Causal Responsibility and Rationing in Medicine

The article addresses the issue of rationing health care services, a topic currently being hotly debated in many countries. The author argues that the aspect of causal responsibility ought to play a decisive role in the allocation of limited medical resources. Starting out from Ronald Dworkin's distinction between option luck and brute luck, the appropriate and meaningful uses of the term causal responsibility are clarified first. A discussion of the conditions which might justify giving lower priority to patients whose illnesses are the result of unhealthy behavior, like e.g. alcohol abuse, follows. Causal responsibility is then viewed in the context of private health insurance and the club model of organ donation. It is argued that individuals themselves are basically responsible for their decisions regarding insurance coverage and membership in organ donors' clubs. Causal responsibility is shown to be a more suitable criterion for rationing scarce medical resources than other criteria which might alternatively be considered, such as patients' age.     

Contemporary Psychotherapy: Promoting Personal Responsibility for Therapeutic Change

An assortment of factors in modern society can be involved in the etiology and treatment of mental illness. Theories about etiology usually underlie, and therefore guide, most strategies for treatment. Although a comprehensive bio-psycho-social approach to mental illness can help to foster the collaboration of an interdisciplinary treatment team, a heavy emphasis on biological factors or cultural deprivation may reduce the client's feelings of personal responsibility for change. Contemporary psychotherapy can help clients reduce their tendency to attribute blame to biological predispositions or external societal factors. Instead, it is more helpful to cultivate attributions for personal responsibility for change, growth, and maturation.     

Conceptualizing and Measuring Historical Trauma Among American Indian People

This article reports on the development of two measures relating to historical trauma among American Indian people: The Historical Loss Scale and The Historical Loss Associated Symptoms Scale. Measurement characteristics including frequencies, internal reliability, and confirmatory factor analyses were calculated based on 143 American Indian adult parents of children aged 10 through 12 years who are part of an ongoing longitudinal study of American Indian families in the upper Midwest. Results indicate both scales have high internal reliability. Frequencies indicate that the current generation of American Indian adults have frequent thoughts pertaining to historical losses and that they associate these losses with negative feelings. Two factors of the Historical Loss Associated Symptoms Scale indicate one anxiety/depression component and one anger/avoidance component. The results are discussed in terms of future research and theory pertaining to historical trauma among American Indian people.     

Identification of shareholder ethics and responsibilities in online reverse auctions for construction projects

The increasing number of companies providing internet services and auction tools helped popularize the online reverse auction trend for purchasing commodities and services in the last decade. As a result, a number of owners, both public and private, accepted the online reverse auctions as the bidding technique for their construction projects. Owners, while trying to minimize their costs for construction projects, are also required to address their ethical responsibilities to the shareholders. In the case of online reverse auctions for construction projects, the ethical issues involved in the bidding technique directly reflects on the owner’s ethical and social responsibilities to their shareholders. The goal of this paper is to identify the shareholder ethics and responsibilities in online reverse auctions for construction projects by analyzing the ethical issues for the parties involved in the process. The identification of the ethical issues and responsibilities requires clear definition and understanding of professional ethics and the roles of the involved parties. In this paper, first, the concept of professional ethics and social responsibility is described in a general form. To illustrate the ethical issues and responsibilities, a sample case of bidding for a construction project using online reverse auction techniques is presented in which the shareholders were actively involved in questioning the ethical issues. The issues involved in the bidding process and their reflection on the shareholder responsibilities are described and analyzed for each stage of the process. A brief discussion of the overall process is also included to address the general ethical issues involved in online reverse auctions. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

The morality of weapons research

I ask whether weapons research is ever justified. Weapons research is identified as the business of the engineer. It is argued that the engineer has responsibility for the uses to which the tools that he designs can be put, and that responsibility extends to the use of weapons. It is maintained that there are no inherently defensive weapons, and hence there is no such thing as ‘defensive’ weapons research. The issue then is what responsibilities as a professional the engineer has in regard to such research. An account is given to ground the injunction not to provide the means to harm as a duty for the engineers. This account is not, however, absolutist, and as such it allows justifiable exceptions. The answer to my question is thus not that weapons research is never justified but there must be a strong assurance that the results will only be used as a just means in a just cause.     

Revisiting the Myth of the Historical Jesus and the Evolution of Consciousness

Hal Childs has written a solid, subtle, and courageous evaluation of the state of Jesus scholarship, focusing on a critique of the work of John Dominic Crossan. The impact of the fact that the scholars in this field are functioning within the limitations of Cartesian epistemology and ontology is addressed throughout this work, but in a subtle and respectful manner. More directly addressed is the fact that the historical Jesus cannot be discovered solely from that perspective; it requires what Childs terms a fundamentally hermeneutic, archetypal and psychological approach (2000, p. 2). The term historical is in quotes because Childs carefully distinguishes the object of the study from what we like to think of as scientific knowledge.     

Ethics and engineering courses at Delft University of Technology: Contents, educational setup and experiences

This article reports on the development and teaching of compulsory courses on ethics and engineering at Delft University of Technology (DUT). Attention is paid to the teaching goals, the educational setup and methods, the contents of the courses, involvement of staff from engineering schools, experiences to date, and challenges for the future. The choices made with respect to the development and teaching of the courses are placed within the European and Dutch context and are compared and contrasted with the American situation and experiences. Previous versions of this article were presented at the meeting of the SEFI Working Group on Engineering Ethics in Rzeszow, Poland, April 29–May 1, 1999 and at the SEFI Annual Conference in Zurich, Switzerland, September 1–3, 1999.     

Molecular geneticists and moral responsibility: “maybe if we were working on the atom bomb I would have a different argument”

Senior molecular geneticists were interviewed about their perceptions of the ethical and social implications of genetic knowledge. Inductive analysis of these interviews identified a number of strategies through which the scientists negotiated their moral responsibilities as they participated in generating knowledge that presents difficult ethical questions. These strategies included: further analysis and application of scientific method; clarification of multiple roles; negotiation with the public through public debate, institutional processes of funding, ethics committees and legislation; and personal responsibility.     

Moral Responsibility, Determinism, and the Ability to do Otherwise

In his classic paper, The Principle of Alternate Possibilities, Harry Frankfurt presented counterexamples to the principle named in his title: A person is morally responsible for what he has done only if he could have done otherwise. He went on to argue that the falsity of the Principle of Alternate Possibilities (PAP) implied that the debate between the compatibilists and the incompatibilists (as regards determinism and the ability to do otherwise) did not have the significance that both parties had attributed to it -- since moral responsibility could exist even if no one was able to do otherwise. I have argued that even if PAP is false, there are other principles that imply that moral responsibility entails the ability to do otherwise, and that these principles are immune to Frankfurt-style counterexamples. Frankfurt has attempted to show that my arguments for this conclusion fail. This paper is a rejoinder to that reply; I argue that he has failed to show this.