David T. Ozar

Every aspect of what healthcare professionals do for patients is ethically significant, so it might seem strange that, when healthcare professionals are asked if anything ethically significant has occurred, their answer frequently is: “No, there were no ethical issues here.” But this answer does not mean that nothing ethically significant occurred during their caregiving. For healthcare professionals attend to the ethical content of their caregiving so routinely, so habitually, that their doing this is rarely thought of as involving a method of ethical reflection. This essay will examine this kind of ethical reflection in detail: its main components, how it works in practice, and how to grow in doing it effectively.

Assessing the effectiveness of an Ethics Across the Curriculum (EAC) program depends on having clear answers to two questions about the aim of the program: (1.) Who is it that the EAC program is intended to serve? and (2.) What good is the program intended to achieve for them? While EAC programs come in many shapes and sizes (See the surveys of types of EAC programs in Davis 2018 and University of San Diego 2009.), almost all would answer these questions in the same way. Their goal is to benefit the institution’s students, that is, to enhance the students’ learning of ethics in some beneficial ways. The first three sections of this article will focus on the best way to identify such Learning Objectives for an EAC program and how to use these Learning Objectives to assess the program’s effectiveness in benefitting the students. The final section will discuss some additional assessment questions about EAC programs, especially for programs with more limited resources that cannot assess their program’s effectiveness in the best way.

Our society’s professions, including the health professions, have long overlooked the possibility that one might learn something valuable about one’s own profession’s ethics by studying the ethics of other professions. Reflecting on the preceding article by Ritwik, Patterson, and Alfonzo-Echeverri, one can identify important similarities between dentistry’s professional ethics and the ethics of the other health professions. But there are also important differences between these professions’ ethics that should prompt reflection on the reasons for these differences, perhaps challenge something that has been taken for granted in one’s own profession, and in any case facilitate better mutual understanding and more effective inter-professional collaboration.

Berger (2019) argues effectively that “representativeness is more aptly understood as a variable that is multidimensional and continuous based on relational moral authority,” and also makes some useful suggestions about how taking this observation seriously might require changes in current patterns of practice regarding surrogates. But the essay raises additional important questions about how the Best Interest Standard (BIS) should be used among unrepresented patients and other patients as well because many surrogates besides those who “have no actionable knowledge of a patient’s preferences” find themselves in positions in which they need to determine, with the physician, what is in the patient’s best interests. In this commentary, we therefore provide support for the ethical superiority of BIS judgments made by a multi-stakeholder process (rather than solo decision-makers), and sketch a process by which such judgments might be made.

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded.

My aim in this paper is to explore the notion that corporations have moral rights within the context of a constitutive rules model of corporate moral agency. The first part of the paper will briefly introduce the notion of moral rights, identifying the distinctive feature of moral rights, as contrasted with other moral categories, in Vlastos' terms of overridingness. The second part will briefly summarize the constitutive rules approach to the moral agency of corporations (à la French, Smith, Ozar) and pose the question of the paper. The third part will argue that, since the moral agency of corporations is dependent on the choices of those whose acceptence of the relevant rules constitutes the corporation as a moral agent, the rights of corporations are conventional; that is, they exist because they are so created. Thus, as a first answer, corporations do not have moral rights.But this raises a further question which we must explore. Once a corporation has been constituted, by the acceptance of the relevant rules by the relevant persons, does the corporation then have rights which endure? Can those who have constituted a corporation with certain rights morally change or cancel those rights in medias res without doing some sort of moral violence to the corporation? Do corporations at least have a moral right to persist in the conventional rights with which they were constituted?

The social ethics of medicine is the study and ethical analysis of social structures which impact on the provision of health care by physicians. There are many such social structures. Not all these structures are responsive to the influence of physicians as health professionals. But some social structures which impact on health care are prompted by or supported by important preconceptions of medical practice. In this article, three such elements of the philosophy of medicine are examined in terms of the negative impact on health care of the social structures to which they contribute. The responsibilities of the medical profession and of individual physicians to work to change these social structures are then examined in the light of a theory of profession.

Health care is not merely a matter of individual encounters between patients and physicians or other health care personnel. For patients and those who provide health care come to these encounters already possessed of learned habits of perception and judgment, valuation and action, which define their roles in relation to one another and affect every aspect of their encounter. So the presuppositions of these encounters must be examined if our understanding of patients' autonomy is to be complete. In this paper I sketch three models of what is presupposed in the relationship between the health care professional and the lay patient; and I discuss the ways in which patients' autonomy is preserved and/or compromised under each of the three models. The models discussed are the Guild Model, the Commercial Model, and the Interactive Model.