The insanity plea: Szaszian ethics and epistemology

The traditional legal verdict of ‘not guilty by reason of insanity’ as well as the more recent verdict of ‘guilty but mentally ill’ rest on often unquestioned epistemological assumptions about human behavior and its causes, unjustified reliance on forensic psychiatrists, and questionable, if not deplorable ethical standards. This paper offers a critique of legal perspectives on insanity, historical and current, based on the altermative epistemological and ethical assumptions of Thomas S. Szasz. In addition, we examine Szasz's unique rhetorical analysis of ‘mental illness’ and its implications for forensic psychiatry.     

Cultural context in medical ethics: lessons from Japan

This paper examines two topics in Japanese medical ethics: non-disclosure of medical information by Japanese physicians, and the history of human rights abuses by Japanese physicians during World War II. These contrasting issues show how culture shapes our view of ethically appropriate behavior in medicine. An understanding of cultural context reveals that certain practices, such as withholding diagnostic information from patients, may represent ethical behavior in that context. In contrast, nonconsensual human experimentation designed to harm the patient is inherently unethical irrespective of cultural context. Attempts to define moral consensus in bioethics, and to distinguish between acceptable and unacceptable variation across different cultural contexts, remain central challenges in articulating international, culturally sensitive norms in medical ethics.     

The notion of the moral: the relation between virtue ethics and virtue epistemology

In this paper I argue that virtue ethics should be understood as a form of ethics which integrates various domains of the practical in relation to which virtues are excellences. To argue this it is necessary to distinguish two senses of the “moral”: the broad sense which integrates the domains of the practical and a narrow classificatory sense. Virtue ethics, understood as above, believes that all genuine virtue should be understood as what I call virtues proper. To possess a virtue proper (such as an excellent disposition of open-mindedness, an epistemic virtue) is to possess a disposition of overall excellence in relation to the sphere or field of the virtue (being open to the opinions of others). Overall excellence in turn involves excellence in integrating to a sufficient degree, standards of excellence in all relevant practical domains. Epistemic virtues, sporting virtues, moral virtues, and so on are all virtues proper. In particular it is impossible for an epistemic virtue to be a moral (narrow sense) vice.     

Getting the ethics right regarding research in the emergency setting: lessons from the PolyHeme study

Research in emergency settings (RES) has become a major public issue with urgent policy implications. Significant attention has focused recently on RES in response to the trial of PolyHeme, a synthetic blood substitute, in trauma victims in hemorrhagic shock. Unfortunately, the discussion of the PolyHeme trial in the popular and scholarly press leaves important questions unanswered. This paper articulates three important lessons from the PolyHeme trial that have significant policy implications. First, the RES regulations should be re-visited, particularly the requirement that existing treatments be unproven or unsatisfactory in order for research to be acceptable without consent. Second, further conceptual and empirical scholarship is needed to accomplish the goal of effectively involving communities. Third, a more subtle analysis is needed regarding how to balance the needs of maintaining public trust and protecting confidential trade information in the context of RES.     

Credentialing and certification in ethics consultation: lessons from palliative care

In response to an article by Acres and colleagues, "Credentialing the Clinical Ethics Consultant: An Academic Medical Center Affirms Professionalism and Practice:" the authors urge continued action for the credentialing and certification of clinical ethics consultants. They also promote a vigorous and engaged model for ethics consultation.     

The development of computer ethics: Contributions from business ethics and medical ethics

In this essay, we demonstrate that the field of computer ethics shares many core similarities with two other areas of applied ethics, Academicians writing and teaching in the area of computer ethics, along with practitioners, must address ethical issues that are qualitatively similar in nature to those raised in medicine and business. In addition, as academic disciplines, these three fields also share some similar concerns. For example, all face the difficult challenge of maintaining a credible dialogue with diverse constituents such as academicians of various disciplines, professionals, policymakers, and the general public, Given these similarities, the fields of bioethics and business ethics can serve as useful models for the development of computer ethics. A version of this paper was presented at ETHICOMP98, the Fourth International Conference on Ethical Issues of Information Technology, March 25–27, 1998, Erasmus University, the Netherlands. Kenman Wong, Ph.D., is an Associate Professor of Business Ethics; Gerhard Steinke, Ph.D., is Professor of Management and Information Systems. Both authors are at Seattle Pacific University's School of Business and Economics.     

Business ethics and computer ethics: The view from Poland

An Aristotelian approach to understanding and teaching business ethics is presented and defended. The newly emerging field of computer ethics is also defined in an Aristotelian fashion, and an argument is made that this new field should be called “information ethics”. It is argued that values have their roots in the life and practices of a community; therefore, morality cannot be taught by training for a special way of reasoning. Transmission of values and norms occurs through socialization — the process by which an individual absorbs not only values but also the whole way of life of his or her community. It follows that business ethics and information ethics can be considered kinds of socialization into a profession: role learning and acquiring a new self-identification. This way of understanding fields of applied ethics is especially important for their proper development in Central-Eastern Europe because of endemic factors which are the result of recent political developments there.     

The ethos and ethics of translational research

Calls for the "translation" of research from bench to bedside are increasingly demanding. What is translation, and why does it matter? We sketch the recent history of outcome-oriented translational research in the United States, with a particular focus on the Roadmap Initiative of the National Institutes of Health (Bethesda, MD). Our main example of contemporary translational research is stem cell research, which has superseded genomics as the translational object of choice. We explore the nature of and obstacles to translational research and assess the ethical and biomedical challenges of embracing a translational ethos.     

The ethics of social science research

ABSTRACT Ethical thinking about social science research is dominated by a biomedical model whose salient features are the assumption that only potential harms to subjects of research are relevant in the ethical evaluation of that research, and in the emphasis on securing informed consent in order to establish ethical probity. A number of counter-examples are considered to the assumption, a number of defences against these counter-examples are examined, and an alternative model is proposed for the ethical evaluation of social science research: a model which can cope with the systemic harms (harms other than those to participants as participants) which have been identified. This model is based on John Rawls's idea of original position reasoning and treats social science research as an institutional feature of the basic structure of society.     

Disciplinary roots and branches of evaluation: Some lessons from agricultural research

Since its origins in North America in the 1960s, the field of program evaluation has grown considerably, and its concerns have broadened from accountability to program improvement, decision support, and institutional learning. Program evaluation is now commonly practiced in governmental organizations not only in North America but also in many countries of Western Europe and Oceania. Although program evaluation is a relatively new field with many controversies and lively debates, a unifying body of evaluation theory, methods, and standards is gradually emerging. Evaluation has recently been described as a “transdiscipline,” as are statistics and measurement. This article is based largely on my personal experiences working in agricultural research organizations in developing regions. Here, a number of different types of evaluation are carried out, but program evaluation as defined by Patton (1997) and as practiced by social scientists to assess public programs is largely unknown. Distinct branches of agricultural research evaluation can be identified, with disciplinary roots in the natural sciences and in agricultural economics. The most rigorous agricultural research evaluations are economic studies. Systematic internal evaluation is notably lacking. Current pressures to improve performance, transparency, and accountability are creating demands for more systematic evaluation, and many program evaluation concepts and methods would seem to be of value in agricultural research organizations. However, in the current scenario of declining funding for agricultural research, managers are yet to be convinced to expand their evaluation activities and explore unfamiliar paradigms and methods. Moreover, they are not yet convinced that social-science-based program evaluation would produce useful results. Natural scientists and economists tend to view program evaluation as “soft-science” or no science at all. Douglas Horton works at the International Service for National Agricultural Research (ISNAR) in The Netherlands. Since joining ISNAR in early 1990, he has done research, training, and advisory work on agricultural research management, with an emphasis on evaluation. Previously, for fifteen years, Horton was head of the social science department of the International Potato Center (CIP) in Peru. With colleagues at CIP and in national agricultural research organizations, he documented patterns and trends in world potato production and use, engaged in participatory technology development and assessed the impact of CIP programs. Horton received B.S. and M.S. degrees in agricultural economics from the University of Illinois, and a Ph.D. in economics from Cornell University. While at Cornell, Horton worked with W.F. Whyte, pioneer in the fields of participant observation and participatory action research.