Casuistry and Principlism: The Convergence of Method in Biomedical Ethics

Casuistry and principlism are two of the leading contenders to be considered the methodology of bioethics. These methods may be incommensurable since the former emphasizes the examination of cases while the latter focuses on moral principles. Conversely, since both analyze cases in terms of mid-level principles, there is hope that these methods may be reconcilable or complementary. I analyze the role of principles in each and thereby show that these theories are virtually identical when interpreted in a certain light. That is, if the gaps in each method are filled by a concept of judgment or Aristotelian practical wisdom, these methods converge.     

The significance of prognosis for a theory of medical practice

A typical problem of modern medicine results from the gap between scientific knowledge and its application in individual cases. Whereas scientific knowledge is generalized and impersonal information, medical practice takes place under conditions which are singular, individual and irreversible. The paper examines whether prognosis is able to bridge this gap or hiatus theoreticus. It is shown that diagnosis of a single case always relies on prognostic considerations. The individual prognosis (as distinguished from the nosologic prognosis of a certain disease) enables doctors to apply scientific knowledge and practice according to the actual situation, the history and personal preferences of the patient. Prognosis – not diagnosis – therefore legitimizes medical interference. A methodology of individual prognosis as the basis for a theory of practice is discussed.     

The Evolutionary Roots of Morality in Theological Perspective

Theological ethics can interpret the relation between evolution and morality in at least three ways. The reductionist approach holds that morality emerges because it is adaptive. The independent approach maintains that morality develops without registering the influence of evolution. Finally, the interdependence position holds that morality reflects the influence of evolution to the extent that the latter shapes human emotional capacities and predispositions, for example, those regarding reciprocity and kin preference. The third approach is more suitable for theological ethics, which attends to ways in which natural desires can be ordered to serve morality, for example, to be habituated to virtue, and to ways in which we must strive to curb or minimize their disruptive effects on human communities.     

Neural fetal tissue transplants: old and new issues

Abstract. Neural fetal tissue transplantation offers promise as a treatment for devasting neurologic conditions such as Parkinson's disease. Two types of issues arise from this procedure: those associated with the use of fetuses, and those associated with the use of neural tissue. The former issues have been examined in many forums; the latter have not. This paper reviews issues and arguments raised by the use of fetal tissue in general, but focuses on the implications of the use of neural tissue for basic concepts of personnood and personal identity.     

Reflections on peer review practices in committees selecting laureates for prestigious awards and prizes: Some relevant and irrelevant criteria

An important function in all scholarly and academic activities is the participation in the peer review system. One aspect of this peer review evaluation is service on committees judging candidates for important awards, prizes and fellowships. Some reflective observations on this process are made in which a number of factors determining the final choice are identified. It is pointed out that the decisions of such committees are based not only on relevant and objective criteria but are also influenced by a number of irrelevant criteria; caution must be exercised to minimize the effect of the latter factors in order to maintain the highest ethical standards in the selection process. The ranking practices of awards committees, national academies and learned societies are briefly reviewed by pointing out some ethical pitfalls, anecdotal incidents, and the ways to avoid the tarnishing of the selection process. Dr. Vijh is a physical chemist whose research interests include interfacial electrochemistry and the chemical physics of solid surface s.     

Evaluating teaching and students’ learning of academic research ethics

A team of philosophers and scientists at Dartmouth College worked for three years to create, train faculty and pilot test an adequate and exportable class in research methods for graduate students of science and engineering. Developing and testing methods for evaluating students’ progress in learning research ethics were part of the project goals. Failure of methods tried in the first year led to the refinement of methods for the second year. These were used successfully in the pilot course and in one university setting external to Dartmouth. The process of development and justification for the final methods are discussed here.     

Unique ethical problems in information technology

A distinction is made between moral indoctrination and instruction in ethics. It is argued that the legitimate and important field of computer ethics should not be permitted to become mere moral indoctrination. Computer ethics is an academic field in its own right with unique ethical issues that would not have existed if computer technology had not been invented. Several example issues are presented to illustrate this point. The failure to find satisfactory non-computer analogies testifies to the uniqueness of computer ethics. Lack of an effective analogy forces us to discover new moral values, formulate new moral principles, develop new policies, and find new ways to think about the issues presented to us. For all of these reasons, the kind of issues presented deserve to be addressed separately from others that might at first appear similar. At the very least, they have been so transformed by computing technology that their altered form demands special attention.     

Philip Roth'sPatrimony: Narrative and ethics in a case study

I assess the ethical content of Philip Roth's account of his father's final years with, and death from, a tumor. I apply this to criticisms of the nature and content of case reports in medicine. I also draw some implications about modernism, postmodernism and narrative understandings.A version of the first two sections of this paper was presented at the annual meeting of the Society for Health and Human Values November 6, 1993, Washington, D.C.     

Policies and perspectives on authorship

Authorship on publications has been described as a “meal ticket” for researchers in academic settings. Given the importance of authorship, inappropriate publication credit is a pertinent ethical issue. This paper presents an overview of authorship problems and policies intended to address them. Previous work has identified three types of inappropriate authorship practices: plagiarism, giving unwarranted credit and failure to give expected credit. Guidelines from universities, journals and professional organizations provide standards about requirements of authors and may describe inappropriate practices; to a lesser extent, they provide guidance for determining authorship order. While policies on authorship may be helpful in some circumstances, they are not panaceas. Formal guidelines may not address serious power imbalances in working relationships and may be difficult to enforce in the face of particular departmental or institutional cultures. In order to develop more effective and useful guidelines, we should gain more knowledge about how students and faculty members perceive policies as well as their understanding of how policies will best benefit collaborators.     

The engineer’s moral right to reputational fairness

This essay explores the issue of the moral rights of engineers. An historical case study is presented in which an accomplished, loyal, senior engineer was apparently wronged as a result of actions taken by his employer in pursuit of legitimate business interests. Belief that the engineer was wronged is justified by showing that what happened to him violated what can validly be termed one of his moral rights as an engineer: the right to reputational fairness. It is then argued that, this right notwithstanding, under certain circumstances it is morally permissible for employers to override it. The paper concludes by identifying two complementary facets of this right, discussing its scope, and indicating what is required of employers obliged to respect it in two types of action contexts. An earlier version of this paper was presented at the Annual Meeting of the Society for the History of Technology in Washington, D.C. on October 16, 1993. I am indebted to Stephanie J. Bird, Taft Broome, Deborah Johnson, Carl Mitcham, Walter Vincenti, Vivian Weil, and Caroline Whitbeck for helpful critical comments. Professor of Industrial Engineering and Engineering Management and, by courtesy, of Civil Engineering, and in the Program in Science, Technology, and Society, School of Engineering, Stanford University, Stanford, CA, USA, 94305-2120.