David Archard

This article provides a philosophical analysis of a putative right of the child to have their expressed views considered in matters that affect them. Article 12 of the United Nations Convention on the Rights of the Child 1989 is an influential and interesting statement of that right. The article shows that the child’s ‘right to a voice’ is complex. Its complexity lies in the problem of contrasting an adult’s normative power of choice with a child’s weighted views, in the various senses in which we might consider the child’s views, and in the questions of how to weight those views and how their weighting makes a practical difference in coming to a decision. In so doing we criticise other accounts that simply regard a child’s views as having consultative value. We also make better sense of how we might weight a child’s views. The philosophical issues addressed in the article carry implications for how we might understand Article 12 that are not satisfactorily identified and addressed in the voluminous literature on Article 12 within childhood studies. These issues also have implications for how we might understand the distinction between adults and children in respect of powers of personal choice. We conclude by emphasising the importance and value of the right that Article 12 seeks to formally identify.

Filial regard is the special consideration that children, even as adults, show their parents and filial morality the demonstration that such a regard is demanded of them. The three main accounts of filial morality, based upon ideas of gratitude, role obligations, and friendship, are shown to be unsatisfactory. The article explores the idea, found in traditional Chinese thinking, that filial regard is the ‘root’ of goodness, and suggests that the Chinese model has been viewed unsympathetically due to an understanding both of the family's role in moral education and of the nature of modern morality.

Background Non-adherence to medication is associated with increased risk of relapse in patients with bipolar disorder. Objectives To validate patient-evaluated adherence to medication measured via smartphones against validated adherence questionnaire; and investigate characteristics for adherence to medication measured via smartphones. Methods Patients with BD evaluated adherence to medication daily for 6–9 months via smartphones. The Medication Adherence Rating Scale and the Rogers’ Empowerment questionnaires were filled out. The 17-item Hamilton Depression Rating Scale, the Young Mania Rating Scale and the Functional Assessment Short Test were clinically rated. Data were collected multiple times per patient. The present study represents exploratory pooled reanalyses of data collected as part of two randomised controlled trials. Findings During the study 90.50% of the days were evaluated as ‘medication taken’, 6.91% as ‘medication taken with changes’ and 2.59% as ‘medication not taken’. Adherence to medication measured via smartphones was valid compared with the MARS. Younger age and longer illness duration were significant predictors for non-adherence to medication. Decreased affective symptoms measured with smartphone-based patient-reported mood and clinical ratings as well as decreased empowerment were associated with non-adherence. Conclusions Smartphone-based monitoring of adherence to medication was valid compared with validated adherence questionnaire. Younger age and longer illness duration were predictors for non-adherence. Increased empowerment was associated with adherence. Clinical implications Using smartphones for empowerment of adherence using patient-reported measures may be helpful in everyday clinical settings. Trial registration number NCT01446406 and NCT02221336.

I consider whether political deference by a citizen within a liberal democracy to moral experts is morally problematic. I compare and contrast deference in the political and personal domains. I set to one side consequentialist worries about political deference and evaluate its possible intrinsic wrongness, expressed as a worry that deference is inconsistent with the grant to individuals of the power exercised in a democratic vote, just as personal deference is inconsistent with the grant of a power of moral choice. I consider several possible versions of such inconsistency: that a vote to delegate decision-making to experts is self-defeating, that it is unfree, or is blind to the significance of exercising a political choice, or is a denial of democratic equality. I conclude that the worries are ill-founded and that political deference is not in itself morally troubling.

Onora O’Neill is one of the foremost moral philosophers writing today. Her work on ethics and bioethics, political philosophy and the philosophy of Kant is extremely influential. Her landmark Reith Lectures on trust did much to establish the subject not only on the philosophical and political agenda but in the world of media, business and law more widely. Reading Onora O’Neill is the first book to examine and critically appraise the work of this important thinker. It includes specially commissioned chapters by leading international philosophers in ethics, Kantian philosophy and political philosophy. The following aspects of O’Neill’s work are examined: global justice Kant the ethics of the family bioethics consent trust. Featuring a substantial reply to her critics at the end of the book, Reading Onora O’Neill is essential reading for students and scholars of ethics and political philosophy

The pace of change and, indeed, the sheer number of clinical ethics committees has accelerated during the COVID-19 pandemic. Committees were formed to support healthcare professionals and to operationalise, interpret and compensate for gaps in national and professional guidance. But as the role of clinical ethics support becomes more prominent and visible, it becomes ever more important to address gaps in the support structure and misconceptions as to role and remit. The recent case of Great Ormond Street Hospital for Children NHS Foundation Trust v MX, FX and X, [21]–[23] and [58]) has highlighted the importance of patient/family representation at clinical ethics committee meetings. The court viewed these meetings as making decisions about such treatment. We argue that this misunderstands the role of ethics support, with treatment decisions remaining with the clinical team and those providing their consent. The considered review by clinical ethics committees of the moral issues surrounding complex treatment decisions is not a matter of determining a single ethical course of action. In this article, we consider current legal understandings of clinical ethics committees, explore current concepts of ethics support and suggest how they may evolve, considering the various mechanisms of the inclusion of patients and their representatives in ethics meetings which is not standard in the UK.