Abortion for life-limiting foetal anomaly is often an intensely painful choice for the parents; though widely offered and supported, it is surprisingly difficult to defend in ethical terms. Abortion on this ground is sometimes defended as foetal euthanasia but has features which sharply differentiate it from standard non-voluntary euthanasia, not least the fact that any suffering otherwise anticipated for the child may be neither severe nor prolonged. Such abortions may be said to reduce suffering for the family including siblings – (...) a consideration rarely stated so explicitly in defences of postnatal euthanasia – or for the woman who must in any case face the eventual loss of her baby, and for whom the abortion is seen as therapeutic in minimising pain. Finally, the abortion may be said to constitute the cessation of morally optional life support on the part of the woman, and/or to be a ‘social’ choice she is entitled to make, whether or not this in fact promotes her interests or those of her child. These defences need honest exploration: the intense parental suffering caused by the choice to end an often much-wanted pregnancy should not preclude but rather encourage the question whether this choice can indeed be ethically proposed to couples, especially compared with the neonatal palliative care (‘perinatal hospice’) approach so well received by parents who experience it. (shrink)

The presence of a human being/organism—a living human ‘whole’, with the defining tendency to promote its own welfare—has value in itself, as do the functions which compose it. Life is inseparable from health, since without some degree of healthy functionality the living whole would not exist. The value of life differs both within a single life and between lives. As with any other form of human flourishing, the value of life-and-health must be distinguished from the moral importance of human beings: (...) less fulfilled means not less important morally, but more in need of being fulfilled. That said, to say that life and health has value is not to say exactly what—if anything—that value requires by way of active promotion at a given time. Many factors must be taken into account in making health care decisions, even if the worth of all lives, and the dignity of all human beings, must in every case be acknowledged. (shrink)

Preimplantation genetic diagnosis (PGD) raises serious moral questions concerning the parent-child relationship. Good parents accept their children unconditionally: they do not reject/attack them because they do not have the features they want. There is nothing wrong with treating a child as someone who can help promote some other worthwhile end, providing the child is also respected as an end in him or herself. However, if the child's presence is not valued in itself, regardless of any further benefits it brings, the (...) child is not being treated as an end in the full sense of the term. In this paper, I argue that these principles apply to human embryos, as well as to born human offspring: the human moral subject is a bodily being, whose interests and rights begin with the onset of his or her bodily life. The rights of the living, bodily human individual include a right not to be attacked/abandoned because of his or her genetic profile. PGD is harmful to the parent-child relationship, and we give mixed messages to parents by expecting them to show unconditional commitment to offspring after birth, while inviting them to take a very different approach at the prenatal stage. (shrink)

In a world of rapid technological advances, the moral issues raised by life and death choices in healthcare remain obscure. _Life and Death in Healthcare Ethics_ provides a concise, thoughtful and extremely accessible guide to these moral issues. Helen Watt examines, using real-life cases, the range of choices taken by healthcare professionals, patients and clients which lead to the shortening of life. The topics looked at include: * euthanasia and withdrawal of treatment * the persistent vegetative state * abortion * (...) IVF and cloning * life-saving treatment of pregnant women Clearly written and insightful, _Life and Death in Healthcare Ethics_ presupposes no prior knowledge of philosophy. It will be of interest to anyone confronting healthcare ethics for the first time, or seeking to develop his or her understanding of some core topics in the field. (shrink)

Germ-line therapy has long been regarded with great caution both by scientists and by ethicists. Even those who do not reject germ-line therapy in principle have tended to reject it in practice as carrying unacceptable risks in our current state of knowledge. For this reason, a recent paper by Rubenstein, Thomasma, Shon, and Zinaman is unusual in putting forward a serious proposal for the use of germ-line therapy in the foreseeable future.

May a couple have the aim of conceiving as their primary purpose in having marital relations? In this paper, I argue against the view of Alexander Pruss that it is wrong to do this since it treats human beings as fungible in their creation when their unique features are not known to their parents. I argue that Pruss cannot separate seeking reproduction as part of a marital vocation from seeking the unknown, unspecified child who is part of what makes for (...) success in this particular area. While neither spouse should treat the other as a mere tool for having a child, success in the shared goal of conceiving, as well as the goal itself and its pursuit, is very much part of the conjugal good. Existing human beings are morally irreplaceable in the sense that they must be individually valued and respected, but we may promote the lives of unknown existing people under a ‘catch all’ description—and may also deliberately conceive new people of some unknown, indeterminate kind. (shrink)

The guidelines on Decisions Relating to Cardiopulmonary Resuscitation begin with a reassuringly objective view of medicine: its “primary goal” is to benefit patients by “restoring or maintaining their health as far as possible, thereby maximising benefit and minimising harm”. Some might want to add that medicine has several goals, not all of which relate to promoting health; however, those who see the aim of the profession as more than consumer satisfaction will welcome the suggestion here that not just any choice (...) counts as medicine. In the same way, the statement which heads the next paragraph would be rejected by very few readers if “quality of life” were suitably defined. If all we mean by “quality of life” is the patient's level of wellbeing, with no suggestion that the value of his or her “being” can fall to zero or below, it is uncontroversial that “it is not an appropriate goal of medicine to prolong life at all costs with no regard to its quality or the burdens of treatment on the patient”. This is, however, an overly benign interpretation of “quality of life” observations as they appear in the guidelines. (shrink)

Cooperation in evil or wrongdoing is one of the most perplexing areas in bioethics, both for those working in the field and those seeking their advice. The papers collected in this book are written by philosophers, theologians and lawyers who have studied these problems and / or by those who have faced these problems in their own work in law, healthcare and research, and political campaigning. The volume includes both general treatments of the subject of cooperation and conscientious objection, and (...) more specific treatments of topics such as voting to improve unjust laws, research on fetal / embryonic cells, and care of suicidal patients. The book is offered as a guide to a field which is both of academic interest and of personal concern to those who face cooperation problems in their own life and work. Contributors include: Bishop Donal Murray, Bishop Anthony Fisher OP, Jane Adolphe, Mike Delany, John Finnis, Luke Gormally, Colin Harte, Cathleen Kaveny, Richard Myers, Charlie O'Donnell, Alexander Pruss, Neil Scolding and Helen Watt. (shrink)

What is sex and why is it important? Does marriage have a basic rationale? How should couples manage their fertility, and when and how should pregnancy be achieved? How should we respond to 'embryo adoption', teenage pregnancy, population growth, HIV/AIDS and other STIs, same-sex attraction? This collection of original essays looks at these and other pivotal issues in reproductive and sexual ethics, from the perspectives of philosophy, theology, psychology and economic science.

What are the duties of carers and health professionals to people with mental incapacity? How ought we to think about the ethical and legal issues? What can any of us do to improve and safeguard the lives of those cared for? This book seeks to examine in detail and find ethically robust answers to such questions. Among the topics discussed are withholding treatment, tube-feeding patients with dementia, the 'persistent vegetative state', medical research, and sterilisation of intellectually disabled adults. Contributors come (...) from a wide range of disciplines, including psychiatry, nursing, philosophy, theology and law. The book includes an account by Wendy Hiscox of non-voluntary euthanasia in the Netherlands and Belgium, and a chapter by John Finnis exploring some aspects of Britain's Mental Capacity Act 2005. (shrink)

_The Ethics of Pregnancy, Abortion and Childbirth_ addresses the unique moral questions raised by pregnancy and its intimate bodily nature. From assisted reproduction to abortion and ‘vital conflict’ resolution to more everyday concerns of the pregnant woman, this book argues for pregnancy as a close human relationship with the woman as guardian or custodian. Four approaches to pregnancy are explored: ‘uni-personal’, ‘neighborly’, ‘maternal’ and ‘spousal’. The author challenges not only the view that there is only one moral subject to consider (...) in pregnancy, but also the idea that the location of the fetus lacks all inherent, unique significance. It is argued that the pregnant woman is not a mere ‘neighbor’ or helpful stranger to the fetus but is rather already in a real familial relationship bringing real familial rights and obligations. If the status of the fetus is conclusive for at least some moral questions raised by pregnancy, so too are facts about its bodily relationship with, and presence in, the woman who supports it. This lucid, accessible and original book explores fundamental ethical issues in a rich and often neglected area of philosophy in ways of interest also to those from other disciplines. (shrink)