Kantymir, Lori, Carolyn McLeod. Justification for Conscience Exemptions in Health Care
2013, Bioethics 28 (1): 16-23.
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Added by: Rochelle DuFord
Abstract: Some bioethicists argue that conscientious objectors in health care should have to justify themselves, just as objectors in the military do. They should have to provide reasons that explain why they should be exempt from offering the services that they find offensive. There are two versions of this view in the literature, each giving different standards of justification. We show these views are each either too permissive (i.e. would result in problematic exemptions based on conscience) or too restrictive (i.e. would produce problematic denials of exemption). We then develop a middle ground position that we believe better combines respect for the conscience of healthcare professionals with concern for the duties that they owe to patients. Our claim, in short, is that insofar as objectors should have to justify themselves, they should have to do it according to the standard that we defend rather than according to the standards that others have developed.Comment : This text responds to two proposals for justifying concientious objection in the provision of health care services: genuineness and reasonableness. It would fit well within a course on medical ethics or bioethics. It also would fit well within a more general course on professional ethics, as it concerns the question of when a professional is able to justify the omission of an action that they are bound by professional duty to complete.Kittay, Eva Feder. When Caring Is Just and Justice is Caring: Justice and Mental Retardation2001, Public Culture 13(3): 557-580-
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Added by: Jamie Robertson
Summary: In this paper, Kittay advances a conception of justice that 'begins with an acknowledgement of dependency and seeks to organise society so that our well-being is not inversely related to our need for care or to care' (576). Her motivation for advancing this view is that ideals of citizenship in liberal society, including independence and productivity, perpetuate the victimisation, social exclusion, or stigmatisation of people with mental retardation and their carers. This is because liberal definitions of personhood do not provide resources for responding in a morally adequate way to the mutual dependence of people with mental retardation and their carers/advocates. People with mental retardation are inescapably dependent because of their central need for attentive care. And, carers' work is so deeply other-directed that they also do not fit the liberal model of the rationally self-interested actor. Thus, both carers and their charges are vulnerable and need to be advocated for so that they can be seen as having important entitlements to public resources and claims to justice. To this end, Kittay proposes a conception of personhood that is based on relationships. Although those with mental retardation are inherently dependent, they still count as persons because they are able to participate in relationships. This makes them entitled to the satisfactions that make life worth living. To achieve the twin goal of achieving justice for familial or paid carers, Kittay advances a new principle of justice, doulia, which calls for larger society to support those who care for the inexorably dependent. Kittay takes her relational conception of personhood and her principle of doulia to ensure that appropriate forms of social organization exist to support all those who become dependent. She claims her view is needed because principles of charity and beneficence are not adequate since they are consistent with the continued stigmatization of mental retardation and care work, and ground only low-priority social obligations.Comment : This paper, with it's helpful discussions of the elements of the liberal tradition with which Kittay specifically takes issue and the inadequacies of the Americans with Disabilities Act, would be an appropriate reading for courses about the philosophy of disability or about liberal political theory.Kuhse, Helga. Critical Notice: Why Killing Is Not Always Worse – and Is Sometimes Better – Than Letting Die1998, Cambridge Quarterly of Healthcare Ethics 7 (4):371-374.-
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Abstract: The philosophical debate over the moral difference between killing and letting die has obvious relevance for the contemporary public debate over voluntary euthanasia. Winston Nesbitt claims to have shown that killing someone is, other things being equal, always worse than allowing someone to die. But this conclusion is illegitimate. While Nesbitt is correct when he suggests that killing is sometimes worse than letting die, this is not always the case. In this article, I argue that there are occasions when it is better to kill than to let dieKuhse, Helga. The Sanctity-of-Life Doctrine in Medicine: A Critique1987, Oxford University Press.-
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Publisher's Note: According to the "sanctity-of-life" view, all human lives are equally valuable and inviolable, and it would be wrong to base life-and-death medical decisions on the quality of the patient's life. Examining the ideas and assumptions behind the sanctity-of-life view, Kuhse argues against the traditional view that allowing someone to die is morally different from killing, and shows that quality-of-life judgments are ubiquitous. Refuting the sanctity-of-life view, she provides a sketch of a quality-of-life ethics based on the belief that there is a profound difference between merely being alive and life being in the patient's interest.Kuhse, Hoyt, Singer, Peter. Should the Baby Live? The Problem of Handicapped Infants1985, Oxford University Press.-
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Publisher's Note: Few subjects have generated so many newspaper headlines and such heated controversy as the treatment, or non-treatment, of handicapped newborns. In 1982, the case of Baby Doe, a child born with Down's syndrome, stirred up a national debate in the United States, while in Britain a year earlier, Dr. Leonard Arthur stood trial for his decision to allow a baby with Down's syndrome to die. Government intervention and these recent legal battles accentuate the need for a reassessment of the complex issues involved. This volume--by two authorities on medical ethics--presents a philosophical analysis of the subject based on particular case studies. Addressing the doctrine of the absolute sanctity of life, Singer and Kuhse examine some actual cases where decisions have been reached; consider the criteria for making these decisions; investigate the differences between killing and letting die; compare Western attitudes and practices with those of other cultures; and conclude by proposing a decision-making framework that offers a rational alternative to the polemics and confusion generated by this highly controversial topic.Lepora, Chiara. Individual Complicity: The Tortured Patient2013, In Chiara Lepora & Robert Goodin (eds.), On complicity and compromise. Oxford: Oxford University Press.-
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Abstract: Medical complicity in torture is prohibited by international law and codes of professional ethics. But in the many countries in which torture is common, doctors frequently are expected to assist unethical acts that they are unable to prevent. Sometimes these doctors face a dilemma: they are asked to provide diagnoses or treatments that respond to genuine health needs but that also make further torture more likely or more effective. The duty to avoid complicity in torture then comes into conflict with the doctor's duty to care for patients. Sometimes the right thing for a doctor to do requires complicity in torture. Whether this is the case depends on: the expected consequences of the doctor's actions; the wishes of the patient; and the extent of the doctor's complicity with wrongdoing. Medical associations can support physicians who face this dilemma while maintaining a commitment to clear principles denouncing torture.Levenbook, Barbara Baum. That Makes It Worse1980, The Monist 63 (2):228-245.-
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Added by: Chris Blake-Turner, Contributed by: Barbara Baum Levenbook
Abstract: Essays on excusing conditions and their correlates, mitigating conditions, usually begin with the assumption that there is general agreement on what the standard excuses are, and on where they are inapplicable. This assumption is justified; criminal law and the history of discussions of excuses have produced accord, though now and then doubts are expressed about particulars. Essays on excuses typically aim not so much to convince one that such-and-such are the general types of excuses but, rather, to show how they work and what their operation reveals about the nature of voluntary acts, full responsibility, etc.Comment : In a course on moral reasoningLiao, Shen-yi, Vanessa Carbonell. Materialized Oppression in Medical Tools and Technologies2023, American Journal of Bioethics 23(4), pp. 9-23-
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Added by: Maria Jimena Clavel VazquezAbstract:
It is well-known that racism is encoded into the social practices and institutions of medicine. Less well-known is that racism is encoded into the material artifacts of medicine. We argue that many medical devices are not merely biased, but materialize oppression. An oppressive device exhibits a harmful bias that reflects and perpetuates unjust power relations. Using pulse oximeters and spirometers as case studies, we show how medical devices can materialize oppression along various axes of social difference, including race, gender, class, and ability. Our account uses political philosophy and cognitive science to give a theoretical basis for understanding materialized oppression, explaining how artifacts encode and carry oppressive ideas from the past to the present and future. Oppressive medical devices present a moral aggregation problem. To remedy this problem, we suggest redundantly layered solutions that are coordinated to disrupt reciprocal causal connections between the attitudes, practices, and artifacts of oppressive systems.Comment : available in this BlueprintLittle, Margaret Olivia. Why a feminist approach to bioethics?1996, Kennedy Institute of Ethics Journal 6 (1):1-18.-
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Abstract: Many have asked how and why feminist theory makes a distinctive contribution to bioethics. In this essay, I outline two ways in which feminist reflection can enrich bioethical studies. First, feminist theory may expose certain themes of androcentric reasoning that can affect, in sometimes crude but often subtle ways, the substantive analysis of topics in bioethics; second, it can unearth the gendered nature of certain basic philosophical concepts that form the working tools of ethical theory.Macklin, Ruth. Cloning and Public Policy2002, In Justine Burley & John Harris (eds.), A companion to genethics. Blackwell. pp. 206-215.-
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Abstract: It seemed like only minutes after a team of Scottish scientists announced, in late February 1997, that they had successfully cloned a sheep, that governmental officials and private citizens throughout the world called for a ban on cloning human beings. The rush to legislate or issue executive orders was so swift, it is reasonable to wonder why the news that a mammal had been cloned ignited such a stampede to prohibit, even criminalize, attempts to clone humans. These events raise a series of separate, yet related questions. Why does the prospect of cloning human beings incite such strong reactions? What reasons have been proposed for enacting national laws or international conventions to prohibit cloning? Can these prohibitions be justified by sound ethical arguments? Before attempting to answer these questions, let us look first at the responses that called for public policy measures to ban human cloning.Can’t find it?Contribute the texts you think should be here and we’ll add them soon!
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