Kennedy Institute of Ethics journal
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Kennedy Inst Ethics J · Jan 2021
Publicly Funded Health Care for Pregnant Undocumented Immigrants: Achieving Moral Progress Through Overlapping Consensus.
What just societies owe to non-citizen immigrants is a controversial question. This paper considers three accounts of the requirements of distributive justice for non-citizens to determine what they might suggest about the provision of publicly funded health care to pregnant undocumented immigrants. These accounts are compared to locate an overlapping consensus on the duty of the state to provide care to pregnant undocumented immigrants. The aim of this paper is not to take a substantive position on the "right" prenatal policy, but rather to explore the moral space that this issue occupies and suggest that real moral progress can be achieved through the consistent application of shared values.
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Medical error is the third-leading cause of death in the United States, but there has been little work done on the associated conceptual and normative questions. What is medical error? Is all medical error bad? The first section of this paper surveys the dominant conception of medical error-promulgated by the Institute of Medicine-and tries to understand whether error necessarily eventuates in adverse events. The second section challenges an asymmetry in the way that we think about error: For example, the received view would allow that undertesting could comprise medical error, whereas overtesting cannot. The third section considers the concept of moral luck and how it bears on our ascriptions of medical error.
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Kennedy Inst Ethics J · Jan 2018
Support for Voluntary Euthanasia with No Logical Slippery Slope to Non-Voluntary Euthanasia.
This paper demonstrates that acceptance of voluntary euthanasia does not generate commitment to either non-voluntary euthanasia or euthanasia on request. This is accomplished through analysis of John Keown's and David Jones's slippery slope arguments, and rejection of their view that voluntary euthanasia requires physicians to judge patients as better off dead. ⋯ Both avoid the purported slippery slopes and both are independently supported by an analogy to uncontroversial elements of medical practice. Moreover, the proposed analyses of voluntary euthanasia suggest parameters for the design of euthanasia legislation, both supporting and challenging elements of existing laws in Oregon and the Netherlands.
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Kennedy Inst Ethics J · Jan 2018
Navigating the Perfect Storm: Ethical Guidance for Conducting Research Involving Participants with Multiple Vulnerabilities.
The development of ethical guidelines and regulations regarding human subjects research has focused upon protection of vulnerable populations by relying on a categorical approach to vulnerability. This results in several challenges: First, Institutional Review Boards (IRBs) struggle to interpret and apply the regulations because they are often vague and inconsistent. ⋯ IRBs and investigators lack guidance on how to address the problem of multiple vulnerabilities in a way that strikes a balance between protection and respect for persons. In this essay, we evaluate the acceptability of the existing federal regulations with respect to research participants with multiple vulnerabilities, offer strategies for rethinking the concept of vulnerability, and outline a context-based normative framework to account for the compounding effects of multiple vulnerabilities.
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In recent editions of Tom Beauchamp and James Childress' Principles of Biomedical Ethics, their famous principles have been deployed as elements of the common morality recruited to anchor bioethical reasoning. In Principles, however, Beauchamp and Childress defend neither their assertions about the content, nor the normativity, of the common morality. ⋯ Here I evaluate three ways of mounting such a defense, arguing that only one-conceptual analysis demonstrating the principles to be part of the "definitional criteria" of morality-might succeed within the confines of Beauchamp and Childress' metaethical paradigm. I argue further that identification of the common morality with these "definitional criteria" presents a compelling way forward.