Some commentators have criticized bioethics as failing to engage religion both as a matter of theory and practice. Bioethics should work toward understanding the influence of religion as it represents people's beliefs and practices, but bioethics should nevertheless observe limits in regard to religion as it does its normative work. Irreligious skepticism toward religious views about health, healthcare practices and institutions, and responses to biomedical innovations can yield important benefits to the field. Irreligious skepticism makes it possible to raise questions (...) that otherwise go unasked and to protect against the overreach of religion. In this sense, bioethics needs a vigorous irreligious outlook every bit as much as it needs descriptive understandings of religion. (shrink)
The topics covered in this volume, originally published in 1973, include the need for a more adequate concept or definition of education, the issue of whether indoctrination is compatible with education, particularly with moral education, and the processes of judging the merits of different approaches to aesthetic education. Two contributors present complementary analyses of the relations between freedom as a characteristic of institutions and the process of learning to be a free man. There is discussion of the neglected subject of (...) rights and duties in education, with special emphasis on the question of a universal right to education. The volume concludes with papers on the relevance of philosophy to the practical judgments of educators and to education as a field of study. (shrink)
The topics covered in this volume, originally published in 1973, include the need for a more adequate concept or definition of education, the issue of whether indoctrination is compatible with education, particularly with moral education, and the processes of judging the merits of different approaches to aesthetic education. Two contributors present complementary analyses of the relations between freedom as a characteristic of institutions and the process of learning to be a free man. There is discussion of the neglected subject of (...) rights and duties in education, with special emphasis on the question of a universal right to education. The volume concludes with papers on the relevance of philosophy to the practical judgments of educators and to education as a field of study. (shrink)
A transgender man legally married to a woman has given birth to two children, raising questions about the ethics of assisted reproductive treatments (ARTs) for people with cross-sex identities. Psychiatry treats cross-sex identities as a disorder, but key medical organizations and the law in some jurisdictions have taken steps to protect people with these identities from discrimination in health care, housing, and employment. In fact, many people with cross-sex identities bypass psychiatric treatment altogether in order to pursue lives that are (...) meaningful to them, lives that sometimes include children. Cross-sex identification does not render people unfit as parents, because transgender identities do not undercut the ability to understand the nature and consequences of pregnancy or necessarily interfere with the ability to raise children. Moreover, no evidence suggests that being born to and raised by transgender parents triggers the kind of harm that would justify exclusion of trans-identified men and women from ARTs as a class. The normalization of transgender identities by the law and professional organizations contributes, moreover, to the need to reassess pathological interpretations of cross-sex identities, and trans-parenthood puts those interpretations into sharp relief. (shrink)
H. Tristram Engelhardt has said that “in the 1960s and 1970s... religious bioethics fell into the shadow of established secular bioethics. I don't think that religious bioethics has ever really...
Some commentators indirectly challenge the ethics of using synthetic gametes as a way for same-sex couples to have children with shared genetics. These commentators typically impose a moral burden of proof on same-sex couples they do not impose on opposite-sex couples in terms of their eligibility to have children. Other commentators directly raise objections to parenthood by same-sex couples on the grounds that it compromises the rights and/or welfare of children. Ironically, the prospect of synthetic gametes neutralises certain of these (...) objections, insofar as they would ensure that children have parents whom they can know as their genetic parents, which outcome is not always possible when same-sex couples involve third parties as the source of gametes or embryos. Not all commentators in bioethics throw the use of synthetic gametes into doubt as far as same-sex couples are concerned, but even these commentators put parenting by gay men and lesbians at the conclusion of an argument rather than presupposing parental legitimacy from the outset. Synthetic gametes do raise questions of ethics in regard to parenthood for gay men and lesbians, but these are largely questions of access and equity, not questions of parental fitness and/or child welfare. (shrink)
The Human Genome Project is an expensive, ambitious, and controversial attempt to locate and map every one of the approximately 100,000 genes in the human body. If it works, and we are able, for instance, to identify markers for genetic diseases long before they develop, who will have the right to obtain such information? What will be the consequences for health care, health insurance, employability, and research priorities? And, more broadly, how will attitudes toward human differences be affected, morally and (...) socially, by the setting of a genetic “standard”? The compatibility of individual rights and genetic fairness is challenged by the technological possibilities of the future, making it difficult to create an agenda for a “just genetics.” Beginning with an account of the utopian dreams and authoritarian tendencies of historical eugenics movements, this book’s nine essays probe the potential social uses and abuses of detailed genetic information. Lucid and wide-ranging, these contributions will interest bioethicists, legal scholars, and policy makers. Essays: “The Genome Project and the Meaning of Difference,” Timothy F. Murphy “Eugenics and the Human Genome Project: Is the Past Prologue?,” Daniel J. Kevles “Handle with Care: Race, Class, and Genetics,” Arthur L. Caplan “Public Choices and Private Choices: Legal Regulation of Genetic Testing,” Lori B. Andrews “Rules for Gene Banks: Protecting Privacy in the Genetics Age,” George J. Annas “Use of Genetic Information by Private Insurers,” Robert J. Pokorski “The Genome Project, Individual Differences, and Just Health Care,” Norman Daniels “Just Genetics: A Problem Agenda,” Leonard M. Fleck “Justice and the Limitations of Genetic Knowledge,” Marc A. Lappé This title is part of UC Press's Voices Revived program, which commemorates University of California Press’s mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1994. (shrink)
Some commentators argue that conception signals the onset of human personhood and that moral responsibilities toward zygotic or embryonic persons begin at this point, not the least of which is to protect them from exposure to death. Critics of the conception threshold of personhood ask how it can be morally consistent to object to the embryo loss that occurs in fertility medicine and research but not object to the significant embryo loss that occurs through conception in vivo. Using that apparent (...) inconsistency as a starting point, they argue that if that embryo loss is tolerable as a way of conceiving children, it should be tolerable in fertility medicine and human embryonic research. Double-effect reasoning shows, by contrast, that conception in vivo is justified even if it involves the death of persons because the motives for wanting children are not inherently objectionable, because the embryo loss that occurs in unassisted conception is not the means by which successful conception occurs, and because the effect of having children is proportionate to the loss involved. A similar outcome holds true for in vitro fertilisation in fertility medicine but not for in vitro fertilisation for research involving human embryos. (shrink)
Jürgen Habermas has argued against prenatal genetic interventions used to influence traits on the grounds that only biogenetic contingency in the conception of children preserves the conditions that make the presumption of moral equality possible. This argument fails for a number of reasons. The contingency that Habermas points to as the condition of moral equality is an artifact of evolutionary contingency and not inviolable in itself. Moreover, as a precedent for genetic interventions, parents and society already affect children's traits, which (...) is to say there is moral precedent for influencing the traits of descendants. A veil-of-ignorance methodology can also be used to justify prenatal interventions through its method of advance consent and its preservation of the contingency of human identities in a moral sense. In any case, the selection of children's traits does not undermine the prospects of authoring a life since their future remains just as contingent morally as if no trait had been selected. Ironically, the prospect of preserving human beings as they are – to counteract genetic drift – might even require interventions to preserve the ability to author a life in a moral sense. In light of these analyses, Habermas' concerns about prenatal genetic interventions cannot succeed as objections to their practice as a matter of principle; the merits of these interventions must be evaluated individually. (shrink)
Professional standards in medicine and psychology treat concurrent sexual relationships with patients as violations of fiduciary trust, and they sometimes rule out sexual relationships even after a clinical relationship is over. These standards also rule out sex with research subjects who are also patients, but what about nonclinical relationships where there are not always parallels to the standards of clinical medicine? One way to treat sex in nonclinical research relationships is to treat it as sex is treated elsewhere among adults, (...) as a matter of individual choice and responsibility. Alternately, one could ask oversight bodies to draw lines between research that can safely accommodate sexual relationships and research that cannot. One could even ask researchers to avoid all concurrent sexual relationships with their research participants, as happens in clinical medicine. Each of these options has drawbacks that undermine its value as a definitive solution. The deficiencies of these options highlight the need for a professional code of conduct for nonclinical researchers. (shrink)
Developments in uterus transplant put assisted gestation within meaningful range of clinical success for women with uterine infertility who want to gestate children. Should this kind of transplantation prove routine and effective for those women, would there be any morally significant reason why men or transgender women should not be eligible for the same opportunity for gestation? Getting to the point of safe and effective uterus transplantation for those parties would require a focused line of research, over and above the (...) study of uterus transplantation for non-transgender women. Some commentators object to the idea that the state has any duty to sponsor research of this kind. They would limit all publicly-funded fertility research to sex-typical ways of having children, which they construe as the basis of reproductive rights. This objection has no force against privately-funded research, of course, and in any case not all social expenditures are responses to ‘rights’ properly speaking. Another possible objection raised against gestation by transgender women is that it could alter the social meaning of sexed bodies. This line of argument fails, however, to substantiate a meaningful objection to gestation by transgender women because social meanings of sexed bodies do not remain constant and because the change in this case would not elicit social effects significant enough to justify closing off gestation to transgender women as a class. (shrink)
Arthur Caplan has argued that the presumptive naturalness, universality, and inevitability of aging are no obstacles to conceptualizing aging as a disease since those traits are themselves merely contingent. Moreover, aging lends itself to discussion in terms of diagnostic symptomatology and etiology. Is aging therefore a disease? I argue that aging need not be shown to be unnatural or a disease in order to make it the subject of biomedical interest. I suggest that rather than ask "Is aging a disease?", (...) the better point of philosophical departure would be to ask "Is aging objectionable such that its prevention and cure ought to be sought?". In this way, the moral issues at stake emerge more clearly. Chief among these issues are the potential results of curing aging and the implications for the prospect of meaningful human life without the de facto limitations that aging (and perhaps death) put upon it. A convincing argument that aging should be cured, therefore, would need to show that human significance warrants and possibly seeks such a cure and that the social costs of curing aging are morally acceptable. Keywords: aging, disease, cure, immortality CiteULike Connotea Del.icio.us What's this? (shrink)
Researchers are pursuing various ways to synthesise human male and female gametes, which would be useful for people facing infertility. Some people are unable to conceive children with their partner because one of them is infertile in the sense of having an anatomical or physiological deficit. Other people—in same sex couples—may not be individually infertile but situationally infertile in relation to one another. Segers et al have described a pathway towards synthetic gametes that would rely on embryonic stem cells, rather (...) than somatic cells. This pathway would be advantageous, they say, for same-sex couples even though it would not offer those couples 50%–50% shared genetics in their children but only 50%–25%. It is unclear, however, why this approach should be preferred morally speaking since it represents a falling off from the kind of shared genetics in children that are functionally a gold standard in parents' expectations generally. Despite raising concerns about whether genetic relatedness is necessary or sufficient as a condition of parental interest in children, Segers et al cede the sociocultural importance of that standard. If so, same-sex couples seem entitled to press a case for some measure of research priority that would offer the same level of access to that social good as everyone else. (shrink)
Developments in uterus transplant put assisted gestation within meaningful range of clinical success for women with uterine infertility who want to gestate children. Should this kind of transplantation prove routine and effective for those women, would there be any morally significant reason why men or transgender women should not be eligible for the same opportunity for gestation? Getting to the point of safe and effective uterus transplantation for those parties would require a focused line of research, over and above the (...) study of uterus transplantation for non-transgender women. Some commentators object to the idea that the state has any duty to sponsor research of this kind. They would limit all publicly-funded fertility research to sex-typical ways of having children, which they construe as the basis of reproductive rights. This objection has no force against privately-funded research, of course, and in any case not all social expenditures are responses to ‘rights’ properly speaking. Another possible objection raised against gestation by transgender women is that it could alter the social meaning of sexed bodies. This line of argument fails, however, to substantiate a meaningful objection to gestation by transgender women because social meanings of sexed bodies do not remain constant and because the change in this case would not elicit social effects significant enough to justify closing off gestation to transgender women as a class. (shrink)
Most advocates of biogenetic modification hope to amplify existing human traits in humans in order to increase the value of such traits as intelligence and resistance to disease. These advocates defend such enhancements as beneficial for the affected parties. By contrast, some commentators recommend certain biogenetic modifications to serve social goals. As Ingmar Persson and Julian Savulescu see things, human moral psychology is deficient relative to the most important risks facing humanity as a whole, including the prospect of Ultimate Harm, (...) the point at which worthwhile life is forever impossible on the planet. These risks can be mitigated, they say, by enhancing moral psychology in novel ways. Persson and Savulescu argue that some parents should modify the underlying biogenetics of their children's moral psychology, if such measures were safe and effective, but they admit these interventions may not decouple humanity from Ultimate Harm. Neither are these modifications the only options, they concede, for addressing risks to humanity. Even with these concessions, saving humanity from itself is a fairly poor reason to modify the moral psychology of children. In most ways, adults would be better candidates, morally speaking, for modifications of psychology. Even then, there is no direct link between morally enhanced human beings and the hoped-for effect of better protection from Ultimate Harm. Asserting a general duty of all to contribute to the avoidance of Ultimate Harm is a better moral strategy than intervening in the moral psychology of some, even though meeting that duty may involve substantial interference with the free exercise of one's interests. (shrink)
The term “ectogenesis” has been around for about a century now, and it is generally understood as the development of embryos and fetuses outside a uterus. In this sense, all in vitro fertilization is ectogenesis, but in vitro development can only proceed to a certain point, at which time human embryos are then either implanted in the attempt to achieve a pregnancy, frozen for that use in the future, used in research, or discarded.
In some areas of clinical medicine, discussions about fertility preservation are routine, such as in the treatment of children and adolescents facing cancer treatments that will destroy their ability to produce gametes of their own. Certain professional organizations now offer guidelines for people who wish to modify their bodies and appearance in regard to sex traits, and these guidelines extend to recommendations about fertility preservation. Since the removal of testicles or ovaries will destroy the ability to have genetically related children (...) later on, it is imperative to counsel transgender people seeking body modifications about fertility preservation options. Fertility preservation with transgender people will, however, lead to unconventional outcomes. If transgender men and women use their ova and sperm, respectively, to have children, they will function as a mother or father in a gametic sense but will function in socially reversed parental identities. There is nothing, however, about fertility preservation with transgender men and women that is objectionable in its motives, practices, or outcomes that would justify closing off these options. In any case, novel reproductive technologies may extend this kind of role reversal in principle to all people, if sperm and ova can be derived from all human beings regardless of sex, as has happened with certain laboratory animals. (shrink)
Bioconservative commentators argue that parents should not take steps to modify the genetics of their children even in the name of enhancement because of the damage they predict for values, identities and relationships. Some commentators have even said that adults should not modify themselves through genetic interventions. One commentator worries that genetic modifications chosen by adults for themselves will undermine moral agency, lead to less valuable experiences and fracture people's sense of self. These worries are not justified, however, since the (...) effects of modification will not undo moral agency as such. Adults can still have valuable experiences, even if some prior choices no longer seem meaningful. Changes at the genetic level will not always, either, alienate people from their own sense of self. On the contrary, genetic modifications can help amplify choice, enrich lives and consolidate identities. Ultimately, there is no moral requirement that people value their contingent genetic endowment to the exclusion of changes important to them in their future genetic identities. Through weighing risks and benefits, adults also have the power to consent to—and assume the risks of—genetic modifications for themselves in a way not possible in prenatal genetic interventions. (shrink)
Accidental human immunodeficiency virus (HIV) infection of patients in health care settings raises the question about whether patients have a right to expect disclosure of HIV/AIDS diagnoses by their health workers. Although such a right – and the correlative duty to disclose – might appear justified by reason of standards of informed consent, I argue that such standards should only apply to questions of risks of and barriers to HIV infection involved in a particular medical treatment, not to disclosure of (...) personal diagnoses. Because the degree of risk of HIV infection is low and disclosure would also have damaging consequences for health workers, and because patient protection is available in other ways, it is argued that no such generalized right should be recognized. Keywords: duty to disclose, HIV infection, HIV/AIDS diagnosis, informed consent, right to know CiteULike Connotea Del.icio.us What's this? (shrink)
Some parents have taken steps to ensure that they have deaf children, a choice that contrasts with the interest that other parents have in enhancing the traits of their children. Julian Savulescu has argued that, morally speaking, parents have a duty to use assisted reproductive technologies to give their children the best opportunity of the best life. This view extends beyond that which is actually required of parents, which is only that they give children reasonable opportunities to form and act (...) on a conception of a life that is good for them. Does the selection of deaf children violate that responsibility? Morally speaking, parents should refrain from using assisted reproductive treatments or prenatal interventions in order to have a child with a disability. Deafness and other disabilities represent intrinsic disadvantages that cannot be offset by other advantages that families and society can offer to people. By the same token, neither should parents seek enhancements of intelligence or physical traits that would undercut intrinsic goods of human life in similar ways. These moral arguments do not, however, sustain the judgment that the law should necessarily interfere with parents' decisions in these matters, even if those choices are morally unwise. (shrink)
Antinatalist commentators recommend that humanity bring itself to a close, on the theory that pain and suffering override the value of any possible life. Other commentators do not require the voluntary extinction of human beings, but they defend that outcome if people were to choose against having children. Against such views, Richard Kraut has defended a general moral obligation to people the future with human beings until the workings of the universe render such efforts impossible. Kraut advances this view on (...) the grounds that we are obliged to exercise beneficence toward others and on the grounds that the goods available in human lives are morally compelling. This account ultimately succeeds in making no more than a prima facie defense of human perpetuation because considerations of beneficence could override – in some cases probably should – override any duty to perpetuate human beings. While the goods of human life may be distinctive, they cannot serve as reason-giving in regard to their own perpetuation. Ironically, the exercise of beneficence may authorize the extinction of human beings, if it becomes possible to enhance the goods available to human descendants in a way that moves them away from human nature as now given. The defense of a morally obligatory and strictly human future remains elusive, even as it becomes morally desirable to work against Fateful Catastrophes, those human-caused events that threaten to extinguish existing lives already good and enriching for their bearers. (shrink)
In this humane and graceful book, philosopher Timothy Murphy offers insight into our attempts--popular and academic, American and non-American, scientific and ...
One way to help ensure the future of human life on the planet is to reduce the total number of people alive, as a hedge against dangers to the environment. One commentator has proposed withdrawing government and insurance subsidies from all fertile people, to help reduce the number of births. Any proposal of this kind does not, however, offer a solution commensurate with current problems of resource use and carbon emissions. Closing off fertility medicine to some people – or even (...) to all – would have only negligible effects in environmental protection. Moreover, the proposal to withdraw financial subsidies from fertile people would have prejudicial effects on lesbian and gay people, who must always reach beyond their same-sex relationships for help in having children. It is, moreover, entirely unclear why some people turning to fertility medicine for help in having children should have to pay their own way even though they contribute to the pool of money available for government and insurance subsidies. Entitlements based on an alleged moral difference between the ‘fertile’ and the ‘infertile’ cannot support such a conclusion. (shrink)
There are no technologies at the present time that would allow parents to select the sexual orientation of their children. But what if there were? Some commentators believe that parents should be able to use those techniques so long as they are effective and safe. Others believe that these techniques are unethical because of the dangers they pose to homosexual men and women in general. Both sides point to motives and consequences when trying to analyse the ethics of this question. (...) These arguments are reviewed, and it is concluded that opponents of these technologies have not shown good reason why the law or policy should override parental choice in this matter. In general, therefore, if technologies become available to choose the sexual orientation of children, parents should be allowed to use them, provided they are safe and disrupt no interest of the child. This use will, at the very least, protect homosexual children from parents who do not want them, but it will also allow parents who want homosexual children to make that choice as well. (shrink)
Bioconservative commentators argue that parents should not take steps to modify the genetics of their children even in the name of enhancement because of the damage they predict for values, identities and relationships. Some commentators have even said that adults should not modify themselves through genetic interventions. One commentator worries that genetic modifications chosen by adults for themselves will undermine moral agency, lead to less valuable experiences and fracture people's sense of self. These worries are not justified, however, since the (...) effects of modification will not undo moral agency as such. Adults can still have valuable experiences, even if some prior choices no longer seem meaningful. Changes at the genetic level will not always, either, alienate people from their own sense of self. On the contrary, genetic modifications can help amplify choice, enrich lives and consolidate identities. Ultimately, there is no moral requirement that people value their contingent genetic endowment to the exclusion of changes important to them in their future genetic identities. Through weighing risks and benefits, adults also have the power to consent to—and assume the risks of—genetic modifications for themselves in a way not possible in prenatal genetic interventions. (shrink)
Some commentators argue that conception constitutes the onset of human personhood in a metaphysical sense. This threshold is usually invoked as the basis both for protecting zygotes and embryos from exposure to risks of death in clinical research and fertility medicine and for objecting to abortion, but it also has consequences for certain religious perspectives, including Catholicism whose doctrines directly engage questions of personhood and its meanings. Since more human zygotes and embryos are lost than survive to birth, conferral of (...) personhood on them would mean – for those believing in personal immortality – that these persons constitute the majority of people living immortally despite having had only the shortest of earthly lives. For those believing in resurrection, zygotes and embryos would also be restored to physical lives. These outcomes do not mean that conception cannot function as a metaphysical threshold of personhood, but this interpretation carries costs that others do not. For example, treating conception as a moral threshold of respect for human life in general, rather than as a metaphysical threshold of personhood, would obviate the prospect of the afterlife being populated in the main by persons who have never lived more than a few hours or days. (shrink)
Some critics of same-sex marriage allege that this kind of union not only betrays the nature of marriage but that it also opens children to various kinds of harm. Same-sex marriage is objectionable, on this view, in its nature and in its effects. A view of marriage as requiring an unassisted capacity to conceive children may be respect as one idea of marriage, but this view need not be understood as marriage itself. It is not clear, in any case, why (...) government should prefer this one idealized view of marriage over other others, so long as recognition of other kinds of marriage do not stand in the way of government carrying out its core interests, such as the protection of children. The idea that children are necessarily harmed when conceived by and for same-sex couples cannot be sustained as a matter of psychological evidence or moral argument. No research shows that such children are routinely harmed or rarely-but-catastrophically. Comparative accounts of the welfare of children of same-sex couples cannot show either that children must be brought into existence only under ideal circumstances. (shrink)
The value of extending the human lifespan remains a key philosophical debate in bioethics. In building a case against the extension of the species-typical human life, Nicolas Agar considers the prospect of transforming human beings near the end of their lives into Galapagos tortoises, which would then live on decades longer. A central question at stake in this transformation is the persistence of human consciousness as a condition of the value of the transformation. Agar entertains the idea that consciousness could (...) persist in some measure, but he thinks little is to be gained from the transformation because the experiences available to tortoises pale in comparison to those available to human beings. Moreover, he thinks persisting human consciousness and values would degrade over time, being remade by tortoise needs and environment. The value available in the transformation would not, then, make the additional years of life desirable. Agar’s account does not, however, dispose of the tortoise transformation as a defensible preference. Some people might still want this kind of transformation for symbolic reasons, but it would probably be better that no human consciousness persist, since that consciousness would be inexpressible as such. Even so, it is not irrational to prefer various kinds of lifespan extension even if they involve significant modifications to human consciousness and values. (shrink)
Certain interventions now permit the derivation of mammalian gametes from stem cells cultivated from either somatic cells or embryos. These gametes can be used in an indefinite cycle of conception in vitro, gamete derivation, conception in vitro, and so on, producing genetic generations that live only in vitro. One commentator has described this prospect for human beings as eugenics, insofar as it would allow for the selection and development of certain traits in human beings. This commentary not only offers this (...) topic for discussion, it also wades into the ethical fray over the practice. Several possible lines of objection can be raised against this practice, but these accounts are by and large insufficient as an ethical analysis of this possible, future way of conceiving human children. (shrink)
Reports about possible genetic bases of homoerotic sexual orientation in adults have received a kind of schizophrenic social reception. On the one hand, these reports have been welcomed by some gay men and lesbians as biological confirmation of the commonly held view that sexual orientation is an involuntary trait, that sexual orientation is not in any meaningful sense chosen. Simon LeVay has received mail from thankful correspondents who welcomed his 1991 report about the possible neuroanatomical basis for male homoerotic sexual (...) orientation, and some legal analysts see important implications of biological studies for the ways in which civil rights are recognized, especially those that depend on an immutable characteristic like race or gender. (shrink)
Should parents be able to select the sexual orientation of their children, if that were possible through prenatal interventions? _Ethics, Sexual Orientation, and Choices about Children_ reviews the history of this debate which started in the 1970s and has been invigorated by scientific reports about the origins of sexual orientation. This book describes the debate and offers an evaluation of key issues in parental rights, children's rights, and family welfare.