to his flamboyant writing style and crude and purely rhetorical oversimplifications has been misinterpreted to advocate for managers to be completely amoral maximisers of profitability. This misinterpretation has become common wisdom, despite him clearly stating that the law and the moral standards of surrounding society must limit profit‐seeking behaviour. Freeman's stakeholder theory, on the other hand, is seen as being on the other end of the continuum, arguing for selflessness—another misinterpretation, as I argue with Ed Freeman's help. Instead, I suggest that both Friedman and Freeman represent the virtuous mean of the business ethics continuum and not its extremes because they both base their theories on the idea of the free and socially embedded individual. The two vicious ends of the continuum are inhabited by the unreal, atomised, completely a‐social and selfish individual on the one end, and by the equally unreal collectivised self‐less individual on the other. The mainstream in business ethics has declared the collective and selfless end to be the ideal that must guide practice and research. The selfish and the selfless strawmen have prevented a proper debate in business ethics for too long. [ABSTRACT FROM AUTHOR]

The enrichment of bioethical proposals built from and for Latin America has been increasing in recent decades. In order to contribute to this, our objective is to present a proposal for a bioethical interpretation from a philosophical approach based on the identification of central concepts of Mexican philosopher Juliana González Valenzuela. A dual bio-ontological foundation was identified: a) the “dialectic phenomenology of life,” which allows the synthesis between the biological and cultural aspects of human beings, as well as the overcoming of its contradictions; and b) the Homo humanus, which enables the existence of the bio-ethical being affirmed as an authentic being and one who seeks a good life (eu-bios and eu-zoein). Reflection on and critique of the implications that the bio-ontological foundation hypothetically couples to law and power led us to identify main arguments. However, the necessary link between the bio-ethical being and said disciplines was evidenced by virtue of their social and communitarian nature (zoon politikón, ζῷον πολῑτῐκόν).

Green hotels have grown in popularity due to customers' increased awareness of environmental issues. This study aims to construct and evaluate a model that combines the theory of Planned Behavior (TPB) and the theory of ethics to explain green hotel visitors' intentions and behavior. The study also considers the role of trust & subjective norms as a moderator. The framework of the study was evaluated using a quantitative method. Most of the respondents to the study, which was carried out in Noakhali, Bangladesh, were students at Noakhali Science and Technology University and their family members. The data was collected from 414 respondents and analyzed using the structural equation modeling (SEM) technique. The data collection took around two weeks, starting from December 3, 2021. According to the study's findings, the deontological (Moral obligation and justice) and teleological variables (perceived benefit and perceived risk) significantly influence green hotel visitors' intentions and actual behavior. Moreover, trust noticeably influences the relationship between subjective norm (SN) and Intention, and subjective norm affects the connection between attitude and intention. Therefore, hotel management can utilize this research to examine and understand visitors' intention and actual behavior to visit green hotels, which will assist them in attracting guests by portraying their services as eco-friendly. Furthermore, the findings may help hotel management formulate competitive marketing strategies, design effective promotional tools, and help generate an eco-conscious customer base.

The enrichment of bioethical proposals built from and for Latin America has been increasing in recent decades. In order to contribute to this, our objective is to present a proposal for a bioethical interpretation from a philosophical approach based on the identification of central concepts of Mexican philosopher Juliana González Valenzuela. A dual bio-ontological foundation was identified: a) the "dialectic phenomenology of life," which allows the synthesis between the biological and cultural aspects of human beings, as well as the overcoming of its contradictions; and b) the Homo humanus, which enables the existence of the bio-ethical being affirmed as an authentic being and one who seeks a good life (eu-bios and eu-zoein). Reflection on and critique of the implications that the bio-ontological foundation hypothetically couples to law and power led us to identify main arguments. However, the necessary link between the bio-ethical being and said disciplines was evidenced by virtue of their social and communitarian nature (zoon politikón, ζῷον πολῑτῐκόν). [ABSTRACT FROM AUTHOR]

This article argues that the MLIS curriculum should offer information ethics courses that enable future information professionals to develop their imaginative powers through close study and discussion of fiction. LIS students reading ethical theory and fiction bring the two into conversation and as a result reach a better understanding of both. Crucially, this process presupposes the exercise of empathetic imagination, a mental capacity that helps us inhabit other perspectives and modes of being in the world. The paper supports this discussion with evidence from an instructional intervention implemented during an information ethics course within an LIS program at a large public research university. [ABSTRACT FROM AUTHOR]

What reasons stand in favor of (or against) violent resistance to oppression? I distinguish two kinds of normative reasons that bear relevantly in such a practical deliberation. I argue that in addition to reasons of impartial morality, victims' personal projects and relationships may also provide reasons for (or against) violent resistance. Moreover, there is no guarantee that conflicts will not occur between such reasons. Thus, some acts of violent resistance may arise from situations of radical choice in which impartial moral reasons and personal reasons pull the agent in opposite directions. Regardless of what we ultimately think agents facing such decisions ought to do, all things considered, recognizing such conflicts is crucial for understanding the circumstances that give rise to violence and for better sympathizing with victims who are pushed to such extreme modes of resistance. [ABSTRACT FROM AUTHOR]

Brad Hooker's rule‐consequentialism and T. M. Scanlon's contractualism have been some of the most debated ethical theories in normative ethics during the last twenty years or so. This article suggests that these theories can be compared at two levels. Firstly, what are the deep, structural differences between the rule‐consequentialist and contractualist frameworks in which Hooker and Scanlon formulate their views? Secondly, what are the more superficial differences between Hooker's and Scanlon's formulations of these theories? Based on exploring these questions and several purported differences between Hooker's and Scanlon's views, this article argues that, at the structural level, the two theories are more similar than previous recognised. It suggests that there is only one candidate for a deeper difference and even it may not be that significant. This insight sheds new light on both contractualism and rule‐consequentialism, and it will also help us to formulate better versions of the views. [ABSTRACT FROM AUTHOR]

The exponential advancement of health technologies has led to an increasing need for awareness and critical thinking about the potential unintended consequences and ethical dilemmas that may arise from using new technologies. Unfortunately, many ethical issues arise post-implementation. Few researchers preemptively consider the ethical implications of health technologies. The current study located more than 24 million articles in PubMed that discussed common health technologies. Of these, 0.07% (n = 17,816) articles deeply considered the technology's potential ethical implications. Critical thinking and ethics are the mainstays of nursing practice. Thus, critically thinking about the potential ethical implications of relevant technologies should be at the forefront of research; we contend that this is not common practice. We hope to shed light on this issue to remind researchers to think like nurses when researching new health technologies. [ABSTRACT FROM AUTHOR]

Engineers make decisions with global impacts and empathy can motivate ethical reasoning and behavior that is sensitive to the needs and perspectives of stakeholders across the globe. Microethics and macroethics offer two frames of reference for engineering ethics education, but different dimensions of empathy play distinct roles in micro- and macroethics. Microethics emphasizes individual responsibility and interpersonal relationships whereas macroethics emphasizes societal obligations and impacts. While empathy can support ethical reasoning and behavior for each, in this paper I argue that affective empathy plays a primary (but not exclusive) role in microethics whereas cognitive empathy plays a primary role in macroethics. Gilligan's and Kohlberg's theories of moral development are used to further depict how affective empathy aligns with care (depicted as an interpersonal phenomenon) and how cognitive empathy aligns with justice (depicted as a systems-focused phenomenon), thus positioning these ethical principles as playing primary (but again, not exclusive) roles in micro- and macro-ethics, respectively. Building on these ideas, this study generates a framework that describes and visualizes how empathy manifests across six frames of reference, each of which are increasingly macro-ethical in nature: self, team, operators, participants, bystanders, and future generations. The paper describes how proxy stakeholders can be identified, developed, and leveraged to empathize with stakeholder groups. Taken together, the manuscript seeks to clarify the role of empathy in engineering ethics and can enable engineering students to better empathize with the range of stakeholders impacted by engineering decisions, ranging from one's self to stakeholders across the globe. The intrapersonal understandings and motivations that students generate by empathizing across six frames of reference can facilitate ethical reasoning processes and behaviors that are more inclusive and comprehensive., (© 2024. The Author(s).)

Moral bioenhancement presents the possibility of enhancing morally desirable emotions and dispositions. While some scholars have proposed that moral bioenhancement can produce virtue, we argue that within a virtue ethics framework moral bioenhancement cannot reliably produce virtue. Moreover, on a virtue ethics framework, the pursuit of moral bioenhancement carries moral risks. To make this argument, we consider three aspects of virtue-its motivational, rational, and behavioral components. In order to be virtuous, we argue, a person must (i) take pleasure in doing the right thing and have the correct motivational attitudes; (ii) reason correctly about what is called for in a particular ethical dilemma; and (iii) intentionally and continuously practice and cultivate virtues. These dimensions of morality-in short: precisely those emphasized in a virtue ethics framework-cannot be consistently or reliably met using existing moral bioenhancement technology., (© The Author(s) 2024. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objectives: The psychology of moral decision-making classically contrasts utilitarianism (based on consequences) and deontology (based on moral norms). Previous studies capitalizing on this dichotomy have suggested the presence of a utilitarian bias among patients with severe alcohol use disorder (SAUD). We aimed to further disentangle the processes involved in such bias through a more validated approach, the CNI model of moral decision-making. This model allows to go further than the classical approach by distinguishing sensitivity to consequences (C), to moral norms (N), and general preference for inaction over action (I) in response to moral dilemmas., Methods: Thirty-four recently detoxified patients with SAUD and 34 matched control participants completed a battery of 48 dilemmas derived from the CNI model, as well as social cognition tasks., Results: In contrast with the utilitarian bias suggested in previous studies based on the classical approach, patients with SAUD did not show an increased sensitivity to consequences in comparison with control participants. However, they showed a reduced sensitivity to moral norms, as well as a greater action tendency. These biases were not related to social cognition deficits., Conclusions: Patients with SAUD are not more utilitarian than healthy controls, this previously reported bias being artificially generated by the methodological limits of the classical approach. Instead, they present a reduced sensitivity to moral norms and an action bias, which might impact their interpersonal relations and contribute to the social isolation frequently reported in this population, thus identifying moral decision-making as a new therapeutic lever in SAUD., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Clinical ethics consultants support mental health professionals in identifying and analyzing moral problems in clinical practice., Objective: Presentation of key ethical concepts and normative theories that are relevant for clinical ethics consultation in mental healthcare., Material and Methods: Conceptual and ethical analyses., Results: After distinguishing between morality, ethics and law, moral problems are differentiated from other types of problems encountered in clinical practice. Subsequently, key ethical concepts and the concept of moral distress are clarified. In relation to the normative framework a distinction is made between philosophical ethical theories and medical ethical theories, such as principlism and the ethics of care. Finally, justification tests for ethical decision-making in situations of danger to self or others based on the harm principle and soft paternalism are proposed., Conclusion: Knowledge of key ethical concepts and normative theories is important for the identification and analysis of moral problems in mental healthcare and should be given greater weight in the training of clinical ethics consultants., (© 2024. The Author(s).)

According to the sufficiency theory of justice in health, justice requires that people have equal access to adequate health. In this article, I lay out the structure of this view and I assess its distributive implications for setting priority (i) between health needs across persons and (ii) between health care spending and other societal goods. I argue, first, that according to the sufficiency theory, deficiency in health cannot be completely offset by providing other societal goods. And, second, that it can prevent the medicalization of societies by stressing that improvements beyond the level of adequate health have relatively little weight, if any, from the standpoint of justice., (© 2024 The Author(s). Bioethics published by John Wiley & Sons Ltd.)

Any moral algorithm for autonomous vehicles must provide a practical solution to moral problems of the trolley type, in which all possible courses of action will result in damage, injury, or death. This article discusses a hitherto neglected variety of this type of problem, based on a recent psychological study whose results are reported here. It argues that the most adequate solution to this problem will be achieved by a moral algorithm that is based on Confucian ethics. In addition to this philosophical and psychological discussion, the article outlines the mathematics, engineering, and legal implementation of a possible Confucian algorithm. The proposed Confucian algorithm is based on the idea of making it possible to set an autonomous vehicle to allow an increased level of protection for selected people. It is shown that the proposed algorithm can be implemented alongside other moral algorithms, using either the framework of personal ethics settings or that of mandatory ethics settings., (© 2024. The Author(s).)

To facilitate engineering students' understanding of engineering ethics and support instructors in developing course content, this study introduces an innovative educational tool drawing inspiration from the Rubik's Cube metaphor. This Engineering Ethics Knowledge Rubik's Cube (EEKRC) integrates six key aspects-ethical theories, codes of ethics, ethical issues, engineering disciplines, stakeholders, and life cycle-identified through an analysis of engineering ethics textbooks and courses across the United States, Singapore, and China. This analysis underpins the selection of the six aspects, reflecting the shared and unique elements of engineering ethics education in these regions. In an engineering ethics course, the EEKRC serves multiple functions: it provides visual support for grasping engineering ethics concepts, acts as a pedagogical guide for both experienced and inexperienced educators in course design, offers a complementary assessment method for evaluating students learning outcomes, and assists as a reference for students engaging in ethical analysis., (© 2024. The Author(s).)

The popularisation of Artificial Intelligence (AI) technologies has sparked discussion about their ethical implications. This development has forced governmental organisations, NGOs, and private companies to react and draft ethics guidelines for future development of ethical AI systems. Whereas many ethics guidelines address values familiar to ethicists, they seem to lack in ethical justifications. Furthermore, most tend to neglect the impact of AI on democracy, governance, and public deliberation. Existing research suggest, however, that AI can threaten key elements of western democracies that are ethically relevant. In this paper, Rawls's theory of justice is applied to draft a set of guidelines for organisations and policy-makers to guide AI development towards a more ethical direction. The goal is to contribute to the broadening of the discussion on AI ethics by exploring the possibility of constructing AI ethics guidelines that are philosophically justified and take a broader perspective of societal justice. The paper discusses how Rawls's theory of justice as fairness and its key concepts relate to the ongoing developments in AI ethics and gives a proposition of how principles that offer a foundation for operationalising AI ethics in practice could look like if aligned with Rawls's theory of justice as fairness., (© 2024. The Author(s).)

Controlled human infection studies (CHIs) involve the intentional infection of human subjects for a scientific aim. Though some past challenge trials have involved serious ethical abuses, in the last few decades, CHIs have had a strong track record of safety. Despite increased attention to the ethics of CHIs during the COVID-19 pandemic, CHIs remain controversial, and there has been no in-depth treatment of CHIs through the lens of virtue ethics. In this article, we argue that virtue theory can be helpful for addressing CHIs that present a constellation of controversial, unresolved, and/or under-regulated ethical issues. We begin with some brief background on virtue ethics. We then substantiate our claim that some CHIs raise a constellation of ethical issues that are unresolved in the ethics literature and/or lack adequate regulatory guidance by demonstrating that CHIs can present indeterminate social value, risks to third parties, limitations on the right to withdraw from research, and questions about the upper limit of allowable risk. We argue that the presence of a virtuous investigator, with virtues such as prudence, compassion, and integrity, is especially important when these unresolved research ethics issues arise, which is the case for certain types of controlled human infection studies. We use the historical example of Walter Reed and the Yellow Fever Commission to illustrate this claim, and we also highlight some contemporary examples. We end by sketching some practical implications of our view, such as ensuring that investigators with experience running CHIs are involved in novel CHI models., (© 2024 The Author(s). Bioethics published by John Wiley & Sons Ltd.)

With the growing application of machine learning models in medicine, principlist bioethics has been put forward as needing revision. This paper reflects on the dominant trope in AI ethics to include a new 'principle of explicability' alongside the traditional four principles of bioethics that make up the theory of principlism. It specifically suggests that these four principles are sufficient and challenges the relevance of explicability as a separate ethical principle by emphasizing the coherentist affinity of principlism. We argue that, through specification, the properties of explicability are already covered by the four bioethical principles. The paper finishes by anticipating an objection that coherent principles could not facilitate technology induced change and are not well-suited to tackle moral differences., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

In this paper, I leverage the pragmatist tradition in philosophy, the collective wisdom of scholarship in clinical ethics consultation, and earlier attempts to apply pragmatism in clinical ethics to develop a new vision of clinical ethics practice called New Clinical Pragmatism. It argues that clinical ethics methodology, from the New Clinical Pragmatist's perspective, amounts to the recommendation that consultants should customize a methodological approach, drawing on the various available methods, depending on the demands of the specific case, and should avoid attempts to identify a 'true' methodology but to the incoherence and inevitable failure of those attempts. I argue that pragmatism's emphasis on practical wisdom and experimentation allow the New Clinical Pragmatist to do this while avoiding irrationality in choosing methods. I discuss how the New Clinical Pragmatist gives a unique, constructive perspective on key aspects of clinical ethics consultation such as the choice of common morality vs. internal morality of medicine approaches, process standards, bioethics mediation, and narrative ethics, and suggest how New Clinical Pragmatism's relaxed approach to choice of methodology encourages consultants to balance attention to the particulars of the case with knowledge of what the many insightful scholars of clinical ethics methodology have found useful in the past. I also argue that New Clinical Pragmatism is consistent with efforts to professionalize clinical ethics consultation., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

To provide deeper insights into the relationships between psychopathic traits and utilitarian moral judgment, we studied N = 702 adults using three psychopathy scales: (a) the Levenson's Self-report Psychopathy Scale; (b) the Psychopathic Personality Inventory; and (c) the Triarchic Psychopathy Measure; and three measures of utilitarian moral judgment: (a) trolley dilemmas; (b) the Consequences, Norms, and Inaction (CNI) model of moral decision-making; and (c) the Oxford Utilitarianism Scale. When using the traditional approach to moral judgment (i.e., trolley dilemmas, instrumental harm, traditional score from the CNI model), we found that higher levels of psychopathic traits were associated with a higher utilitarian tendency. When using the modeling approach, we found that a higher level of psychopathic traits was related to weaker sensitivity to moral norms and less action averse in morally problematic situations. In addition, we found negative associations between impartial beneficence and all psychopathy scores., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In pursuit of a theory of expressive reasons, I focus on the practical rationality of actions such as welcoming, thanking, congratulating, saluting – I label them 'expressive actions.' How should we understand the kinds of practical reasons that count in favour of expressive actions? This question is related to the question of how to understand non-instrumental fittingness-type reasons for emotion. Expressive actions often are and should be expressions of emotion. It seems to be an important feature of such actions that the reasons that count in favour of the action are entangled with reasons of fittingness that count in favour of the relevantly connected emotion. But how should we understand this entanglement? I argue that the relevant category of reasons cannot be captured on approaches standard in normative theory. I develop a theory of sui generis expressive reasons. I argue that we have reason to perform actions that mark certain situations that contain some significant value or disvalue, independently of any reason to alter those situations. This is the role of expressive actions. Sui generis reasons for expressive actions are entangled with reasons for relevantly connected emotions because (some) emotions have the same role of marking extraordinary situations. [ABSTRACT FROM AUTHOR]

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina 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.)

Background: The value framework governing the health system can guide the policymaking. This study presents a set of values governing the health policies for adopting policies that are in harmony with the ideology of Iran. Methods: This study was conducted in two phases. In the first phase, using the qualitative approach, Shams et al. framework was adopted to identify values. Identification of health-related national documents (nine documents) was performed purposefully. In the next phase, semi-structured interviews on individual experts in the health system were carried out. The key question was "What values and principles govern the health policy system?" Participants included 15 individuals. Both phases were analyzed based on qualitative content analysis. Results: In this study, a taxonomy of values governing policymaking is presented. Results show that equity in different dimensions, comprehensive health and a healthy human being, pioneering in health in the region, and accountability are the most important terminal values. Individual responsibility, government responsibility for health, endogenous and extrinsic economics, fair access, transparency, efficiency, quality and integrity in the supply, development and fair allocation of public health resources, and professional commitment are the most important instrumental values in Iran. Participants believed that, despite the many higher-order documents available, the health system policymaking was not based on a predetermined value. Conclusions: It is not enough to provide a set of values in upstream documents for implementation. It is necessary to specify the relative weight of the reference values in policymaking and their relation to each other in order to apply them in policymaking. [ABSTRACT FROM AUTHOR]

Danny Boyle's film Yesterday (2019) is a contemporary morality play in which the main character, Jack Malik, a failing singer-songwriter, is magically sent to a different possible world in which the Beatles never existed. Possessing his memory of the Beatles’ catalogue in the new possible world, he is now in sole possession of an extremely valuable artifact. Recording and performing the songs of the Beatles and passing them off as his own, he becomes rich, famous, and deeply unhappy. Once he confesses his wrong-doing, however, he is redeemed and his life becomes wonderful. The presupposition that underlays the plot is that in claiming authorship of the songs of the Beatles in a world in which the Beatles never existed, he is acting immorally. But on what theoretical grounds can this intuitive judgment be justified? Can one plagiarize work for which there is no author in one's world? Saul Kripke, in Naming and Necessity, dubs terms that refer in all possible worlds to be “rigid designators” and considers the metaphysics necessary to support them. In this case, it is not reference but moral responsibility that is invariant under changes of possible world and so we must ask a similar question for “rigid obligators.” We argue that a virtue ethics approach is the only way to support the foundational moral intuition.

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina 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.)