This paper analyzes the use of public reason requirements in bioethical discourse and discusses when such requirements are warranted. By a “public reason requirement,” I mean a requirement that those involved in a particular discourse or debate only use reasons that can properly be described as public reasons. The first part of the paper outlines the concept of public reasons as developed by John Rawls and others and discusses some of the general criticisms of the concept and its importance. The (...) second part then distinguishes between two types of public reason requirements in bioethics. One type is what I will call the orthodox public reason requirement since it hews closely to the original Rawlsian conception. The second is what I will call the expansive public reason requirement, which departs quite radically from the Rawlsian conception and applies the requirement not to policy discourse or policymaking, but to the actions of individuals. Both types of requirements will be analyzed, and some problems in applying public reason requirements in bioethics will be identified. It will be argued that the expansive public reason requirement is misguided. The concluding part argues that requirements of civic civility and what Rawls terms an “inclusive view” of public reason should be important in bioethical discourse. (shrink)

In a recent article, Fiona Woollard draws attention to a number of problems, both theoretical and pragmatic, with current discourse around infant feeding. References both to the ‘benefits of breastfeeding’ and ‘harms of formula’ are problematic, since there is no obvious baseline of comparison against which to make these evaluations. Further, she highlights the pragmatic consequences of these linguistic choices. Saying that formula feeding harms babies, for instance, is likely to exacerbate feelings of guilt and shame felt by many mothers (...) who use formula, for various reasons. Since I agree with much that Woollard says, this response is mostly sympathetic, but I wish to draw attention to one point that is largely missing from her analysis. The pragmatic effect of an utterance depends significantly on who is speaking, to whom, and in what context. Thus, we might differentiate between what it is appropriate to say in a professional context, such as an academic journal, from what one might say in a policy document or to a new mother. While we should always be careful about the language that we use, we need not assume that the same language is appropriate in all contexts nor that equal care is always required. (shrink)

Early intervention aims to identify children or families at risk of poor health, and take preventative measures at an early stage, when intervention is more likely to succeed. EI is concerned with the just distribution of “life chances,” so that all children are given fair opportunity to realize their potential and lead a good life; EI policy design, therefore, invokes ethical questions about the balance of responsibilities between the state, society, and individuals in addressing inequalities. We analyze a corpus of (...) EI policy guidance to investigate explicit and implicit ethical arguments about who should be held morally responsible for safeguarding child health and well-being. We examine the implications of these claims and explore what it would mean to put the proposed policies into practice. We conclude with some remarks about the useful role that philosophical analysis can play in EI policy development. (shrink)