Conflict of interest in medicine in Lithuania: legal and ethical aspects

The current legal framework within the Lithuanian health system is described including a review of the physician’s autonomy, rights and duties, and patients’ rights including the right to reimbursement. The role of ethical codes and the law are discussed. An earlier version of this paper was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland on 5–6 April, 2002.     

Hotep's Story: Exploring the Wounds of Health Vulnerability in the US

A wide variety of forms of domination hasresulted in a highly heterogeneous health riskcategory, ``the vulnerable.' The study of healthinequities sheds light on forces thatgenerate, sustain, and alter vulnerabilities toillness, injury, suffering and death. Thispaper analyzes the case of a high-risk teenfrom a Boston ghetto that illuminatesintersections between ``race' and class in theconstruction of vulnerability in the US.Exploration of his ``wounds' helps specify howlarge-scale social and cultural forces becomeembodied as individual experience of disparatehealth risk. The case demonstrates that healthinequities would not occur if resources –employment, income, wealth, education, housing,profiling in the legal system, and health care– were more justly managed in keeping withstandards outlined in the Universal Declarationof Human Rights. Professional responses to the``wounds of vulnerability' may reveal importantaspects of who we are and what our work asscholars, practitioners, and advocates mustbecome.     

From case management to prevention of scientific dishonesty in Denmark

In 1992, The Danish Medical Research Council established a national committee on scientific dishonesty with the twofold task of handling cases of scientific misconduct and taking preventive initiatives. Scientific dishonesty was proven in only five cases, but in another nine cases lesser degrees of deviations from good scientific practice were found. The experiences from a total of 24 treated cases indicated that three key areas were at the basis of most of the accusations and the deviations from good practice: uncertainty about 1) authorship, about 2) rights and duties to use scientific data and about 3) agreements at the initiation of joint studies. As a consequence guidelines on good practice have been issued on these key subjects. An earlier version of this paper was presented at a symposium, Scientific Misconduct. An International Perspective, organised by The Medical University of Warsaw, 16 November, 1998.     

The Duty to Eradicate Global Poverty: Positive or Negative?

In World Poverty and Human Rights, Thomas Pogge argues that the global rich have a duty to eradicate severe poverty in the world. The novelty of Pogges approach is to present this demand as stemming from basic commands which are negative rather than positive in nature: the global rich have an obligation to eradicate the radical poverty of the global poor not because of a norm of beneficence asking them to help those in need when they can at little cost to themselves, but because of their having violated a principle of justice not to unduly harm others by imposing on them a coercive global order that makes their access to the objects of their human right to subsistence insecure. In this paper, I claim that although Pogge is right in arguing that negative duties are crucial in an account of global justice, he is wrong in saying that they are the only ones that are crucial. Harming the global poor by causing their poverty provides a sufficient but not a necessary condition for the global rich to have a duty of justice to assist them. After engaging in a critical analysis of Pogges argument, I conclude by suggesting the need for a robust conception of cosmopolitan solidarity that includes positive duties of assistance which are not mere duties of charity, but enforceable ones of justice.     

Ethical Assumptions in Economic Theory: Some Lessons from the History of Credit and Bankruptcy

This paper evaluates the economic assumptions of economic theory via an examination of the capitalist transformation of creditor–debtor relations in the 18th century. This transformation enabled masses of people to obtain credit without moral opprobrium or social subordination. Classical 18th century economics had the ethical concepts to appreciate these facts. Ironically, contemporary economic theory cannot. I trace this fault to its abstract representations of freedom, efficiency, and markets. The virtues of capitalism lie in the concrete social relations and social meanings through which capital and commodities are exchanged. Contrary to laissez faire capitalism, the conditions for sustaining these concrete capitalist formations require limits on freedom of contract and the scope of private property rights.     

In Defense of Individualism

This paper offers a programmatic philosophical articulation of moral and political individualism. This individualism consists of two main components: value individualism and rights individualism. The former is the view that, for each individual, the end which is of ultimate value is his own well-being. Each individual's well-being has ultimate agent-relative value and the only ultimate values are these agent-relative values. The latter view is that individuals possess moral jurisdiction over themselves, i.e., rights of self-ownership. These rights (along with other rights individuals may come to possess) constrain the manner in which agents may pursue value. For this reason, the articulated individualism is an constrained individualism. Sketches of arguments are offered for both value and rights individualism. And it is argued that the sole legitimate function of legal/political institutions is to further delineate and protect the rights of individuals. However, the paper is also concerned to indicate why this radical moral and political individualism does not have many of the features or implications that are commonly ascribed to it. In this connection, I seek to show how this social doctrine accords with individuals' having concern for the well-being of others, with the emergence of relationships among individuals that have both instrumental and non-instrumental value, with a degree of responsibility for self and others that is often thought to be antithetical to individualism and, in general, with a flourishing of civil order.     

What Is Legal Philosophy?

This article delineates some of the main issues that are debated by philosophers of law. It explores the connections between legal philosophy and other areas of philosophy, while also seeking to specify the distinctiveness of many of the concerns that have preoccupied philosophers of law. It illustrates its abstract points with examples focused on the separability of law and morality, the nature of the rule of law, the nature of rights, justifications for the imposition of punishment, and the identification of basic legal entitlements.     

Children’s rights and the non-identity problem

Abstract

Can appealing to children’s rights help to solve the non-identity problem in cases of procreation? A number of philosophers have answered affirmatively, arguing that even if children cannot be harmed by being born into disadvantaged conditions, they may nevertheless be wronged if those conditions fail to meet a minimal standard of decency to which all children are putatively entitled. This paper defends the tenability of this view by outlining and responding to five prominent objections that have been raised against it in the contemporary literature: (1) the identifiability objection; (2) the non-existence objection; (3) the waiving of rights objection, (4) the lack of legitimate complaint objection; and (5) the unfairness objection.     

For the greater goods? Ownership rights and utilitarian moral judgment

People often judge it unacceptable to directly harm a person, even when this is necessary to produce an overall positive outcome, such as saving five other lives. We demonstrate that similar judgments arise when people consider damage to owned objects. In two experiments, participants considered dilemmas where saving five inanimate objects required destroying one. Participants judged this unacceptable when it required violating another’s ownership rights, but not otherwise. They also judged that sacrificing another’s object was less acceptable as a means than as a side-effect; judgments did not depend on whether property damage involved personal force. These findings inform theories of moral decision-making. They show that utilitarian judgment can be decreased without physical harm to persons, and without personal force. The findings also show that the distinction between means and side-effects influences the acceptability of damaging objects, and that ownership impacts utilitarian moral judgment.     

Changing American Congregations: Findings from the Third Wave of the National Congregations Study

The third wave of the National Congregations Study (NCS‐III) was conducted in 2012. The 2012 General Social Survey asked respondents who attend religious services to name their religious congregation, producing a nationally representative cross‐section of congregations from across the religious spectrum. Data about these congregations were collected via a 50‐minute interview with one key informant from 1,331 congregations. Information was gathered about multiple aspects of congregations’ social composition, structure, activities, and programming. Approximately two‐thirds of the NCS‐III questionnaire replicates items from 1998 or 2006–2007 NCS waves. Each congregation was geocoded, and selected data from the 2010 U.S. Census or American Community Survey have been appended. We describe NCS‐III methodology and use the cumulative NCS dataset (containing 4,071 cases) to describe five trends: more ethnic diversity, greater acceptance of gays and lesbians, increasingly informal worship styles, declining size (but not from the perspective of the average attendee), and declining denominational affiliation.