Publications

Conflicting Obligations in the International Migration of Health Workers

jcs12 — Mon, 01 Mar 2010 06:00:00 GMT

Think Globally, Act Locally: Collective Consent and the Ethics of Knowledge Production

nick stock — Mon, 01 Mar 2010 06:00:00 GMT

Maui Hudson

Ethical review is an integral part of the process of developing research and considering issues associated with the production of knowledge. It is part of a system that primarily legitimises western traditions of inquiry and reinforces western assumptions about knowledge and its benefit to society. Around the world the process of colonisation has excluded indigenous understandings. In New Zealand, Māori (indigenous) knowledge has been similarly marginalised; this pattern is also reflected within ethical review. Māori values, while acknowledged, are not yet considered to have equal weight in ethical deliberations. The notion of collective rights and the possibility of developing processes to allow collective consent to be recognised and mandated by ethics committees have been raised by communities but largely ignored by the ethical review system. While kaupapa Māori researchers espouse the benefits of closer community involvement, policy makers and ethics committees have focused on "consultation" as the mechanism which confirms proof of engagement, the establishment of community support, and the relevance of the project. This article highlights the potential of the concept of collective consent in negotiations between researchers and communities.

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The Very Idea of a Judge

cait — Mon, 01 Mar 2010 06:00:00 GMT

ByDavid Dyzenhaus

"I argue that we cannot have legal order without judges who have an understanding of legal principles that transcends the law of their land. But this is an understanding of the principles of legality, rather than of the moral content of the law. Moreover, the reason we cannot have legal order without judges is that law must claim not only authority but also legitimate authority over its subjects. It follows that the willingness to engage in any kind of analysis of cases in order to answer questions about what judges should or should not do requires that certain positions sceptical about judicial review openly revise a fundamental commitment - the practically unrealizable commitment to have law without judges. But it also requires the common law tradition, including Ronald Dworkin, to attend more to the independent status of legality. In sum, the focus on the question 'What is a judge?' brings with it attention both to the idea of legality and to the specific authority of law."

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Medical Education as Moral Formation: An Aristotelian Account of Medical Professionalsim

cait — Mon, 01 Mar 2010 06:00:00 GMT

By Warren A. Kinghorn

The medical professionalism movement, bolstered by many influential medical organizations and institutions, has in the last decade produced a number of conceptual definitions of professionalism and a number of concrete proposals for its measurement and teaching. These projects, however laudable, are misguided when they treat professionalism as a unitary descriptive concept rather than as a contested and therefore primarily evaluative one; when they conceive professionalism as a domain of medical practice separable in principle from other domains; and when they treat professionalism as, in principle, a specifiable goal or product of sufficiently well designed educational curricula. The logic of professionalism-as-product corresponds to the logic of techne (art or practical skill) in Aristotle's Nicomachean Ethics. Aristotle provides a cogent argument, however, that the moral excellences denoted by "professionalism" cannot be "produced" or even prespecified in the concrete; rather, they must be acquired through long practice under the careful concrete guidance of teachers who themselves embody these moral excellences. Phronesis (practical wisdom) rather than techne must therefore be the guiding logic of educational initiatives in medical professional formation, with particular emphasis on close mentorship and on the moral character both of students and of those who teach them.

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A Virtue Ethical Account of Making Decisions About Risk

cait — Mon, 01 Mar 2010 06:00:00 GMT

By Nafsika Athanassoulis and Allison Ross

Most discussions of risk are developed in broadly consequentialist terms, focusing on the outcomes of risks as such. This paper will provide an alternative account of risk from a virtue ethical perspective, shifting the focus on the decision to take the risk. Making ethical decisions about risk is, we will argue, not fundamentally about the actual chain of events that the decision sets in process, but about the reasonableness of the decision to take the risk in the first place. A virtue ethical account of risk is needed because the notion of the 'reasonableness' of the decision to take the risk is affected by the complexity of the moral status of particular instances of risk-taking and the risk-taker's responsiveness to these contextual features. The very idea of 'reasonable risk' welcomes judgements about the nature of the risk itself, raises questions about complicity, culpability and responsibility, while at its heart, involves a judgement about the justification of risk which unavoidably focuses our attention on the character of the individuals involved in risk-making decisions.

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Moral Distress: A Growing Problem in the Health Professions?

cait — Mon, 01 Feb 2010 06:00:00 GMT

By Connie M. Ulrich, Ann B. Hamric and Christine Grady.

In the insightful and provocative book Final Exam, noted author and liver transplant surgeon Pauline Chen chronicles her medical education and some of the ethical dilemmas physicians face in practice. 1 She describes a hierarchal and often authoritative system of care, reflecting upon the frailties of care providers as well as patients. Though she does not explicitly use the term, Chen implicitly describes the impact of moral distress on health care quality, providers’ ability to meet professional and ethical obligations, and subsequent provider satisfaction and retention.
Moral distress, as defined by Andrew Jameton in 1984, is the inability of a moral agent to act according to his or her core values and perceived obligations due to internal and external constraints. 2 Others have noted the psychological and physical burdens resulting from moral distress. 3 Today, nurses and their colleagues face ethical issues that seem more complex and more frequent than when Jameton coined the term twenty-five years ago. Although moral distress was originally conceptualized to address ethical issues in nursing, all health care professionals tackle morally relevant questions pertaining to the “rightness” or “wrongness” of decisions, treatments, or procedures, while feeling powerless to change situations they perceive to be morally wrong. Providers frequently say things like, “It’s not my job to speak out; no one will listen anyway,” or, “This doesn’t make any sense; why are we continuing to do this?,” or “I want to tell the patient to run.”

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Diversity in the person, diversity in the group: Challenges of identity complexity for social perception and social interaction

nick stock — Mon, 01 Feb 2010 06:00:00 GMT

Galen V. Bodenhausen

Social psychological research is increasingly coming to grips with the complexity of social identity within the individual, both from the perspective of perceivers trying to form impressions and make judgments about multiply categorizable targets, as well as from the perspective of actors using their different self-aspects as a framework for guiding their interactions with the social world. I review several contributions to the effort to better understand these issues and then explore some of their possible implications for understanding the nature and consequences of diversity within the group.

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Beyond the information given: The power of a belief in self-interest

nick stock — Mon, 01 Feb 2010 06:00:00 GMT

Joel H. K. Vuolevi, Paul A. M. Van Lange

How do we interpret other's behavior when we lack important pieces of information? Do we give the other the benefit of the doubt, believing that the other behaves in a fair manner? Or do we fill in the blanks with self-interest? To address these questions, we designed a new method - the dice-rolling paradigm - in which participants observed another person assigning outcomes by rolling two dice and allocating one of them to the participant, who only had information about one of the two dice. Using different baselines, the results revealed that participants underestimated the outcomes the other allocated to the participants, and overestimated the outcomes the other allocated to self, indicating that people assume self-interest from others when information is incomplete.

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Psychological mechanisms underlying support for juvenile sex offender registry laws: prototypes, moral outrage, and perceived threat

nick stock — Mon, 01 Feb 2010 06:00:00 GMT

Jessica M. Salerno, Cynthia J. Najdowski, Margaret C. Stevenson, Tisha R. A. Wiley, Bette L. Bottoms, Roberto Vaca Jr., Pamela S. Pimentel

In three studies, we investigated support for applying sex offender registry laws to juveniles. Family law attorneys supported registry laws less for juveniles than for adults. Laypeople and prosecutors supported juvenile and adult sex offender registration equally - even though they perceived juveniles as generally less threatening than adults (Study 1) - because most people spontaneously envision a severe sex offender prototype regardless of offender age (Study 2). People are less supportive of registry laws, however, when they envision less severe prototypes spontaneously (Study 2) or when induced to do so (Study 3). Effects of offender age, offender prototypes, and offense severity were mediated by perceptions of threat posed by the juvenile sex offender (i.e., utilitarian concerns). The effect of offense severity was also mediated by moral outrage (i.e., retributive concerns).

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Sharing

cait — Mon, 01 Feb 2010 06:00:00 GMT

By Russell Belk.

Sharing is a fundamental consumer behavior that we have either tended to overlook or to confuse with commodity exchange and gift giving. Sharing is a distinct, ancient, and increasingly vital consumer research topic that bears on a broad array of consumption issues ranging from sharing household resources versus atomized family possessions to file sharing versus intellectual property rights. This theoretical review distinguishes between sharing in and sharing out, and suggests that sharing in dissolves interpersonal boundaries posed by materialism and possession attachment through expanding the aggregate extended self. However, such sharing is challenged by growing market commoditization. Implications for consumer theory and research are considered.

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Emotions in Action through the Looking Glass

nick stock — Mon, 01 Feb 2010 06:00:00 GMT

Corrado Sinigaglia, Laura Sparaci

The paper aims at highlighting how our primary understanding of others' actions is rooted in the mirror mechanism. To this end, the anatomical architecture of the mirror neuron system for action will be outlined as well as its role in grasping goals and intentions in others' motor behaviour. One further step through the looking glass of social cognition will be referring to the ubiquitous emotional colouring of actions and considering its links with the motor domain. This will allow a clearer perspective on the mechanism underlying our abilities for emotional understanding and on cases in which these abilities are amiss, as in autistic spectrum disorders.

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Integrity and Fragmentation

nick stock — Mon, 01 Feb 2010 06:00:00 GMT

John Cottingham

The virtue of integrity does not appear explicitly in either the Aristotelian or the Judaeo-Christian list of virtues, but elements of both ethical systems implicitly acknowledge the importance of a unified and integrated life. This paper argues that integrity is indispensible for a good human life; the fragmented or compartmentalized life is always subject to instability, in so far as unresolved psychological conflicts and tensions may threaten to derail our ethical plans and projects. Achieving a stable and integrated life requires self-awareness; and (drawing on insights from the psychoanalytic tradition) it is suggested that self-awareness is not a simple matter, but requires a complex process of self-discovery. The paper's final section argues that although vitally necessary for the good life, integrity cannot be sufficient. Against the view of influential writers such as Bernard Williams and Harry Frankfurt, our commitment to our chosen projects, however authentic and integrated, cannot in itself give our lives meaning and value. The good and meaningful life cannot be a matter of authenticity alone, but requires us, whether we like it or not, to bring our projects into line with enduring objective values that we did not create, and which we cannot alter.

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The Inherent Limitations on Human Freedom

cait — Mon, 01 Feb 2010 06:00:00 GMT

By James M. Jacobs

That the essence of human nature is to be free is a common theme of many otherwise disparate philosophical traditions. From Augustine to Sartre, the fact of human freedom has been the point of departure for the consideration of humanity’s essence. If philosophers are correct about the centrality of freedom, then every action humans undertake ought to be characterized by freedom in some way. This fact is made intelligible in light of the Thomistic doctrine, agere sequitur esse, or action follows from being.1 Indeed, St. Thomas argues that the very purpose of a substance’s existence is the characteristic operations by which it manifests its actuality. As he puts it, “All things created would seem, in a way, to be purposeless, if they lacked an operation proper to them; since the purpose of everything is its operation. For the less perfect is always for the sake of the more perfect: and consequently as the matter is for the sake of the form, so the form which is the first act is for the sake of its operation, which is the second act; and thus operation is the end of the creature.”2 If this is true, then it follows that the very existence
of freedom in human nature is justified by the performance of free acts, since the substantial act of existence is necessarily fulfilled only in the second act, the characteristic operations or activities that substance undertakes.

In this article, therefore, I analyze the manifestation of human freedom in terms of the various activities proper to humans. This enables us to better grasp the existential significance of human freedom, for it is in these activities that freedom is fully realized. I base my analysis on the thought of Aquinas; moreover, I use many neo-Thomistic philoso-
phers who have reflected critically on the idea of freedom in response to the Kantian notion of autonomy that has led modernity to define freedom in a radically different (and ultimately nihilistic) way. A true notion of freedom must recognize limits imposed by nature that are not acknowledged by the idea of autonomy.

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Feminism, Property in the Person and Concepts of Self

nick stock — Fri, 01 Jan 2010 06:00:00 GMT

Janice Richardson

In this article, I examine the role of the fiction of property in the person in recent feminist debate, comparing Carole Pateman's position with those who are more sympathetic to the image of contract for feminist/anti-racist political theory, such as Charles Mills, Jean Hampton and Susan Moller Okin. I then turn to the question of selfhood. As a fiction, property in the person does not say anything regarding what it is to be a 'self'. However, I explore Balibar's rich analysis of Locke's position on identity. I then extend Balibar's analysis to argue that the fiction of property in the person is associated with an image of a self that is 'bounded' against the outside in a way that is disrupted by this view of identity.

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ADAM SMITH AND THE GREAT MIND FALLACY

nick stock — Fri, 01 Jan 2010 06:00:00 GMT

James R. Otteson

Adam Smith raised a series of obstacles to effective large-scale social planning. In this paper, I draw these Smithian obstacles together to construct what I call the “Great Mind Fallacy,” or the belief that there exists some person or persons who can overcome the obstacles Smith raises. The putative scope of the Great Mind Fallacy is larger than one might initially suppose, which I demonstrate by reviewing several contemporary thinkers who would seem to commit it. I then address two ways the fallacy might be overcome, finding both wanting. I close the paper by suggesting that Smith's Great Mind Fallacy sheds interesting light on his “impartial spectator” standard of morality, including with respect to the specific issues of property and ownership.

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