When do claims to be saved of a small or moderate harm aggregate against a competing claim to be saved from an early death? In this short response to Kamm's Bioethical Prescriptions, I argue for the following answer: aggregation of weaker claims against a life is permitted just in case, in a one-to-one contest, a person with a weaker claim would have a personal prerogative to prioritize her claim over a stranger’s competing claim to life.

This text focuses on selected basic arguments of libertarianism that could be found in certain debates on the moral issues of euthanasia and the application of moral fictionalism in bioethics. Firstly, I devote my article to the criticism of libertarian arguments (as one of the dominant discourses related to the debate over euthanasia) in a wider perspective of moral philosophy. The article is based on an approach that understands morality as a kind of social practice and the primary goal is (...) to grasp the key theoretical concepts which are included in the mechanism for identifying and assessing our moral intuitions. This text is primarily an analysis of selected arguments of current normative theories of libertarianism on two levels: first it examines the idea of self-ownership in connection with certain debates over euthanasia, while the latter part of the article concerns an analysis of the critique of libertarian arguments and a comparison of the alternative arguments of moral fictionalism. The last part of this text, focusing on moral fictionalism and its general application in bioethics, is the core of the article. (shrink)

Deontologists believe that it is wrong to violate a right even if this will prevent a greater number of violations of the same right. This leads to the paradox of deontology: If respecting everyone’s rights is equally important, why should we not minimize the number of rights violations? One possible answer is agent-based. This answer points out that you should not violate rights even if this will prevent someone else’s violations. In this paper, I defend a relational agent-based justification that (...) focuses on the relation in which the agent stands to her would-be victims. I argue that this justification can avoid two key objections levelled against agent-based justifications: It can explain why we are not permitted to minimize our own rights violations, and the justification avoids the charge of being excessively self-concerned. (shrink)

In this paper, there were presented ethical arguments concerning the application of modern techniques of genetic intervention in human procreation. In particular, the rationalistic arguments in favour of genetic interventions were critically presented, namely the argument on ethical neutrality of technology, liberal argument on procreative freedom and argument on genetic enhancement. There were also analysed the negative emotional reaction to genetic engineering. The main aim of the paper was to express the cognitive element from these emotions enabling a wider understanding (...) of human procreation and the values of parent-child relations. (shrink)

The article addresses the problem of disability in the context of reproductive decisions based on genetic information. It poses the question of whether selective procreation should be considered as a moral obligation of prospective parents. To answer this question, a number of different ethical approaches to the problem are presented and critically analysed: the utilitarian; Julian Savulescu's principle of procreative beneficence; the rights-based. The main thesis of the article is that these approaches fail to provide any appealing principles on which (...) reproductive decisions should be based. They constitute failures of imagination which may result in counter-intuitive moral judgments about both life with disability and genetic selection. A full appreciation of the ethical significance of recognition in procreative decisions leads to a more nuanced and morally satisfying view than other leading alternatives presented in the article. (shrink)

Temkin asks how we should distribute resources between the social determinants of health and health care; Sreenivasan argues that if our goal is fair opportunity, funding universal health coverage is the wrong policy. He argues that social equality in health has not improved under UHC and concludes that fair opportunity would be better served by using the resources to address the SDOH instead. His criticism applies more broadly than he claims: it applies to any argument for UHC based on health (...) equity. However, neither his strong causal conclusion nor his stark policy proposal is justified. I review methodological challenges for establishing the relative causal contributions of health care and social policy, concluding that we may never have a robust causal account to support a consequentialist choice. Fortunately, we may not need to answer the allocation question as a dichotomy. Given what Sen calls the multidimensional nature of health equity and the role of UHC in cost containment, UHC may not be a threat to health equity. I also argue against Sreenivasan's claim that the data he discusses should not trouble sufficientists and prioritarians. The worst-off are not simply lagging in improvement; rather, their health status is stagnating or worsening. (shrink)

In this article, part of a special issue on meaning in life and medical ethics, I argue that several issues encountered in a bioethical context are not adequately addressed only with values such as morality and welfare. I maintain, more specifically, that the value of what makes a life meaningful is essential to being able to provide conclusive judgements about which decisions to make. After briefly indicating how meaningfulness differs from rightness and happiness, I point out how it is plausibly (...) central to making decisions in six ‘life and death’ matters. My aim is not to draw any firm conclusions about what to do when it comes to these topics, but rather to show that in order to arrive at any, one cannot plausibly ignore the category of life’s meaning that has, until recently, been nearly absent from Western bioethics since its inception. (shrink)

Temporal nihilism is the view that our lives won’t matter after we die. According to the standard interpretation, this is because our lives won’t make a permanent difference. Many who consider the view thus reject it by denying that our lives need to have an eternal impact. However, in this paper, I develop a different formulation of temporal nihilism revolving around the persistence of personal value itself. According to this stronger version, we do not have personal value after death, so (...) our past life no longer has wellbeing after we die. The standard objections to the standard interpretation don’t apply to this more nihilistic nihilism. I offer a new response according to which personal value persists after death because the person continues to exist. (shrink)

Fetuses and their mothers (and other adults) share many objective interests. These include interests in disjunctive ways of achieving human well-being, including the formation and success of good projects such as particular friendships. Pursuing such good projects is in the individual’s interests and is what growing up is all about. Some interests are time-sensitive, and determining which interests apply at what stages in life requires asking which benefits are in some sense appropriate to the individual and still in his/her actual (...) or possible or even hypothetical future. Human individuals not only have interests in unconditional benefits to them, including the welfare of existing family members, but in conditional benefits to them, including the welfare of possible future family members. Even if not all interests apply to the individual at every stage, if an adult-type benefit is still in the (long-term) future, the young individual including the fetus has a stake in that benefit, conditional as the benefit may sometimes be. Fulfilment is enhanced by pursuit and conscious enjoyment of ‘human goods’, but as with adults, the stake in these remains strong even if psychological links with the long-term future in which this happens are tenuous or non-existent. (shrink)