Ethical concepts are, or purport to be, normative. They make claims on us: they command, oblige, recommend, or guide. Or at least when we invoke them, we make claims on one another; but where does their authority over us - or ours over one another - come from? Christine Korsgaard identifies four accounts of the source of normativity that have been advocated by modern moral philosophers: voluntarism, realism, reflective endorsement, and the appeal to autonomy. She traces their history, showing how each developed in response to the prior one and comparing their early versions with those on the contemporary philosophical scene. Kant's theory that normativity springs from our own autonomy emerges as a synthesis of the other three, and Korsgaard concludes with her own version of the Kantian account. Her discussion is followed by commentary from G. A. Cohen, Raymond Geuss, Thomas Nagel, and Bernard Williams, and a reply by Korsgaard.
Informed consent is a central topic in contemporary biomedical ethics. Yet attempts to set defensible and feasible standards for consenting have led to persistent difficulties. In Rethinking Informed Consent in Bioethics, first published in 2007, Neil Manson and Onora O'Neill set debates about informed consent in medicine and research in a fresh light. They show why informed consent cannot be fully specific or fully explicit, and why more specific consent is not always ethically better. They argue that consent needs distinctive communicative transactions, by which other obligations, prohibitions, and rights can be waived or set aside in controlled and specific ways. Their book offers a coherent, wide-ranging and practical account of the role of consent in biomedicine which will be valuable to readers working in a range of areas in bioethics, medicine and law.
Many accounts of informed consent in medical ethics claim that it is valuable because it supports individual autonomy. Unfortunately there are many distinct conceptions of individual autonomy, and their ethical importance varies. A better reason for taking informed consent seriously is that it provides assurance that patients and others are neither deceived nor coerced. Present debates about the relative importance ofgenericandspecificconsent (particularly in the use of human tissues for research and in secondary studies) do not address this issue squarely. Consent is a propositional attitude, so intransitive: complete, wholly specific consent is an illusion. Since the point of consent procedures is to limit deception and coercion, they should be designed to give patients and others control over the amount of information they receive and opportunity to rescind consent already given.
Transparency is widely supposed to make institutions and their officeholders both more trustworthy and more trusted. Yet in the United Kingdom many institutions and office-holders on whom transparency requirements have been imposed across the last fifteen years are now seen as less trustworthy, and are apparently less trusted than they were before the requirements were introduced. Does this suggest that transparency does not improve trustworthiness? Or that it increases trustworthiness without increasing trust? Or is the supposed evidence for declining trustworthiness and declining trust misleading? How confident can we be that transparency supports either trustworthiness or trust? Government, corporations, and their critics seemingly converge in seeing transparency as indispensable for accountability and good governance, for preventing corruption and improving performance, and for increasing trustworthiness and trust. But does transparency have these desirable effects? Transparency requirements may fail to improve either trustworthiness or trust because they set a one-sided standard for public, corporate, or other communication. Although transparency demands too little for effective communication, it is an effective antidote to secrecy.
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