The intention of this course, which will be held at the Inter-University Centre, Dubrovnik, Croatia from 18 - 23 June, 2001, is to address ….

Legal scholars and philosophers have long debated the moral standing of the act-omission distinction, with some favoring the view that actions ought to be considered as morally different from omissions, while others disagree. Several empirical studies suggest that people judge actions that cause harm as worse than omissions that cause the same harm with the implication that our folk psychology commonly perceives this distinction as morally significant. Here we explore the robustness of people's moral intuitions, and in particular, whether the (...) omission bias can be eliminated in the face of explicit and familiar laws that take away the moral standing of the distinction between actions and omissions. We show that although Dutch law allows both active and passive euthanasia, and although our Dutch participants were well aware of this law and supported it, they nonetheless showed a robust omission bias across a wide range of moral dilemmas. We conclude by discussing the relationship between our folk moral intuitions and explicit moral rules that are handed down by law and religion. (shrink)

Ordinary people often make moral judgments that are consistent with philosophical principles and legal distinctions. For example, they judge killing as worse than letting die, and harm caused as a necessary means to a greater good as worse than harm caused as a side-effect (Cushman, Young, & Hauser, 2006). Are these patterns of judgment produced by mechanisms specific to the moral domain, or do they derive from other psychological domains? We show that the action/omission and means/side-effect distinctions affect nonmoral representations (...) and provide evidence that their role in moral judgment is mediated by these nonmoral psychological representations. Specifically, the action/omission distinction affects moral judgment primarily via causal attribution, while the means/side-effect distinction affects moral judgment via intentional attribution. We suggest that many of the specific patterns evident in our moral judgments in fact derive from nonmoral psychological mechanisms, and especially from the processes of causal and intentional attribution. (shrink)

The recent Covid-19 pandemic has brought a broad range of ethical problems to the forefront, raising fundamental questions about the role of government in response to such outbreaks, the scarcity and allocation of health care resources, the unequal distribution of health risks and economic impacts, and the extent to which individual freedom can be restricted. In this clear introduction to the topic Iwao Hirose explores these ethical questions and analyzes the central issues in the ethics of pandemic response and preparedness (...) such as: The general nature of pandemics and the ethics of preparedness Ethical questions about general goals of pandemic response and preparedness The distribution of scarce resources, e.g., ventilators, hospital beds, antiviral drugs and vaccines Restrictions on individual freedom Ethical questions in the wake of pandemics, including contact-tracing, vaccine passports and socioeconomic inequalities. With the use of real-life examples and a clear philosophical approach, The Ethics of Pandemics is a much-needed introduction to some of the most important ethical issues surrounding pandemics. It is essential reading for students of ethics, bioethics, and political philosophy and will also be of interest to those working in related areas such as public policy, public health, health law, nursing and life sciences. (shrink)

In this chapter, I consider the idea that physician-assisted death might come into question in the cases of psychiatric patients who are incapable of making autonomous choices about ending their lives. I maintain that the main arguments for physician-assisted death found in recent medical ethical literature support physician-assisted death in some of those cases. After assessing several possible criticisms of what I have argued, I conclude that the idea that physicianassisted death can be acceptable in some cases of psychiatric patients (...) who lack autonomy ought to be taken into account in assessing the moral and legal acceptability of physician-assisted death. (shrink)

Anti-war pacifism rejects modern war as a means of attaining peace. This paper outlines two varieties of theoretical anti-war pacifism: conditional pacifism (war is conditionally unjustifiable due to the harm it causes to innocent persons) and contingent pacifism (war is justified if certain criteria are met but contingent facts about modern war mean that few, if any, actual wars meet these criteria). It elucidates the main points of contention at which these positions intersect with other war institution preserving theories, and (...) each other, and defends them as plausible positions that can add significant value to the critical studies and international relations conversations on war. (shrink)

What proper role should considerations of risk, particularly to research subjects, play when it comes to conducting research on human enhancement in the military context? We introduce the currently visible military enhancement techniques (1) and the standard discussion of risk for these (2), in particular what we refer to as the ‘Assumption’, which states that the demands for risk-avoidance are higher for enhancement than for therapy. We challenge the Assumption through the introduction of three categories of enhancements (3): therapeutic, preventive, (...) and pure enhancements. This demands a revision of the Assumption (4), alongside which we propose some further general principles bearing on how to balance risks and benefits in the context of military enhancement research. We identify a particular type of therapeutic enhancements as providing a more responsible path to human trials of the relevant interventions than pure enhancement applications. Finally, we discuss some possible objections to our line of thought (5). While acknowledging their potential insights, we ultimately find them to be unpersuasive, at least provided that our proposal is understood as fully non-coercive towards the candidates for such therapeutic enhancement trials. (shrink)

This chapter examines the ethical case that can be mounted for veganism. Because there has been comparatively little discussion in ethics focused directly on veganism, the central aim of this chapter is threefold: to orient readers to (some of) the most important philosophical literature relevant to the topic, to provide a clear explanation of the current state of the ethical case for veganism, and to focus attention on the most important outstanding or underexplored questions in this domain. The chapter examines (...) the range of positions that deserve to be called ethical veganism, and some of the types of reasons that philosophers can potentially appeal to in arguing for veganism. It then spells out the core of the most promising case for veganism, which argues directly for the wrongness of making animals suffer and die. The chapter then considers three ways of arguing from this conclusion to an ethical defense of the vegan lifestyle, which appeal respectively to the ethical significance of the effects of individual use of animal products, of group efficacy, and of complicity with wrongdoing. The chapter concludes by examining several neglected complications facing the ethical case for veganism. (shrink)

This volume collects selected papers delivered at the 15th Conference of the International Society for Utilitarian Studies, which was held at Karlsruhe Institute of Technology in July 2018. It includes papers dealing with the past, present, and future of utilitarianism – the theory that human happiness is the fundamental moral value – as well as on its applications to animal ethics, population ethics, and the future of humanity, among other topics.

This book sheds light on various ethical challenges military and humanitarian health care personnel face while working in adverse conditions. Contexts of armed conflict, hybrid wars or other forms of violence short of war, as well as natural disasters, all have in common that ordinary circumstances can no longer be taken for granted. Hence, the provision of health care has to adapt, for example, to a different level of risk, to scarce resources, or uncommon approaches due to external incentives or (...) requirements. This affects the practice of health care as well as its ethics. This book offers a panoramic overview on various challenges healthcare faces in extraordinary situations and provides new insights from practitioners’ as well as from academic scholars’ perspectives. (shrink)

Ad blockers are a category of computer software program, typically run as web browser extensions, that allow users to selectively eliminate advertisements from the webpages they visit. Many people have alleged that using an ad blocker is morally problematic because it is bad for content providers and consumers, and it is morally akin to theft. We disagree. In this paper, we defend an independent argument for the conclusion that using an ad blocker is morally permissible. In doing so, we respond (...) to the criticisms that ad blocking is bad for content providers and consumers, that it is morally akin to theft, and that it violates a contract between consumers and web publishers. (shrink)

According to the Doctrine of Doing and Allowing, the distinction between doing and allowing harm is morally significant. Doing harm is harder to justify than merely allowing harm. This paper is the second of a two paper critical overview of the literature on the Doctrine of Doing and Allowing. In this paper, I consider the moral status of the distinction between doing and allowing harm. I look at objections to the doctrine such as James’ Rachels’ Wicked Uncle Case and Jonathan (...) Bennett’s argument that any acceptable analysis of the distinction leaves it implausible that the distinction is morally relevant. I consider putative defences of the Doctrine from Philippa Foot and Warren Quinn. I argue that neither Foot not Quinn provides a satisfactory justification of the Doctrine of Doing and Allowing, but that the idea of self-ownership discussed by Quinn can be developed to provide a justification of the doctrine. (shrink)

I defend the Doctrine of Doing and Allowing: the claim that doing harm is harder to justify than merely allowing harm. A thing does not genuinely belong to a person unless he has special authority over it. The Doctrine of Doing and Allowing protects us against harmful imposition – against the actions or needs of another intruding on what is ours. This protection is necessary for something to genuinely belong to a person. The opponent of the Doctrine must claim that (...) nothing genuinely belongs to a person, even his own body. (shrink)

Many philosophers display relaxed scepticism about the Doctrine of Doing and Allowing and the Doctrine of Double Effect, suspecting, without great alarm, that one or both of these Doctrines is indefensible. This relaxed scepticism is misplaced. Anyone who aims to endorse a theory of right action with Nonconsequentialist implications should accept both the DDA and the DDE. First, even to state a Nonconsequentialist theory requires drawing a distinction between respecting and promoting values. This cannot be done without accepting some deontological (...) distinction. Second, if someone is going to accept any deontological distinction she should accept either the DDE or the DDA or some replacement. Finally, anyone who accepts either the DDE or the DDA should accept both doctrines or a replacement of each. Unless both Doctrines can be defended or given a defensible replacement, any Nonconsequentialist is in trouble. (shrink)

This paper is part of a larger project. My overall aim is to argue that the evolution of familiar forms of termination of life sustaining treatment, constituting so called passive euthanasia,1 has severaly undercut the logic of every form of reasoning that has traditionally been used to oppose active euthanasia and assistance in suicide. Basically, there are two such forms of traditional opposition, each represented in a range of different versions. There is the inevitable argument concerning social utilities — that (...) permitting euthanasia and assisted suicide will have bad social consequences. But more fundamentally, the idea persists that killing is intrinsically worse than letting‐die in some sense that justifies the current practice of prohibiting the first while allowing the latter. In this paper, I first consider this latter claim. My ultimate strategy, as I have said, is to show that the nature of certain things we have all come to approve regarding termination of treatment makes it next to impossible to convincingly explain, in either of these ways, what is wrong with certain forms of assistance in suicide and euthanasia. In the second part of this paper I take another step in this direction by discussing, in a preliminary way, a special case of the argument from social risks. (shrink)

There are an infinite variety of attitudes to euthanasia, each individual response to the concept being influenced by many factors. Consequently there is a literature on the subject ranging from the popular article to papers in specialized journals. This study, however, has taken a well defined sample of people, inviting them to answer a questionnaire which was designed to elicit their attitudes to euthanasia in a way which could be analysed statistically. Nor surprisingly attitudes appeared to 'harden' as those answering (...) the questionnaire grew more experienced in dealing with patients and also more professionally established. Thus it was found that of the seven groups questioned practising physicians showed more positive attitudes to euthanasia and their responses did not differ significantly from those of senior medical students. It is these groups which actually or potentially have to resolve the clinical dilemma posed by the dying patient. (shrink)

This paper develops an account of rigour in the use of thought experiments in ethics. I argue that there are two separate challenges to be faced. The first is internal validity: is the thought experiment designed in a way that allows its readers to make judgements that are confident and free of bias about the hypothesis or point of principle that it aims to test? The second is external validity: to what extent do ethical judgements that are correct of the (...) world of the thought experiment generalize to a wide variety of other contexts, including ethical decision-making in the actual world? Ensuring external validity is the harder and more important problem of rigour, yet it is one that few philosophers have even noticed, let alone begun to solve. (shrink)

This paper reflects on the relationship between theory and practice in bioethics, by using various concepts drawn from debates on innovation in healthcare research—in particular debates around how best to connect up blue skies ‘basic’ research with practical innovations that can improve human lives. It argues that it is a mistake to assume that the most difficult and important questions in bioethics are the most abstract ones, and also a mistake to assume that getting clear about abstract cases will automatically (...) be of much help in getting clear about more complex cases. It replaces this implicitly linear model with a more complex one that draws on the idea of translational research in healthcare. On the translational model, there is a continuum of cases from the most simple and abstract to the most concrete and complex. Insights need to travel in both directions along this continuum—from the more abstract to the more concrete and from the more concrete to the more abstract. The paper maps out some difficulties in moving from simpler to more complex cases, and in doing so makes recommendations about the future of bioethics. (shrink)

Ethical analyses, professional guidelines and legal decisions support the equivalence thesis for life-sustaining treatment: if it is ethical to withhold treatment, it would be ethical to withdraw the same treatment. In this paper we explore reasons why the majority of medical professionals disagree with the conclusions of ethical analysis. Resource allocation is considered by clinicians to be a legitimate reason to withhold but not to withdraw intensive care treatment. We analyse five arguments in favour of non-equivalence, and find only relatively (...) weak reasons to restrict rationing to withholding treatment. On the contrary, resource allocation provides a strong argument in favour of equivalence: non-equivalence causes preventable death in critically ill patients. We outline two proposals for increasing equivalence in practice: (1) reduction of the mortality threshold for treatment withdrawal, (2) time-limited trials of intensive care. These strategies would help to move practice towards more rational treatment limitation decisions. (shrink)

Routinely, in Arriving at decisions on what treatments to recommend in intensive care wards, the moral presumption is that there is an intrinsic difference between the positive duty to save lives and the negative duty not to take lives. The discontinuation of treatment – say stopping chemotherapy or removing a ventilator – is thought of as a “negative” action, an allowing to die, not “positively”, say as an act of suicide by the patient, or a killing by the hospital staff. (...) But the distinction between “positive” and “negative” here, despite its grave ethical import, is elusive and difficult to grasp firmly. St. Anselm of Canterbury was fond of citing the trickiness of the distinction between “to do” and “not to do”. In answer to the question “What's he doing?” we say “He's just sitting there.”, really meaning something negative: “He's not doing anything at all.” Sometimes the “negative” action is described in “positive” terms, or vice versa, and that makes one wonder if the distinction might be somehow trivial, a bit of jesuitry too insubstantial to bear much serious ethical weight. (shrink)

This essay offers an action-theoretic analysis of the distinction between positively bringing something about and passively letting something happen. The analysis, based on the notion of an agent''s bringing about some state of affairs, is closest to the analysis of omissions of Brand (1971), but utilizes the relatedness logic of Epstein (1979). Syntactic features bring out the idea that an action can be partially positive and partially negative, e.g., by not bringing about one thing an agent can bring about something (...) else. An ethical implication of this analysis is that a passive course of action is sometimes less culpable than an active one, just because it is passive. (shrink)

Thought experiments have played a pivotal role in many debates within ethics—and in particular within applied ethics—over the past 30 years. Nonetheless, despite their having become a commonly used philosophical tool, there is something odd about the extensive reliance upon thought experiments in areas of philosophy, such as applied ethics, that are so obviously oriented towards practical life. Herein I provide a moderate defence of their use in applied philosophy against those three objections. I do not defend all possible uses (...) of thought experiments but suggest that we should distinguish between legitimate and illegitimate uses. Their legitimate uses are determined not so much by the modal content of any actual thought experiment itself, but by the extent to which the argument in which it is nested follows basic tenets of informal logic and respects the fundamental contingency of applied ethical problems. In pursuing these ideas, I do not so much provide a set of criteria for their legitimate use, but more modestly present two significant ways in which their use can go awry. (shrink)

Opponents of voluntary euthanasia and physician-assisted suicide often maintain that the procedures ought not to be accepted because ending an innocent human life would both be morally wrong in itself and have unfortunate consequences. A gravely suffering patient can grant that ending his life would involve such harm but still insist that he would have reason to continue living only if there were something to him in his abstaining from ending his life. Though relatively rarely, the notion of meaning of (...) life has figured in recent medical ethical debate on voluntary euthanasia and physician-assisted suicide. And in current philosophical discussion on meaning of life outside the medical ethical debate on voluntary euthanasia and physician-assisted suicide several authors have argued that being moral and having a meaningful existence are connected to each other. In this article, I assess whether his intentionally refraining from causing the harm related to voluntary euthanasia and physician-assisted suicide would involve something to such a patient in the sense that it would promote the meaningfulness of his life. (shrink)

There are a number of cases where, collectively, groups cause harm, and yet no single individual’s contribution to the collective makes any difference to the amount of harm that is caused. For instance, though human activity is collectively causing climate change, my individual greenhouse gas emissions are neither necessary nor sufficient for any harm that results from climate change. Some (e.g., Sinnott-Armstrong) take this to indicate that there is no individual moral obligation to reduce emissions. There is a collective action (...) problem here, to which I offer a solution. My solution rests on an argument for a (sometimes) bare moral difference between intending harm and foreseeing with near certainty that harm will result as an unintended side-effect of one’s action. I conclude that we have a moral obligation to reduce our individual emissions; and, more broadly, an obligation to not participate in many other harmful group activities (e.g., factory-farming). (shrink)

Withholding and withdrawing treatment are widely regarded as ethically equivalent in medical guidelines and ethics literature. Health care personnel, however, widely perceive moral differences between withholding and withdrawing. The proponents of equivalence argue that any perceived difference can be explained in terms of cognitive biases and flawed reasoning. Thus, policymakers should clear away any resistance to accept the equivalence stance by moral education. To embark on such a campaign of changing attitudes, we need to be convinced that the ethical analysis (...) is correct. Is it? In this article, I take a closer look at the moral relation between withholding and withdrawing. My conclusion is that withholding and withdrawing are not in general ethically equivalent. Thus, medical guidelines should be rewritten, and rather than being “educated” away from their sound judgments, medical professionals and patients should have nuanced medico-ethical discussions regarding withholding and withdrawing treatment. (shrink)

Physicians have long aided their patients in dying in an effort to ease human suffering. It is only in the nineteenth and twentieth centuries that the prolongation of life has taken on new meaning due to the powers now available to physicians, through new drugs and high technology interventions. Whereas earlier physicians and patients could readily acknowledge that nothing further could be done, today that judgment is problematic.Most often, aiding the dying took the form of not doing anything further to (...) prolong life. Morally, this act of restraint was not difficult, because few options could have been considered. However, some physicians, rarely, would help patients die either by hastening death directly or by increasing pain control with the risk of hastening death, the so-called double effect. When directly hastening death, physicians either directly caused the death of the patient through euthansia, or supplied the means to the patient to bring about death with or without encouragement to use these means. The latter is physician-assisted suicide. (shrink)

This article analyses proportionality as a potential element of a theory of morally justified surveillance, and sets out a teleological account. It draws on conceptions in criminal justice ethics and just war theory, defines teleological proportionality in the context of surveillance, and sketches some of the central values likely to go into the consideration. It then explores some of the ways in which deontologists might want to modify the account and illustrates the difficulties of doing so. Having set out the (...) account, however, it considers whether the proportionality condition is necessary to a theory of morally justified surveillance. The article concludes that we need and should apply only a necessity condition, but notes that proportionality considerations may retain some use in in practice, as a form of coarse‐grained filter applied before assessing necessity when deliberating the permissibility of potential forms of surveillance. (shrink)

The position of the United Methodist Church on end-of-life decisions is best described as intentional ambiguity or ambiguous intentions or both. The paper analyzes the official position of the denomination and then considers the actions of a U.M.C. bishop who served as a foreman for a trial of Dr. Jack Kevorkian. In an effort to find some common ground within an increasingly divided denomination, the work concludes with a consideration of the work of John Wesley and his approach to human (...) death. (shrink)

There are some ideas that at first seem simple, but which become more complex and profound the more they are explored. Great art, of course, is like that. When I first saw Vermeer's Girl with a Pearl Earring I was excited by its fresh simplicity. I thought, however, it a painting I would soon understand. I was wrong. It becomes increasingly mysterious with increasing familiarity. It has recently inspired a novel.1The distinction between acts and omissions is one of these simple, (...) complex, ideas. When I first studied philosophy I thought I would rapidly be able to decide once and for all whether the distinction is of moral importance or not. I did in fact come to a decision. The problem is that I have kept revising that decision ever since. The issues raised by the arguments over acts and omissions continue to inspire philosophical discussion. They also continue to haunt doctors and relatives at the bedsides of those near the end of their lives.Donna Dickenson, in this issue of the journal,2 reports the results of a survey of opinions from those taking part in an Open University course on death and dying. She believes that for many bioethicists the acts/omissions distinction has been shown to be wrong as a distinction of moral worth. Her survey suggests, however, that for many health professionals this distinction is seen as morally important. She asks whether the bioethical consensus, as she sees it, against the distinction is a result of clear thinking, or whether the views of practitioners result from their taking into account, in a way bioethicists do not, the richness of reality.There is I believe, less consensus amongst bioethicists than Dickenson suggests. In this issue of the journal, Marc Stauch3 argues in favour of the acts/omissions …. (shrink)

BackgroundEnd-of-life decisions remain a hotly debated issue in many European countries and the acceptance in the general population can act as an important anchor point in these discussions. Previous studies on determinants of the acceptance of end-of-life interventions in the general population have not systematically assessed whether determinants differ between withdrawal of life-prolonging treatment and euthanasia.MethodsA large, representative survey of the Austrian adult population conducted in 2014 included items on WLPT and EUT. We constructed the following categorical outcome: rejection of (...) both WLPT and EUT, approval of WLPT but rejection of EUT, and approval of both WLPT and EUT. The influence of socio-demographics, personal experiences, and religious and socio-cultural orientations on the three levels of approval were assessed via multinomial logistic regression analysis.ResultsHigher education and stronger socio-cultural liberal orientations increased the likelihood of approving both WLPT and EUT; personal experience with end-of-life care increased only the likelihood of approval of WLPT; and religiosity decreased approval of EUT only.ConclusionThis study found evidence for both shared and different determinants for the acceptance of WLPT and EUT. (shrink)

In this article I am concerned with analogical reasoning in ethics. There is no doubt that the use of analogy can be a powerful tool in our ethical reasoning. The importance of this mode of reasoning is therefore commonly accepted, but there is considerable debate concerning how its structure should be understood and how it should be assessed, both logically and epistemically. In this paper, I first explain the basic structure of arguments from analogy in ethics. I then discuss the (...) diversity of analogical arguments that can be found in ethics. I analyse their structure, assess them from a logical viewpoint, and show how they can be epistemically challenged and defended. The result of this investigation is that, contrary to a commonly held view, analogical reasoning can be a logically valid type of ethical reasoning that can provide reasons for action that are not worse than the reasons provided by any other kind of practical reasoning. (shrink)

For millennia, philosophers have speculated about the origins of ethics. Recent research in evolutionary psychology and the neurosciences has shed light on that question. But this research also has normative significance. A standard way of arguing against a normative ethical theory is to show that in some circumstances the theory leads to judgments that are contrary to our common moral intuitions. If, however, these moral intuitions are the biological residue of our evolutionary history, it is not clear why we should (...) regard them as having any normative force. Research in the neurosciences should therefore lead us to reconsider the role of intuitions in normative ethics. (shrink)

Opposition to induced abortion rests on the belief that fetuses have a moral status comparable to beings like us, and that the loss of such a life is tragic. Antiabortion, or pro-life, theorists argue that it is wrong to induce abortion and it is wrong to allow others to perform induced abortion. However, evidence suggests that spontaneous abortion kills far more fetuses than induced abortion, and critics argue that most pro-life theorists neglect the threat of spontaneous abortion and ought to (...) do more to prevent it. Friberg-Fernros contends such an obligation would be implausibly strong, arguing that induced abortions are far worse than spontaneous abortions because while both involve the tragedy of the death of the fetus, induced abortion involves a second tragedy—one person killing another. I argue this two tragedies argument fails to explain what is morally relevant about induced abortion. (shrink)

Most opposition to abortion turns on the claim that human fetuses are full moral agents from conception. Critics argue that antiabortion theorists act hypocritically when they neglect spontaneous abortions—valuing some fetal lives and not others. Many philosophers draw a distinction between killing and letting die, with the former being morally impermissible and latter acceptable. Henrick Friberg-Fernros appeals to this distinction with his Two Tragedies Argument, contending that anti-abortion theorists are justified in prioritising preventing induced abortions over spontaneous ones, as the (...) former involves two tragedies—a death and a killing. However, induced abortion can involve either killing or letting die, and thus this view is incompatible with the traditional anti-abortion view. Furthermore, Friberg-Fernros appears to value preventing killing attempts more than preventing actual deaths. (shrink)

Mitochondrial replacement techniques are designed to allow couples to have children without passing on mitochondrial diseases. Recently, Giulia Cavaliere and César Palacios-González argued that prospective parents have the right to use MRTs to pursue genetic relatedness, such that some same-sex couples and/or polygamous triads could use the process to impart genetic relatedness between a child and more of its caregivers. Although MRTs carry medical risks, Cavaliere and Palacios-González contend that because MRTs are identity-affecting, they do not cause harm to an (...) existing human being, and our intuitions otherwise arise from the non-identity problem. Here, I review several attempts to address the non-identity problem, and propose a solution to the problem. Furthermore, I argue that regardless of one’s stance on whether MRTs are identity-affecting, the use of MRTs to pursue genetic relatedness alone falls outside the scope of the medical profession, as they involve substantive medical risk for no medical benefit. (shrink)

The contemporary philosophical literature on abortion primarily revolves around three seemingly intractable debates, concerning the (1) moral status of the fetus, (2) scope of women’s rights and (3) moral relevance of the killing/letting die distinction. The possibility of ectogenesis—technology that would allow a fetus to develop outside of a gestational mother’s womb—presents a unique opportunity for moral compromise. Here, I argue those opposed to abortion have aprima faciemoral obligation to pursue ectogenesis technology and provide ectogenesis for disconnected fetuses as part (...) of a moral compromise. (shrink)

In January 2012, the Journal of Medical Ethics published online Giubilini and Minerva's paper, ‘After-birth abortion. Why should the baby live?’.1 The Journal publishes articles based on the quality of their argument, their contribution to the existing literature, and relevance to current medicine. This article met those criteria. It created unprecedented global outrage for a paper published in an academic medical ethics journal. In this special issue of the Journal, Giubilini and Minerva's paper comes to print along with 31 articles (...) from some of the best scholars in the world, from the broadest range of perspectives on abortion and infanticide, including those strongly critical of Giubilini and Minerva.The killing of a baby is among the most shocking of human practices. I am strongly opposed to the legalisation of infanticide along the lines discussed by Giubilini and Minerva. But I would like to explain why a journal of medical ethics published an article examining infanticide and now devotes a special issue to bringing a wide range of perspectives for further examination of these issues.Infanticide has been practised throughout human history for various reasons and continues to be practised today throughout the world. In rare cases, infanticide can be practised openly and legally—for example, as specified under the ‘Groningen Protocol’, in the Netherlands. The Groningen Protocol allows doctors to end the life of neonates at the request of their parents if the infant is experiencing hopeless and unbearable suffering.2But medical infanticide arguably occurs elsewhere other than in the Netherlands today.In neonatal intensive care, it is not uncommon for a doctor to withdraw artificial ventilation with the consequence that a baby dies.3 If anyone else performed that act, including the parents of the child, it would be viewed as an act of homicide, in some cases …. (shrink)

I argue that, according to ordinary morality, there is moral inertia, that is, moral pressure to fail to intervene in certain circumstances. Moral inertia is manifested in scenarios with a particular causal structure: deflection scenarios, where a threatening or benefiting process is diverted from a group of people to another. I explain why the deflection structure is essential for moral inertia to be manifested. I argue that there are two different manifestations of moral inertia: strict prohibitions on interventions, and constraints (...) on interventions. Finally, I discuss the connection between moral inertia and the distinction between killing and letting die (or doing and allowing harm). (shrink)

In “Nudging and Informed Consent,” ShlomoCohen (2013) attempts to address the common objection against nudges that they are autonomy-thwarting because they foster irrationality. He explicitly focuses on informed consent, which he contrasts with the policy context in which health nudges are usually discussed. I think Cohen’s rich article is a significant contribution to the nudge literature. However, I have some concerns with the way he frames and motivates his inquiry...

In the United Kingdom women have access to termination of pregnancy for maternal reasons until 24 weeks’ completed gestation, but it is accepted practice for children born at or beyond 25 weeks’ gestation to be treated according to the child’s perceived best interests even if this is not in accordance with parental wishes. The authors present a case drawn from clinical practice which highlights the discomfort that parents may feel about such an abrupt change in their rights over their child, (...) and argue that parents should have greater autonomy over treatment decisions regarding their prematurely born children. (shrink)

In the United States, judicialrulings that unrealistically addressed the complexityof cases and demonstrated limited understanding ofprinciples, helped to create a legal quagmire whichlegislatures had to confront. Moreover, thelegislative response was often slow and inadequate interms of both the scope and clarity of the laws. However, since the 1970s, progress has been made onmany fronts, particularly in regard to advancedirectives dealing with end-of-life decisions. Thedebate over physician-assisted suicide has spawned arepetition of moral and legal arguments. Thoseagainst legalization have failed to make (...) a realisticappraisal of the dilemmas facing patients and theirfamilies in an age of technological medicine deliveredin the context of the marketplace. The underlyingproblem is a system in dire need of reform that willno longer treat health care as a commodity of themarketplace and provide universal health care. Terminal care as an integral part of health care willsubstantially benefit from such reforms because amajor obstacle to comprehensive palliative care is thecondition of the present system. (shrink)

I argue that embryonic stem cell research is fair to the embryo, even on the assumption that the embryo has attained full personhood and an attendant right to life at conception. This is because the only feasible alternatives open to the embryo are to exist briefly in an unconscious state and be killed or to not exist at all. Hence, one is neither depriving the embryo of an enduring life it would otherwise have had nor is one causing the embryo (...) pain. I also argue that a rational agent in a situation relevantly similar to that of the embryo would consent to such research, and I use this insight to ground two justice-based arguments in favor of this research. (shrink)

According to the Doctrine of Doing and Allowing, it is more difficult to justify doing harm than it is to justify allowing harm. Enabling harm consists in withdrawing an obstacle that would, if left in place, prevent a pre-existing causal sequence from leading to foreseen harm. There has been a lively debate concerning the moral status of enabling harm. According to some (e.g. McMahan, Vihvelin and Tomkow), many cases of enabling harm are morally indistinguishable from doing harm. Others (e.g. Foot, (...) Hanser) support the Equivalence Hypothesis, according to which enabling harm is morally equivalent to allowing harm. Here I argue that there is every reason to embrace, and no reason to reject, the Equivalence Hypothesis. (shrink)