Recent discussions of the doctrine of double effect have contained improved versions of the doctrine not subject to some of the difficulties of earlier versions. There is no longer one doctrine of double effect. This essay evaluates four versions of the doctrine: two formulations of the traditional Catholic doctrine, Joseph Boyle's revision of that doctrine, and Warren Quinn's version of the doctrine. I conclude that all of these versions are flawed. Keywords: double effect, intention, Joseph Boyle, medical ethics, Warren Quinn (...) CiteULike Connotea Del.icio.us What's this? (shrink)
Opponents of human embryonic stem cell (hESC) research claim that such research is incompatible with the moral principle that it is always wrong intentionally to end a human life. In this essay, I discuss how that principle might be revised so that it is subject to as few difficulties as possible. I then argue that even the most defensible version of the principle is compatible with the moral permissibility of hESC research.
The three major classical accounts of the morality of abortion are all subject to at least one major problem. Can we do better? This article aims to discuss three accounts that purport to be superior to the classical accounts. First, it discusses the future of value argument for the immorality of abortion. It defends the claim that the future of value argument is superior to all three of the classical accounts. It then goes on to discuss Warren's attempt to fix (...) up her personhood account and David Boonin's attempt to fix up Tooley's desire account. Warren claims that her updated version of a personhood account is superior to any potentiality account, such as the future of value account. The article evaluates her claim. Boonin argues that his improved desire view both deals adequately with the apparent counterexamples to Tooley's original account and also is superior to the future of value account. The article evaluates his views as well. (shrink)
According to Carson Strong, the future of value account of the wrongness of killing is subject to counterexamples. Ezio Di Nucci has disagreed. Their disagreement turns on whether the concepts of a future of value and a future like ours are equivalent. Unfortunately, both concepts are fuzzy, which explains, at least in part, the disagreement. I suggest that both concepts can be clarified in ways that seem plausible and that makes them equivalent. Strong claims that better accounts of the wrongness (...) of killing exist. I show that those alternative accounts are unsatisfactory. (shrink)
John Lizza says that to define death well, we must go beyond biological considerations. Death is the absence of life in an entity that was once alive. Biology is the study of life. Therefore, the definition of death should not involve non-biological concerns.
In my essay, Why abortion is immoral, I criticised discussions of the morality of abortion in which the crucial issue is whether fetuses are human beings or whether fetuses are persons. Both argument strategies are inadequate because they rely on indefensible assumptions. Why should being a human being or being a person make a moral difference? I argued that the correct account of the morality of abortion should be based upon a defensible account of why killing children and adults is (...) wrong. I claimed that what makes killing us wrong is that our premature deaths deprive us of our futures of value, that is, the goods of life we would have experienced had we survived. This account of the wrongness of killing explains why killing is one of the worst of crimes and how killing greatly harms the victim. It coheres with the attitudes of those with cancer or HIV facing premature death. It explains why we believe it is wrong to kill infants. It does not entail that it wrongs a human being to end her life if she is in persistent vegetative state or if her future must consist only of unbearable physical suffering and she wants to die. This account of the wrongness of killing implies that abortion is immoral because we were fetuses once and we know those fetuses had futures of value. Mark Brown claims that this potential future of value account is unsound because it implies that we have welfare rights to what we need to stay alive that most people would reject. I argue that Brown is incorrect in two ways: a welfare right to what we need to stay alive is not directly implied by my account and, in addition, most of us do believe that dependent human beings have substantial welfare rights to what they need to stay alive. Brown argues that depriving us of a future of value of which we have mental representations both is a better explanation of the wrongness of killing and does not imply that abortion is immoral. I reply that if Brown's arguments against my view were sound, those arguments could be easily adapted to show that his view is unsound as well and Brown's view is both ambiguous and unsound on any interpretation. The most popular class of pro-choice argument strategies appeals to the view that some or all fetuses lack either a mental state or function or a capacity for a mental state or function necessary for possession of the right to life. Desires, interests, sentience, various concepts, moral agency, and rationality have all been suggested as candidates for this crucial mental role. Brown's analysis is one member of this class of strategies. I believe that it is possible to show that none of these strategies is reasonable. However, there are so many of these strategies that the required argument demands something more like a book and less like a short essay. The argument of the following essay is a piece of this larger argument. (shrink)
An apparent ethical dilemma arises when physicians consider enrolling their patients in randomized clinical trials. Suppose that a randomized clinical trial comparing two treatments is in progress, and a physician has an opinion about which treatment is better. The physician has a duty to promote the patient's best medical interests and therefore seems to be obliged to advise the patient to receive the treatment that the physician prefers. This duty creates a barrier to the enrollment of patients in randomized clinical (...) trials.1-10 Two strategies are often used to resolve the dilemma in favor of enrolling patients in clinical trials. (shrink)
In this issue of the journal Mark Brown has offered a new argument against my potential future of value theory. I argue that even though the premises of this new argument are far more defensible than the premises of his old argument, the new argument does not show that the potential future of value theory of the wrongness of killing is false. If the considerations to which Brown appeals are used, not to show that the potential future of value theory (...) is false, but to show that abortion is morally permissible, they are also unsuccessful. I also argue that Brown's clarified self-represented future of value account and Simon Parsons's account of the wrongness of killing are both subject to major difficulties. Finally, I show, in an appendix, that Brown's assertion that my discussion of his views suffers from major logical errors is false. (shrink)
How can the abortion issue be resolved? Many believe that the issue can be resolved if, and only if, we can determine when human life begins. Those opposed to abortion choice typically say that human life begins at conception. Many who favor abortion choice say that we will never know when human life begins. The importance of the when-does-human-life-begin issue is not so much argued for as it is taken to be self-evident. Furthermore, belief that this issue is fundamental is (...) taken for granted – at least outside of philosophy – by many of the people who seem to disagree about almost everything else concerning abortion. It has been my experience that – with rare exceptions – even those who insist that the issue of abortion should focus on the interests of pregnant women believe that this focus is warranted because fetuses are either not yet fully alive or not yet fully human. (shrink)
The doctrine that it is wrong to end the existence of something because it is a human life I call “the standard view.” I argue that attempts by proponents of abortion choice to avoid the implications of the standard view by suggesting that we don't know when life begins or by suggesting that fetuses are only potential lives fail. Nevertheless, opponents of abortion choice should not base their arguments on the standard view, for the standard view is false. I propose (...) a substitute for the standard view that avoids the difficulties with it, that explains why most people believe that the standard view is true and that also underwrites opposition to abortion choice. (shrink)
Conversion of slowly accruing conventionally randomized studies to a prerandomized design has apparently been successful in increasing accrual enough so that some of these studies can be completed. Ellenberg (1984) has pointed out some of the ethical dangers of prerandomization. This paper argues that prerandomization must be either unsuccessful or unethical: either conversion to prerandomization will result in no significant increase in the rate of completion of the study or a significant increase in accrual rate will be achieved either at (...) the price of an inadequate attempt to obtain informed consent, at the price of the deceit of patients, or at the price of violations of patient autonomy. The argument of the paper can be sketched as follows: For any given randomized study, either patients prefer one treatment arm to the other or they do not. On the one hand, if they do, then conventional randomization fails. But prerandomization, if done ethically, will fail also. Hence, if prerandomization succeeds in this sort of case, then the trial has been conducted unethically. On the other hand, if patients do not prefer One arm to the other, then prerandomization will succeed. So will conventional randomization. Hence, prerandomization is either unnecessary or unethical. Ellenberg's concerns count as good moral reasons for not prerandomizing if prerandomization is unnecessary. It follows that prerandomization is always wrong. (shrink)
This essay is a response to Julian Savulescu’s objections to the future of value argument for the immorality of abortion published in the Journal of Medical Ethics, June 2002. Firstly, Savulescu’s claim that the future of value argument has implausible implications is considered. The author argues that the argument does not have these implications. Secondly, properties which, according to Savulescu, could underwrite the wrongness of killing and that are acquired only after implantation, are considered. It is argued that none of (...) these properties is an adequate basis for the distinction between wrongful and permissible killing. (shrink)
The surgical treatment of breast cancer has changed in recent years. Analysis of the research that led to these changes yields apparently good arguments for all of the following: (1) The research yielded very great benefits for women. (2) There was no other way of obtaining these benefits. (3) This research violated the fundamental rights of the women who were research subjects. This sets a problem for ethics at many levels.
