C. James

The current legal status and medical ethics of routine or religious penile circumcision of minors is a matter of ongoing controversy in many countries. We focus on the United Kingdom as an illustrative example, giving a detailed analysis of the most recent British Medical Association guidance from 2019. We argue that the guidance paints a confused and conflicting portrait of the law and ethics of the procedure in the UK context, reflecting deeper, unresolved moral and legal tensions surrounding child genital cutting practices more generally. Of particular note is a lack of clarity around how to apply the “best interests” standard—ordinarily associated with time-sensitive proxy decision making regarding therapeutic options for a medically unwell patient—to a parental request for a medically unnecessary surgery to be carried out on the genitalia of a healthy child. Challenges arise in measuring and assigning weights to intended sociocultural or religious/spiritual benefits, and even to health-related prophylactic benefits, and in balancing these against potential physical, functional, and psychosexual risks or harms. Also of concern are apparently inconsistent safeguarding standards being applied to children based on their birth sex categorization or gender of rearing. We identify and discuss recent trends in British and international medical ethics and law, finding gradual movement toward a more unified standard for evaluating the permissibility of surgically modifying healthy children's genitals before they can meaningfully participate in the decision.

This essay explores some of the conceptual and moral issues raised by illegal actions in health care. The author first identifies several types of illegal action, concentrating on civil disobedience, conscientious objection or refusal, and evasive noncompliance. Then he sketches a framework for the moral justification of these types of illegal action. Finally, he applies the conceptual and normative frameworks to several major cases of illegal action in health care, such as "mercy killing" and some decisions not to treat incompetent patients. Keywords: illegal actions, mercy killing, non-treatment of incompetent patients, civil disobedience, conscientious objection, evasive non-compliance, moral justification and disobedience, dissent in health care CiteULike Connotea Del.icio.us What's this?

After expressing our gratitude to the commentators for their valuable analyses and assessments of Principles of Biomedical Ethics, we respond to several particular critiques raised by the commentators under the following rubrics: the compatibility of different sets of principles and rules; challenges to the principle of respect for autonomy; connecting principles to cases and resolving their conflicts; the value of and compatibility of virtues and principles; common morality theory; and moral status. We point to areas where we see common agreement with our commentators and respond to their critical evaluations.

At present, Third World countries owe over one trillion dollars to the developed Western nations; much of the debt is held by the leading international commercial banks. The debt of six Latin American countries alone — Argentina, Brazil, Chile, Mexico, Peru, and Venezuela — is over $330 billion, of which $240 billion is owed to commercial banks. Let us immediately narrow our focus to loans made by the major international commercial banks to Third World governments. We shall not be concerned with government-to-government loans, or private-party-to-private-party loans, or with debt owed to the World Bank or the International Monetary Fund. The bank-to-government loans — the so-called “sovereign loans” — are the most economically troublesome and morally interesting. The largest lenders, at least with respect to the Latin American countries, are the American banks Citibank, Chase Manhattan, Bank of America, Manufacturers Hanover, and Chemical Bank. About fifteen Third World countries have serious debt problems, including the largest: Brazil, Mexico, and Argentina.

After briefly sketching common-morality principlism, as presented in Principles of Biomedical Ethics, this paper responds to two recent sets of challenges to this framework. The first challenge claims that medical ethics is autonomous and unique and thus not a form of, or justified or guided by, a common morality or by any external morality or moral theory. The second challenge denies that there is a common morality and insists that futile efforts to develop common-morality approaches to bioethics limit diversity and prevent needed moral change. This paper argues that these two critiques fundamentally fail because they significantly misunderstand their target and because their proposed alternatives have major deficiencies and encounter insurmountable problems.

We have all heard the admonition to “take religion seriously.” It is a perplexing command, since AHA statistics indicate that graduate students have been flocking to religious topics for years. Library shelves groan under the weight of recent works that take religion seriously. What, then, might it mean to take religion more seriously, as it has been such a booming academic field for decades now? As Elizabeth Pritchard has pointed out, the imperative is not a methodological recommendation at all, but an ethical–political one. To take religion “seriously” is to grant it its rightful place as an independent variable amidst others, without reducing it to the old categories of politics or class or gender. It is implicitly frivolous to see religion as a superstructural manifestation of a deeper social or economic reality, as have many functionalist theories from Marx onwards. These accounts are routinely pilloried as condescending towards the past, and as failing to take historical actors at their word when they claim to act for religious reasons. There is much to this; nonetheless, the currently reigning assumption of religious autonomy, like that of other cultural artifacts, has been perilously undertheorized. In this joint review, I would like to show how this understanding of religion impedes historical understanding. It might be the case that, to paraphrase Oscar Wilde, religion is too important to take seriously.

This fresh analysis of the "state of the question" in Christian ethics charts the course for future study and exploration in the field. Written in honor of James Gustafson, who provides a conclusion, these 22 original and tightly argued essays examine hotly debated controversies on a wide range of topics, from sources of theological ethics to the moral life. At the core of these complementary perspectives is the ever-increasing tension between the particularly of religious and philosophical traditions and the universality of moral discourse. Designed for classroom use.