Ethics in health care and medical technologies

In this paper a case is used to demonstrate how ethical analysis enables health care professionals, patients and family members to make treatment decisions which ensure that medical technologies are used in the overall best interests of the patient. The claim is made and defended that ethical analysis can secure four beneficial outcomes when medical technologies are employed: (1) not allowing any medical technologies to be employed until the appropriate decision makers are identified and consulted; (2) insisting that medical technologies be employed not merely to promote the medical interests of the patient but rather on the basis of their ability to contribute to the overall well-being of the patient; (3) challenging caregivers to reflect on the dynamic interplay between their conscious and unconscious values and consequent determinations of what is in the patient's best interests; and (4) providing a justification for selected interventions which makes possible rational dialogue between caregivers espousing different viewpoints about treatment options.     

Medicine as business and profession

This paper analyzes one dimension of the frequently alleged contradiction between treating medicine as a business and as a profession, namely the incompatibility between viewing the physician patient relationship in economic and moral terms. The paper explores the utilitarian foundations of economics and the deontological foundations of professional medical ethics as one source for the business/medicine conflict that influences beliefs about the proper understanding of the therapeutic relationship. It, then, focuses on the contrast and distinction between medicine as business and profession by critically analyzing the classic economic view of the moral status of medicine articulated by Kenneth Arrow. The paper concludes with a discussion of some advantages associated with regarding medicine as a business.     

Culture wars: American moral divisions across the adult lifespan

Sociologists have argued that the public moral debate in contemporary America is characterized by a “culture war,” pitting “orthodox” and “progressivist” groups against one another (Hunter, 1991). This study addressed whether the culture war is evident in the moral thinking of ordinary Americans, and whether age-related patterns exist. Sixty fundamentalist Baptists (orthodox) and 60 mainline Baptists (progressivist) evaluated and reasoned about moral issues such as divorce and abortion. Each group was divided evenly into three age groups copsisting of young, midlife, and older adults. Moral reasoning was analyzed in terms of Shweder's (1990) ethics of autonomy, community, and divinity. Within all three age groups, progressivists used the ethic of, autonomy more than orthodox participants. Orthodox participants used the ethic of divinity more than progressivists. Orthodox and progressivist groups did not differ much in their use of the ethic, of community. Very few age group differences were found within the orthodox and progressivist groups. It is concluded that morality is conceived of in markedly different wasy by orthodox and progressivist groups, and that these conceptions are consistent across age groups.     

The Question of God in an Age of Science: Constructions of Reality and Ultimate Reality in Theology and Science

Both science and theology have lately faced a crisis of authority. Their shared realization of the extent to which knowledge is underdetermined by the data and socially constructed provides a kind of common ground for reconsideration of their respective methods of inquiry as well as of the status of the claims they have warrant to make. Both fields are now consciously and critically employing a models approach. This article proposes criteria for assessing models and applies the criteria to one model from each field. The model of understanding evolution as a struggle for existence is considered from the field of science, and the traditional model for understanding the God-world relation as that of a king's relation to his kingdom is considered from the field of theology. Each of these models is evaluated with respect to its credibility, religious viability, and moral adequacy. In each case an alternative analogy is proposed and argued for.     

Why are there no objective values?

Using the mathematical frameworks of economic preference ranking, subjective probability, and rational learning through empirical evidence, the epistemological implications of teleological ethical intuitionism are pointed out to the extent to which the latter is based on cognitivist and objectivist concepts of value. The notions of objective value and objective norm are critically analysed with reference to epistemological criteria of intersubjectively shared valuative experience. It is concluded that one cannot meaningfully postulate general material theories of morality that could be tested, confirmed or refuted by intersubjective empirical evidence of preferences and values, however loosely the empirical evidence of values may be interpreted. This situation is explained with reference to the ways in which preceived values become systematically influenced by the concomitants of individual valuative experience, but which have nothing to do with contingent subjective interests.     

Reflections on segregating and assessing areas of competence

Various complexities that arise in the application of legal and/or clinical criteria to the actual assessment of competence/capacity are discussed, and a particular way of understanding the nature of such criteria is recommended.     

结果预期与结果反应对儿童意图认知和道德判断的影响

考察了结果预期与结果反应对儿童意图认知和道德判断的影响。结果表明,结果预期影响幼儿园和小学儿童的意图认知,结果反应仅影响幼儿园儿童的意图认知;结果预期和结果反应显著地影响幼儿园和小学儿童的道德判断,但结果预期对小学儿童道德判断的影响要比结果反应大。     

Do medical decision analyses' largest gains grow from the smallest trees?

Some decision analysts recommend reserving their models for careful, complete study of complex problems. Others believe simple problem analyses provide the greatest gains. To clarify these issues, I tested: (1) whether simple published analyses compared to complex ones, produced results as non-intuitive; and (2) whether non-intuitiveness represented analytic gain (or equivalently, intuitive loss). Very limited data also examined (3) the gain from adding model intricacy for a given problem vs. selecting more complex problems for analysis. To assess two non-intuitiveness measures, 75 subjects (33 physicians and 42) non-physicians stated their intuitive preferences in 40 (22 published and 18 unpublished) medical dilemmas. For both physicians and non-physicians, simpler models (those with lees than 30 terminal branches in the decision tree) had about one third the non-intuitiveness of more complex ones. Three tests also supported the premise that analyses outperform intuition, therefore that on average the formers' non-intuitiveness reflects less analytic gain. In addition, for different models of the same problem, tree complexity did not correlate with gain. Thus, simpler trees may not generally gain less because they inadequately describe problems. Instead, simpler analyses may represent simpler problems, with more similar intuitive and formal solutions. If so, these findings may help us avoid some costly but unnecessary simple analyses.     

CHRISTIANITY,SCIENCE, AND THREE PHASES OF BEING HUMAN

The alleged conflict between religion and science most pointedly focuses on what it is to be human. Western philosophical thought regarding this has progressed through three broad stages: mind/body dualism, Neo‐Darwinism, and most recently strong artificial intelligence (AI). I trace these views with respect to their relation to Christian views of humans, suggesting that while the first two might be compatible with Christian thought, strong AI presents serious challenges to a Christian understanding of personhood, including our freedom to choose, moral choice itself, self‐consciousness, and the relevance of God to our beginning, being, and ending.