In the last ten years, there have been a number of attempts to refute Julian Savulescu's Principle of Procreative Beneficence; a principle which claims that parents have a moral obligation to have the best child that they can possibly have. So far, no arguments against this principle have succeeded at refuting it. This paper tries to explain the shortcomings of some of the more notable arguments against this principle. I attempt to break down the argument for the principle and (...) in doing so, I explain what is needed to properly refute it. This helps me show how and why the arguments of Rebecca Bennett, Sarah Stoller and others fail to refute the principle. Afterwards, I offer a new challenge to the principle. I attack what I understand to be a fundamental premise of the argument, a premise which has been overlooked in the literature written about this principle. I argue that there is no reason to suppose, as Savulescu does, that morality requires us to do what we have most reason to do. If we reject this premise, as I believe we have reason to do, the argument for Procreative Beneficence fails. (shrink)
The claim that we have a moral obligation, where a choice can be made, to bring to birth the 'best' child possible, has been highly controversial for a number of decades. More recently Savulescu has labelled this claim the Principle of Procreative Beneficence. It has been argued that this Principle is problematic in both its reasoning and its implications, most notably in that it places lower moral value on the disabled. Relentless criticism of this proposed moral obligation, however, has (...) been unable, thus far, to discredit this Principle convincingly and as a result its influence shows no sign of abating. I will argue that while criticisms of the implications and detail of the reasoning behind it are well founded, they are unlikely to produce an argument that will ultimately discredit the obligation that the Principle of Procreative Beneficence represents. I believe that what is needed finally and convincingly to reveal the fallacy of this Principle is a critique of its ultimate theoretical foundation, the notion of impersonal harm. In this paper I argue that while the notion of impersonal harm is intuitively very appealing, its plausibility is based entirely on this intuitive appeal and not on sound moral reasoning. I show that there is another plausible explanation for our intuitive response and I believe that this, in conjunction with the other theoretical criticisms that I and others have levelled at this Principle, shows that the Principle of Procreative Beneficence should be rejected. (shrink)
Recently, Julian Savulescu and Guy Kahane have defended the Principle of Procreative Beneficence (PB), according to which prospective parents ought to select children with the view that their future child has ‘the best chance of the best life’. I argue that the arguments Savulescu and Kahane adduce in favour of PB equally well support what I call the Principle of General Procreative Beneficence (GPB). GPB states that couples ought to select children in view of maximizing the overall expected (...) value in the world, not just the welfare of their future child. I further argue that Savulescu and Kahane's claim that PB has significantly more weight than competing moral principles, such as GPB, lacks justification. A possible argument for PB having significant weight builds on a principle of parental partiality towards one's own children. But this principle does not support PB; it supports a Principle of Sibling-Oriented Procreative Beneficence (SPB), according to which parents selecting a child should maximize the benefit of all their children. Indeed, PB itself will in some cases be self-effacing in favour of SPB. (shrink)
I contend that there are important moral reasons for individuals, organisations and states to aid others that have gone largely unrecognised in the literature. Most of the acknowledged reasons for acting beneficently in the absence of a promise to do so are either impartial and intrinsic, on the one hand, being grounded in properties internal to and universal among individuals, such as their pleasure or autonomy, or partial and extrinsic, on the other, being grounded in non-universal properties regarding an actual (...) relation to the agent, such as common membership in a family or culture. In contrast, I articulate and defend the existence of two unrecognised reasons for beneficence that can take the form of being impartial and extrinsic. One is that a being’s capacity to be part of a sharing relationship with us can provide some reason to help it, and another is that a sharing relationship qua relationship is an end-in-itself that can provide some reason to help another. I differentiate these considerations from one another and from the more standard reasons for beneficence, provide arguments for thinking that they are central to beneficence, and rebut objections that are likely to be offered by friends of the more standard reasons. (shrink)
Consider the Strong Beneficence Principle (SBP): Persons of affluent means ought to give to those who might fail basic human subsistence until the point at which they must give up something of comparable moral importance. This principle has been the subject of much recent discussion. In this paper, I argue that no coherent interpretation of SBP can be found. SBP faces an interpretive trilemma, each horn of which should be unacceptable to fans of SBP; SBP is either (a) so (...) strong as to be patently absurd; (b) implausible given its acceptance of a form of numbers skepticism; (c) drained of all its demanding force. In the conclusion, I show how the problems with SBP generalize to all similarly demanding principles of beneficence. (shrink)
Common sense tells us that in certain circumstances, helping someone is morally obligatory. That intuition appears incompatible with Kant's account of beneficence as a wide imperfect duty, and its implication that agents may exercise latitude over which beneficent actions to perform. In this paper, I offer a resolution to the problem from which it follows that some opportunities to help admit latitude and others do not. I argue that beneficence has two components: the familiar wide duty to help (...) others achieve their ends and a narrow duty to avoid indifference to others as end-setters. Although we are not always required to help, we are always required not to be indifferent. When helping someone is the only way not to be indifferent to a person, helping him/her is obligatory. My account avoids certain difficulties with other proposed solutions and can also address an important concern about proximity. (shrink)
Rebecca Bennett, in a recent paper dismissing Julian Savulescu's principle of procreative beneficence, advances both a negative and a positive thesis. The negative thesis holds that the principle's theoretical foundation – the notion of impersonal harm or non-person-affecting wrong – is indefensible. Therefore, there can be no obligations of the sort that the principle asserts. The positive thesis, on the other hand, attempts to plug an explanatory gap that arises once the principle has been rejected. That is, it holds (...) that the intuitions of those who adhere to the principle are not genuine moral intuitions, but instead simply give voice to mere (non-moral) preferences. This paper, while agreeing that Savulescu's principle does not express a genuine moral obligation, takes issue with both of Bennett's theses. It is suggested that the argument for the negative thesis is either weak or question-begging, while there is insufficient reason to suppose the positive thesis true. (shrink)
Substantial efforts have recently been made to reform the physician-patient relationship, particularly toward replacing the `silent world of doctor and patient' with informed patient participation in medical decision-making. This 'new ethos of patient autonomy' has especially insisted on the routine provision of informed consent for all medical interventions. Stronly supported by most bioethicists and the law, as well as more popular writings and expectations, it still seems clear that informed consent has, at best, been received in a lukewarm fashion by (...) most clinicians, many simply rejecting what they commonly refer to as the `myth of informed consent'. The purpose of this book is to defuse this seemingly intractable controversy by offering an efficient and effective operational model of informed consent. This goal is pursued first by reviewing and evaluating, in detail, the agendas, arguments, and supporting materials of its proponents and detractors. A comprehensive review of empirical studies of informed consent is provided, as well as a detailed reflection on the common clinician experience with attempts at informed consent and the exercise of autonomy by patients. In the end, informed consent is recast as a management tool for pursuing clinically and ethically important goods and values that any clinician should see as meriting pursuit. Concurrently, the model incorporates a flexible, anticipatory approach that recognizes that no static, generic ritual can legitimately pursue the quite variable goods and values that may be at stake with different patients in different situations. Finally, efficiency of provision is addressed by not pursuing the unattainable and ancillary. Throughout, the traditional principle of beneficence is appealed to toward articulating an operational model of informed consent as an intervention that is likely to change outcomes at the bedside for the better. (shrink)
Few in our society believe that access to health care should be determined primarily by ability to pay. We believe instead that society has an obligation to assure access to adequate health care for all. This is the view explicitly endorsed in the President's Commission Report Securing Access to Health Care. But there is an important moral ambiguity here, for this obligation may be construed as being either beneficence-based or justice-based. A beneficience-based construal would yield a much weaker (...) obligation with respect to the distribution of health care. In the first section of this paper I argue that the President's Commission is committed only to this weaker construal of this obligation. In the second section I argue that such a beneficence-based obligation is really rooted in a libertarian conception of justice, similar to that recently articulated by Engelhardt, and that this conception is seriously flawed when it comes to effecting a just distribution of health care. (shrink)
The concept of dignity has occasioned a robust conversation in recent healthcare scholarship. When viewed as a whole, research on dignity in healthcare has engaged each of the four bioethical principles popularized by Beauchamp and Childress, but has paid the least attention to beneficence. In this paper, we look at dignity and beneficence. We focus on the dignity promotion component of a model of dignity derived from a grounded theory study. After describing the study and presenting a précis (...) of the resulting model, we review the principle of beneficence and look at the ways in which the notion of dignity promotion can be used to complement our understanding of this principle. Specifically, we explore what we can learn from dignity promotion about the relational nature of beneficence in healthcare and how dignity promotion can be marshaled to help address the epistemological quandary of soft paternalism. (shrink)
Beneficence is usually regarded as adequate when it results in an actual benefit for a beneficiary and satisfies her self-chosen end. However, beneficence that satisfies these conditions can harm beneficiaries' free agency, particularly when they are robustly dependent on benefactors. First, the means that benefactors choose can have undesirable side-effects on resources that beneficiaries need for future free action. Second, benefactors may undermine beneficiaries' ability to freely deliberate and choose. It is therefore insufficient to satisfy someone's self-chosen ends. (...) Instead, good beneficence depends on whether the benefactor avoids undue influence over a beneficiary's deliberation and whether the choice of means is compatible with the beneficiary's conception of her good. Consequently, benefactors must have substantial respect for a beneficiary's free agency and the practical competence to choose means that take into account the beneficiary's conception of her good and the wider set of circumstances that influence her life. (shrink)
The concept of dignity has occasioned a robust conversation in recent healthcare scholarship. When viewed as a whole, research on dignity in healthcare has engaged each of the four bioethical principles popularized by Beauchamp and Childress, but has paid the least attention to beneficence. In this paper, we look at dignity and beneficence. We focus on the dignity promotion component of a model of dignity derived from a grounded theory study. After describing the study and presenting a précis (...) of the resulting model, we review the principle of beneficence and look at the ways in which the notion of dignity promotion can be used to complement our understanding of this principle. Specifically, we explore what we can learn from dignity promotion about the relational nature of beneficence in healthcare and how dignity promotion can be marshaled to help address the epistemological quandary of soft paternalism. (shrink)
My purpose in this paper is to show that current legal criteria for paternalistic involuntary psychiatric confinement of the mentally ill are both too narrow and too broad. I do this by first developing a principle of justified paternalistic interference with adults, which I take to be acceptably protective of individual liberty, but which does not require unnecessary sacrifices of individual welfare. After offering an analysis of current legal criteria for involuntary confinement, 1 argue that an acceptable theory of paternalistic (...) interference reveals that those criteria (1) exclude some cases where confinement would be morally permissible, and (2) allow paternalistic confinement of many whose detention is not morally justifiable. Keywords: paternalism, incompetence, involuntary civil confinement, liberty, beneficence, harm CiteULike Connotea Del.icio.us What's this? (shrink)
Some participants will get HIV-infected in HIV prevention trials, despite risk reduction measures. The subsequent treatment responsibilities of sponsor-investigators have been widely debated, especially where access to antiretroviral therapy (ART) is not available. In this paper, we explore two accounts of beneficence to establish whether they can shed light on sponsor-investigator responsibilities. We find the notion of general beneficence helpful insofar as it clarifies that some beneficent actions will be obligatory where they can be dispensed without scuppering the (...) trial. We find the notion of specific beneficence helpful insofar as it directs investigators to attend to the needs of trial participants; however the range of interventions that could be provided remains unhelpfully broad. We then examine accounts of the investigator-participant relationship to narrow the range of interventions that investigators should provide, concluding that health-care, and HIV infection, are appropriate foci. We conclude that when investigators are able to meet the ART needs of their participants (e.g. referral, assisted referral or direct provision) without sacrificing trial quality, they must do so. However, there is little of this explicit direction to be found in the account of specific beneficence itself, but rather it is found in accounts of the relationship that are compatible with beneficence. (shrink)
The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research published in March of 1983 its Report, Securing Access to Health Care: The Ethical Implications of Differences in the Availability of Health Services . Concluding that there are "ethical obligations" on behalf of society which are balanced by individual obligations, the Report provides an ethical framework for ensuring "ultimate responsibility" of the Federal government to arrange for equitable access to health and to a fair (...) share of cost. In doing so the Report neither makes justice nor beneficence the prime moral principle in public health care, it rather calls for a common sense approach in "approximating adequacy". But how to define equality without creating uniformity in a society rich in its diversity, including attitudes towards health? Keywords: justice, beneficence, right to health care, equality, distribution CiteULike Connotea Del.icio.us What's this? (shrink)
If Savulescu's (2001, 2009) controversial principle of Procreative Beneficence (PB) is correct, then an important implication is that couples should employ genetic tests for non-disease traits in selecting which child to bring into existence. Both defenders as well as some critics of this normative entailment of PB have typically accepted the comparatively less controversial claim about non-disease traits: that there are non-disease traits such that testing and selecting for them would in fact contribute to bringing about the child who (...) is expected to have the best life. We challenge this less controversial claim, not by arguing deductively for its falsity, but by showing that Savulescu's central argument for this presumably less controversial claim fails. Savulescu offers intelligence as the paradigm example of a testable non-disease trait such that testing and selecting for it would increase the likelihood that the child selected would be the one who is expected to have the best life (or at least as good a life as the others). We provide a series of arguments aimed at demonstrating that Savulescu's argument from intelligence fails. If our arguments are successful, the upshot is not that PB is false, but more modestly, that the burden of proof remains squarely with Savulescu. (shrink)
Discussions of reproductive responsibility generally draw heavily upon the principles of nonmaleficence and beneficence. However, these principles are typically only applied to women due to the incorrect belief that only women can cause fetal harm. The cultural perception that women are likely to cause fetal and child harm is reflected in numerous social norms, policies, and laws. Conversely, there is little public discussion of men and fetal and child harm, which implies that men do not (or cannot) cause such (...) harm. My goal in this paper is to begin to fill the void in the academic literature about men’s reproductive responsibility by highlighting the health-related, economic, and social harms men can cause to potential fetuses and children and then examining what it would mean to hold them responsible for preventing these harms. Applying the principles of nonmaleficence and beneficence to men, I conclude that men have a moral duty to use contraception if their behavior—past, current, or future—could harm the potential fetuses and children who result from their unprotected sexual behavior. (shrink)
In this companion volume to their 1981 work, A Philosophical Basis of Medical Practice, Pellegrino and Thomasma examine the principle of beneficence and its role in the practice of medicine. Their analysis, which is grounded in a thorough-going philosophy of medicine, addresses a wide array of practical and ethical concerns that are a part of health care decision-making today. Among these issues are the withdrawing and withholding of nutrition and hydration, competency assessment, the requirements for valid surrogate decision-making, quality-of-life (...) determinations, the allocation of scarce health care resources, medical gatekeeping, and for-profit medicine. The authors argue for the restoration of beneficence (re-interpreted as beneficence-in-trust) to its place as the fundamental principle of medical ethics. They maintain that to be guided by beneficence a physician must perform a right and good healing action which is consonant with the individual patient's values. In order to act in the patient's best interests, or the patient's good, the physician and patient must discern what that good is. This knowledge is gained only through a process of dialogue between patient and/or family and physician which respects and honors the patient's autonomous self-understanding and choice in the matter of treatment options. This emphasis on a dialogical discernment of the patient's good rejects the assumption long held in medicine that what is considered to be the medical good is necessarily the good for this patient. In viewing autonomy as a necessary condition of beneficence, the authors move beyond a trend in the medical ethics literature which identifies beneficence with paternalism. In their analysis of beneficence, the authors reject the current emphasis on rights- and duty-based ethical systems in favor of a virtue-based theory which is grounded in the physician-patient relationship. This book's provocative contributions to medical ethics will be of great interest not only to physicians and other health professionals, but also to ethicists, students, patients, families, and all others concerned with the relationship of professional to patient and patient to professional in health care today. (shrink)
In an era of rapidly rising health care costs, physicians and policymakers are searching for new and effective ways to contain health care spending without sacrificing the quality of services provided. These proposals are increasingly articulated in terms of an ethical duty of stewardship. The duty of stewardship in medicine, however, is not at present well understood, and it is frequently conflated with other duties. This article presents a critical analysis of the notion of stewardship, which shows that it has (...) an important and distinctive place in medical ethics. It claims that stewardship in medicine concerns the responsible use of a society’s medical resources and it discusses the extent to which medical professionals are the proper stewards of these resources. The article argues that the duty of stewardship is best understood as a duty that applies in a space between the obligations of health care providers to provide beneficent care to their patients on the one hand and the obligations of citizens to bring about and support a just health care system on the other. Seen with clear eyes, stewardship in medicine is neither a consequence of beneficent medical care nor a substitute for justice. (shrink)
Principles of bcnciiccnce require us to promote the good. If we believe that a plausible mom] conception will contain some such principle, we must address the issue of the demands it imposes on agents. Some writers have defended extremely demanding principles, while others have argued that only principles with limited demands are acceptable. In this paper I su ggest that we 100k at the demands 0f beneficencc in a different way; 0ur concern should not just be with the extent of (...) the demands faced by individual agents. Instead, we should consider how the demands imposed Ol'] an agent by a principle of beneiiccncc are affected by the level of compliance with the principle by others. Act—consequ@ntia.lism, for example, in effect requires each complying agent to shoulder her share of the demands of bcncficcnce plus as many of the shares of noncomplying agents as would be optimal. I suggest that we focus OH this feature ofconsequentialism, and not just on the very high demands it can impose Ol'] individual agents. Thus I defend the View that principles of beneiicence should not demand more of agents as expected compliance by othcr agents decreases, and formulate a principle of bencficcnce that meets this condition. This View about beneiicence and compliance is supported by a particular conception 0f beneiiccnce. Rather than as an aim we each have as individuals, benciicence could be understood as a cooperative project, where each of us aims to promote the good together with others. If s0, it would be natural t.. (shrink)
If you came upon a small child drowning in a pond, you ought to save the child even at considerable cost and risk to yourself. In 1972 Peter Singer observed that inhabitants of affluent industrialized societies stand in exactly the same relationship to the millions of poor inhabitants of poor undeveloped societies that you would stand to the small child drowning in the example just given. Given that you ought to help the drowning child, by parity of reasoning we ought (...) to help the impoverished needy persons around the globe. To capture this intuition Singer proposed this principle of benevolence: If one can prevent some significant bad from occurring, without sacrificing anything of comparable moral importance, one ought morally to do so.1 Premature death caused by preventable disease, injury, and poverty is uncontroversially a significant bad. Donations to charitable organizations such as Oxfam can prevent many of these deaths around the world, so Singer’s principle holds that we ought to donate (or take some action that is comparably efficient at saving lives). (shrink)
According to Peter Singer, virtually all of us would be forced by adequate reflection on our own convictions to embrace a radical conclusion about giving. The following principle, he says, is “surely undeniable” -- at least once we reflect on secure convictions concerning rescue, as in his famous case of the drowning toddler.
Moral puzzles about actions which bring about very small or what are said to be imperceptible harms or benefits for each of a large number of people are well known. Less well known is an argument by Warren Quinn that standard theories of rationality can lead an agent to end up torturing himself or herself in a completely foreseeable way, and that this shows that standard theories of rationality need to be revised. We show where Quinn's argument goes wrong, and (...) apply this to the moral puzzles. (shrink)
The popular view of non-directive genetic counseling limits the counselor's role to providing information to clients and assisting families in making decisions in a morally neutral fashion. This view of non-directive genetic counseling is shown to be incomplete. A fuller understanding of what it means to respect autonomy shows that merely respecting client choices does not exhaust the duty. Moreover, the genetic counselor/client relationship should also be governed by the counselor's commitment to the principle of beneficience. When non-directive counseling is (...) reexamined in light of both these principles, it becomes clear that there are cases in which counselors should attempt to persuade clients to reconsider their decisions. Such attempts are consistent with non-directive counseling because, while respecting the clients' decision-making authority, they insure that clients act with full knowledge of the moral consequences of their decisions. (shrink)
This paper provides an introductory discussion of questions about three moral duties in the context of global poverty: the duty to aid; the duty not to harm; and the duty to promote just global institutions.
Duties of beneficence are not well understood. Peter Singer has argued that the scope of beneficence should not be restricted to those who are, in some sense, near us. According to Singer, refusing to contribute to humanitarian relief efforts is just as wrong as refusing to rescue a child drowning before you. Most people do not seem convinced by Singer’s arguments, yet no one has offered a plausible justification for restricting the scope of beneficence that doesn’t produce (...) counterintuitive results elsewhere. I offer a defence of this restricted scope by introducing the notion of unique dependence, a notion that is both intuitively attractive and theoretically grounded. It explains why your reason to rescue the drowning child is more stringent than your reason to contribute to humanitarian relief, while blocking the conclusion that we have no reason at all to aid distant sufferers . (shrink)
What do we do when a loved one is seriously messing up her life? While Kantianism describes the predicament nicely as a tension between love and respect, it is not well-suited to resolving it. Kantian respect prevents minding another’s business in cases where love demands it. Virtue ethics can readily explain the predicament as a tension between the virtues of sympathy and humility. Moreover, by changing the focus away from the other as a setter of ends and toward the would-be-benefactor’s (...) own degree of practical wisdom, virtue ethics permits a more nuanced set of loving responses to self-destructive people. (shrink)
Background Even though we are now well into the 21st century and notwithstanding all the abuse to individuals involved in clinical studies that has been documented throughout History, fundamental ethical principles continue to be violated in one way or another. Discussion Here are some of the main factors that contribute to the abuse of subjects participating in clinical trials: paternalism, improper use of informed consent, lack of strict ethical supervision, pressure exerted by health institutions to increase the production of scientific (...) material, and the absence of legislation regarding ethics in terms of health care and research. Are researchers ready to respect fundamental ethical principles in light of the ample window of information provided by individual genomes, while defending the rights of the subjects participating in clinical studies as a major priority? Summary As one of the possible solutions to this problem, education regarding fundamental ethical principles is suggested for participants in research studies as an initial method of cognitive training in ethics, together with the promotion of ethical behavior in order to encourage the adoption of reasonable policies in the field of values, attitudes and behavior. (shrink)
O objetivo deste artigo é demonstrar como, apesar da sobredeterminação, a vida moral e a biológica se articulam, observando-se não apenas a grandeza daquela sobre esta, mas realçando o papel da vida moral ao significar a vida biológica, seja ela humana ou de outra espécie. Nesse contexto, pode-se perguntar: por quais caminhos morais é possível se chegar à significação da vida biológica? É possível se fugir do paradigma da consciência e se aquilatar moralmente tanto um quanto outro tipo de vida? (...) Para respondermos a estas questões, analisaremos o § 42 da Crítica da Faculdade de Juízo, a partir do qual demonstraremos o aspecto moral kantiano acerca da natureza animada e inanimada. Em seguida, articularemos o caráter pragmático e prático na relação humano e não humano. A partir disso, afirmaremos não a sobredeterminação de uma forma de vida sobre outra, mas a relação direta de uma com a outra. (shrink)
In World Poverty and Human Rights, Thomas Pogge argues that the global rich have a duty to eradicate severe poverty in the world. The novelty of Pogges approach is to present this demand as stemming from basic commands which are negative rather than positive in nature: the global rich have an obligation to eradicate the radical poverty of the global poor not because of a norm of beneficence asking them to help those in need when they can at little (...) cost to themselves, but because of their having violated a principle of justice not to unduly harm others by imposing on them a coercive global order that makes their access to the objects of their human right to subsistence insecure. In this paper, I claim that although Pogge is right in arguing that negative duties are crucial in an account of global justice, he is wrong in saying that they are the only ones that are crucial. Harming the global poor by causing their poverty provides a sufficient but not a necessary condition for the global rich to have a duty of justice to assist them. After engaging in a critical analysis of Pogges argument, I conclude by suggesting the need for a robust conception of cosmopolitan solidarity that includes positive duties of assistance which are not mere duties of charity, but enforceable ones of justice. (shrink)
According to what we call the Principle of Procreative Beneficence (PB), couples who decide to have a child have a significant moral reason to select the child who, given his or her genetic endowment, can be expected to enjoy the most well-being. In the first part of this paper, we introduce PB, explain its content, grounds, and implications, and defend it against various objections. In the second part, we argue that PB is superior to competing principles of procreative selection (...) such as that of procreative autonomy. In the third part of the paper, we consider the relation between PB and disability. We develop a revisionary account of disability, in which disability is a species of instrumental badness that is context- and person-relative. Although PB instructs us to aim to reduce disability in future children whenever possible, it does not privilege the normal. What matters is not whether future children meet certain biological or statistical norms, but what level of well-being they can be expected to have. (shrink)
This paper discusses the "numbers problem," the problem of explaining why you should save more people rather than fewer when forced to choose. Existing non-consequentialist approaches to the problem appeal to fairness to explain why. I argue that this is a mistake and that we can give a more satisfying answer by appealing to requirements of charity or beneficence.
Many claim that a plausible moral theory would have to include a principle of beneficence, a principle telling us to produce goods that are both welfarist and agent-neutral. But when we think carefully about the necessary connection between moral obligations and reasons for action, we see that agents have two reasons for action, and two moral obligations: they must not interfere with any agent's exercise of his rational capacities and they must do what they can to make sure that (...) agents have rational capacities to exercise. According to this distinctively deontological view of morality, though we are obliged to produce goods, the goods in question are non-welfarist and agent-relative. The value of welfare thus turns out to be, at best, instrumental. (shrink)
Sweatshop labor is often cited as an example of the worst and most pervasive form of exploitation today, yet understanding what is meant by the charge has proven surprisingly difficult for philosophers. I develop an account of what I call “Needs Exploitation,” grounded in a specification of the duty of beneficence. In the case of sweatshop labor, I argue that employers face a duty to extend to employees a wage sufficient to meet their basic needs. This duty is limited (...) by the degree of the employees’ dependence on the employer for basic needs and a reasonability standard where the employer may remain within a range of well-being between deficiency and luxury. (shrink)
The purpose of this paper is to review critically Julian Savulescu's principle of 'Procreative Beneficence,' which holds that prospective parents are morally obligated to select, of the possible children they could have, those with the greatest chance of leading the best life. According to this principle, prospective parents are obliged to use the technique of pre-implantation genetic diagnosis (PGD) to select for the 'best' embryos, a decision that ought to be made based on the presence or absence of both (...) disease traits and non-disease traits such as intelligence. While several articles have been written in response to Savulescu's principle, none has systematically explored its philosophical underpinnings to demonstrate where it breaks down. In this paper I argue that the examples that Savulescu employs to support his theory in fact fail to justify it. He presents these examples as analogous to PGD, when in fact they differ from it in subtle but morally relevant ways. Specifically, Savulescu fails to acknowledge the fact that his examples evoke deontological and virtue ethics concerns that are absent in the context of PGD. These differences turn out to be crucial, so that, in the end, the analogies bear little support for his theory. Finally, I lay out the implications of this analysis for reproductive ethics. (shrink)
Some of the virtues have a very stable place in our understanding of goodness – beneficence and courage are unlikely ever to lose their high standing. But other virtues have something like a life cycle: they move from a marginal status to to a central one, and sometimes they move back again to the margins, or even beyond the domain of virtue altogether. Chastity is one example of this; humility is another. There was a period in which humility wasn’t (...) a virtue at all (see Aristotle on the great-souled man); with the rise of Christianity (blessed are the meek) it became, not a cardinal, but still a central, virtue, though possibly more honoured in the breach than in the observance; now in the post-Christian world it seems, if a virtue at all, a somewhat creepy one. Why is this – what is it about humility that made it so important during the Christian period, and now makes us so ambivalent about it? And is there any way of rescuing it for a secular context, so that we can once again wholeheartedly endorse and admire it as one of the virtues? (shrink)
Peter Singer and Peter Unger argue that moral decency requires giving away all one's “surplus” for the relief or prevention of “absolute poverty,” because not doing so is analogous to refusing to save a drowning child to avoid making one's clothes muddy. I argue that there is a crucial disanalogy between the two cases and, moreover, that there are four independent moral objections to their thesis: it is monomaniacal in ignoring the variety of morally worthy ideals and elevating self-sacrificial aid (...) to the global poor into the sole ideal; it is misanthropic in its indifference to the happiness of those it adjures to give; it is incompatible with integrity; it would have disastrous effects for the poor if it were generally adopted. I argue that genuine beneficence aims at creating or restoring the conditions that enable its beneficiaries to become self-sufficient creators themselves — creators of wealth and of meaningful and enjoyable lives. Small-scale beneficence is necessary for moral goodness, but large-scale beneficence is optional, so long as its absence is not due to a lack of regard for those in need. The uncharitable person violates the neo-Lockean non-waste proviso that we acquire or keep for ourselves and those we love as much, but only as much, as we can use or invest meaningfully or enjoyably, now or in the long run. But someone who invests all his resources in creating something of worth leads a morally worthy life even if he reserves nothing for large-scale charity. Both our capacity for beneficence, which bids us stretch out a hand to those in need, and our capacity for creation, which bids us reach for the stars, are important aspects of our humanity. The Singer-Unger ideal advocates not genuine beneficence but the profligate giving away of wealth to prolong lives, while failing to appreciate what makes life worth living. a Footnotesa I am grateful for helpful comments on this paper from Ellen Frankel Paul, Larry White (who commented on the paper at the 2005 conference of the Association for Private Enterprise Education), David Blumenfeld, and Garrett Cullity (whose comments from Australia were a wonderful example of voluntary international aid to a stranger). I would also like to thank Georgia State University, Bowling Green State University, and the Association for Private Enterprise Education for inviting me to present this paper, and the audiences at these presentations for their helpful discussion. Finally, I would like to thank Harry Dolan for his expert copyediting, which saved me from some embarrassing mistakes and infelicities. (shrink)
Principles of procreative beneficence (PPBs) hold that parents have good reasons to select the child with the best life prospects. Sparrow (2010) claims that PPBs imply that we should select only female children, unlesswe attach normative significance to “normal” human capacities. We argue that this claim fails on both empirical and logical grounds. Empirically, Sparrow’s argument for greater female wellbeing rests on a selective reading of the evidence and the incorrect assumption that an advantage for females would persist even (...) when a serious gender imbalance is obtained. Logically, PPBs cite only pro tanto reasons and allow that the good of an individual child could be outweighed by other morally relevant considerations, such as those which take collectively suboptimal outcomes into account. There is thus no need to attach value to the “normal.”. (shrink)
The Internet appears to offer psychologists doing research unrestricted access to infinite amounts and types of data. However, the ethical issues surrounding the use of data and data collection methods are challenging research review boards at many institutions. This article illuminates some of the obstacles facing researchers who wish to take advantage of the Internet's flexibility. The applications of the APA ethical codes for conducting research on human participants on the Internet are reviewed. The principle of beneficence, as well (...) as privacy and confidentiality, informed consent, deception, and avoiding harm are all illustrated through the use of a hypothetical online study. (shrink)
There is a remedy available for many of our ailments: Psychopharmacology promises to alleviate unsatisfying memory, bad moods, and low self-esteem. Bioethicists have long discussed the ethical implications of enhancement interventions. However, they have not considered relevant evidence from psychology and economics. The growth in autonomy in many areas of life is publicized as progress for the individual. However, the broadening of areas at one’s disposal together with the increasing individualization of value systems leads to situations in which the range (...) of options asks too much of the individual. I scrutinize whether increased self-determination and unbound possibilities are really in a person’s best interests. Evidence from psychology and economics challenges the assumption that unlimited autonomy is best in all cases. The responsibility for autonomous self-formation that comes with possibilities provided by neuro-enhancement developments can be a burden. To guarantee quality of life I suggest a balance of beneficence, support, and respect for autonomy. (shrink)
In a previous essay I criticized Engelhardt's libertarian conception of justice, which grounds the view that society's obligation to assure access to adequate health care for all is a matter of beneficence [1].Beneficence fails to capture the moral stringency associated with many claims for access to health care. In the present paper I argue that these claims are really matters of justice proper, where justice is conceived along moderate egalitarian lines, such as those suggested by (...) Rawls and Daniels, rather than strong egalitarian lines. Further, given the empirical complexity associated with the distribution of contemporary health care, I argue that what we really need to address the relevant policy issues adequately is a theory of health care justice, as opposed to an all-purpose conception of justice. Daniels has made an important start toward that goal, though there are some large policy areas which I discuss that his account of health care justice does not really speak to. Finally, practical matters of health care justice really need to be addressed in a non-ideal mode, a framework in which philosophers have done little. (shrink)
Issues in reproductive ethics, such as the capacity of parents to ‘choose children’, present challenges to philosophical ideas of freedom, responsibility and harm. This book responds to these challenges by proposing a new framework for thinking about the ethics of reproduction that emphasizes the ways that social norms affect decisions about who is born. The book provides clear and thorough discussions of some of the dominant problems in reproductive ethics - human enhancement and the notion of the normal, reproductive liberty (...) and procreative beneficence, the principle of harm and discrimination against disability - while also proposing new ways of addressing these. The author draws upon the work of Michel Foucault, especially his discussions of biopolitics and norms, and later work on ethics, alongside feminist theorists of embodiment to argue for a new bioethics that is responsive to social norms, human vulnerability and the relational context of freedom and responsibility. This is done through compelling discussions of new technologies and practices, including the debate on liberal eugenics and human enhancement, the deliberate selection of disabilities, PGD and obstetric ultrasound. (shrink)
We describe the application of fundamental moral principles, with particular emphasis on prima facie duties, to formal codes of ethics that regulate the conduct of forensic psychologists who act as expert witnesses. Then we discuss the American Psychological Association's (1992) "Ethical Principles of Psychologists and Code of Conduct" and the Committee on Ethical Guidelines for Forensic Psychologists's "Specialty Guidelines for Forensic Psychologists" (1991) and critically appraise how these documents translate basic moral principles. We conclude that, in many ways, the documents (...) exemplify ethical obligations such as nonmaleficence, beneficence, and justice, but they fall short in many other ways, particularly with regard to autonomy and fidelity. (shrink)
John Harris has previously proposed that there is a moral duty to participate in scientific research. This concept has recently been challenged by Iain Brassington, who asserts that the principles cited by Harris in support of the duty to research fail to establish its existence. In this paper we address these criticisms and provide new arguments for the existence of a moral obligation to research participation. This obligation, we argue, arises from two separate but related principles. The principle of fairness (...) obliges us to support the social institutions which sustain us, of which research is one; while the principle of beneficence, or the duty of rescue, imposes upon us a duty to prevent harm to others, including by supporting potentially beneficial, even life-saving research. We argue that both these lines of argument support the duty to research, and explore further aspects of this duty, such as to whom it is owed and how it might be discharged. (shrink)
This paper’s first section invokes a relevant meta-ethical principle about what a moral theory needs in order to be plausible and superior to its rivals. In subsequent sections, I try to pinpoint exactly what the demandingness objection has been taken to be. I try to explain how the demandingness objection developed in reaction to impartial act-consequentialism’s requirement of beneficence toward strangers. In zeroing in on the demandingness objection, I distinguish it from other, more or less closely related, objections. In (...) particular, I discuss arguments put forward by Bernard Williams concerning integrity, Samuel Scheffler on prerogatives, and Liam Murphy on fairness. The final part of the paper acknowledges some ways in which vagueness bedevils my own rule-consequentialism’s rules about doing good and preventing disasters. (shrink)
This article provides an intellectual archeology of how the term "respect" has functioned in the field of bioethics. I argue that over time the function of the term has shifted, with a significant turning point occurring in 1979. Prior to 1979, the term "respect" connoted primarily the notion of "respect for persons" which functioned as an umbrella which conferred protection to autonomous persons and those with compromised autonomy. But in 1979, with the First Edition of Principles of Biomedical Ethics by (...) Beauchamp and Childress, and the report of the Ethical Advisory Board (EAB) of the (then) Department of Health, Education, and Welfare entitled Research on In Vitro Fertilization, usage shifts from "respect for persons" to "respect for autonomy." Two results: 1) those with compromised autonomy are no longer protected by the canons of "respect" but rather the less overriding canons of beneficence; and 2) the term "respect" functions increasingly as a rhetorical device in public bioethics discourse. (shrink)
Deep Brain Stimulation (DBS) is a treatment involving the implantation of electrodes into the brain. Presently, it is used for neurological disorders like Parkinson’s disease, but indications are expanding to psychiatric disorders such as depression, addiction and Obsessive Compulsive Disorder (OCD). Theoretically, it may be possible to use DBS for the enhancement of various mental functions. This article discusses a case of an OCD patient who felt very happy with the DBS treatment, even though her symptoms were not reduced. First, (...) it is explored if the argument that ‘doctors are not in the business of trading happiness’, as used by her psychiatrist to justify his discontinuation of the DBS treatment, holds. The relationship between enhancement and the goals of medicine is discussed and it is concluded that even though the goals of medicine do not set strict limits and may even include certain types of enhancement, there are some good reasons for limiting the kind of things doctors are required or allowed to do. Next, the case is discussed from the perspective of beneficence and autonomy. It is argued that making people feel good is not the same as enhancing their well-being and that it is unlikely—though not absolutely impossible—that the well-being of the happy OCD patient is really improved. Finally, some concerns regarding the autonomy of a request made under the influence of DBS treatment are considered. (shrink)
