Unconsented intimate exams on men and women are known to occur for training purposes and diagnostic reasons, mostly during gynecological surgeries but also during prostate examinations and abdominal surgeries. UIEs most often occur on anesthetized patients but have also been reported on conscious patients. Over the last 30 years, several parties—both within and external to medicine—have increasingly voiced opposition to these exams. Arguments from medical associations, legal scholars, ethicists, nurses, and some physicians have not compelled meaningful institutional change. Opposition is (...) escalating in the form of legislative bans and whistleblower reports. Aspiring to professional and scientific detachment, institutional consent policies make no distinction between intimate exams and exams on any other body part, but patients do not think of their intimate regions in a detached or neutral way and believe intimate exams call for special protections. UIEs are found to contribute to moral erosion and moral distress of medical students and compromise the sacred trust between the medical community and the general public. This paper refutes the main arguments in favor of the status quo, identifies a series of harms related to continuing the current practice, and proposes an explicit consent policy for intimate exams along with specific changes to medical school curriculum and institutional culture. Because patients are the rights-holders of their bodies, consent practices should reflect and uphold patient values which call for explicit consent for intimate exams. (shrink)

We regularly wield powers that, upon close scrutiny, appear remarkably magical. By sheer exercise of will, we bring into existence things that have never existed before. With but a nod, we effect the disappearance of things that have long served as barriers to the actions of others. And, by mere resolve, we generate things that pose significant obstacles to others' exercise of liberty. What is the nature of these things that we create and destroy by our mere decision to do (...) so? The answer: the rights and obligations of others. And by what seemingly magical means do we alter these rights and obligations? By making promises and issuing or revoking consent When we make promises, we generate obligations for ourselves, and when we give consent, we create rights for others. Since the rights and obligations that are affected by means of promising and consenting largely define the boundaries of permissible action, our exercise of these seemingly magical powers can significantly affect the lives and liberties of others. (shrink)

Much of the discussion surrounding the ethics of abortion has centered around the notion of personhood. This is because many philosophers hold that the morality of abortion is contingent on whether the fetus is a person - though, of course, some famous philosophers have rejected this thesis (e.g. Judith Thomson and Don Marquis). In this article, I construct a novel argument for the immorality of abortion based on the notion of impairment. This argument does not assume that the fetus is (...) a person - indeed, I concede (for the sake of argument) that the fetus is not a person - and hence the morality of abortion is not contingent on whether the fetus is a person. I finish by answering a plethora of objections to my argument, concluding that none of them are successful. (shrink)

It is argued here that the practice of medical students performing pelvic exams on women who are under anesthetic and have not consented is immoral and indefensible. This argument begins by laying out the ethical justification for the practice of informed consent, which can be found in autonomy and basic rights. Foregoing the process of consent within medicine can result in violations of both autonomy and basic rights, as well as trust, forming the basis of the wrong of unauthorized pelvic (...) examinations. Several objections to this argument are considered, all of which stem from the idea that this practice constitutes an exception to the general requirement of informed consent. These objections suggest that nonconsensual pelvic examinations on women under anesthetic are ethically acceptable on utilitarian grounds, in that they offer benefits either to the patient or to society, or on the grounds of triviality, in that consent is already presumed, or the practice is insignificant. Each of these objections is rejected and the practice is deemed indefensible. (shrink)

This essay deals with the question of the morality of abortion and infanticide. The fundamental ethical objection traditionally advanced against these practices rests on the contention that human fetuses and infants have a right to life, and it is this claim that is the primary focus of attention here. Consequently, the basic question to be discussed is what properties a thing must possess in order to have a serious right to life. The approach involves defending, then, a basic principle specifying (...) a condition living things must satisfy to have a serious right to life, and the answer given makes it unlikely that this condition is satisfied by human fetuses and infants, though this tentative conclusion could be altered by future scientific studies of the development of the human brain. As things stand at the moment, however, it seems unlikely that developing humans acquire the physical basis of the psychological capacities on which the right to continued existence rests, and therefore unless there are other substantial objections to abortion and infanticide that undercut the above line of thought, the conclusion is that such practices are not intrinsically wrong. (shrink)