Health-care systems within most countries are resource-limited – budgets are finite and not every service one would like to provide can be funded. In publicly funded health systems, those responsible for procuring health-care need to be able to explain how taxpayers’ money has been spent. Decisions are made at both individual patient and population levels. At an individual level, the decision might be: which statin should this patient get a prescription for to lower her blood cholesterol? At a population level, the decision might be: will a health and social care commissioning organization purchase a heart-failure specialist nurse or an additional sexual health clinic?

This chapter focuses on how such decisions are made and considers a framework for priority setting, a discussion of what factors should be taken into account when comparing options, a consideration of basic health economic concepts, and an overview of ethical principles which influence decisions.

Agape-justice conflicts provide unique opportunities for growth in supernatural excellence. There are “no tidy answers” in sorting through competing duties of justice and agape. However, justice’s obligees who hold strong legal and moral claims can voluntarily and generously choose to forego their claim-rights in favor of those who have none—agape’s beneficiaries. If we can give of ourselves with alacrity, then, even the most intractable agape-justice conflicts can be resolved with the adjudication of last resort—to love as Christ loves. Doing so leads to growth in Christified agape, that is, caritas. Such self-giving dissolves the competing claims of agape and justice.

Book 2 of De Officiis is devoted to an exploration of the utile, what is beneficial or advantageous for humans in pursuing desirable objectives, and the resources needed to achieve them. As Section 1 discusses, it focuses on the human resource that someone intent on a successful political career will best harness, and on outlining the methods for attaining it. That outline then provides Cicero with a basis for the main body of the book, which has two main parts, the first expounding the methods he endorses for achieving glory, with an accent on the need for justice in pursuing it, the second examining liberality, and good and bad ways of exercising it. Section 2 turns to the detail of his analysis of the complexities of liberality and its vocabulary. Section 3 asks whether glory is the main pay-off he sees as the fruit of liberality, and argues that gratitude is of no less importance. A brief conclusion notes that the cohesion of the res publica emerges as the primary object of appropriate human concern, and comments on Cicero’s view that in its safeguarding lies simultaneously our main advantage and the ultimate focus of the social virtues of justice and beneficence.

Beneficence is the act of doing good, while benevolence is being willing to do good. Walmart is cited as a case where, despite its founder’s belief that businesses do sufficient good simply by fueling wealth through commerce and employment, the company is nevertheless highly involved in community projects. Corporate philanthropy may be used strategically to increase future profits, while many corporations see themselves as morally responsible for stakeholders – employees, communities, consumers, and the wider environment – without requiring a clear return on investment. Corporate intervention is discussed historically in terms of apartheid, where some companies applied pressure for social change whereas others felt firms should abide by local norms despite violating human rights. Corporate intervention in the political affairs of Central America are discussed, as well as businesses that supply biased educational materials. The final case describes the sponsorship of an artistic production that becomes politically embroiled and asks what an appropriate level of corporate involvement in the community should be.

The movement toward increasing maternal age comes with many new challenges. As reproductive physicians now see increasingly older patients, they are also confronted with complex ethical questions regarding the medical, psychological, and psychosocial implications of providing services to this population. It is well established that increased maternal age is associated with many obstetric complications. These complications may have both short and long-term effects on the mother as well as the fetus and child. In addition to medical complications, many providers are concerned about psychosocial ramifications of pregnancies at the extremes of maternal age. These concerns largely pertain to the well-being of children born to older parents, and are often subject to societal and cultural norms. These factors combined have led many to question the ethics of providing ART to patients in their 40s and beyond, however most ethical scrutiny has been aimed at post-menopausal mothers and those greater than 50 years of age. This chapter explores the ethical issues and available guidance in relation to this group of patients and the practical application of medical ethics and the core ethical principles.

Chapter five describes the ethical framework regulating research using linked data and examines the applicable international ethics guidelines. A hypothetical research project is used to compare how these guidelines address the ethical assessment of research using linked data and in particular to compare how they address a waiver of consent and the extent to which they consider collective interests. The chapter goes on to discuss how the core ethical values of research merit and integrity, justice, beneficence, and respect can be reinterpreted to encompass the ethical concerns raised by research using linked data.

Chapter five describes the ethical framework regulating research using linked data and examines the applicable international ethics guidelines. A hypothetical research project is used to compare how these guidelines address the ethical assessment of research using linked data and in particular to compare how they address a waiver of consent and the extent to which they consider collective interests. The chapter goes on to discuss how the core ethical values of research merit and integrity, justice, beneficence, and respect can be reinterpreted to encompass the ethical concerns raised by research using linked data.

The twentieth century ushered in a dazzling array of modern medical technologies including many effective new treatments for disease and novel preventative therapies that have helped extend the average lifespan dramatically. From penicillin and polio vaccines to statins to immunotherapies and robotic surgery, we enjoy the benefits of science and medicine. While life expectancy at birth in the United States in 1900 was just over 47 years,1 we now live, on average for 78.7 years.

Chapter 3 develops a theoretical grounding for the PDE, the solidarity rationale. Taking a cue from Philippa Foot, I situate the PDE within a larger region of morality, one structured around the concept of solidarity. I propose that our conduct is measured by a standard of human solidarity toward each other person, that is, a standard of concern and goodwill that is based on our common humanity, and that a person’s conduct is wrong when it deviates from this standard. I argue that the solidarity standard grounds more specific moral norms, including the precept of beneficence, the strict constraint against intentional harm, and the Principles of Proportionality and Due Care. Finally, I argue that the normative foundation for the solidarity standard is the dignity of human beings.

This chapter considers the question of whether corporations have positive obligations in relation to fundamental rights and, if so, how to determine the substantive content of those obligations. The chapter examines justifications for the ‘negative obligations model’ which asserts that non-state actors only have negative obligations – to avoid harming – fundamental rights. I show why the negative/positive obligation distinction is not adequate to distinguish the obligations of the state from those of non-state actors and also provide positive justifications for why non-state actors and, particularly, corporations should have such obligations. The multi-factoral model, suitably modified, I argue complimented by a seven-step test – instead of proportionality – provides a structured analytical process for legally determining the substantive content of the positive obligations of corporations. Lastly, I consider the legal instantiation of positive obligations through the courts in South Africa and the legislature in India. The multi-factoral model, I suggest, could be helpful in systematising and guiding these developments.

Which elements of tyranny are paramount wax and wane across eras, but tyranny itself remains a consistent concern. In Western political thought, defining tyranny in one or two sentences is rare, and when undertaken, it is often embedded in a specific political context. Defining tyranny may appear straightforward; nonetheless, diagnosing and remedying it, enabling recovery and inoculation, requires more than a rigid definition. All governance orders display a range of features. For instance, no two democracies are alike, and the political, economic and social realities they serve must always be considered; the same is true of tyrannies.

This chapter explores distributive justice and beneficence. Justice involves giving individuals what they are due. Distributive justice governs the distribution of valuable resources and of burdens, and the granting of certain legal rights. Beneficence concerns agents’ duties to benefit other individuals. The chapter highlights distinctions (1) between the ideal and the nonideal and (2) between how institutions should be arranged and how individuals should act. We understand nonideal theory to address what particular actors – both states and persons – should do in the actual world today. Regarding institutions, domestically, we defend a liberal egalitarian view about distributive justice: unchosen differences in individual advantage within a society are prima facie unjust. Globally, we endorse cosmopolitanism: similar principles of justice apply internationally as apply domestically. Regarding individuals’ obligations, we defend moderately extensive duties of beneficence. We argue that national governments should ensure that all their residents have access to affordable health care and that the international community ought to amend the global intellectual property regime that governs pharmaceutical patents.