Evidence that some executed prisoners suffered excruciating pain has reinvigorated the ethical debate about physician participation in executions. In widely publicized litigation, death row inmates argue that participation of anesthesiologists in their execution is constitutionally required to minimize the risk of unnecessary suffering. For many years, commentators supported the ethical ban on physician participation reflected in codes of professional medical organizations. However, a recent wave of scholarship concurs with inmate advocates, urging the law to require or permit physician participation. Both (...) the anti- and pro-physician-participation literature share a common premise: the ethics of physician participation should be analyzed independently from the moral status of capital punishment. This considerable literature implausibly divorces the ethics of physician participation from the moral status of the death penalty. Any ethical position on physician involvement requires some judgment about the moral status of capital punishment. The article examines anti- and pro-participation arguments to show that each one either is unpersuasive without discussion of the death penalty's moral status or implicitly assumes a view on the social worth of the death penalty. The article then articulates the practical implications of its arguments for both lawmakers and professional medical organizations. (shrink)
Psychopathy presents a difficult challenge to moral and criminal responsibility theorists. Persons with the disorder have an impaired capacity for empathy and other moral emotions, and fail to feel the force of moral considerations. They have some rational impairments, but they reason adequately to manipulate, con, and exploit their victims, and otherwise to engage successfully in antisocial behavior. Is it appropriate to hold them morally responsible for their wrongdoing? Should the law hold psychopaths criminally responsible? This essay discusses philosophical debates (...) involved in addressing these questions. (shrink)
The nanotechnology hype, engendering both fanatical optimism and apocalyptic fears, has produced calls from different commentators for "a radical change in the way we address ethical issues" and a "novel [ethical] approach to the future" that must be divorced from existing moral theories. However, a unique ethical framework devised specifically for nanotechnology is both impossible and unnecessary. The ethical issues predicted to accompany nanomedicine and nanotechnology (e.g., safety, justice, and privacy concerns) are raised by medicine, biotechnology, genetics, and other technologies, (...) and will call for balancing familiar values: autonomy, beneficence, fairness, etc. At present, ethical attention should concentrate on safety and environmental studies and preparing for unforeseeable consequences, while the scientific community should prepare for a public dialogue. (shrink)
*The opinions expressed are the views of the author and do not necessarily reflect the policy of the National Institutes of Health, the Public Health Service, or the U.S. Department of Health and Human Services.
Federal efforts beginning in the 1990's have successfully increased pediatric research to improve medical care for all children. Since 1997, the FDA has requested 800 pediatric studies involving 45,000 children. Much of this research is "non-beneficial"; that is, it exposes pediatric subjects to risk even though these children will not benefit from participating in the research. Non-beneficial pediatric research (NBPR) seems, by definition, contrary to the best interests of pediatric subjects, which is why one state supreme court has essentially prohibited (...) it. It also appears that the only plausible rationale for this research is utilitarian, as it risks some children for the good of all. But that rationale is troubling. This Article answers two related questions: (1) What is the appropriate legal relationship between NBPR and the "best interests of the child" standard? (2) What is the ethical justification for this research? I argue that courts should hold that the "best interests" standard governs pediatric research. But, contrary to existing case law, courts must consider the benefits to each child, including pediatric subjects, from a policy that permits NBPR, and not simply consider that a non-beneficial protocol presents more risk than potential benefit to a child. Moreover, I argue that the justification for the practice need not be utilitarian. There is no need to appeal to the greater good to justify the research because each child has reason to endorse a policy permitting NBPR where there is a very low ceiling on acceptable risk, and each child has reason to participate in a practice from which she benefits. More controversially, I argue that each child, like other persons, has reason to help others when she can do so at little to no cost to herself. The Article then highlights practical implications of the offered justifications. (shrink)
Responsibility theorists frequently discuss psychopathy because it challenges various accounts of the capacities required for appropriate ascriptions of moral and legal responsibility. As often described, the psychopath has the capacity to reason practically but lacks the capacity to grasp and control himself in light of moral considerations. As portrayed, then, the psychopath resides in the area of disagreement between two philosophical camps: (i) theorists who put forth the general capacity for practical reasoning or rational self-governance as sufficient for an agent (...) to be appropriately held morally responsible for his conduct; and (ii) theorists who view that general capacity as necessary but not sufficient for moral responsibility, additionally requiring the capacity to grasp and respond to distinctly moral reasons. On the former view, we may appropriately hold psychopaths responsible for their wrongful actions, but not on the latter. This article does not aim to describe the opposing views and argue for one over the other. Rather, I propose to deflate the debate as far as possible, attempting to reduce the area of disagreement. Meaningful disagreement exists only if there are, or could be, agents who have an undiminished capacity for practical reasoning or rational self-governance, yet truly are incapable of moral reasoning. However, I suggest that the capacity for rational self-governance entails the capacity to comprehend and act on moral considerations; thus, to the extent that an individual truly is incapable of grasping moral reasons, we should expect to find deeper, more general deficiencies in that individual's rational capacities. I appeal to the work of leading researchers who study individuals with psychopathy to determine whether psychopaths do represent rational self-governors without the capacity to grasp moral considerations. I argue that this work strongly suggests that the psychopath's incapacity for moral reasoning is, indeed, evidence of more general deficits in the rational capacities required for fully accountable agency. The Article closes with relevant considerations for thinking about any implications for criminal law. (shrink)