The role of beneficence in clinical genetics: Non-directive counseling reconsidered

The popular view of non-directive genetic counseling limits the counselor's role to providing information to clients and assisting families in making decisions in a morally neutral fashion. This view of non-directive genetic counseling is shown to be incomplete. A fuller understanding of what it means to respect autonomy shows that merely respecting client choices does not exhaust the duty. Moreover, the genetic counselor/client relationship should also be governed by the counselor's commitment to the principle of beneficience. When non-directive counseling is reexamined in light of both these principles, it becomes clear that there are cases in which counselors should attempt to persuade clients to reconsider their decisions. Such attempts are consistent with non-directive counseling because, while respecting the clients' decision-making authority, they insure that clients act with full knowledge of the moral consequences of their decisions.     

Decision-Making About Inherited Cancer Risk: Exploring Dimensions of Genetic Responsibility

Since genetic information has implications for family members, some choices about genetic risk may be influenced by perceptions of responsibility to relatives. Drawing upon 25 semi-structured interviews with test recipients in Canada, this study explored decisions about inherited breast-ovarian and colon cancer. Qualitative data analysis revealed the pervasive significance of genetic responsibility in test decisions. We highlight three dimensions of genetic responsibility: 1) to know about the self for self; 2) to know about the self for others; 3) to know about the self to oblige others to know. It is argued that these dimensions of genetic responsibility have implications for test decisions, family relationships and other family members’ desire to know (or not know) and to act (or not act) with respect to their own genetic risk. In particular, genetic responsibility may play out as a framing of a relative’s moral obligation to know their risk that could obviate any interest they might have in not knowing. We conclude that perceptions of responsibility to—and of−other family members be thoroughly explored in genetic counseling sessions.     

Ethics,metaphysics, and psychoanalysis∗

An attempt is made to point out some of the moral presuppositions and implications of psychotherapy in theory and in practice. In the various forms of dynamically oriented psychotherapy, the setting of goals and decisions concerning maturation and health have value components. Even in psychoanalysis in its strict sense, decisions made in accepting or rejecting contracts and determination of the terminating point of analysis are value laden.

Finally, in the theorizing of Freud and others about psychotherapy moral positions are assumed.     

Once a Utilitarian,Consistently a Utilitarian? Examining Principledness in Moral Judgment via the Robustness of Individual Differences

Although individual differences in the application of moral principles, such as utilitarianism, have been documented, so too have powerful context effects—effects that raise doubts about the durability of people's moral principles. In this article, we examine the robustness of individual differences in moral judgment by examining them across time and across different decision contexts. In Study 1, consistency in utilitarian judgment of 122 adult participants was examined over two different survey sessions. In Studies 2A and 2B, large samples (Ns = 130 and 327, respectively) of adult participants made a series of 32 moral judgments across eight different contexts that are known to affect utilitarian endorsement. Contrary to some contemporary theorizing, our results reveal a strong degree of consistency in moral judgment. Across time and experimental manipulations of context, individuals maintained their relative standing on utilitarianism, and aggregated moral decisions reached levels of near‐perfect consistency. Results support the view that on at least one dimension (utilitarianism), people's moral judgments are robustly consistent, with context effects tailoring the application of principles to the particulars of any given moral judgment.     

addressing career issues online: perceptions of counselor education professionals

The Internet is the latest arena in which counseling services are available for a variety of issues. This study surveyed counselor education professionals about their perceptions regarding the use of online counseling to address various mental health issues including career counseling. It also examined their perceptions about 3 formats of online counseling: e‐mail, text‐based chat, and videoconferencing. Results indicated that counselor education professionals were open to the use of online counseling to address career issues. The implications for the practice of online career counseling and for the training of counselors are discussed.     

Why Drug Testing in Elite Sport Does Not Work: Perceptual Deterrence Theory and the Role of Personal Moral Beliefs1

Performance‐enhancing drug use by elite athletes is a modern sporting and social concern. We applied a long‐overdue theoretical framework, perceptual deterrence, to predicting the banned drug‐use decisions of 116 elite Australian footballers and soccer players. The strongest influence on athletes' hypothetical decisions to use drugs was their personal moral beliefs and health concerns, each of which also mediated the relationship between drug testing and athletes' decisions to use banned substances. Drug testing had little influence on athletes' imagined drug use decisions, although there are athletes for whom legal sanctions are necessary. The results have important implications for the way in which authorities fund and frame future anti‐drug initiatives; particularly the relationship between drug testing and athletes' personal moral beliefs.     

Should we presume moral turpitude in our children? – Small children and consent to medical research

When children are too young to make their ownautonomous decisions, decisions have to be madefor them. In certain contexts we allow parentsand others to make these decisions, and do notinterfere unless the decision clearly violatesthe best interest of the child. In othercontexts we put a priori limits on whatkind of decisions parents can make, and/or whatkinds of considerations they have to take intoaccount. Consent to medical research currentlyfalls into the second group mentioned here. Wewant to consider and ultimately reject one ofthe arguments put forward for putting medicalresearch into the second category. We willargue that some objections to children'sparticipation in research are either based onan implausibly restrictive conception of whatis in fact in the child's best interests orthat there is an implicit and false premisehidden in this argument; i.e., the premise thatour children have so deeply fallen into moralturpitude that we must assume that they wouldnot want to fulfill their moral obligations,or, that they will grow up to be morallydeficient and will then wish not to have actedwell while a child.     

Probability Biases in Genetic Problem Solving: A Comparison of Undergraduates, Genetic Counseling Graduate Students, and Genetic Counselors

Heuristics are mental shortcuts that aid people in everyday problem-solving and decision-making. Although numerous studies have demonstrated their use in contexts ranging from consumers’ shopping decisions to experts’ estimations of experimental validity, virtually no published research has addressed heuristics use in problems involving genetic conditions and associated risk probabilities. The present research consists of two studies. In the first study, 220 undergraduates attempted to solve four genetic problems—two common heuristic problems modified to focus on genetic likelihood, and two created to study heuristics and probability rule application. Results revealed that the vast majority of undergraduates used heuristics and also demonstrated a complete misuse of probability rules. In the second study, 156 practicing genetic counselors and 89 genetic counseling students solved slightly modified versions of the genetic problems used in Study 1. Results indicated that a large percentage of both genetic counselors and students used heuristics, but the counselors demonstrated superior problem-solving performance compared to both the genetic counseling students and the undergraduates from Study 1. Research, training, and practice recommendations are presented.     

Counseling in a Complex World: Advancing Relational Well-Being

In a globalized world, people's attempts at living a good life interfere with one another in complex ways. In particular, tension and conflict are inevitable. This confronts counselors/therapists with the ethical question of how to take into account (global) interdependence and relational complexity. In this article, I explore what moral visions—assumptions of what a person is and should be—help counselors shift their focus from individual to relational well-being. First, I examine the moral vision of narrative therapy, as an alternative to more traditional, individualistic moral visions. Then, I construct a moral vision of relational being, based on the relational being perspective of Kenneth Gergen. This vision represents an ethical stance that may, using work by philosopher Judith Butler, be understood as an ethic of recognition and nonviolence. Finally, implications of the moral vision of relational being for counseling/therapeutic practice are explored.     

Careerist,Wage-Earner,or Entrepreneur: Work Values and Counseling

Work values play a major role in career decisions, but how often are these values consciously addressed in counseling? Studies based on ethnology offer new insight into the importance of work values. This article points to some implications for counseling.     

Moral disagreement and procedural justice: Moral mandates as constraints to voice effects

Procedural voice is a widely used and effective means to reduce or eliminate conflict. Moral disagreements, however, are particularly inflammatory, divisive, and difficult to manage. The current article reports two studies that demonstrated the unique challenge that moral disagreements pose. Specifically, the studies tested the extent to which procedural voice affected justice judgements, group climate, and decision acceptance when people perceived decisions to have moral implications. Results indicated that when people's outcome preferences represent strong moral convictions, outcomes were the primary determinant of perceived fairness and related judgements, irrespective of whether people had voice in the decision‐making process.     

A Theory,Philosophy, and Practice for the Employment Counselor

Employment counselors have many pressures brought on them by various publics. Many of these forces make it difficult for them to engage in counseling with their clients. Although there are varying definitions of counseling, many focus on dynamic problems such as defining roles and making decisions. There is a need for theory in the practice of counseling, and a specific approach described is based on existential philosophy. Directing attention in counseling to the meaning of life and to what each person may do to provide answers to this question is the main point in this existential approach.     

PHILOSOPHERS,THEIR CONTEXT,AND THEIR RESPONSIBILITIES

Abstract: It has at various times been said, both before and since the fall of apartheid, that philosophers in South Africa are neglecting to do certain sorts of work. Behind this accusation lies a general claim that philosophers have responsibilities to their contexts. This essay is dedicated to (i) defending this claim against objections, and (ii) offering a positive argument for there being moral pressure on philosophers to increase understanding. My aim is not to accuse any philosopher or community of philosophers of neglect. It is rather to defend an understanding of both philosophy and ethical responsibilities that makes room for philosophers to have moral responsibilities. Whether or not it has ever in fact been appropriate to accuse philosophers in South Africa, or indeed anywhere else, of neglect, philosophers do indeed have responsibilities to their contexts.     

Age-Related Hearing Loss: Implications for Counseling

As the U.S. population ages, counseling practitioners are working with increasing numbers of hearing-impaired older adults. Age-related hearing loss affects various dimensions of the counseling process, in which communication is of primary importance. More generally, hearing loss has consequences for the overall lifestyle of the client and for effective functioning in the workplace and in social and family contexts. This article examines adaptation strategies used by hearing-impaired listeners and the implications of age-related hearing loss for counseling, intervention, and self-management.     

The Legacy of Lawrence Kohlberg: Implications for Counseling and Human Development

Despite the great contribution by Lawrence Kohlberg to our understanding of moral development, counselors are only beginning to appreciate fully the implications of his developmental psychology for the practice of counseling and human development. Drawing on the collective body of Kohlberg's work, seven basic assumptions are shown to have direct relevance for conceptualizing counseling from a constructivist developmental approach.     

The role of emotions for moral judgments depends on the type of emotion and moral scenario

Emotions seem to play a critical role in moral judgment. However, the way in which emotions exert their influence on moral judgments is still poorly understood. This study proposes a novel theoretical approach suggesting that emotions influence moral judgments based on their motivational dimension. We tested the effects of two types of induced emotions with equal valence but with different motivational implications (anger and disgust), and four types of moral scenarios (disgust-related, impersonal, personal, and beliefs) on moral judgments. We hypothesized and found that approach motivation associated with anger would make moral judgments more permissible, while disgust, associated with withdrawal motivation, would make them less permissible. Moreover, these effects varied as a function of the type of scenario: the induced emotions only affected moral judgments concerning impersonal and personal scenarios, while we observed no effects for the other scenarios. These findings suggest that emotions can play an important role in moral judgment, but that their specific effects depend upon the type of emotion induced. Furthermore, induced emotion effects were more prevalent for moral decisions in personal and impersonal scenarios, possibly because these require the performance of an action rather than making an abstract judgment. We conclude that the effects of induced emotions on moral judgments can be predicted by taking their motivational dimension into account. This finding has important implications for moral psychology, as it points toward a previously overlooked mechanism linking emotions to moral judgments.     

Moral disengagement in ethical decision making: a study of antecedents and outcomes

This article advances understanding of the antecedents and outcomes of moral disengagement by testing hypotheses with 3 waves of survey data from 307 business and education undergraduate students. The authors theorize that 6 individual differences will either increase or decrease moral disengagement, defined as a set of cognitive mechanisms that deactivate moral self-regulatory processes and thereby help to explain why individuals often make unethical decisions without apparent guilt or self-censure (Bandura, 1986). Results support 4 individual difference hypotheses, specifically, that empathy and moral identity are negatively related to moral disengagement, while trait cynicism and chance locus of control orientation are positively related to moral disengagement. Two additional locus of control orientations are not significantly related to moral disengagement. The authors also hypothesize and find that moral disengagement is positively related to unethical decision making. Finally, the authors hypothesize that moral disengagement plays a mediating role between the individual differences they studied and unethical decisions. Their results offer partial support for these mediating hypotheses. The authors discuss the implications of these findings for future research and for practice.     

Naturalizing Moral Justification: Rethinking the Method of Moral Epistemology

The companion piece to this article, “Situating Moral Justification,” challenges the idea that moral epistemology's mission is to establish a single, all‐purpose reasoning strategy for moral justification because no reasoning practice can be expected to deliver authoritative moral conclusions in all social contexts. The present article argues that rethinking the mission of moral epistemology requires rethinking its method as well. Philosophers cannot learn which reasoning practices are suitable to use in particular contexts exclusively by exploring logical relations among concepts. Instead, in order to understand which reasoning practices are capable of justifying moral claims in different types of contexts, we need to study empirically the relationships between reasoning practices and the contexts in which they are used. The article proposes that philosophers investigate case studies of real‐world moral disputes in which people lack shared cultural assumptions and/or are unequal in social power. It motivates and explains the proposed case study method and illustrates the philosophical value of this method through a case study.     

Quasi-Realism, Negation and the Frege-Geach Problem

Every expressivist theory of moral language requires a solution to the Frege-Geach problem, i.e., the problem of explaining how moral sentences retain their meaning in unasserted (e.g., conditional and disjunctive) contexts. An essential part of Blackburn's ' quasi -realist project', i.e., the project of showing how we can earn the right to treat moral sentences as if they have ordinary truth-conditions, is to provide a sophisticated solution. I show, however, that simple negated contexts provide a fundamental difficulty, since accepting the negation of a sentence is easily confused with merely refusing to accept that sentence. I argue that Blackburn's model-set semantics for his 'Hooray!' and 'Boo!' operators requires logical apparatus to which he is not entitled. I consider various modifications, but show that they do not succeed.
email : n.unwin@bolton.ac.uk