Various authors, for instance Elizabeth Anderson, Rosemary Tong, Mary Warnock and Margaret Brazier have argued that commercial surrogate motherhood is exploitative and that it should be prohibited. Their arguments are unconvincing. Exploitation is a more complex notion than it is usually presented as being. Unequal bargaining power can be a cause of exploitation but the exercise of unequal bargaining power is not inevitably or inherently exploitative. Exploitation concerns unfair and/or unjust strategies - rather than the exercise of power as such. (...) Commercial surrogate motherhood is not necessarily exploitative. Furthermore, not all transactions which are exploitative should be made illegal. (shrink)

Le Grand describes a situation where a drunk driver, who has medical insurance, is the cause of an accident in which he and a sober pedestrian, who has no medical insurance, are both equally and seriously injured. At the private hospital to which they are both taken, there is available emergency treatment for one of them only. Who should receive it? The issues raised by Le Grand's example are shown to be more interesting, more complex and less clearcut than Le (...) Grand suggests and implies. In particular, it is not the case that, unequivocally, the drunkenness of the driver establishes that the pedestrian rather than he should be treated nor that, unequivocally, the driver's possession of health insurance is morally irrelevant. (shrink)

It is argued by Anderson and also in the BrazierReport that Commercial Surrogate Motherhood (C.S.M.)contracts and agencies should be illegal on thegrounds that C.S.M. involves the commodification ofboth mothers and babies. This paper takes issue withthis view and argues that C.S.M. is not inconsistentwith the proper respect for, and treatment of,children and women. A case for the legalisation ofC.S.M. is made.

In a recent article in Health Care Analysis (Vol. 8, No. 1),Campbell misrepresents our specific arguments about commercialsurrogate motherhood (C.S.M.) and our general philosophical andpolitical views by saying or suggesting that we are `Millsian'liberals and consequentialists. He gives too the false impressionthat we do not oppose, in principle, slavery and child purchase.Here our position on C.S.M. is re-expressed and elaborated uponin order to eliminate possible confusion. Our general ethical andphilosophical framework is also outlined and shown to be otherthan Campbell says (...) that it is. In particular, a moral philosophythat it is based on neither consequentialism nor Kantianism ispresented. C.S.M., it is argued, is not child purchase. It is like it insome respects and unlike it in others. It is unlike it in therespects which, relative to the present discussion, matter. (shrink)

This new edition of Law and Medical Ethics continues to chart the ever-widening field that the topics cover. The interplay between the health caring professions and the public during the period intervening since the last edition has, perhaps, been mainly dominated by wide-ranging changes in the administration of the National Health Service and of the professions themselves but these have been paralleled by important developments in medical jurisprudence.

_Practical Bioethics_ offers a mix of theory and readings, presented in a format that is succinct and approachable. Each chapter begins and ends with a case study, illustrating the core issues at play and emphasizing the practical nature of the dilemmas arising in medicine. Primary source texts are provided to flesh out the issues, and each of these is carefully edited and presented with interwoven explanatory comments to assist student readers. Throughout, J.K. Miles shows the importance of health-care ethics to (...) us all, whether we be medical providers, patients, or both. (shrink)

In this paper I describe and analyze an economic situation involving two competitive organizations. I put forth the argument that because of the systemic nature of decision making relative to managing the requirements of utilizing a descriptive equation that determines how many people an economic system can support, that even if all the players in the situation act ethically, the results will still be harmful, and necessarily so, to the system and to many innocent people. I will demonstrate that harming (...) innocent people is required and morally defensible given the choices available. The best one can do is slow down the increase in disutilities and possibly operate the system within a range of acceptable behavior that minimizes the resulting harm to innocent people, even if we cannot entirely remove this harm. In this context ethics becomes the study of the acceptable as opposed to the preferable. (shrink)

A set is said to be amorphous if it is infinite, but is not the disjoint union of two infinite subsets. Thus amorphous sets can exist only if the axiom of choice is false. We give a general study of the structure which an amorphous set can carry, with the object of eventually obtaining a complete classification. The principal types of amorphous set we distinguish are the following: amorphous sets not of projective type, either bounded or unbounded size of members (...) of partitions of the set into finite pieces), and amorphous sets of projective type, meaning that the set admits a non-degenerate pregeometry, over finite fields either of bounded cardinality or of unbounded cardinality. The hope is that all amorphous sets will be of one of these types. Examples of each sort are constructed, and a reconstruction result for bounded amorphous sets is presented, indicating that the amorphous sets of this kind constructed in the paper are the only possible ones. The final section examines some questions concerned with the resulting cardinal arithmetic. (shrink)

Recently, new developments took place in the Dutch debate on the legislation of euthanasia. After a brief account of that debate, the article discusses a new government proposal for legislation in this field, which was submitted to the Dutch parliament in November 1991. This proposal relates not only to euthanasia but also to some other medical decisions concerning the end of life. The author concludes that, for several reasons, it is unsatisfactory.

This article revisits long-standing questions about consent, membership and emigration in Locke’s thought. Commentators such as A John Simmons have argued that Locke opens political membership to both express consenters and some kind of tacit consenters, and not just to the former, as some have suggested. Simmons’s reading seems to render Locke more sensible in that it does not exclude large numbers of people from membership or burden the few members with all the civic duties, and also in that it (...) allows at least tacit-consenting members the right to relocate, while this right is denied to express-consenting members. Against this reading, the article shows, by resolving seemingly conflicting claims in the text, that people become members only by express consent. It also responds to the criticism that the express-consent-only reading would limit membership to a few and so would render Locke’s account implausible from a practical point of view. The article then addresses the purported restriction Locke imposes on express consenters’ right to emigrate, arguing that the restriction concerns the change of membership and not the right to relocate. (shrink)

Originally published in 1926, this book attempts to state 'what has been believed with regard to God's incapacity for suffering'. Mozley charts the development of the doctrine from the Apostolic Fathers through the Reformation to the modern influence of metaphysical philosophy and concludes with six questions intended to prompt further theological discussion on this point. This book will be of value to anyone with an interest in the history of Christian theology.

Recent scholarship on technology-induced ‘conceptual disruption’ has spotlighted the notion of a conceptual gap. Conceptual gaps have also been discussed in scholarship on epistemic injustice, yet up until now these bodies of work have remained disconnected. This article shows that ‘gaps’ of interest to both bodies of literature are closely related, and argues that a joint examination of conceptual disruption and epistemic injustice is fruitful for both fields. I argue that hermeneutical marginalization—a skewed division of hermeneutical resources, which serves to (...) diminish the experiences of marginalized folk—does not only transpire because of conceptual gaps, but also because of two other kinds of conceptual disruption: conceptual overlaps and conceptual misalignments. Hence, there are multiple kinds of conceptual disruption that can be usefully studied through the normative lens of epistemic injustice. Technology can play different roles vis-a-vis epistemic injustices, both as a causal trigger of conceptual disruption, but also as a mediator of hermeneutical resources. Its role is normatively significant, in particular because socially disruptive technologies can have different epistemic implications for different groups: they may amplify the epistemic resources of some groups, while diminishing those of others. (shrink)

The literature on collective action largely ignores the constraints that moral principle places on action-prompting intentions. Here I suggest that neither individualism nor holism can account for the generality of intentional contents demanded by universalizability principles, respect for persons, or proactive altruism. Utilitarian and communitarian ethics are criticized for nominalism with respect to social intentions. The failure of individualism and holism as grounds for moral theory is confirmed by comparing Tuomela's reductivist analysis of we-intentions with Gilbert's analysis of social facts. (...) Tuomela's account founders over intentions to cooperate, and Gilbert's cannot accommodate legitimate authority, vicarious agency, or group structure. (shrink)

Mason and McCall Smith's classic textbook discusses the relationship of medical practice and ethics with the operation of the law. The subjects covered include natural and assisted reproduction, the impact of modern genetics on medicine, medical confidentiality, consent to medical treatment, the use of resources and problems surrounding death in the new medical era. It is of significance to anyone with an interest in the ethical and legal practice of medicine.

This paper traces the development of parental rights to accept or to refuse treatment for a defective newborn infant in the United Kingdom and in the United States of America; its main purpose is to explore the common trends from which an acceptable policy may be derived. It is probable that the British law on parental decision-making in respect of infants suffering from Down's syndrome is to be found in the civil case of In Re B rather than in the (...) criminal case of R v Arthur. United States court decisions are strongly influenced by constitutional law and reflect the right to personal privacy. The position on each side of the Atlantic seems very similar but this similarity includes a sense of uncertainty as to legal responsibility. There is a case for agreed guidelines and a suggested format is offered for consideration. (shrink)

In this paper an attempt is made to establish that the parties on both sides of the disputes concerning whether reasons are causes have mischaracterized or misdescribed what is involved in acting from a reason. A characterization of acting from a reason is provided, and, as a result, it is shown why contradictory positions have been and still are maintained by opposing parties. As a consequence of this account, an attempt is made to show why all parties have missed the (...) nature and significance of empathetic understanding. (shrink)

Background: The American Medical Association, the British Medical Association and the Canadian Medical Association have guidelines that specifically discourage physicians from self-prescribing or prescribing to family members, but only the BMA addresses informal prescription requests between colleagues. Objective: To examine the practices of paediatric providers regarding self-prescribing, curbsiding colleagues, and prescribing and refusing to prescribe to friends and family. Methods: 1086 paediatricians listed from the American Academy of Paediatrics 2007 web-based directory were surveyed. Results: 44% of eligible survey respondents returned (...) usable surveys. Almost half of respondents had prescribed for themselves. An equal number had informally requested a prescription from a colleague. Three-quarters stated they had been asked to prescribe a prescription drug for a first-degree or second-degree relative, and 51% had been asked by their spouse. Eighty-six per cent stated that they had refused to write a prescription on at least one occasion for a friend or family member. The following reasons “strongly influenced” their decision to refuse a prescription request: outside of provider’s expertise ; patient’s need for his or her own physician ; not medically indicated ; need for a physical examination. Conclusion: These data confirm that most physicians have engaged in self-prescribing or curbside requests for prescriptions. It can be argued that curbsiding is more morally problematic than self-prescribing because it implicates a third party, and should be discouraged regardless of whether the requester is a colleague, family member or friend. (shrink)