Jeffrey Blustein

No profession has undergone as much scrutiny in the past several decades as that of medicine. Indeed, one might well argue that no profession has ever undergone so much change in so short a time. An essential part of this change has been the growing insistence that competent, adult patients have the right to decide about the course of their own medical treatment. However, the familiar and widely accepted principle of patient self-determination entails a corollary that has received little attention in the growing literature on the ethics of physician-patient relations: if patients are to direct the course of their own medical treatment, then physicians are at least sometimes to be guided in their actions on behalf of patients by values that are not, and may even be incompatible with, their own values. Unless it is supposed that it would be best if physicians were simply to accommodate any and all patient requests, a possibility I consider and reject in this paper, there are bound to be numerous instances of legitimate moral conflict between the preferences of physicians and patients. In this paper, I examine the implications of this sort of moral conflict from the standpoint of the integrity of the physician. Critical to a proper appreciation of the significance of this conflict is a distinction that the literature on biomedical ethics has largely failed to draw: that between medical paternalism and physician integrity.

The recent child custody case Weisberger v Weisberger raises a number of ethical issues concerning the rights and responsibilities of parents. Chavie Weisberger, thirty‐five, and her husband, both members of an ultraorthodox Hasidic community, appeared before a religious court in 2008 to obtain a divorce. There are two sharply contrasting legal rulings in this case. Setting aside the legally significant fact that Chavie had signed the divorce agreement with the clause requiring her to raise her children Hasidic, which decision is ethically more defensible and why? Were Chavie's parental rights violated when the court removed her children from her care? Should her ex‐husband have been awarded full custody on the ground that this was in the children's best interest, and is this the right standard to use in making custody decisions? What parental responsibilities did Chavie and her ex‐husband have, and were they satisfactorily discharging them? A theory of the moral foundations of parenthood should provide answers to these questions among others. Joseph Millum, in his excellent new book The Moral Foundations of Parenthood, does this and more. His theory encompasses accounts of the foundation and content of parental rights and responsibilities, the acquisition of parental responsibilities, and the standards governing parental decision‐making.

Despite an explosion of studies on memory in historical and cultural studies, there is relatively little in moral philosophy on this subject. In this book, Jeffrey Blustein provides a systematic and philosophically rigorous account of a morality of memory. Drawing on a broad range of philosophical and humanistic literatures, he offers a novel examination of memory and our relations to people and events from our past, the ways in which memory is preserved and transmitted, and the moral responsibilities associated with it. Blustein treats topics of responsibility for one's own past; historical injustice and the role of memory in doing justice to the past; the relationship of collective memory to history and identity; collective and individual obligations to remember those who have died, including those who are dear to us; and the moral significance of bearing witness.

RÉSUMÉ: J'examine ici trois façons de défendre l'idée que les personnes ont individuellement une valeur. Je pars de la thèse selon laquelle la valeur des individus tient à la valeur de leurs qualités particulières. Je m'arrête alors sur l'objection que pour comprendre ce qui fait la valeur individuelle des personnes, il nous faut accorder une place distinctive à leurs conceptions d'elles-mêmes. L'approche par la conception de soi qui résulte de ces considérations se révèle problématique à l'examen, mais elle nous oriente vers une façon «kantienne», plus satisfaisante, de rendre compte de la valeur des individus. L'explication en question développe la doctrine des «deux points de vue» avancée par Christine Korsgaard et fait reposer ma valeur en tant qu'individu sur la dignité qui est la mienne en tant que maître d'œuvre de ma propre vie, un titre que personne d'autre ne peut avoir.

What is a disability? What sorts of limitations do persons with disabilities or impairments experience? What is there about having a disability or impairment that makes it disadvantageous for the individuals with it? Are persons with severe cognitive impairments capable of making autonomous decisions? What role should disability play in the construction of theories of justice? Is it ever ethical for parents to seek to create a child with an impairment? This anthology addresses these and other questions and is a valuable addition to a growing interdisciplinary literature exploring issues at the intersection of disability studies, philosophy, and bioethics. Most of the authors are well-known from their previous work in the disability field and have already made significant philosophical contributions to it

: Urban bioethics seeks to broaden the traditional focus of bioethics to encompass questions about the interplay of individuals with family, group, community, and society. Urban bioethics will need to deal with cultural diversity, issues of equity, and the conflict between individual rights and the public good. Encouraging a multicultural ethical discernment, fostering an appreciation of the political, economic, sociological, and psychological issues that inform the question of urban moral choice, urban bioethics is essentially a multi-disciplinary, synthesizing enterprise. Several theoretical models including social contract, rule utilitarian, communitarian, and feminist paradigms offer complementary conceptual frameworks. This paper is offered as a proposal, a road map for future study to place current bioethical analysis into a broader context

RÉSUMÉ: J'examine ici trois façons de défendre l'idée que les personnes ont individuellement une valeur. Je pars de la thèse selon laquelle la valeur des individus tient à la valeur de leurs qualités particulières. Je m'arrête alors sur l'objection que pour comprendre ce qui fait la valeur individuelle des personnes, il nous faut accorder une place distinctive à leurs conceptions d'elles-mêmes. L'approche par la conception de soi qui résulte de ces considérations se révèle problématique à l'examen, mais elle nous oriente vers une façon «kantienne», plus satisfaisante, de rendre compte de la valeur des individus. L'explication en question développe la doctrine des «deux points de vue» avancée par Christine Korsgaard et fait reposer ma valeur en tant qu'individu sur la dignité qui est la mienne en tant que maître d'œuvre de ma propre vie, un titre que personne d'autre ne peut avoir.

The meaning of valid proxy consent for children has recently been the subject of an important debate between Richard McCormick and Paul Ramsey on the ethics of experimenting with children. Ramsey is willing to agree with McCormick that parental consent for a child to undergo some medical procedure is valid only if parents consider what the child would consent to if he could. But beyond this, Ramsey has a fundamentally different conception of the child from McCormick, and therefore gives a very different interpretation to this standard for valid proxy consent. In Ramsey's view, McCormick's basic mistake is to think of the child as a small adult, thereby overlooking the child's peculiar vulnerabilities and needs. In particular, McCormick fails to attend to the child's needs for "preservation in life and healthful growth". In this paper, the author pursues Ramsey's suggestion that a correct analysis of valid proxy consent for children would replace the "language of consent" with the "language of need". He does this by sketching a theory of parenthood that rests on two central notions: that of primary goods, as found in the writing of John Rawls, and that of autonomy