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Moral quandaries often pit concerns about principles against concerns about practical consequences. Should we ban assault rifles and large sodas, restricting people's liberties for the sake of physical health and safety? Should we allow drone killings or torture, if violating one person's rights could save a thousand lives? We like to believe that the principled side of the equation is rooted in deep, reasoned conviction. But a growing wealth of research shows that those values often prove to be finicky, inconsistent intuitions, swayed by ethically irrelevant factors. What you say now you might disagree with in five minutes. And such wavering has implications for both public policy and our personal lives. Philosophers and psychologists often distinguish between two ethical frameworks. A utilitarian perspective evaluates an action purely by its consequences. If it does good, it's good. A deontological approach, meanwhile, also takes into account aspects of the action itself, like whether it adheres to certain rules. Do not kill, even if killing does good. No one adheres strictly to either philosophy, and it turns out we can be nudged one way or the other for illogical reasons.... Regardless of whether you endorse following the rules or calculating benefits, knowing that our instincts are so sensitive to outside factors can prevent us from settling on our first response. Objective moral truth doesn't exist, and these studies show that even if it did, our grasp of it would be tenuous. ...But we can encourage consistency in moral reasoning by viewing issues from many angles, discussing them with other people and monitoring our emotions closely. In recognizing our psychological quirks, we just might find answers we can live with.

'Haidt's lone hero among the great philosophers - David Hume - points out, there is a logical gap between what is done (descriptive ethics) and what ought to be done (normative ethics). Haidt acknowledges that his concern as a psychologist is overwhelmingly descriptive. But he says almost nothing about how to connect his work with the compelling normative questions of human life. Engaging with the extensive philosophical discussions of Hume's distinction between "is" and "ought" could help fill this major gap in Haidt's account of ethics.'

"[I]f our brain's chemistry does affect our moral behavior, the question of whether that balance is set in a natural way or by medical intervention will make no difference in how freely we act. If there are already biochemical differences between us that can be used to predict how ethically we will act, then either such differences are compatible with free will, or they are evidence that at least as far as some of our ethical actions are concerned, none of us have ever had free will anyway. In any case, whether or not we have free will, we may soon face new choices about the ways in which we are willing to influence behavior for the better.

"Moral distress - knowing what is ethically appropriate but being unable to act on it because of obstacles inherent in a situation - was first described in 1984 in a book on nursing ethics. Subsequent researchers focused primarily on the experiences of nurses and found that those who suffered from moral distress often became reluctant to interact with patients and other providers. In one recent study, 15 percent of nurses left their jobs because of moral distress."

Given time, American Muslims, like all other religious minorities before them, will adjust their legal and theological traditions, if necessary, to accord with American values. America's exceptionalism has always been its ability to transform itself - economically, culturally and religiously. In the 20th century, we thrived by promoting a Judeo-Christian ethic, respecting differences and accentuating commonalities among Jews, Catholics and Protestants. Today, we need an Abrahamic ethic that welcomes Islam into the religious tapestry of American life. Anti-Shariah legislation fosters a hostile environment that will stymie the growth of America's tolerant strand of Islam. The continuation of America's pluralistic religious tradition depends on the ability to distinguish between punishing groups that support terror and blaming terrorist activities on a faith that represents roughly a quarter of the world's population.

"Health Law, Ethics, and Human Rights" Hospitals/systems should disclose large-scale adverse events (e.g., non-sterile equip't)

J.L.A. Garcia sees as wicked the viewpoint he attributes to Singer: "He has little use for most of the central elements of ethical sensibility and compunction, seeing rights and virtues as mere instruments in the service of maximizing the satisfaction of interests; and indeed he vigorously rejects the notion that there are distinctively human values-a view he dismisses as the pernicious consequence of "speciesism."

Catholic theologian Tim Muldoon: when "social contract" theory fails as a source of social ethics, then - said Martin Luther King Jr. (in "Letter from a Birmingham prison") - the appeal must be to some kind of transcendant "natural law." (I would only add that new views of "natural law" evolve with history and social circumstances - the incompatibility of slavery wasn't clearly seen till the 19thC, of segregation till the 20th, of discrimination against homosexuals in all the rights & privileges of civil society until the 21st.)

Until very recently, technology had a clear, if boring, purpose: by taking care of the Little Things, it enabled us, its human masters, to focus on the Big Things. "Unless there are slaves to do the ugly, horrible, uninteresting work, culture and contemplation become almost impossible," proclaimed that noted connoisseur of contemplation Oscar Wilde. Fortunately, he added a charming clarification: "Human slavery is wrong, insecure and demoralizing. On mechanical slavery, on the slavery of the machine, the future of the world depends." ...Alas, most designers, following Wilde, think of technologies as nothing more than mechanical slaves that must maximize efficiency. But some are realizing that technologies don't have to be just trivial problem-solvers: they can also be subversive troublemakers, making us question our habits and received ideas. Recently, designers in Germany built devices - "transformational products," they call them - that engage users in "conversations without words." My favorite is a caterpillar-shaped extension cord. If any of the devices plugged into it are left in standby mode, the "caterpillar" starts twisting as if it were in pain. Does it do what normal extension cords do? Yes. But it also awakens users to the fact that the cord is simply the endpoint of a complex socio-technical system with its own politics and ethics. Before, designers have tried to conceal that system. In the future, designers will be obliged to make it visible. While devices-as-problem-solvers seek to avoid friction, devices-as-troublemakers seek to create an "aesthetic of friction" that engages users in new ways. Will such extra seconds of thought - nay, contemplation - slow down civilization? They well might. But who said that stopping to catch a breath on our way to the abyss is not a sensible strategy?

Even when the system works as it's supposed to, and palliative care specialists arrive like the cavalry to provide comfort care, to stop fruitless and painful interventions and to support what patients want, their own colleagues may brand them murderers. It takes strong doctors to stand up to that kind of verbal abuse, to explain that courts and ethics committees have approved care that's intended to reduce suffering, to point out that the patient's own wishes are paramount. Perhaps they have to be stronger than we know. "The culture is changing," Dr. Matlock told me. "But it's not changed yet."

"...beyond the medical advances, Dr. DeBakey's story is emblematic of the difficulties that often accompany care at the end of life. It is a story of debates over how far to go in treating someone so old, ... and risky decisions that, while still being argued over, clearly saved Dr. DeBakey's life. It is also a story of Dr. DeBakey himself, a strong-willed pioneer who at one point was willing to die, concedes he was at times in denial about how sick he was and is now plowing into life with as much zest and verve as ever. But Dr. DeBakey's rescue almost never happened. He refused to be admitted to a hospital until late January. As his health deteriorated and he became unresponsive in the hospital in early February, his surgical partner of 40 years, Dr. George P. Noon, decided an operation was the only way to save his life. But the hospital's anesthesiologists refused to put Dr. DeBakey to sleep because such an operation had never been performed on someone his age and in his condition. Also, they said Dr. DeBakey had signed a directive that forbade surgery. As the hospital's ethics committee debated in a late-night emergency meeting on the 12th floor of Methodist Hospital, Dr. DeBakey's wife, Katrin, barged in to demand that the operation begin immediately.

'...the Cochrane Collaboration reported last year that patients who used tools to guide their decisions had a better grasp of their choices and risks. They were also more likely to select less intense or invasive treatment when considering major elective surgery, though results were mixed for other decisions. The influence of decision aids on adherence to medication or overall costs was "inconclusive," according to the report. 'But that uncertainty does not reduce the ethical obligation to better inform patients, or lessen the promise of tools that help patients understand their options and identify their values, some doctors say. "It is the right thing to do," said Dr. Victor Montori, associate director of the Health Care Delivery Research Program at the Mayo Clinic Center for the Science of Health Care Delivery....'

Ben Rich - from law to health law & bioethics. See also: Rich BA. Prognosis terminal: truth-telling in the context of end-of-life care. Camb Q Healthc Ethics 2014;23:209-19.

'"Contamination" ... is an evocative term. When people speak for an ideal of cultural purity, sustaining the authentic culture of the Asante or the American family farm, I find myself drawn to contamination as the name for a counterideal. [The Roman playwright] Terence [whose plays acquired that label to describe his conflation of Greek plays into a single Roman comedy] had a notably firm grasp on the range of human variety: "So many men, so many opinions" was a line of his. And it's in his comedy "The Self-Tormentor" that you'll find what may be the golden rule of cosmopolitanism - Homo sum: humani nil a me alienum puto; "I am human: nothing human is alien to me." The context is illuminating. A busybody farmer named Chremes is told by his neighbor to mind his own affairs; the homo sum credo is Chremes's breezy rejoinder. It isn't meant to be an ordinance from on high; it's just the case for gossip. Then again, gossip - the fascination people have for the small doings of other people - has been a powerful force for conversation among cultures. 'The ideal of contamination has few exponents more eloquent than Salman Rushdie, who has insisted that the novel that occasioned his fatwa "celebrates hybridity, impurity, intermingling, the transformation that comes of new and unexpected combinations of human beings, cultures, ideas, politics, movies, songs. It rejoices in mongrelisation and fears the absolutism of the Pure. Mélange, hotch-potch, a bit of this and a bit of that is how newness enters the world." No doubt there can be an easy and spurious utopianism of "mixture," as there is of "purity" or "authenticity." And yet the larger human truth is on the side of contamination - that endless process of imitation and revision. 'A tenable global ethics has to temper a respect for difference with a respect for the freedom of actual human beings to make their own choices. That's why cosmopolitans don't insist that everyone become cosmopolitan. They know they don't hav

Concern re elim'n of DS comm'ty (at time of progress, & self-stated happiness)

6 views - 3 pro, 3 con