This article summarizes some of the results of the BIOMED II project “Basic Ethical Principles in European Bioethics and Biolaw” connected to a research project of the Danish Research Councils “Bioethics and Law”. The BIOMED project was based on cooperation between 22 partners in most EU countries. The aim of the project was to identify the ethical principles of respect for autonomy, dignity, integrity and vulnerability as four important ideas or values for a European bioethics and biolaw. The research concluded (...) that the basic ethical principles cannot be understood as universal everlasting ideas or transcendental truths but they rather function reflective guidelines and important values in European culture. The method of the research was conceptual, philosophical analysis of the cultural background of the four values or normative ideas that people use and find important in their existence. Moreover, this was combined with analysis of empirical legal material and policy documents. Also, a number of qualitative interviews with relevant experts were carried out. Another important result of the BIOMED project was the partner's Policy Proposals to the European Commission, the Barcelona Declaration, unique as a philosophical and political agreement between experts in bioethics and biolaw from many different countries. The Policy Proposals are reprinted here at the end of the article. (shrink)

A number of business writers have argued that business is a game and, like a game, possesses its own special rules for acting. While we do not normally tolerate deceit, bluffing is not merely acceptable but also expected within the game of poker. Similarly, lies of omission, overstatements, puffery and bluffs are morally acceptable within business because it, like a game, has a special ethic which permits these normally immoral practices. Although critics of this reasoning have used deontological and utilitarian (...) arguments to show that deceit in business is just an immoral as it is in any other realm of human practice, little attention has been paid to the fact that the argument is one of analogy. The analogical argument for business' special ethic is only as strong as the alleged similarities between business and game-playing. This paper argues that this analogy is quite weak and incapable of either providing much insight into business or of offering a reason to think that the ethics of business are, or even could be, like those of a game. (shrink)

Bioethicists appearing in the media have been accused of "shooting from the hip" (Rachels, 1991). The criticism is sometimes justified. We identify some reasons our interactions with the press can have bad results and suggest remedies. In particular we describe a target (fostering better public dialogue), obstacles to hitting the target (such as intrinsic and accidental defects in our knowledge) and suggest some practical ways to surmont those obstacles (including seeking out ways to write or speak at length, rather than (...) in sound bites). We make use of our own research into the way journalists quote bioethicists. We end by suggesting that the profession as a whole look into this question more fully. (shrink)

Following the Introduction, the second section of this essay lays out Tom Cavanaugh’s helpful and convincing account of the enduring significance of the Hippocratic Oath in terms of how it responds to the problem of iatrogenic harm. The third section discusses something underemphasized in Cavanaugh’s account, namely, the key role of the virtue of piety within the Oath and the profession it establishes, and argues that this virtue should be regarded as integral to an authentic Hippocratic ethic. The fourth and (...) final section briefly examines the connection between medicine and philosophy, focusing on how both should be seen as wisdom-seeking ways of life, and shows the relevance of this for regarding the virtue of piety as the key virtue of medical practice. (shrink)

Gary Comstock considers whether it is ethically justified to pursue genetically modified (GM) crops and foods. He first considers intrinsic objections to GM crops that allege that the process of making GMOs is objectionable in itself. He argues that there is no justifiable basis for the objections — i.e. GM crops are not intrinsically ethically problematic. He then considers extrinsic objections to GM crops, including objections based on the precautionary principle, which focus on the potential harms that may result from (...) the adoption of GM organisms. He argues that these concerns have some merit. However, they do not justify giving up GM crops altogether. Instead, they require that GM crops be developed carefully and with appropriate oversight. Comstock then presents the positive case for GM crops that he endorses. It is based on three considerations: (i) the right of people to choose to adopt GM technology; (ii) the balance of likely benefits over harms to consumers and the environment from GM technology; and (iii) the wisdom of encouraging discovery, innovation, and careful regulation of GM technology. (shrink)

In this article we critically examine the principle of equivalence of care in prison medicine. First, we provide an overview of how the principle of equivalence is utilized in various national and international guidelines on health care provision to prisoners. Second, we outline some of the problems associated with its applications, and argue that the principle of equivalence should go beyond equivalence to access and include equivalence of outcomes. However, because of the particular context of the prison environment, third, we (...) contend that the concept of “health” in equivalence of health outcomes needs conceptual clarity; otherwise, it fails to provide a threshold for healthy states among inmates. We accomplish this by examining common understandings of the concepts of health and disease. We conclude our article by showing why the conceptualization of diseases as clinical problems provides a helpful approach in the delivery of health care in prison. (shrink)

Alternative allocations of a fixed bundle of healthcare resources often involve significantly different indirect, non-health effects. The question arises whether these effects must figure in accounts of the conditions under which a distribution of healthcare resources is morally justifiable. In this article we defend a Scanlonian, affirmative answer to this question: healthcare resource managers should sometimes select an allocation which has worse direct, health-related effects but better indirect, nonhealth effects; they should do this when the interests served by such a (...) policy are more urgent than the healthcare interests better served by an alternative allocation. We note that there is a prima facie case for the claim that such benefits (and costs) are relevant—i.e. they are real benefits, and in other contexts our decisions can permissibly be guided by them. We then proceed to rebut three lines of argument that might be thought to defeat this prima facie case: they appeal to fairness, the Kantian Formula of Humanity as an End in Itself, and the equal moral worth of persons, respectively. (shrink)

Definition of the Problem: The ethical debate on the cloning of human beings is by no means new. Its history goes back to the middle of the 1960s. However, the theoretical level of the contents of this debate still doesn't seem to have got past its initial stages.Arguments and conclusion: First, a short overview will be given of these 30 years of history of ethical debate, and some central concepts will be explained. Subsequently a critical analysis will be made of (...) the arguments for and against the cloning of people which are used in this debate. The intention of this exposition is to stimulate further ethical discussion on the cloning of human beings. (shrink)

Recent developments in biogerontology—the study of the biology of ageing—suggest that it may eventually be possible to intervene in the human ageing process. This, in turn, offers the prospect of significantly postponing the onset of age-related diseases. The biogerontological project, however, has met with strong resistance, especially by deontologists. They consider the act of intervening in the ageing process impermissible on the grounds that it would (most probably) bring about an extended maximum lifespan—a state of affairs that they deem intrinsically (...) bad. In a bid to convince their deontological opponents of the permissibility of this act, proponents of biogerontology invoke an argument which is grounded in the doctrine of double effect. Surprisingly, their argument, which we refer to as the ‘double effect argument’, has gone unnoticed. This article exposes and critically evaluates this ‘double effect argument’. To this end, we first review a series of excerpts from the ethical debate on biogerontology in order to substantiate the presence of double effect reasoning. Next, we attempt to determine the role that the ‘double effect argument’ is meant to fulfil within this debate. Finally, we assess whether the act of intervening in ageing actually can be justified using double effect reasoning. (shrink)

Mark J. Cherry; The Body for Charity, Profit and Holiness: Commerce in Human Body Parts, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume.

Don Marquis has argued that abortion is immoral because it deprives the fetus of a "future like ours." But Marquis's argument fails by incorrectly assuming that a zygote and the late-term fetus with which it is physically continuous are numerically identical. In fact, the identity of a prebirth human (PBH) across gestation is indeterminate, such that it is determinately morally permissible to destroy an early-term PBH and determinately immoral to destroy a late-term PBH. Beginning at some indeterminate point during gestation (...) and ending at some indeterminate point later in gestation, destroying a PBH is neither determinately morally permissible nor determinately immoral. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

Cowdin and Tuohey argue for a rethinking of Catholic bioethical principles and the Church's moral authority. Citing the Second Vatican council for support, they argue that if the Church were to respect the proper autonomy of medicine, it would allow sterilizations. In this essay I argue against Cowdin and Tuohey's understanding that the Church has derived its moral laws independent of consultation with medicine and that it treats medicine simply as a source of technical expertise. I also argue that they (...) misunderstand the nature of autonomy as well as the Church's position regarding the type of autonomy they request for medicine. I will especially argue against their understanding of the principles of totality and double effect as “dispensations” from the moral order. I conclude that they have provided no grounds to cause the Church to reconsider its condemnation of all sterilizations. (shrink)

The technoscientific consequences of both the human drives for glory on the one hand and a comfortable life on the other potentially threaten human existence. R.U.R., a science fiction play by Karel Čapek, bridges ancient writers and contemporary technoscientific endeavors, encouraging us to consider these issues in light of persistent human nature.

This article considers the sort of diversity in perspective appropriate for a presidential commission on bioethics, and by implication, high-level governmental commissions on ethics more generally. It takes as its point of comparison the respective reports on human cloning produced by the National Bioethics Advisory Commission, appointed by President Bill Clinton, and George W. Bush's President's Council on Bioethics, under the leadership of its original chair, Leon Kass. I argue that the Clinton Commission Report exemplifies forensic diversity (the type of (...) diversity between contesting parties in a legal case), while the Kass Council Report exemplifies academic diversity (the diversity found in a medieval disputatio). Drawing upon Thomas Aquinas, I argue that the type of diversity most appropriate for such advisory bodies is deliberative diversity, which facilitates the President's process of taking counsel. After considering their respective charges, I suggest that neither the Clinton Commission nor the Kass Council possessed an adequate degree of deliberative diversity for their respective tasks. (shrink)

Recientes avances tecnológicos, como la primera celula sin historia genética, creada por el Instituto Craig Venter en mayo de 2010, a partir de un genoma sintetizado químicamente, demuestran que la obra “Un Mundo Feliz”, de Aldous Huxley, conserva plena vigencia 78 años después de haber sido escrita. En consecuencia, este ensayo discute cómo fue posible que Huxley anticipara, satíricamente, algunos de los grandes temas éticos de la agenda contemporánea: la reproducción controlada, el choque de civilizaciones, la clonación humana y la (...) vida como invención, entre otros, que han llevado a que el siglo XXI sea calificado como el siglo de la Biotech, o el umbral hacia una sociedad posthumana. Para ello el ensayo pasa revista al contexto intelectual, social y político de la obra, así como a sus características y méritos literarios. Analizando, sobre todo, los dilemas éticos y políticos profetizados en la novela, y que Francis Fukuyama replantea en nuestro tiempo: ¿Deberíamos salir en defensa de la antiquísima “naturaleza humana”? ¿O es la clave de nuestra verdadera naturaleza, precisamente, la tendencia a modificarnos continuamente a nosotros mismos? (shrink)

What is Christian about Christian bioethics? The short answer to this question is that the Incarnation should shape the form and content of Christian bioethics. In explicating this answer it is argued that contemporary medicine is unwittingly embracing and implementing the transhumanist dream of transforming humans into posthumans. Contemporary medicine does not admit that there are any limits in principle to the extent to which it should intervene to improve the quality of human life. This largely inarticulate, yet ambitious, agenda (...) is derived first in late modernity's failed, but nonetheless ongoing, attempt to transform necessity into goodness, and second the loss of any viable concept of eternity, thereby stripping temporal existence of any normative significance. In short, medicine has become the vanguard of a profane attempt to save humankind by extracting data from flesh. In response, it is contended that an alternative Christian bioethics must be shaped by the Incarnation, the Word made flesh. This assertion does not entitle Christians to oppose the posthuman trajectory of contemporary medicine on the basis of any natural or biological essentialism. Rather, it is an evangelical witness to the grace of Christ's redemption instead of the work of self-transformation. It is Christ alone who thereby makes the vulnerability and mortality of finitude a gift and blessing. Specifically, it is maintained that the chasm separating necessity and goodness cannot be filled but only bridged through the suffering entailed in Christ's cross, and through Christ's resurrection eternity becomes the standard against which the temporal lives of human creatures are properly formed and measured. Consequently, Christian bioethics should help us become conformed to Christ rather than enabling selftransformation. (shrink)

Clinical research employing the randomized clinical trial has, traditionally, been understood to pose an ethical dilemma. On the one hand, each patient ought to get the treatment that best meets her needs, as judged by the patient in consultation with her doctor. On the other hand, the method most helpful to advancing our understanding about what treatments are indeed best able to meet patient needs is the randomized trial, which necessitates that each patient's care is decided not by physician judgment (...) or patient choice but instead by random assignment. The tension can be described as a conflict between the interests of individual patients who are sick today, and the interests of the group of people who will become sick in the future and would benefit from advances in medical understanding. How one ought to balance these important and often competing interests is an important ethical question that resists easy resolution. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:THE MAN BLIND FROM BIRTH AND THE SUBVERSION OF SIN: SOME QUESTIONS ABOUT FUNDAMENTAL MORALS1 James Alison I would like to undertake with you a reading of a passage from the Bible, John Chapter 9. I hope that we will see this chapter yield some interesting insights in the light of my attempt to apply to it the mimetic theory ofRené Girard. I'm not going to expound mimetic theory (...) for you: there is no shortage of books in which such expositions are to be found.2 I'mjust going to put the theory to work, with minimal recourse to technical jargon, in a reading from Scripture, hoping that it will be something like an exercise in publicity for the fecund use to which any of you might put mimetic theory. The reading will not be a simple commentary, but an attempt to experiment with the perspective of the reading. That is to say, we're asking "Who is reading this passage?," "With whom do we identify?" And the reason for this approach is to nudge us into beginning to raise certain questions of fundamental morals, how 'This paper was first published in Theology andSexuality 6, March 1997, and appears here by kind permission ofthe editor. With minor alterations this is the author's translation and adaptation ofa talk given at the Instituto Teológico de America Central (ITAC) in San Pedro Montes de Oca, San José, Costa Rica in May 1995. For instance: R. Schwager, Must there be Scapegoats? Violence andRedemption in the Bible (San Francisco: Harper and Row, 1987); R. Hamerton-Kelly, Sacred Violence: Paul's Hermeneutic ofthe Cross (Minneapolis: Fortress, 1992); J. Williams, The Bible, Violence and the Sacred: Liberationfrom the Myth ofSanctioned Violence (HarperSanFrancisco, 1991); Gil Bailie, Violence Unveiled: Humanity at the Crossroads (New York: Crossroad, 1995)—this is the most accessible ofthe accounts. James Alison27 we talk about them, or live them in a more or less coherent and convincing way. I can't promise you any great conclusions, because I'm only just beginning to get into this subject. For that reason, I'll begin by saying that what follows is somewhat experimental, and will end with a few hints as to possible future paths to follow. I should also begin by saying that my intention is not to cause scandal, but to provoke a discussion which allows a fuller way ofliving a Christian life. In this sense what I'm trying out is an attempt at a search for a theological method which I have not yet mastered and which, if developed, will, I hope, prove somewhat emancipatory for all ofus. Miracle or theological debate? Let us begin our reading of John 9. At first sight we have an account of a miraculous healing. It is the story of a man blind from birth who receives his sight from Jesus one Sabbath, and then of the consequences of this healing among the people who witness, or hear about, the matter. Ifthe account were to be found in one of the synoptic Gospels, perhaps it might remain at that—there is no shortage of such stories. I have no doubt that in the background to the story we're dealing with an historical incident of a healing carried out by Jesus on a Sabbath. However, here the "miraculous healing" element doesn't receive much emphasis, nor does the Sabbath or rather, the matter ofthe Sabbath does receive a certain weight, as we will see later on, but with some very idiosyncratically Johannine touches. In any case, the purpose of this Chapter is determined by the debate about sin, sight, blindness and judgement within which it is set: these are the jeweller's artwork which show forth, and make sense of, the gem ofthe healing. Let us look at the beginning of the story. Jesus sees a man born blind, and his disciples ask him: "Master, who sinned, this man or his parents, that he was born blind?" Jesus answers them: "Neither this man nor his parents. He is blind so that the works of God may be made manifest in him." That is to say, the whole story which follows comes as an illustration... (shrink)

Transhumanism at once embodies our most modern thinking and our biggest longstanding problems. Transhumanism aims to enhance human core capacities: health-span, lifespan, and cognition. The thesis answers the following ethical challenges arising from transhumanist aims. First, whether transhumanism can be an ethical endeavour if it relies on authoritarian intervention by governments and governing bodies to change, generate and enforce behaviour, or to influence and enforce the uptake of medical procedures. Second, the thesis answers the challenge that it is unethical deliberately (...) to encourage the uptake of and pursuit of medical transhumanism given the extent of accessibility and distributive issues that remain unresolved in existing medicine. Finally, the thesis addresses a particular mental health crisis that is often predicted for transhuman beings, namely loss of meaning from loss of death and vulnerability, resulting in widespread loss of social cohesion. The thesis argues that the right solution to the first two problems is a libertarian paternalist approach, viz. nudging, and that this approach will also neutralise the risk of widespread and inevitable boredom or alienation that might otherwise result from the widespread introduction of human enhancement if people are nudged to engage more and more reflectively in their enhancement choices. Additionally, lifestyle issues like obesity, heart disease, cancers, and inaccessibility of vaccines and birth control pose unresolved problems for existing general medicine, killing millions every year worldwide. As a result, another serious challenge for enhancement medicine, which I propose would be addressed by the nudge approach, is to justify its place in the professional domain of medicine. (shrink)

A debate has emerged in the bioethics literature about the use of biotechnology to modify human nature. A failure to define humanness has produced conceptual confusion in this debate. We draw upon recent social psychological work on folk concepts of humanness and dehumanization to analyse the understandings of humanness that underpin the rival positions. We argue that advocates and opponents of human nature modification employ distinct conceptions of humanness, and that their differing evaluations of modification make sense in light of (...) these conceptions. Advocates view modification as the enhancement of a non-essentialist sense of humanness that takes us further from animal nature. Opponents view it as the loss of an essentialist sense of humanness that takes us closer to a robotic state. Recognition that humanness has multiple senses implies that there is no mutually exclusive choice between seeing the outcome of modification as a quantitative gain in humanness or a fundamental, qualitative loss of it. (shrink)

Germund Hesslow has argued that concepts of health and disease serve no important scientific, clinical, or ethical function. However, this conclusion depends upon the particular concept of disease he espouses; namely, on Boorse's functional notion. The fact/value split embodied in the functional notion of disease leads to a sharp split between the science of medicine and bioethics, making the philosophy of medicine irrelevant for both. By placing this disease concept in the broader context of medical history, I shall show that (...) it does capture an essential part of modern medical ideology. However, it is also a self-contradictory notion. By making explicit the value desiderata of medical nosologies, a reconfiguration of the relation between medicine, bioethics, and the philosophy of medicine is initiated. This, in turn, will involve a recovery of the caring dimensions of medicine, and thus a more humane practice. (shrink)

As we approach the 21st century, the threat of nuclear Armageddon has lessened somewhat, but a new threat has emerged: biological warfare. The splitting of the atom eventually led to the detonation of atomic bombs, and the discovery of DNA may soon lead to the use of genetic weapons. This article argues that the scientific community has a responsibility to help protect the world against the threat of biological weapons.

The recent financial meltdown in the US mortgage markets and the ongoing budgetary crises in Europe suggest that we are at an economic and ethical crossroads. What has caused the problems? Do we need to rethink in some fundamental way our ethical notions and some of our practices? These questions clearly are not separable, for, as I shall argue, some of our ideas about corporate responsibilities, technological innovations, and nation states’ ability to regulate corporations have been a cause of the (...) recent problems. Key ethical notions need to be rethought. (shrink)

Abstract. This essay discusses the deep perceptual and social changes that the advanced applications of biotechnology could bring in the West. It examines the probable collapse of a fundamental perceptual bipolarity on which the Western mind and social mobilization have been based since its inception in the West: Athens--Jerusalem. This collapse will quite possibly radically reshape Western perceptions of self and nature and will remodel established constellations and modes of social mobilization and social organization. The radical collapse of the preceding (...) established feature of Western modernity is due to take place in the field of biotechnology, since the latter promises to produce a deliverable perfection of flesh and an equally corporeal personal bliss. I call this promise ``eutopia,'' an actual and tangible utopia-- ``a laboratory on the hill.''. (shrink)

This article considers the sort of diversity in perspective appropriate for a presidential commission on bioethics, and by implication, high-level governmental commissions on ethics more generally. It takes as its point of comparison the respective reports on human cloning produced by the National Bioethics Advisory Commission, appointed by President Bill Clinton, and George W. Bush's President's Council on Bioethics, under the leadership of its original chair, Leon Kass. I argue that the Clinton Commission Report exemplifies forensic diversity (the type of (...) diversity between contesting parties in a legal case), while the Kass Council Report exemplifies academic diversity (the diversity found in a medieval disputatio). Drawing upon Thomas Aquinas, I argue that the type of diversity most appropriate for such advisory bodies is deliberative diversity, which facilitates the President's process of taking counsel. After considering their respective charges, I suggest that neither the Clinton Commission nor the Kass Council possessed an adequate degree of deliberative diversity for their respective tasks. (shrink)

This paper represents the first installment of alarger project devoted to the relevance of pragmatism forbioethics. One self-consciously pragmatist move would be toreturn to the classical pragmatist canon of Peirce, James andDewey in search of substantive doctrines or methodologicalapproaches that might be applied to current bioethicalcontroversies. Another pragmatist (or neopragmatist) move wouldbe to subject the regnant principlist paradigm to Richard Rorty'ssubversive assaults on foundationalism in epistemology andethics. A third pragmatist method, dubbed ``freestandingpragmatism'' by its proponents, embraces a ``pragmatist'' approachto practical (...) reasoning without discernable moorings either to theclassical canon or to Rorty's neopragmatism. This thirdpragmatist approach to method in practical ethics is the subjectof this article. I begin with an examination of freestandingpragmatism in the theory of judicial decision making. I arguethat this version of legal pragmatism – so described on account ofits commitments to contextualism, instrumentalism, eclecticism,and freedom from grand theory – bears a striking resemblance tomuch self-described pragmatist work in bioethics today. Ifurther argue that if this is what we mean by ``pragmatism,'' thenin a certain sense ``we are all pragmatists now.''. (shrink)

What is humane work? What does such work look like in a business context? This paper articulates two ways of thinking about humane work using an Aristotelian and a Confucian virtue ethics approach. This approach reveals the need to think about (1) work’s connection not merely with autonomy but with self-refinement and self-perfection, with craft, and with the production of genuinely good goods; (2) possible dangers (e.g., the risk of generating envy) of focusing too much on pay issues in connection (...) with humane work; (3) the relation between humane work and political regimes; and (4) the role played by stakeholders other than managers in the humanizing of work. (shrink)

This paper discusses the hazards of regulating controversial biomedical research in light of the emergence of powerful, multi-national biotechnology corporations. Prohibitions on the use of government funds can simply force controversial research into the private sphere, and unilateral or multilateral research bans can simply encourage multi-national companies to conduct research in countries that lack restrictive laws. Thus, a net effect of government regulation is that research migrates from the public to the private sphere. Because private research receives less oversight and (...) external scrutiny than public research, it can threaten the welfare and rights of human subjects, scientific progress and openness, and the quality of the approval process for new biomedical technologies. In order to avoid the harmful effects of government regulation of biotechnology, society should promote meaningful discussion and dialogue among scientists, industry leaders, and the public before resorting to regulatory solutions. Legislative or executive initiatives should be applied with great discretion and care, and should be crafted in such a way that they protect public health and safety, promote scientific progress, and avoid the hazards of privatized research and polarized debates. (shrink)