Duty Of Beneficence Research Articles

PREPARING FOR THE NEXT PANDEMIC

AbstractMy aim in this essay is to argue for a better moral-conceptual framework and for institutional innovation in preparation for the next pandemic. My main conclusions are as follows. (1) The primary moral principle that should guide responses to the next pandemic is the duty to prevent and mitigate serious harms. (2) A proper understanding of the moral foundations and scope of the duty to prevent and mitigate serious harms requires rejecting both Extreme Nationalism and Extreme Cosmopolitanism. (3) A better response to the next pandemic requires transforming the moral landscape through institutional innovation by developing an international institution that can perfect indeterminate duties (i) by identifying duty-bearers, (ii) by specifying their duties to provide medical resources and other forms of aid, (iii) by allocating the specified duties to various public and private entities in such a way as to ensure effective coordination and that the costs of providing aid are fairly distributed, and (iv) by providing effective mechanisms for compliance with the specified duties. (4) Institutional innovation is morally required, regardless of whether the harm prevention and mitigation duties of the better-off are duties of justice or of beneficence, because without institutionalization, some duties of justice, including those requiring the prevention and mitigation of serious harms, suffer some of the same indeterminacies that are present in duties of beneficence.

The All-Stakeholders-Considered Case for Corporate Beneficence

In ways accentuated by the global coronavirus pandemic, corporations constitute vital instruments of the acts of beneficence needed by the people of the world to make progress in public health and increase collective and individual well-being. This article contributes to understanding the variety of moral forces that may lead corporations to commit acts of beneficence, including Friedman’s business case for corporate beneficence, the duty of beneficence as developed by business ethicists, and Dunfee’s social contract account of corporate obligation. Whereas Mejia recently contributed to scholarship on corporate beneficence by expressly adopting shareholder primacy’s conception of corporate governance, this article embraces a stakeholder-oriented, managerialist picture of corporate governance. I extend the literature on beneficence by incorporating what I argue is the intuition underlying Dunfee’s contractualist formula of minimal contribution, namely that management’s duty to do good is awakened and unshackled to the extent management judges the corporation can afford to commit acts of beneficence, all stakeholders considered. The all-stakeholders-considered case for corporate beneficence compels management to act, I argue, when inaction would undermine the moral integrity of managers personally committed to promoting the well-being of humanity.

Probing Status Quo Bias in Dentistry

The status quo bias in dentistry refers to a practitioner's preference for certain treatment modalities and resistance to contemplating the need for a change. Lack of updating skills and amending their work routine accordingly can result in them providing treatment that is dated or even totally obsolete. It could even be detrimental to their patient's oral health and open them up to the risk of litigation. The concept of Continuing Professional Development (CPD) was introduced to try enforce clinicians to improve their knowledge and skills, and keep abreast of current best practice recommendations. However, it should not be seen as a mere points collecting exercise that has little effect on bringing about changes in their work. Dentists need to continually review their work, and make adjustments when necessary in order to do better and be better. Only then canthey claim to be acting in their patients’ best interest and fulfilling their duty of beneficence.

Kant’s moral theory as a guide in philanthropy

This paper focuses on Kant?s moral theory and how it can guide our actions in philanthropy. Philanthropy is usually defined as a voluntary action aimed at relieving suffering and improving the quality of lives of others. It has been argued that, within the framework of Kant?s theory, it is our duty to be beneficent, sacrificing a part of our welfare for others. The duty of beneficence is a wide one. Interpreters of Kant disagree on what the wide duty of beneficence requires. While a few argue that it only requires that we provide help sometimes, others hold that the duty of beneficence should be seen as more demanding, particularly in cases of emergency when help is urgently required. We are morally obliged to promote the happiness of others, but the duty of beneficence does not tell us whose happiness and how much of our resources to give. Other than emergency cases, in fulfilling the duty of beneficence, we can prioritize the ends of those near and dear to us who concern us more. Moreover, on condition that we are not indifferent to others, it is morally permissible to prioritize our ends. Finally, the paper argues that it is not always straightforward what kind of action is required in helping someone in need, and that beneficence in Kantian terms is not limited to the philanthropic sector.

Beneficence, Non-Identity, and Responsibility: How Identity-Affecting Interventions in Nature can Generate Secondary Moral Duties

In chapter 3 of Wild Animal Ethics Johannsen argues for a collective obligation based on beneficence to intervene in nature in order to reduce the suffering of wild animals. In the same chapter he claims that the non-identity problem is merely a “theoretical puzzle” (p.32) which doesn’t affect our reasons for intervention. In this paper I argue that the non-identity problem affects both the strength and the nature of our reasons to intervene. By intervening in nature on a large scale we change which animals come into existence. In doing so, we enable harmful animals to inflict harms on other animals, and we put other animals in harm’s way. The harms that these animals will inflict and endure are foreseeable. Furthermore, since non-human animals aren’t moral agents, harmful animals cannot be morally responsible for their harmful actions. I argue therefore that by causing animals to exist, knowing that they will inflict and suffer harms, we become morally responsible for those harms. By engaging in identity-affecting actions then we take on secondary moral duties towards the animals we have thereby caused to exist, and these secondary moral duties may be extremely demanding, even more so than the initial costs of intervention. Finally, these duties are duties of justice rather than duties of beneficence, and as such are more stringent than purely beneficence-based moral reasons. Furthermore, this conclusion flows naturally from several plausible principles which Johannsen explicitly endorses.

Ethical Framework to Guide Decisions of Treatment Over Objection

Whether to proceed with a medical intervention over the objection of a patient who lacks capacity is a common problem facing practitioners. Despite this, there is a notable gap in the literature describing how to proceed in such situations in an ethically rigorous and consistent fashion. We elaborate on the practical application of the 2018 Rubin and Prager 7-question algorithm for ethics consultations about treatment over objection and we describe the impact of each of the 7 questions. We retrospectively review a series of consultations at Columbia University Irving Medical Center between April 2017 and May 2020 for treatment over objection in adult patients determined to lack capacity. Outcomes about the final ethics recommendation and the assessment of each of the 7 questions are reported. The statistical analysis was designed to determine which of the 7 questions in the algorithm were most predictive of the final ethics recommendation. In our series, there was an ethics recommendation to proceed over the objection of a patient in 63% of consultations. Although all 7 questions were considered to be important to the ethical analysis of a patient's situation, the presence of logistical barriers to treatment and the imminence of harm to a patient without treatment emerged as the most significant drivers of the recommendation of whether to proceed over objection or not. Cases of treatment over objection in a patient lacking capacity are frequently encountered problems that require a careful balance of patient autonomy and a physician's duty of beneficence. The application of the Rubin and Prager 7-question algorithm reliably guides a care team through such a complex ethical dilemma.

The Peculiar Nature of the Duty to Help During a Pandemic

Duties of beneficence are said to allow for leeway to discharge them. By distinguishing between two different types of leeway, Mejia (2020) identified three structurally different duties of beneficence. In this Commentary I deploy those distinctions to clarify the nature of a fourth type of duty of beneficence, one prompted by a global pandemic, a duty with a peculiar, and seldom recognized, conceptual logic. I provide some guidelines that should orient managers when they take themselves to be fulfilling such a duty on behalf of shareholders.

Miller’s Tale: Why the Sympathy Principle is Inadequate

Abstract In the aftermath of Peter Singer’s ‘Famine, Affluence and Morality’, the argument he put forward received significant criticism, largely on the grounds that it demanded too much of moral agents. Several attempts have been made since to formulate moral principles that adequately express the stringency of our duties of beneficence. Richard Miller proposed one such option, which has several advantages over Singer’s principle. In particular, because it concerns our dispositions rather than operating over every possible occasion for beneficence, it avoids problems of iterative demands. However, I argue that Miller’s principle is inadequate, because 1) it seems too weak, 2) it appears to be ambiguous and 3) it can give unduly harsh verdicts on unlucky moral agents.

Exploiting Hope: How the Promise of New Medical Interventions Sustains Us—and Makes Us Vulnerable by Jeremy Snyder

The book engages with hope in the setting of phase I cancer trials, stem cell interventions, right-to-try laws and crowd funding, offering a new language to explain our discomfort with some of these quests. The book’s main claim consists of three components: (1) There is something special about hope in the health care setting, (2) Thwarting of such hope creates a distinctive wrong: exploitation, (3) Such exploitation of hope is a problem of respect and a failure to fulfil a specified duty of beneficence. [...]he illustrates that misunderstanding is not just about simple information provision, by illustrating the diverse origins and targets of hope. Snyder submits that hope may be instrumental for individuals as a means to feel in control of one’s destiny, but wonders if a patients’ feeling of control and hope would be reasonable to trade off for a tumour, a serious concern with stem cell interventions, or for a significant loss of money.

El deber de beneficencia en Kant y Fichte

Este artículo expone los argumentos de Kant y Fichte a favor del deber ético de la beneficencia. De manera concreta, se evalúan las razones para que este deber, en sus respectivos sistemas de deberes morales, obtenga un posicionamiento particular y requiera consideraciones aparte de los criterios que, en general, estructuran dichos sistemas. Además, se hacen comentarios comparativos respecto al papel que juega la facultad de juzgar ante el margen de latitud o de juego que, en particular, implica este deber ético en uno y otro autor.

Oral manifestation of a possible eating disorder in a minor patient

Oral manifestation of a possible eating disorder in a minor patient

Assisting Wild Animals Vulnerable to Climate Change: Why Ethical Strategies Diverge

AbstractMany individual sentient wild animals are vulnerable to anthropogenic climate change. In this article, I suggest that animal ethicists who take sentient animals’ moral status seriously are likely to agree that, other things being equal, we have moral responsibilities to assist wild animals made vulnerable to climate change. However, I also argue that these ethicists are likely to diverge in terms of the strategies they believe would actually fulfil such moral responsibilities, depending on whether their primary concern is rectificatory justice or duties of beneficence. To support this argument, I consider three plausible strategies for helping wild animals vulnerable to climate change: rescue and rehabilitation, habitat restoration, and assisted migration. I argue that different theoretical approaches to animal ethics are likely to diverge on aspects of all these strategies. These differences mean that the process of creating wide agreement among animal ethicists on climate adaptation strategies to assist vulnerable wild animals faces significant hurdles.

The Demandingness of Beneficence and Kant’s System of Duties

This paper contributes to the discussion of the moral demandingness of Kantian ethics by critically discussing an argument that is currently popular among Kantians. The argument from the system of duties holds that (a) in the Kantian system of duties the demandingness of our duty of beneficence is internally moderated by other moral prescriptions, such as the indirect duty to secure happiness, duties to oneself and special obligations. Furthermore, proponents of this argument claim (b) that via these prescriptions Kant’s system of duties incorporates into morality what current debates on (over-)demandingness call happiness and personal projects. These two claims are in conjunction supposed to establish that Kant’s ethics, at least when it comes to beneficence, is not plagued by the problem of excessive moral demands. We show that claims (a) and (b) are mistaken given what Kant says about beneficence, the application of imperfect duties and about emergencies. We finally argue that special obligations towards loved ones, a class of obligations largely overlooked by advocates of the system of duties, are the most promising candidates for internal moderation. These duties are, however, of a narrow scope.

Moral Transformation and Duties of Beneficence

Some ideas are at the heart of the world’s great ethical and religious traditions, yet they play little or no role within certain debates in modern philosophical ethics. One such idea is that most of us have unreliable moral intuitions and we must transform ourselves into better people before we can reliably judge how to behave. This paper explores that idea by focusing on a transformative experience that I will call the moral experience. In the paper’s initial sections, I describe the moral experience and explain why it constitutes a genuine transformation in ethical outlook. I then argue that the moral experience could thereby affect our views on certain contemporary ethical debates, illustrating those points with a discussion of the debate about global poverty.

Justice and beneficence

What is a duty of justice? And how is it different from a duty of beneficence? We need a clear account of the contrast. Unfortunately, there is no consensus in the philosophical literature as to how to characterize it. Different articulations of it have been provided, but it is hard to identify a common core that is invariant across them. In this paper, I propose an account of how to understand duties of justice, explain how it contrasts with several proposals as to how to distinguish justice and beneficence, respond to some objections, and suggest further elaborations of it. The conceptual exploration pursued in this paper has practical stakes. A central aim is to propose and defend a capacious concept of justice that makes a direct discussion of important demands of justice (domestic and global) possible. Duties of justice can be positive besides negative, they can be imperfect as well as perfect, they can range over personal besides institutional contexts, they can include multiple associative reasons such us non-domination, non-exploitation, and reciprocity, and they can even go beyond existing national, political, and economic associative frameworks to embrace strictly universal humanist concerns. We should reject ideological abridgments of the concept of justice that render these possibilities, and the important human interests and claims they may foster, invisible.

Can Deontological Principles Be Unified? Reflections on the Mere Means Principle

The mere means principle says it is impermissible to treat someone as merely a means to someone else’s ends. I specify this principle with two conditions: a victim is used as merely a means if the victim does not want the treatment by the agent and the agent wants the presence of the victim’s body. This principle is a specification of the doctrine of double effect which is compatible with moral intuitions and with a restricted kind of libertarianism. An extension of this mere means principle, where not only using but also considering someone as merely a means is immoral, can explain and unify other deontological principles: doing versus allowing, partiality in imperfect duties of beneficence, and the asymmetry of procreational duties. A loop trolley dilemma is often presented as a counterexample of the mere means principle, but I argue that this dilemma generates a moral illusion, comparable to perceptual illusions.

The Bystander in Commercial Life: Obliged by Beneficence or Rescue?

Liberalist thinking argues that moral agents have a right (or duty) to pursue an ordinary life. It also insists that moral agent can be bystanders. A bystander is involved with morally bad states of affairs in the sense that they are bound by moral duty, but for a non-blameworthy reason. A common view on the morality of commercial life argues that commercial agents cannot and ought not to assume the status of bystander, when confronted with child labor, pollution, or other overwhelmingly big morally bad states of affairs (oMBS). According to the common view, the agent will get overdemanded. In this paper, the overdemandingness charge is interpreted as a criticism of the liberalist position. According to this charge, bystander status must be given up in the market because otherwise the right (or duty) to pursue a personal life is crushed. In this paper, we demonstrate that the overdemandingness charge fails. It does not make sense if bystander status is grounded in the duty of beneficence. It would make sense if the status were grounded in the duty of rescue but that duty does not apply in relation to oMBS. The condition of ‘subjective urgency’ is not fulfilled. Hence, liberalist thinking can withstand the charge of overdemandingness and commercial agents cannot assume a right never to acknowledge bystander status (on account of the overdemandingness argument).

Ethical Challenges and Legal Issues for Mental Health Professionals Working With Family Caregivers of Individuals With Serious Mental Illness

Mental health professionals frequently work with family caregivers in the provision of psychotherapy services to individuals with serious mental illness. To address the need for ethical guidelines for working with family caregivers, an analysis of relevant ethical and legal issues is provided within the context of dynamic mental health care and legal systems. When working with family caregivers, practitioners utilize the American Psychological Association’s Ethics Code (2010), legal codes, and a complex decision-making plan; identify and communicate ethical obligations to family caregivers; consider the unmet needs of this population; avoid harm resulting from multiple relationships; and balance ethical duties of beneficence and respect for autonomy.

When the strictest right is the greatest wrong: Kant on Fairness

In this paper, I put forward an interpretation of the Kantian state that offers an alternative to the traditionalminimalist and to recent welfare interpretations of the Kantian state. I show that although the Kantian state has no duty to redistribute, Kant’s conception of equity or fairness (Billigkeit, MS RL VI: 234) allows the state to recognize redistribution as belonging to the ideal republic (republica noumenon), towards which all states have a non-coercible obligation to strive. I back up my interpretation with passages of the Metaphysics of Morals and of Kant’s lectures in which Kant questions the character of the duty of beneficence as a meritorious duty, given the fact that need is often the result of previous injustice of governments. The problem is that although the destitute have a right to collective aid, unlike strict right, these rights cannot be juridically enforced. This has led to the wrong conclusion that the state or the supreme commander has a duty of virtue towards its subjects and that the poor have no right to aid.

The words of prevention, part I: changing the model

Objective: this part I article explores the different meanings of relevant keywords for General Practice/Family Medicine (GP/FM) in the prevention domain. The aim is to contribute to information process in GP/FM by keeping in line with the main terms used in health care organization. Methods: important keywords for GP/FM in the prevention domain were selected. Then, a search was carried out on the main sources in GP/FM databases, as well as in Medical Subject Heading and major terminological databases available online. Results and Discussion: there is discrepancy between the conceptual contents of major prevention models amongst the usual bibliographic sources of knowledge in GP/FM in particular and medicine in general. Conclusion: For GP/FM, distribution of preventive activities is now firmly established on a new constructivist model, privileging the doctor-patient relationships and introducing a cybernetic thinking on the health care activities with a special commitment to ethics and the positive duty of beneficence.