Since the 1960s we have moved rapidly from a “doctor-knows-best” society which in which medical paternalism -- such as withholding information from patients “for their benefit” -- was common, towards a society which celebrates patients’ rights to make informed decisions about their care. In Choosing Life, Choosing Death, Charles Foster mounts a polemic against the current enthusiasm for respect for autonomy in medical ethics and law.
When we talk about intellectual property, it is often implicitly assumed that we are talking about private intellectual property. However, private property and the idea of private ownership do not exhaust the possibilities for accounts of ownership and of property. There are other ways that ownership can operate, such as common property. A resource is common property if its use is ‘governed by rules whose point is to make them available for use by all or any members of the society.’.
This thesis is a constructive work in the tradition of morality. The thesis divides into three parts. Part One argues that morality is best considered as a tradition (in MacIntyre’s sense) in ethical thinking which begins with the Stoics, develops in Christian thought and reaches its apotheosis in Kant. This tradition structures ethical thinking around three basic concepts: cosmopolitanism, or universal applicability to human beings as such, the dignity of human beings and reciprocity. It is this tradition in ethical thinking (...) which Nietzsche sets out to destroy. Part One then critiques conceptions of morality which take it that universal and exceptionless rules form the core of morality: it criticises both the possibility of putting forward an adequate set of such rules and the proposed relationship between morality and human life that is implicit in these accounts. Part Two begins with Nietzsche’s challenge: that morality is a system of values rooted in nihilistic resentment at the vitality of other, stronger modes of living. It argues that this challenge must be taken seriously, and that the best way to do this is to make it clear that morality has as its fundamental basis a responsiveness to the value of human life; hence it is Nietzsche’s ethics that should be called nihilistic. The rest of Part Two examines the possibility of answering Nietzsche’s challenge by demonstrating a necessary connection between human selfhood and the acknowledgement of the dignity of human beings. Here I argue that neither Christine Korsgaard’s neo-Kantian arguments nor Charles Taylor’s phenomenologically based approach can provide a convincing reason for thinking that there is such a necessary connection. Part Three turns towards pragmatism, and in so doing gives up on the attempt to show that morality is somehow necessary for all human beings. Nietzsche’s challenge is answered more subtly: an empirically backed theory of human selfhood explains the point of morality in terms of our basic need for recognition. I complete the reconstruction of morality by reinterpreting the dignity of human beings in a naturalistic way and adopting a conception of moral rules that is informed by Jürgen Habermas’ discourse ethics. (shrink)
The infant mortality rate in Liberia is 50 times higher than it is in Sweden, whilst a child born in Japan has a life expectancy at birth of more than double that of one born in Zambia. 1 And within countries, we see differences which are nearly as great. For example, if you were in the USA and travelled the short journey from the poorer parts of Washington to Montgomery County Maryland, you would find that ‘for each mile travelled life (...) expectancy rises about a year and a half. There is a twenty-year gap between poor blacks at one end of the journey and rich whites at the other’. (Marmot, 2004, p.2). There are two types of questions which it is important to ask about inequalities in health such as these. The first are social scientific questions about the extent of inequalities in health and the factors which are causally responsible for these inequalities. Examples of social scientific questions to ask might be: how do infant mortality rates in the UK differ according to social class? What is the difference in life expectancy between Japanese who emigrate to the US and those who remain in Japan? Why do civil servants in higher ranked jobs tend to live longer than civil servants in lower ranked jobs? The second type are normative questions about the reasons we have to care about inequalities in health. Important normative questions to answer are: which inequalities in health should we care about (all inequalities or merely some of them)? When is an inequality in health unjust? How should we weigh our concern for equality in health against other factors such as maximising the.. (shrink)
“This chapter looks at four arguments which Microsoft has used to justify the claim that illegal copying of software is wrong: software piracy is theft; software piracy violates the rights of copyright holders; software piracy is free riding; and software piracy reduces incentives to future innovation. It argues that the first argument is simply wrong, and the other three do not establish that it is in fact wrong to pirate Microsoft’s programs.
In this chapter we argue that the four principles of medical ethics -- beneficence, non-maleficence, respect for autonomy and justice (Beauchamp & Childress, 2001; Gillon, 1985), a new Family Interest Principle (introduced below) and a consideration of ‘capacity’ provide a reasoned practice guide for work with mothers experiencing health problems, focussing here on mental health when a parent is a patient. Our concern is the relationship of the clinician with a parent and through the parent their child. Ethics of service (...) provision or services planning (e.g. Culyer, 2001; McLachlan, 2005; see also Newbigging and Paul, chapter xxx), or the provision of other services (e.g. education, child protection) although intensely relevant to this area are not addressed in this chapter nor will we deal with the complex aspects of medical ethics relating to the treatment of children (Baines, 2008). We use the term ‘parent’ to refer to any adult person who fulfils a substantive parental role with a child. Defining what counts as a family will in certain circumstances be contentious. There are diverse patterns of family arrangements that may be influenced by cultural, political economic and temporal factors. For the purposes of our discussion, we define a family in terms of its role in childrearing, as a group of at least one adult and at least one child, living together in long term relationships on an ongoing basis with vested interest in the well being of each of the family members. (shrink)
Jansen and Wall suggest a new way of defending hard paternalism in clinical research. They argue that non-therapeutic research exposing people to more than minimal risk should be banned on egalitarian grounds: in preventing poor decision-makers from making bad decisions, we will promote equality of welfare. We argue that their proposal is flawed for four reasons.First, the idea of poor decision-makers is much more problematic than Jansen and Wall allow. Second, pace Jansen and Wall, it may be practicable for regulators (...) to uncover the values that a potential research participant holds when agreeing to enter a research project, so their claim that we must ban such research projects for all if we are to ban them for poor decision-makers looks to be unmotivated. Third, there seem to be cases where the liberty to enter the sort of research project Jansen and Wall discuss is morally weighty, and arguably should outweigh concerns of egalitarian distribution. Fourth, banning certain types of research, which seem on the face of it to offer an unfavourable risk-benefit ratio, would have unwelcome consequences for all clinical research, which Jansen and Wall do not recognize. (shrink)
Drugs are much more expensive whilst they are subject to patent protection than once patents expire: patented drugs make up only 20% of NHS drugs prescriptions, but consume 80% of the total NHS drugs bill. This article argues that, given the relatively uncontroversial assumption that we should save the greater number in cases where all are equally deserving and we cannot save both groups, it is more difficult than is usually thought to justify why publicly funded healthcare systems should pay (...) for patented treatments. The claim to medical treatment of those who will be sick with a given condition once the patent runs out is just as strong as those who are sick with it now, but we will be able to treat more people with the same unit of resource in the future. Hence, when resource constraints entail that both cannot be funded, publicly funded healthcare systems ought to wait until patents expire before approving drugs for general use in the publicly funded system. (shrink)
Research involving human subjects is much more stringently regulated than many other nonresearch activities that appear to be at least as risky. A number of prominent figures now argue that research is overregulated. We argue that the reasons typically offered to justify the present system of research regulation fail to show that research should be subject to more stringent regulation than other equally risky activities. However, there are three often overlooked reasons for thinking that research should be treated as a (...) special case. First, research typically involves the imposition of risk on people who do not benefit from this risk imposition. Second, research depends on public trust. Third, the complexity of the moral decision making required favors ethics committees as a regulative solution for research. (shrink)
Philosophical reflection on intellectual property (IP) is still very young. Whilst much has been written by lawyers on intellectual property, the vast majority of this writing is philosophically unsophisticated. This paper aims to at least partially remedy this philosophical deficit by examining what reflection on the ontology of intellectual property can add to our understanding of how to regulate IP. I argue that ontological reflection should bring us to an important basic fact, namely that ownership of intellectual property involves the (...) ownership of types rather than tokens. This difference in the ontological status of the objects owned makes a normative difference to how we should regulate ownership of intellectual property as compared to tangible property. The argument falls into three main parts. I begin by arguing that the type-token distinction is the best way to account for the ontology of intellectual property. I next argue that the realisation that we are dealing with ownership of types rather than tokens has important normative implications. In particular some of the standard arguments in favour of private ownership of physical property simply do not apply in the case of ownership of types, whilst some other arguments apply only in an attenuated way. The next section examines the limitations of ontology as a guide to the regulation of IP. I argue that whilst thinking through the normative implications of the type-token distinction is a necessary 1 condition for a sound regulatory approach to IP, it is certainly not sufficient. This is because many of the specific questions about the regulation of intellectual property that matter most in practice—such as how long the patent term should be, or how much someone should be able to quote from a book and it count as fair use—are not answerable by ontological reflection. Such questions concern the fair distribution of the burdens and benefits involved in the construction of public goods, rather than questions of ontology.. (shrink)
Research involving human subjects is much more stringently regulated than many other nonresearch activities that appear to be at least as risky. A number of prominent figures now argue that research is overregulated. We argue that the reasons typically offered to justify the present system of research regulation fail to show that research should be subject to more stringent regulation than other equally risky activities. However, there are three often overlooked reasons for thinking that research should be treated as a (...) special case. First, research typically involves the imposition of risk on people who do not benefit from this risk imposition. Second, research depends on public trust. Third, the complexity of the moral decision making required favors ethics committees as a regulative solution for research. (shrink)
This article examines when deceptive withholding of information is ethically acceptable in research. The first half analyses the concept of deception. We argue that there are two types of accounts of deception: normative and non-normative, and argue that non-normative accounts are preferable. The second half of the article argues that the relevant ethical question which ethics committees should focus on is not whether the person from whom the information is withheld will be deceived, but rather on the reasonableness of withholding (...) the information from the person who is deceived. We further argue that the reasonableness of withholding information is dependent on the context. The last section examines how the context of research should shape our judgements about the circumstances in which withholding information from research participants is ethically acceptable. We argue that some important features of research make it more difficult to justify withholding information in the context of research than elsewhere. (shrink)
Comprehensive Biomedical Research Centre and Centre for Philosophy, Justice and Health, UCL, First Floor, Charles Bell House, 67–73 Riding House Street, London W1W 7EJ, UK. Tel.: +44 (0)20 7679 9417; Fax: +44 (0)20 7679 9426; Email: james-gs.wilson{at}ucl.ac.uk ' + u + '@' + d + ' '//--> . Abstract This paper aims to shed some light on the difficulties we face in constructing a generally acceptable normative framework for thinking about public health. It argues that there are three factors that (...) combine to make theorising about public health difficult, and which when taken together defeat simplistic top-down and bottom-up approaches to the design of public health policies. The first factor is the problem of complex systems, namely that the distribution of health both affects and is affected by the distribution of other goods. The second is the difficulty of defining the goals of public health: we still need to get clear about what we should mean by health in this context, and what the goals of public health should be. The third is that we stand in need of an account of how important health is relative to the importance of other goods that a just society should be trying to secure for its citizens. The paper argues that these problems should lead us to abandon the search for a ‘one-size fits all’ normative framework for thinking about public health. Rather, different approaches will be appropriate at different levels of abstraction. CiteULike Connotea Del.icio.us What's this? (shrink)
Intellectual property typically involves claims of ownership of types, rather than particulars. In this article I argue that this difference in ontology makes an important moral difference. In particular I argue that there cannot be an intrinsic moral right to own intellectual property. I begin by establishing a necessary condition for the justification of intrinsic moral rights claims, which I call the Rights Justification Principle. Briefly, this holds that if we want to claim that there is an intrinsic moral right (...) to φ, we must be able to show that (a) violating this right would typically result in either a wrongful harm or other significant wrong to the holder of the right, and (b) the wrongful harm or other wrong in question is independent of the existence of the intrinsic right we are trying to justify. I then argue that merely creating a new instance of a type is not the kind of action which can wrongfully harm the creator of that type. Insofar as there do seem to be wrongs involved in copying a published poem or computer program, these wrongs presuppose the existence of an intrinsic right to own intellectual property, and so cannot be used to justify it. I conclude that there cannot be an intrinsic right to own intellectual property. (shrink)
This paper focuses on the ethical justifiability of patents on Genetically Modified (GM) crops. I argue that there are three distinguishing features of GM crops that make it unethical to grant patents on GM crops, even if we assume that the patent system is in general justified. The first half of the paper critiques David Resnik’s recent arguments in favor of patents on GM crops. Resnik argues that we should take a consequentialist approach to the issue, and that the best (...) way to do so is to apply the Precautionary Principle, and that the Precautionary Principle, in this case, supports patents on GM crops. I argue that his argument in favor of a consequentialist treatment is invalid; his Precautionary Principle in any case appears to be incompatible with consequentialism; and his conception of reasonable precautions is too ill-defined to have any argumentative purchase. In the second half of the paper, I argue against GM crop patents, on three grounds. First, there is insufficient evidence to say whether allowing patents on GM crops will make research go faster than not having patents, whilst there is a good reason to think that, other things being equal, a society that allows patents on GM crops will be less just than one that does not. Second, even assuming that patents on GM crops will increase the pace of GM crop research, there is no social need to do so. Third, patents on GM crops will frequently have ethically unacceptable side effects. (shrink)
Three main claims are made in this paper. First, it is argued that Onora O’Neill has uncovered a serious problem in the way medical ethicists have thought about both respect for autonomy and informed consent. Medical ethicists have tended to think that autonomous choices are intrinsically worthy of respect, and that informed consent procedures are the best way to respect the autonomous choices of individuals. However, O’Neill convincingly argues that we should abandon both these thoughts. Second, it is argued that (...) O’Neill’s proposed solution to this problem is inadequate. O’Neill’s approach requires that a more modest view of the purpose of informed consent procedures be adopted. In her view, the purpose of informed consent procedures is simply to avoid deception and coercion, and the ethical justification for informed consent derives from a different ethical principle, which she calls principled autonomy. It is argued that contrary to what O’Neill claims, the wrongness of coercion cannot be derived from principled autonomy, and so its credentials as a justification for informed consent procedures is weak. Third, it is argued that we do better to rethink autonomy and informed consent in terms of respecting persons as ends in themselves, and a characteristically liberal commitment to allowing individuals to make certain categories of decisions for themselves. -/- Respect for autonomy is in trouble. In recent work in this journal1 and elsewhere,2 O’Neill has forcefully argued that respect for autonomy, as it has come to be used in medical ethics, is philosophically indefensible. If her arguments are sound, then, contrary to the standard view, respect for autonomy cannot be the source of the ethical requirement to seek informed consent before treating a patient or enrolling a participant in a trial. So her critique goes to the heart of contemporary medical ethics: if O’Neill is right, medical ethicists have systematically misunderstood two of the most fundamental concepts they deal with—respect for autonomy and informed consent. -/- This paper has four sections. Section 1 distinguishes between three different ways of talking about respect for autonomy, and looks in more detail at the one that has come to be central to bioethical writing on informed consent—namely, the idea that we should respect autonomous choices. Section 2 argues, following O’Neill, that it is implausible to think that the purpose of informed consent requirements is to respect autonomous choices. Section 3 argues that O’Neill’s proposed reworking of autonomy and informed consent is inadequate. O’Neill’s approach requires us to adopt a more modest view of the purpose of informed consent procedures. In her view, the purpose of informed consent procedures is simply to avoid deception and coercion, and the ethical justification for informed consent derives from a different ethical principle, which she calls principled autonomy. I argue that contrary to what O’Neill claims, we cannot derive the wrongness of coercion from principled autonomy, and so its credentials as a justification for informed consent procedures is weak. Section 4 argues that we do better to rethink autonomy and informed consent in terms of respecting persons as ends in themselves, and a characteristically liberal commitment to allowing individuals to make certain categories of decisions for themselves. (shrink)
The idea that there is something ethically corrupt or ethically corrupting about Nietzsche’s work is an anathema to Nietzsche scholars today. Although there are some serious moral philosophers, such as Philippa Foot, Jonathan Glover and Martha Nussbaum who write about Nietzsche whilst finding his position ethically deplorable, most Nietzsche scholars tend to focus rather more heavily on his positive aspects. This means that negative ethical assessments of Nietzsche now tend to be relatively few and far between, and given that they (...) tend to be composed by people who know the texts less well than the dedicated Nietzsche scholars, these criticisms can usually be swatted away quite easily. There are two halves to this paper. The first half sets up the problem for the Nietzsche interpreter: the moral equality of human beings is the basic idea through which we (now) think about morality; and Nietzsche’s views on the nature of human ethical life commit him to opposing the moral equality of human beings. The second half of the paper examines Nietzsche’s critique of moral egalitarianism in more detail. Nietzsche’s critique, I suggest, is composed of two parts: a negative and a positive. The negative part (the slave morality thesis) argues that (a) we should make a distinction between moralities of affirmation and moralities of denial; and (b) all moralities which have the equality of human beings as their fundamental value are moralities of denial. The positive part, which, following Nietzsche, I shall call the pathos of distance thesis claims that human greatness requires a feeling of great height from which the great person looks down in lofty contempt on others. I shall argue that it is false to claim that all moralities which have the equality of human beings as their fundamental value are moralities of denial, and that the pathos of distance thesis is either false or question begging or both. Hence there is no reason, even being as generous to Nietzsche as we can be, to think his critique should force us to give up moral egalitarianism. However, even if not all egalitarian moralities are moralities of denial, it is certainly true that some are, which leaves us with a very difficult question: how do we ensure that our belief in the moral equality of human beings forms part of a morality of affirmation rather than one of denial? (shrink)
Conservative thinkers such as Francis Fukuyama have produced a battery of objections to the transhumanist project of fundamentally enhancing human capacities. This article examines one of these objections, namely that by allowing some to greatly extend their capacities, we will undermine the fundamental moral equality of human beings. I argue that this objection is groundless: once we understand the basis for human equality, it is clear that anyone who now has sufficient capacities to count as a person from the moral (...) point of view will continue to count as one even if others are fundamentally enhanced; and it is mistaken to think that a creature which had even far greater capacities than an unenhanced human being should count as more than an equal from the moral point of view. (shrink)
We are all familiar with assertions of rights: we talk of the right to confi dentiality, the right to health care and, more controversially, the right to die. But beneath this surface familiarity lies a heap of diffi culties about what it is to have a right, how we should go about determining which assertions of rights are genuine and what role (if any) rights should play in our broader moral thinking. This chapter aims to offer a guide through these (...) perplexities. (shrink)
In this article the basic principles of responsible authorship and peer review are surveyed, with special emphasis on (a) guidelines for refereeing archival journal articles and proposals; and (b) how these guidelines should be taken into account at all stages of writing.
Abstract Donald A. Wittman's Myth of Democratic Failure attempts to show that government is more rational than is often believed. For instance, Wittman argues that voters are tolerably well informed and that politicians are responsive to the voters? will. Unfortunately, Wittman's argument proceeds at the level of economic theory, which is often contradicted by empirical reality (and by non?economic theories that take account of political reality). It is no better to defend democracy on a priori grounds, as Wittman does, than (...) to attack it on those grounds, as other economists who turn to the analysis of politics tend to do. (shrink)
In The Market Experience, Robert Lane restates the central criticism of economic views of human satisfaction?namely, that they define welfare as utility and, in practice if not in theory, use money as the measure of utility, while in reality utility (or welfare) ought to be defined as happiness. In exploring the implications of this noneconomic definition for our assessment of markets, Lane summarizes the evidence about how people assess their own happiness more successfully than he clarifies the meaning of that (...) word. Since increases in income above a certain minimum do not increase happiness, work must be made more meaningful. (shrink)
