Real Donors, Real Consent: Testing the Theory of Reasoned Action on Organ Donor Consent

In an attempt to apply the theory of reasoned action (TRA) to the process underlying organ donor consent, participants completed questionnaires concerning their affective responses to organ donation, as well as their intentions to donate. Participants were given the opportunity to sign an organ donor card. Those who chose to sign the card had more positive attitudes about donation, perceived donation as something that their reference group would encourage, and had stronger intentions to consent to signing a card. The current investigation extends the organ donor literature by using a true behavioral outcome measure indicating consent. Moreover, the pattern of results between attitudes, norms, intention, and behavior illustrates the usefulness of applying the TRA to yet another health-related behavior.     

Over-Determined Harms and Harmless Pluralities

A popular strategy for meeting over-determination and pre-emption challenges to the comparative counterfactual conception of harm is Derek Parfit’s suggestion, more recently defended by Neil Feit, that a plurality of events harms A if and only if that plurality is the smallest plurality of events such that, if none of them had occurred, A would have been better off. This analysis of ‘harm’ rests on a simple but natural mistake about the relevant counterfactual comparison. Pluralities fulfilling these conditions make no difference to the worse for anyone in the over-determination cases that prompted the need for revising the comparative conception of harm to begin with. We may choose to call them harmful anyway, but then we must abandon the idea that making a difference to the worse for someone is essential to harming. I argue that we should hold on to the difference-making criterion and give up the plural harm principle. I offer an explanation of why Parfit’s and Feit’s plural harm approach seems attractive. Finally, I argue that the consequences of giving up the plural harm principle and holding on to the simple comparative counterfactual analysis of harm are less radical than we may think, in relation to questions about wrongness and responsibility.     

How to Reverse the Organ Shortage

Thousands of lives are lost each year because of a lack of organs available for transplant, but currently, in the UK and many other countries, organs cannot be taken from a deceased donor without explicit consent from the donor or his or her relatives. Switching to an ‘opt‐out’ (or ‘presumed consent’) system for organ donation could substantially increase the supply of organs, and save many lives. However, it has been argued in some quarters that there are serious ethical objections to an opt‐out policy, and that it would be better to adopt a different policy known as the ‘presumptive approach’, that requires explicit consent while also attempting to sway the choices of potential donors and family in the direction of donating, using various persuasive techniques. This article shows how reflection on the impact of a well‐known cognitive bias known as ‘status quo bias’ can explain (i) why moving from the status quo to an opt‐out policy might be effective in increasing organ availability, even without impinging on anyone's autonomous choices, (ii) why we might have overestimated the strength of the objections to an opt‐out policy, and (iii) why the presumptive approach is morally objectionable, while an opt‐out policy is not.     

Counseling Philanthropic Donors

People who wish to make direct gifts to charities or other nonprofit organizations are faced with an overwhelming number of choices. There exist several types of sources of information to help potential donors choose whether, where, and how much to give. Each of these has its limitations, and at some point the size of the gift contemplated by the donor can justify the marginal cost of consulting with an advisor, particularly when the donor is already consulting with legal or financial planners for estate or other planning. Fundraisers and nonprofit organizations advocate for advisors to encourage their clients to donate. This raises the questions of the proper role of, and the duties incumbent on, those who counsel potential donors on donations (whether or not such counsel is given in connection with other professional advice). After reviewing the situation that gives rise to these issues, this article discusses answers to these questions and how philanthropy and client service can be furthered as part of the same process.     

Benefits and Changes for Family to Family Graduates

Family members of people with serious mental illnesses (SMI) need information and support to cope with the considerable stresses they experience. The Family to Family Education Program (FtF) is a structured, peer-led, 12-week information and support self-help class for such individuals. Previous research by Dixon et al. (2004) shows reduced subjective burden and increased empowerment among graduates. The present study sought to understand what processes take place during FtF participation that might lead to these benefits, as a first step in building a conceptual model of how FtF causes its effects, using semi-structured interviews with 31 FtF graduates. Qualitative data analysis suggested that new factual and emotional information from FtF shifts interviewees' understanding of their situation and that skills acquired through FtF then allow participants to incorporate these new perspectives into more adaptive behaviors. These changes led to both proximal and distal benefits for the FtF participants interviewed. The results are discussed in the context of self-help, stress-and-coping, and trauma recovery theories.     

Robust Individual Responsibility for Climate Harms

According to some scholars, while sets of greenhouse gases emissions generate harms deriving from climate change, which can be mitigated through collective actions, individual emissions and mitigation activities seem to be causally insufficient to cause harms. If so, single individuals are neither responsible for climate harms, nor they have mitigation duties. If this view were true, there would be collective responsibility for climate harms without individual responsibility and collective mitigation duties without individual duties: this is puzzling. This paper explores a way to solve this puzzle. First, it will be argued that individual emissions, though not proper and full-fledged causes, causally contribute to raise the probability of climate harms. As a consequence, individuals are in fact responsible for their expected contributions to climate harms – this is contributive responsibility for likely outcomes. Second, it will be argued that people have responsibility also for the possible impacts of their individual emissions on climate harms. People can plausibly be regarded as individually responsible for the possible outcomes of their actions in close possible alternative worlds – this is robust responsibility. Non-causal individual responsibility for climate harms is plausible, and the puzzle may be solved.     

Ideology and the Harms of Self-Deception: Why We Should Act to End Poverty

In thinking about global poverty, the question of moral motivation is of central importance: Why should the average person in the West feel morally compelled to do anything to help the poor? Various answers to this question have been constructed—and yet poverty persists. In this paper I will argue that, among other difficulties, the current approaches to the problem of poverty (from Peter Singer and Thomas Pogge) overlook a critical element: that poverty not only harms the poor, it harms every human being. Its existence forces us to live in a world where we are compelled by a pervasive ideology to eviscerate our own humanity and neglect our human impulses. Drawing on Karl Marx’s Aristotelian-influenced notion of our human essence as “species-being,” I will construct an account of moral motivation in the face of poverty that stems from a selfish desire to avoid these harms. Thus our moral impetus for acting to help the poor comes not from feelings of guilt about how poverty harms them, but rather from recognizing that poverty is harming all of us. By fighting against global poverty, we seek to make the world a better place for ourselves and the poor alike.     

Longitudinal Predictors of Alcohol‐Related Harms During the Transition to Adulthood

While a range of factors have been found to increase the likelihood of alcohol‐related harms among young people, little is known about their relative importance. This article aimed to identify the risks for alcohol‐related harms at an age when alcohol use and problems tend to peak in Australia (19–20 years). A wide range of concurrent and antecedent factors from multiple domains were examined using path analysis, including individual characteristics, family environment, and externalising and internalising problems. The sample comprised of 941 individuals from the Australian Temperament Project, a large longitudinal community‐based study. The path model controlled for current risky drinking and revealed a number of variables that were significant longitudinal predictors of alcohol‐related harms within each of the domains, including adolescent antisocial behaviour and drinking behaviour, low agreeableness, impulsivity, and paternal drinking levels. The potential for developmental prevention approaches to reduce alcohol‐related harms by targeting externalising behaviour problems, interpersonal influences, and individual characteristics is discussed.