Can Rawlsian public reason sufficiently justify public policies that regulate or restrain controversial medical and technological interventions in bioethics (and the broader social world), such as abortion, physician aid-in-dying, CRISPER-cas9 gene editing of embryos, surrogate mothers, pre-implantation genetic diagnosis of eight-cell embryos, and so on? The first part of this essay briefly explicates the central concepts that define Rawlsian political liberalism. The latter half of this essay then demonstrates how a commitment to Rawlsian public reason can ameliorate (not completely resolve) (...) many of the policy disagreements related to bioethically controversial medical interventions today. The goal of public reason is to reduce the size of the disagreement by eliminating features of the disagreement that violate the norms of public reason. The norms of public reason are those norms that are politically necessary to preserve the liberal, pluralistic, democratic character of this society. What remains is reasonable disagreement to be addressed through normal democratic deliberative processes. Specific issues addressed from a public reason perspective include personal responsibility for excessive health costs, the utility of a metaphysical definition of death for organ transplantation, and the moral status of excess embryos generated through IVF and/or their use in medical research. (shrink)

The Embryo Rescue Case asks us to consider whether we should save a fully-developed child or a tray full of many embryos from a fire. Most people pick the child. This allegedly provides evidence against the view that embryos have the same moral status as developed humans. Pro-life philosophers usually grant that you should save the child, but say that this doesn’t undermine the claim that embryos possess full moral status. There may be reasons besides differing moral status to save (...) the child. Meanwhile, many ordinary pro-life people think that stopping abortion is far and away the most morally urgent socio-political issue. They reason that since abortion (in their view) consists in the unjust killing of so many human persons, fighting it should be an overwhelming priority. Here I argue that this way of reasoning about the urgency of combating abortion (given the pro-life view) conflicts with the usual response to the Embryo Rescue Case. If the fact that you should save a developed human rather than many more embryos doesn’t imply that embryos lack personhood, then embryonic personhood doesn’t imply that you should save embryos rather than many fewer developed humans. (shrink)

Opponents of abortion are often described as ‘inconsistent’ (hypocrites) in terms of their beliefs, actions and/or priorities. They are alleged to do too little to combat spontaneous abortion, they should be adopting cryopreserved embryos with greater frequency and so on. These types of arguments—which we call ‘inconsistency arguments’—conform to a common pattern. Each specifies what consistent opponents of abortion would do (or believe), asserts that they fail to act (or believe) accordingly and concludes that they are inconsistent. Here, we show (...) that inconsistency arguments fail en masse. In short, inconsistency arguments typically face four problems. First, they usually fail to account for diversity among opponents of abortion. Second, they rely on inferences about consistency based on isolated beliefs shared by some opponents of abortion (and these inferences often do not survive once we consider other beliefs opponents of abortion tend to hold). Third, inconsistency arguments usually ignore the diverse ways in which opponents of abortion might act on their beliefs. Fourth, inconsistency arguments criticise groups of people without threatening their beliefs (eg, that abortion is immoral). Setting these problems aside, even supposing inconsistency arguments are successful, they hardly matter. In fact, in the two best-case scenarios—where inconsistency arguments succeed—they either encourage millions of people to make the world a (much) worse place (from the critic’s perspective) or promote epistemically and morally irresponsible practices. We conclude that a more valuable discussion would be had by focusing on the arguments made by opponents of abortion rather than opponents themselves. (shrink)

In this article, we discuss Beauchamp and Childress’s treatment of the issue of moral status. In particular, we introduce the five different perspectives on moral status that Beauchamp and Childress consider in Principles of Biomedical Ethics and explain their alternative to those perspectives, raise some critical questions about their approach, and offer a different way to think about one of the five theories of moral status that is more in line with what we believe some of its leading advocates affirm.

According to the theory of intrinsic value and moral standing known as the “substance view,” all human beings have intrinsic value, full moral standing and, with these, a right to life. The substance view has been defended by numerous contemporary philosophers who use the theory to argue that the standard human fetus has a right to life and, ultimately, that abortion is prima facie seriously wrong. In this paper, I identify three important errors committed by some of these philosophers in (...) their defense of the theory---what I refer to as the “extratheoretical-proposition error,” “quantitative-differences error,” and “non-normative-answer error”---and conclude that these errors render their defense inadequate. (shrink)

I consider cases of multifetal pregnancy in which one fetus with a fatal birth defect poses a risk to the survival of another healthy fetus to show that the substance view anti-abortion position leads to a contradiction. In cases of complicated multifetal pregnancy, if intervention by selective abortion to terminate the defective fetus is not performed, both fetuses will die due to the conditions created by the defective fetus’s fatal birth defect. Because abortion is wrong on the anti-abortion position, and (...) a moderate anti-abortion position cannot make an exception for selective abortion in cases of complicated multifetal pregnancy if it operates on the substance view, choosing selective abortion must be wrong, so one must let both fetuses die. However, the substance view anti-abortion position must take letting both fetuses die to be wrong, otherwise it will undermine itself as an anti-abortion position. Further, the substance view provides grounds for why letting fetuses die would be wrong anyway. Thus, the substance view anti-abortion position must take both having an abortion and not having an abortion to be wrong, which is a contradiction. Therefore, cases of complicated multifetal pregnancy show that the substance view anti-abortion position is false. (shrink)

The frequency of death from miscarriage is very high, greater than the number of deaths from induced abortion or major diseases.Berg (2017, Philosophical Studies 174:1217–26) argues that, given this, those who contend that personhood begins at conception (PAC) are obliged to reorient their resources accordingly—towards stopping miscarriage, in preference to stopping abortion or diseases. This argument depends on there being a basic moral similarity between these deaths. I argue that, for those that hold to PAC, there are good reasons to (...) think that there is no such similarity. There is a morally relevant difference between preventing killing and letting die, giving PAC supporters reasons to prioritize reducing abortion over reducing miscarriage. And the time-relative interest account provides a morally relevant difference in the badness of death of miscarriages and deaths of born adults, justifying attempts to combat major diseases over attempts to combat miscarriage. I consider recent developments in the literature and contend that these new arguments are unsuccessful in establishing moral similarities between deaths from miscarriage and abortion, and deaths from miscarriage and disease. (shrink)

Most opponents of abortion (OA) believe fetuses matter. Critics argue that OA act inconsistently with regards to fetal life, seeking to restrict access to induced abortion, but largely ignoring spontaneous abortion and the creation of surplus embryos by IVF. Nicholas Colgrove, Bruce Blackshaw, and Daniel Rodger call such arguments inconsistency arguments and contend they do not matter. They present three objections to these arguments — the other beliefs, other actions, and hypocrisy objection. Previously, I argued these objections fail and threaten (...) to undermine ethical inquiry. Colgrove et al. have recently replied, but here, I argue their reply fails as well and raises a new criticism of the other actions’ objection. This essay sets out to show, as well as any philosophical argument can, that inconsistency arguments are morally significant. (shrink)

Recent publications debate the value of inconsistency arguments. Here, I argue that 'Cause of Death Arguments' - inconsistency arguments that claim miscarriage causes death far more often than induced abortion - are unsound or invalid. 'Miscarriage' ambiguously refers both to intrauterine death, an outcome that does not itself cause death, and preterm delivery, which only sometimes causes death. The referential ambiguity also obscures actions people do take to prevent 'miscarriage.' When using the most plausible versions of each premise, these arguments (...) equivocate. Thus, they cannot prove anything. However, missing the equivocation also causes those responding to Cause of Death Arguments to make unconvincing arguments; they inadvertently make or grant false claims themselves. To avoid such mistakes and expose the merely rhetorical power of Cause of Death Arguments, philosophers should replace 'miscarriage' with disambiguated terms. Doing so should lead people across the abortion debate to finally abandon the Cause of Death Argument. (shrink)

Most opposition to induced abortion turns on the belief that human fetuses are persons from conception. On this view, the moral status of the fetus alone requires those in a position to provide aid—gestational mothers—to make tremendous sacrifices to benefit the fetus. Recently, critics have argued that this pro-life position requires more than opposition to induced abortion. Pro-life theorists are relatively silent on the issues of spontaneous abortion, surplus in vitro fertilisation human embryos, and the suffering and death of born (...) persons due to lack of access to food, shelter and medical care. Colgrove et al call such arguments inconsistency arguments, arguing they ‘do not matter’ and mischaracterise them as ad hominem attacks. Here, I argue these are better understood as moral dilemmas. While some critics argue pro-life inaction is evidence that they do not really believe human fetuses are persons, I contend this inaction is likely the result of resolvable confusion rather than moral negligence. (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)

Volume 26, Issue 3, September 2020, Page 273-274.

The substance view is an account of personhood that regards all human beings as possessing instrinsic value and moral status equivalent to that of an adult human being. Consequently, substance view proponents typically regard abortion as impermissible in most circumstances. The substance view, however, has difficulty accounting for certain intuitions regarding the badness of death for embryos and fetuses, and the wrongness of killing them. Jeff McMahan’s time-relative interest account is designed to cater for such intuitions, and so I present (...) a proposal for strengthening the substance view by incorporating McMahan’s account – the Dual-Aspect Account of the morality of killing. I show that it resolves some important issues for the substance view while preserving its central premise of moral equality for all human beings. I then compare the Dual-Aspect Account with McMahan’s Two-Tiered Account of the morality of killing, which he derives from his time-relative interest account. (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 (1) it is wrong to induce abortion and (2) 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)

Many people believe human fetuses have the same moral status as adult human persons, that it is wrong to allow harm to befall things with this moral status, and thus voluntary, induced abortion is seriously morally wrong. Recently, many prochoice theorists have argued that this antiabortion stance is inconsistent; approximately 60% of human fetuses die from spontaneous abortion, far more than die from induced abortion, so if antiabortion theorists really believe that human fetuses have significant moral status, they have strong (...) moral obligations to oppose spontaneous abortion. Yet, few antiabortion theorists devote any effort to doing so. Many prochoice theorists argue that to resolve this inconsistency, antiabortion theorists should abandon their opposition to induced abortion. Here, I argue that those who do not abandon their opposition to induced abortion but continue to neglect spontaneous abortion act immorally. Aristotle argues that moral responsibility requires both control and awareness; I argue that once an antiabortion theorist becomes aware of the frequency of spontaneous abortion, they have a strong moral obligation to redirect their efforts towards combating spontaneous abortion; failure to do so is morally monstrous. (shrink)

While most theorists agree with the claim that human beings have high and equal moral standing, there are strong disagreements about how to justify this claim. These disagreements arise because there are different ways of managing the difficulty of finding a basis for this claim, which is sufficiently substantial to do this justifying work, but not vary in degree in order to not give rise to inequality of moral considerability. The aim of this paper is to review previous attempts to (...) address this difficulty and to demonstrate why they fail and then to defend another way of dealing with this challenge by applying two views: the substance view on the human person and the natural-law account of morality. My claim is that this approach has comparative advantages because it provides a binary and a normatively significant basis of justification for equality without being implausibly inclusive. (shrink)

A response to Henrik Friberg-Fernros' commentary on ‘The Ethics of Killing: Strengthening the Substance View with Time-relative Interests’.

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)

Recently, the substance view of persons has been heavily criticized for the counterintuitive conclusions it seems to imply in scenarios such as embryo rescue cases and embryo loss. These criticisms...

A response to Henrik Friberg-Fernros' commentary on ‘The Ethics of Killing: Strengthening the Substance View with Time-relative Interests’.

Many people believe the morality of abortion stands or falls with the moral status of the fetus. Judith Jarvis Thomson’s violinist argument bypasses the question of fetal moral status; even if the fetus has a right to life, she argues the gestational mother has a right to disconnect herself from the fetus. However, should ectogenesis – a technology that would allow the fetus to develop outside the womb – become sufficiently advanced, the fetus would no longer need a gestational mother (...) to live. Recently, Joona Räsänen has argued that parents have a right to secure the death of a fetus that has been removed from the mother’s body, and that this right might extend to infanticide. However, here I argue Räsänen’s position ignores the moral status of the fetus; if the fetus is morally comparable to beings like us, then of course parents lack a right to the death of their children. However, if the fetus is morally comparable to a tumor, then the right to kill it is philosophically uninteresting. (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)