The crisis in the numbers of donated organs has featured strongly in the U. K. literature highlighting the growing gap between those waiting for a transplant currently 6,698 and the numbers of organs available for transplant in 2006 numbering 2,195 (UKT, 2006). To address this the new Human Tissue (Scotland) Act 2006 and the Human Tissue Act 2004 (England and Wales) have sought to increase the numbers of organs available for donation, whilst upholding the principle of informed consent to the donation of one's organs contained within the previous legislation. Critics of this "opt in" system however, suggest the adoption of presumed consent legislation or "opt out" as is the case in much of Europe. Little research exists that explores impact on the health care professionals (HCPs), the bereaved relatives, the health care system and society overall of any change to presumed consent legislation. The aim of this study was to explore the views and experiences of the HCPs who utilise this legislation in their practice, identifying implications for these professionals, the bereaved relatives and the health care system of using presumed consent legislation. Methods Adopting a phenomenological approach this study utilised the responses to an initial quantitative survey using a questionnaire and combined this with qualitative semi- structured interviews with HCPs who had experience of organ donation in three European countries, Portugal, Norway and Belgium thus capturing the "lived experiences" of the professionals who use this approach to organ donation. A phenomenological framework first identified by Heidegger (1962) and Gadamer (1976) was adopted to structure these interviews and analyse the data developed from these sources. Results and Discussion The initial survey of HCPs in the three countries yielded 31 responses (10.6% n=300) from Portugal, 47 (10.4% n=450) from Norway and 44 (35.7% n=123) from Belgium, providing data relating to their experiences in applying presumed consent legislation in organ donation, together with the benefits and challenges of their particular organ donation system. Subsequently, semi-structured interviews undertaken with 14 HCPs in Portugal, 13 HCPs in Norway and 15 HCPs in Belgium demonstrated different approaches to the application of this legislation in these three countries, as a result of varying infrastructures utilised to underpin organ donation. Additionally, there was a dissonance between the requirements of the legislation and the application of this by HCPs within the individual counties resulting from ethical, cultural and professional practice considerations identified by these professionals. Key amongst these considerations was the need to respect the wishes of the donor and involve the bereaved relatives in the organ donation decision-making process. Conclusion Implications exist for HCPs, bereaved relatives, NHS and society of any change to presumed consent legislation from ethical, cultural and professional practice perspectives. These require to be explored in more detail and addressed, should this approach to organ donation be considered in the U. K.

The ancient theory of virtue ethics has been rejuvenated in recent years, and many believe that this ‘new’ approach to ethical theory might not only revitalise the sometimes stale and often intractable nature of contemporary moral debate, but also serve as a viable alternative to traditional normative theories. This thesis aimed firstly to test this claim, and secondly, to construct a modified version which would not only be useful for the theist, but could also serve as a heuristic device for reading the text of the Old Testament. The method employed to conduct this investigation was to identify and critique the essential features of a virtue-based theory, and then suggest theological interpretations of each based on the text of the OT. These interpretations would be subsequently tested through a canonical reading of the Book of Amos. It was found that an Aristotelian form of virtue ethics admitted the closest parallels with the biblical text, and provided the best framework for the construction of a theistic version. But it was also found that virtue ethics, in all its contemporary forms, was unable to justify an account of right action, and so explain the source of normativity. We concluded that, while a theistic version of virtue ethical theory could indeed provide a useful heuristic device for reading the biblical text, virtue ethics alone could not provide a viable alternative to traditional normative theories. However, it was suggested that this shortcoming could be rectified through a partnership with a modified natural law theory.

HIV/AIDS is a major health problem for sub-Saharan Africa. There are identifiable prevention and treatment regimes which would greatly ameliorate the situation, but these are beyond the resources of the sub-Saharan countries themselves. The research focus of this thesis is an investigation of the responsibility that the developed world has towards supplying help to combat this disease process. A series of arguments are adduced in support of the contention that the developed world has responsibility in this area and that that legitimate responsibility is very demanding indeed. These arguments are drawn firstly from a consideration of beneficence, secondly, from considerations of distributive justice, and finally from a consideration of reparative justice and rights based arguments. With beneficence the accent was upon Singer and his child in the pond thought experiment. With distributive justice the focus was upon contractualism, primarily considering Rawls, but then extending this both into health and in a cosmopolitan direction. Where reparative justice and rights based arguments were concerned the arguments were constructed from Pogge, Shue and Ooms. Major objections to this position were considered and largely rejected arising from the question of over-demandingness, from libertarianism and from a consideration of Murphy and the question of fairness in a non-ideal situation. However it was accepted that there is a place for partiality in moral obligations and that there are reasonable moral duties and prerogatives with regards to self and the needs of those in close relationships with the moral agent involved. Major writers involved in these countervailing arguments included Scheffler and Cullity. The original extreme demand provisionally accepted was counterbalanced by a consideration of partialist obligations. Nonetheless the overall moral position would be such that the needs outlined in the Millennium Development Goals in regard to HIV/AIDS fall easily within the limits of moral obligations of the developed world.

There are differing views on the exact nature of moral distress in nursing, but essentially, most empirical work indicates that it is the nurse’s inability to do the right thing because she feels impeded from doing so, due to constraints such as organisational structures or lack of authority in medical decision making. This thesis will begin with a philosophical analysis of the meaning of moral distress. It will be argued that it is a poorly defined concept but that even so, the emotional and rational challenges that it brings to the nurse, are valid and worthy of more exploration. It will be argued that moral distress is more or less synonymous with ‘troubled conscience’. Thereafter Catlin et al’s (2008) claim that the nursing profession ought to sanction conscientious objection to doctors’ orders when nurses are morally distressed by perceived futile care will be examined. I will oppose this position, and argue that instead, nurses can limit their sense of responsibility for actions performed on the behalf of doctors. To defend my position will require the construction of arguments based on current legal and professional practice and philosophical concepts such as erroneous conscience, moral luck and the ethics of care. In seeking to defend my alternate view of how the nursing profession ought to behave under such circumstances, I will propose a new resolution to moral distress. This will involve ethical reasoning that includes consequetialist justifications within the paradigm of the ethics of care. It will also involve addressing the emotional and spiritual challenges of nursing care, which I will argue have so far not been recognised as significant components of moral distress. Catlin A, Volat D, Hadley M., Bassir R., Armigo C., Valle E., Gong W. and Anderson K. (2008) Conscientious Objection: A Potential Neonatal Nursing Response to Care Orders That Cause Suffering at the End of Life? Study of a Concept. Research in Nursing 27 (2) p. 101 – 108.

This thesis utilises radical feminism to assess whether it could be argued that marriage in the UK context has moved beyond a sexual definition: beyond consummation. The research looks at alternative relationship forms that have emerged to challenge sexual requirements in relationship law, including civil partnerships, same sex marriage and the marriages and civil partnerships of transsexuals. The thesis argues that through incorporating a nullity clause in matrimonial law on the basis of non-consummation, the law effectively requires sex from its heterosexual married citizens. The thesis demonstrates the patriarchal values underlying the consummation requirement and concludes that the challenges that have emerged have not served to dismantle the requirement. We have not moved beyond marriage or consummation.

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In this thesis I present a challenge to anyone who continues to engage in moral thinking – that is to say, I present a challenge to most people currently alive. In the first three chapters, I defend the idea that no non-negative moral proposition is ever true ('Moral Error Theory'). On the back of this defence, I then provide arguments in support of the related - but not entailed – Moral Abolitionist account. According to this view, moral thought, moral talk and morally-coloured motivations should be abolished in favour of an entirely non-moral assessment of the world and the options that face us when we deliberate on questions regarding to ‘how to act’ or ‘how to live’.

Theories of social justice propose various principles for the just regulation of social institutions and practices. However, why should individuals comply with the rules of just social institutions? To answer this question, a theory of obligation is required. This thesis examines and defends the principle of fairness as a theory of individual obligation. It begins by reviewing the debates within political philosophy over the principle since its initial formulation by H. L. A. Hart. Thereafter, the defence of the principle of fairness proceeds in three stages. First, the thesis explores the moral foundations of the principle. It is argued that the concepts of right, equality, and fairness as reciprocity work as the moral foundations provided that fairness as reciprocity has priority over right and equality. On the basis of this reciprocity-based foundation, a revised principle of fairness is stated, which specifies the conditions for the justification of an obligation to follow institutional rules. Second, the thesis rebuts main objections levelled against the principle: the consent argument, the limiting argument, and the utility argument. Finally, the principle of fairness is defended as a principle that has appealing normative implications for one of the most important challenges we face in recent times, global climate change. With theoretical elaboration, defence against main objections, and practical application, this thesis presents a comprehensive development of the principle of fairness as a plausible theory of obligation.

This thesis provides an outline for how we should think of the ethics of Non-Governmental Organisations (NGOs) by giving sense to what it means to treat an NGO as a moral agent. That is, it aims to answer the following question: Which special moral obligations do NGOs have in virtue of the distinctive type of organisation that they are? In brief, the answer provided by this thesis is that NGO agency is defined by the multiple relationships that threaten to undermine its unity. Obligations are identified as what an NGO must do in order to maintain such a unified organisational self. In Chapter 1, I define an NGO as an autonomous, norm-enacting organisation not motivated by profit and reliant on voluntary interaction. The idea of NGOs as unique agents is then developed indirectly in the middle four chapters. Each chapter engages with a central topic pertaining to NGO ethics, arguing for a particular position with respect to the topics of accountability (Chapter 2), resource allocation (Chapter 3), contributions to domestic and global justice (Chapter 4), and NGOs’ impact on the viability of universal welfare rights (Chapter 5). The second task performed by each chapter is the identification of a particular ability, or power, possessed by NGOs as agents. These four abilities characterise the moral agency of an NGO and form the basis for identifying four types of NGO obligation: 1) accountability, 2) acting consistently with organisational norms, 3) demonstration of positive social change, and 4) epistemic procedural virtue. In Chapter 6 I produce a basic framework for NGOs to use as a way of assessing themselves with respect to these four obligations. This framework is then connected to the findings from a 10-month qualitative research project, conducted from 2007-2008, on the ethical perspectives of NGO workers in Mongolia.