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Forum on Public Policy Online

Spring 2009 edition (Posted September 2009)

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Ethics

• New Wine in Old Wineskins—Twenty-First Century Ethical Challenges for the Just War Tradition
  Timothy J. Demy, Associate Professor of Military Ethics, U.S. Naval War College
• Nurturing Ethical Values in The 21st Century Adolescent
  Joanne Fitzmaurice Kuttner , Adjunct Professor of Theology at Lewis University in Romeoville, Illinois and Director of Youth Ministry at Saints Peter and Paul Parish, Naperville, Illinois
• Nurses and Conundrums of Conscience
  Carolyn A. Laabs, Assistant Professor, Marquette University
• Measuring the Ethical Quotient of Corporations: The Case of Small And Medium Enterprises in India
  Anu Singh Lather, Professor and Dean, University School of Management Studies, Guru Gobind Singh Indraprastha University, Delhi
• Referral for Profit: Deprofessionalization of Health Care in America
  Dina S. Macs, Adjunct Professor of Physical Therapy, University of Puget Sound
• Deep Time: Its Meaning and Moral Implications
  Paul R. Pinet, Professor of Geology and Environmental Sciences, Department of Geology, Colgate University
• Dehumanizing the Humanities: Neoliberalism and the Unethical Dimension of the Market Ethic
  Paul Andrew Sukys, Professor of Philosophy and Law, Humanities Department, North Central State College
• A Comparison of Physicians’ and Nurses’ Responses to Selected Ethical Dilemmas
  Jill E. Winland-Brown, and Adam L. Dobrin

New Wine in Old Wineskins—Twenty-First Century Ethical Challenges for the Just War Tradition
Timothy J. Demy, Associate Professor of Military Ethics, U.S. Naval War College

Abstract
Throughout western history the just war tradition has provided philosophers and practitioners of war the prevailing ethical framework for thinking about issues of war, peace, and justice.  Although its principles have been rarely fully realized, its tenets established a foundation pertinent to discussions in disciplines such as ethics, law, international relations, political science, and religion.  In the twenty-first century new challenges have arisen that question the validity of the just war tradition in an era of globalization and pluralist ethics.  Questions regarding the role of military contractors, rise of child soldiers, employment of new technologies, inviolable state sovereignty, and integrated global economics are forcing reevaluations of this ethical model’s continued viability.  This paper addresses several of these issues, especially as related to business and law, arguing that while the challenges are significant, the tradition is flexible enough to accommodate them.  However, responsible parties from all disciplines need to understand what is at stake and attempt to provide consistent, comprehensive, and non-contradictory enhancement of the tradition.

Nurturing Ethical Values in The 21st Century Adolescent
Joanne Fitzmaurice Kuttner , Adjunct Professor of Theology at Lewis University in Romeoville, Illinois and Director of Youth Ministry at Saints Peter and Paul Parish, Naperville, Illinois

Abstract
There is a wise proverb that insists it takes a whole village to raise a child to adulthood.  In light of the expanding convolution of contemporary values, it is especially important to attentively nurture the inherent desire in each developing human person to seek good and avoid evil, especially during the critical years of adolescent formation.

The special focus of this paper will be to present a vision document from the United States, called Renewing The Vision, which provides a comprehensive framework for developmentally appropriate activities, programming, and spiritual formation that support and nurture the development of ethical values in the adolescent.

This holistic approach also integrates the resources of the community in a common effort for intergenerational mentoring of the young.  Further, by utilizing eight components of this dynamic vision, adolescents can be drawn into active participation in building their moral value system to insure their lifelong commitment to personal integrity and moral social action within the fabric of society.

Ideally, adolescents will develop sound moral reasoning to be able to face the ethical realities and personal choices the 21st century demands, and be empowered to embrace the worthy adventure of living a moral, ethical Life!

Nurses and Conundrums of Conscience
Carolyn A. Laabs, Assistant Professor, Marquette University

Abstract
There is controversy today concerning conscience, conscientious objection, and health care professionals.  Nurses reportedly have said that they are expected to “set aside” or “deaden” their conscience to work in health care.  Given the morally serious work that nurses do, this expectation is puzzling and concerning.  It suggests a misunderstanding of the meaning of conscience, a conundrum which could be contributing to the persistent problem of nurses’ moral distress and to the chronic shortage of nurses.  This conundrum may be confounding efforts by society to formulate coherent policy on conscience and conscientious objection by health care professionals. 
In this essay I offer reflections on various understandings of conscience as they relate to nurses.  I suggest that when conscience is conceptualized in terms of relativism and subjectivism, setting aside one’s conscience may seem possible and even understandable in a morally pluralistic society.  However, conscience may not be entirely subjective or relative but, rather, deep-seated and grounded in objective moral norms, and, as a result, it is difficult to completely ignore one’s conscience and troubling to act contrary to it.  Because persons of good will may disagree in their conscientious judgments, tolerance, or mutual respect for conscience, is needed.  Thus, reasoned discussions are necessary to formulate policy on conscientious objection that is coherent, morally defensible and avoids misunderstandings.  It is my hope that this essay contributes to the discussion and to clearing up the conundrums.

Measuring the Ethical Quotient of Corporations: The Case of Small And Medium Enterprises in India
Anu Singh Lather, Professor and Dean, University School of Management Studies, Guru Gobind Singh Indraprastha University, Delhi

Abstract
This paper presents an overview of issues in business and professional ethics along with the whole gamut of practical ethical problems and phenomena which arise out of specific functional areas of companies including ethics of accounting information, human resource management, sales and marketing, production, etc. A study has been carried out to measure the Ethical Quotient of small and medium size enterprises (differentiated as High Intellectual Soft Services and Low Intellectual Soft Services depending upon the industry) located in the National Capital Region of Delhi, India. The total sample was 100 working professionals in 25 SMEs and response rate was 70%. The research instrument included a two–part questionnaire with the profile of the organization and a five-point Likert scale consisting of statements related to Organizational Ethical Standard, Employee Ethical Perception, ethical considerations towards Finance, HR, Marketing, Production and IPR.
The results indicate that companies from High Intellectual Soft Services sector such as IT, Pharmaceuticals and KPOs have scored lower on financial ethics, marketing ethics, production ethics and IPR ethics. This is alarming for the economy and needs to be addressed immediately. It is an issue of concern since Indian economy is driven by and large by SMEs especially for exports, and the High Intellectual Soft Services have shown a high growth rate. In the case of Low Intellectual Soft Services, it is the critical Financial Ethics that fall in the Low category. This is again a poor sign since it is these very ethical considerations that need to be at least medium if not high, for organizations to operate in today’s turbulent times. Overall the Ethical Quotient for these organizations is in Medium range. The results are used to develop a framework called the Ethics Strategy, which incorporates concerns related to both policy and action that needs to be taken by companies so as to remove any ethical deficiencies, if they exist.

Referral for Profit: Deprofessionalization of Health Care in America
Dina S. Macs, Adjunct Professor of Physical Therapy, University of Puget Sound

Abstract
Recently, sociologists have described an erosion of the trust historically given to professions within society. Traditionally elevated to a unique form of occupation, professions—medicine, law, teaching, and religion—were originally afforded special privileges, including the ability to self-regulate, the right to autonomous practice, and a high level of respect. Antithetically, when medical professionals invest in services to which they refer, when consumers pay too much for visits, when patients don't get the consistently high quality care they deserve, and when the overall financial impact increases the economic burden on society, public trust is compromised. Physician-owned physical therapy practices (POPTS) provide a contemporary illustration of deprofessionalization in the current, troubled US health care system. Although these fee-splitting, kick-back, referral-for-profit arrangements have been deemed illegal, they continue to thrive. Valuing profit over integrity, POPTS violate the unique fiduciary relationship between a health care practitioner and the patient. This complex paradigm of practice and its consequences are illustrated through the following: an historic and social context of physical therapy; a detailed account of the relevant laws; an account of educating health care professionals for moral action; and a clinician's pragmatic perspective of ethical practice.

Deep Time: Its Meaning and Moral Implications
Paul R. Pinet, Professor of Geology and Environmental Sciences, Department of Geology, Colgate University

Abstract
Responding to the normative query “What ought we to do?” depends on what the world and we are, and how the world and we came to be.  The latter claim relates moral appraisal to co-evolution, the former to ecological dynamics.  The interminable duration of deep time subsumes both evolutionary and ecological emergence.  Currently, the rate of habitat destruction and its attendant mass extinction is accelerating, and threatens human existence more that its contributor, global warming.  This mass extinction can be mitigated, but not stopped.  What does this mean for future generations of people, given our direct dependence on ecosystem functions?  How will humans face not just incurring the loss of an economic way of life, but likely losing forever the possibility of that reality?  An ethos based on “radical hope” when conjoined to deep time may help us not only assuage despair, but also flourish with values, stories, and traditions better adapted to the reality of our ecological and moral existence.

Dehumanizing the Humanities: Neoliberalism and the Unethical Dimension of the Market Ethic
Paul Andrew Sukys, Professor of Philosophy and Law, Humanities Department, North Central State College

Abstract
Neoliberalism is a philosophical theory that uses market value as the primary method of evaluating all aspects of life. Thus, the market is seen as the template for all other activities within a society, even those that involve an ethical dimension. This paper explores the ethical impact of neoliberalism on several aspects of the social structure, focusing on the effects that the neoliberal, market-oriented evaluation process has had on education in general, and on the humanities in particular. The paper also explores the origin of this theory and argues that the emergence of neoliberal values was made possible by nineteenth century philosophers who eliminated absolute moral values in order to establish an ethical system based solely on human ideals. Finally, the paper suggests that neoliberalism is fundamentally flawed and recommends that the use of market values as an ethical template be tempered by a qualitative perspective that provides a unified, coherent, and normative description of human nature based on absolute values.

A Comparison of Physicians’ and Nurses’ Responses to Selected Ethical Dilemmas
Jill E. Winland-Brown, and Adam L. Dobrin

Abstract
In ethical decision making, some research shows that nurses stress patient autonomy while physicians stress beneficence (Robertson, 1996). When these two ethical principles are in conflict, which takes precedence? In addition, other research states that nurses encounter more moral distress than physicians in their everyday ethical environment.  The purpose of this study was to explore the similarities and differences of physicians’ and nurses’ responses on four different ethical dilemmas. The dilemmas included surgical error; end-of-life care; possible physician or nurse drug use; and the medical repatriation of an illegal immigrant. Additional questions were asked relating to any formal ethics training as well as if the participant had ever experienced any moral distress at the outcome of an ethical situation. The physicians and nurses were invited to share written comments after each dilemma.
                Exactly 67 nurses and 26 physicians completed the questionnaires. Descriptive statistics were used to show participant characteristics with all the variables as well as the numbers of persons choosing the different responses to the dilemmas. Tests of significance were done to assess these relationships. Interestingly, this study found that physicians and nurses reason more alike than differently on ethical dilemmas. There was only one response where physicians and nurses reasoned significantly different. Similarly, an equal number of physicians and nurses had experienced moral distress in the past. The variables of religion, gender, education, and ethnicity were significant for some of the responses to the dilemmas. Strategies will be suggested to enhance moral reasoning and possible lessen some moral distress.