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.

The concept of basic healt.h care has grown steadily in importance in recent years as more and more of those who reflect on the issue of a right to health care conclude that we need to distinguish between kinds of health care to which people do have a right and others to which they do not have a right. There is little consensus on where to draw this line. But there does seem to be general agreement that, if this distinction is valid, it is so because some kinds of health care are less important, less essential, less something than others, and because the right to health care (if there is such a thing) extends only to those kinds of health care that are more important, more essential, more whatever-it-is. A number of authors have used the term 'basic' to represent this something and this is the term which I shall use. In this article, I shall offer a theory of what we mean by basic health care. I shall do this by developing, in Section 1 of the paper, a general theory of kinds of needs. In Section 2 I will give a brief account of the special moral significance of the levels of need which I designate as basic. In Sections 3-4 1 shall try to identify, in the context of the health care resources available in our society, the health care needs which fall into the previously developed categories of basic need.

In this paper I clarify the distinction between actions performed under a social rule and a mere pattern of behavior through an examination of two distinctive features of actions performed under a social rule. Developing an argument proposed by H.L.A. Hart in The Concept of Law, I first argue that, where a social rule exists, there nonconformity/conformity to the pattern of behavior set down in the rule count as good reasons for criticism/commendation of actions covered by the rule. Secondly I argue that, where a social rule exists, nonconformity/conformity to the pattern set down in the rule must be taken account of (at the risk of self-contradiction) in judging actions covered by the rule commendable or subject to criticism. This in turn means that, where a social rule exists, there can be no genuine exceptions to the rule because the notion of a genuine exception to a social rule makes no sense.

The notion of group responsibility has received some very fruitful examination in recent years. But there still remains an important commonsense objection to this notion. Moral responsibility for an action is ordinarily linked to and held to depend upon the action's being the product of an act of choice on the part of the agent. The thrust of the objection here is that it is extremely difficult to understand how intentional acts like acts of choice can be properly attributed to a group. The notion of a group "consciousness" does not seem a very satisfactory resolution of this problem. In this paper I shall propose that there are actually three distinct processes, as well as many hybrid combinations of them there, by which groups "make choices." That is, when we look at the activities of groups, we discover three different kinds of analogues to the act of choice of the individual person. I shall be illustrating each of these models with examples of health care decisions. In addition, I shall also try to illustrate how the level of personal moral responsibility of each of the individuals making up the group, i.e., each one's responsibility for the group's action, can be seen to flow from the particular role that an individual plays within the process of "group choice" that is involved. In this way, I hope to shed light not only on the topics of group choice, group responsibility, and the interplay of personal and group responsibility, but also to show concretely the valuable role that these themes can play in our understanding of the moral elements of the health care setting. CiteULike Connotea Del.icio.us What's this?

The word “forgiveness” and its verbal form, “forgiving,” may appear to have one and the same meaning whenever it is used. But the first thesis of this essay is that several distinct kinds of human activity are denominated by this word, and their differences are philosophically important. The second thesis of this essay is that some of the human activities denominated by this word have a close connection with hope, more specifically with hoping-in-a-person. The third thesis of this essay is that, because of this connection, some kinds of forgiving have important communal aspects that are often overlooked. The essay develops its three theses through discussions of the expression “forgive and forgot,” a theme from Charles Bosk’s study, Forgive and Remember, a scene from Jane Austen’s, Emma, and a description of forgiving by theologian and spiritual writer, Louis Every.

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?