Recent research in moral psychology has attempted to characterize patterns of moral judgments of actions in terms of the causal and intentional properties of those actions. The present study directly compares the roles of consequence, causation, belief and desire in determining moral judgments. Judgments of the wrongness or permissibility of action were found to rely principally on the mental states of an agent, while judgments of blame and punishment are found to rely jointly on mental states and the causal connection (...) of an agent to a harmful consequence. Also, selectively for judgments of punishment and blame, people who attempt but fail to cause harm more are judged more leniently if the harm occurs by independent means than if the harm does not occur at all. An account of these phenomena is proposed that distinguishes two processes of moral judgment: one which begins with harmful consequences and seeks a causally responsible agent, and the other which begins with an action and analyzes the mental states responsible for that action. Ó 2008 Elsevier B.V. All rights reserved. (shrink)

This paper explores an emerging sub-field of both empirical bioethics and experimental philosophy, which has been called “experimental philosophical bioethics” (bioxphi). As an empirical discipline, bioxphi adopts the methods of experimental moral psychology and cognitive science; it does so to make sense of the eliciting factors and underlying cognitive processes that shape people’s moral judgments, particularly about real-world matters of bioethical concern. Yet, as a normative discipline situated within the broader field of bioethics, it also aims to contribute to substantive (...) ethical questions about what should be done in a given context. What are some of the ways in which this aim has been pursued? In this paper, we employ a case study approach to examine and critically evaluate four strategies from the recent literature by which scholars in bioxphi have leveraged empirical data in the service of normative arguments. (shrink)

A powerful argument against the counterfactual comparative account of harm is that it cannot distinguish harming from failing to benefit. In reply to this problem, I suggest a new account of harm. The account is a counterfactual comparative one, but it counts as harms only those events that make a person occupy his level of well-being at the world at which the event occurs. This account distinguishes harming from failing to benefit in a way that accommodates our intuitions about the (...) standard problem cases. In laying the groundwork for this account, I also demonstrate that rival accounts of harm are able to distinguish harming from failing to benefit only if, and because, they also appeal to the distinction between making upshots happen and allowing upshots to happen. One important implication of my discussion is that preserving the moral asymmetry between harming and failing to benefit requires a commitment to the existence of a metaphysical and moral distinction between making and allowing. (shrink)

Withholding and withdrawing treatment are widely regarded as ethically equivalent in medical guidelines and ethics literature. Health care personnel, however, widely perceive moral differences between withholding and withdrawing. The proponents of equivalence argue that any perceived difference can be explained in terms of cognitive biases and flawed reasoning. Thus, policymakers should clear away any resistance to accept the equivalence stance by moral education. To embark on such a campaign of changing attitudes, we need to be convinced that the ethical analysis (...) is correct. Is it? In this article, I take a closer look at the moral relation between withholding and withdrawing. My conclusion is that withholding and withdrawing are not in general ethically equivalent. Thus, medical guidelines should be rewritten, and rather than being “educated” away from their sound judgments, medical professionals and patients should have nuanced medico-ethical discussions regarding withholding and withdrawing treatment. (shrink)

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)

Recent empirical work calls into question the so-called Simple View that an agent who A’s intentionally intends to A. In experimental studies, ordinary speakers frequently assent to claims that, in certain cases, agents who knowingly behave wrongly intentionally bring about the harm they do; yet the speakers tend to deny that it was the intention of those agents to cause the harm. This paper reports two additional studies that at first appear to support the original ones, but argues that in (...) fact, the evidence of all the studies considered is best understood in terms of the Simple View. (shrink)

Ordinary people often make moral judgments that are consistent with philosophical principles and legal distinctions. For example, they judge killing as worse than letting die, and harm caused as a necessary means to a greater good as worse than harm caused as a side-effect (Cushman, Young, & Hauser, 2006). Are these patterns of judgment produced by mechanisms specific to the moral domain, or do they derive from other psychological domains? We show that the action/omission and means/side-effect distinctions affect nonmoral representations (...) and provide evidence that their role in moral judgment is mediated by these nonmoral psychological representations. Specifically, the action/omission distinction affects moral judgment primarily via causal attribution, while the means/side-effect distinction affects moral judgment via intentional attribution. We suggest that many of the specific patterns evident in our moral judgments in fact derive from nonmoral psychological mechanisms, and especially from the processes of causal and intentional attribution. (shrink)

I defend the Doctrine of Doing and Allowing: the claim that doing harm is harder to justify than merely allowing harm. A thing does not genuinely belong to a person unless he has special authority over it. The Doctrine of Doing and Allowing protects us against harmful imposition – against the actions or needs of another intruding on what is ours. This protection is necessary for something to genuinely belong to a person. The opponent of the Doctrine must claim that (...) nothing genuinely belongs to a person, even his own body. (shrink)

Most people believe that suffering is intrinsically bad. In conjunction with facts about our world and plausible moral principles, this yields a pro tanto obligation to reduce suffering. This is the intuitive starting point for the moral argument in favor of interventions to prevent wild animal suffering. If we accept the moral principle that we ought, pro tanto, to reduce the suffering of all sentient creatures, and we recognize the prevalence of suffering in the wild, then we seem committed to (...) the existence of such a pro tanto obligation. Of course, competing values such as the aesthetic, scientific or moral values of species, biodiversity, naturalness or wildness, might be relevant to the all-things-considered case for or against intervention. Still, many argue that, even if we were to give some weight to such values, no plausible theory could resist the conclusion that WAS is overridingly important. This article is concerned with large-scale interventions to prevent WAS and their tractability and the deep epistemic problem they raise. We concede that suffering gives us a reason to prevent it where it occurs, but we argue that the nature of ecosystems leaves us with no reason to predict that interventions would reduce, rather than exacerbate, suffering. We consider two interventions, based on gene editing technology, proposed as holding promise to prevent WAS; raise epistemic concerns about them; discuss their potential moral costs; and conclude by proposing a way forward: to justify interventions to prevent WAS, we need to develop models that predict the effects of interventions on biodiversity, ecosystem functioning, and animals’ well-being. (shrink)

This chapter examines the ethical case that can be mounted for veganism. Because there has been comparatively little discussion in ethics focused directly on veganism, the central aim of this chapter is threefold: to orient readers to (some of) the most important philosophical literature relevant to the topic, to provide a clear explanation of the current state of the ethical case for veganism, and to focus attention on the most important outstanding or underexplored questions in this domain. The chapter examines (...) the range of positions that deserve to be called ethical veganism, and some of the types of reasons that philosophers can potentially appeal to in arguing for veganism. It then spells out the core of the most promising case for veganism, which argues directly for the wrongness of making animals suffer and die. The chapter then considers three ways of arguing from this conclusion to an ethical defense of the vegan lifestyle, which appeal respectively to the ethical significance of the effects of individual use of animal products, of group efficacy, and of complicity with wrongdoing. The chapter concludes by examining several neglected complications facing the ethical case for veganism. (shrink)

Many philosophers, psychologists, and medical practitioners believe that killing is no worse than letting die on the basis of James Rachels's Bare-Difference Argument. I show that his argument is unsound. In particular, a premise of the argument is that his examples are as similar as is consistent with one being a case of killing and the other being a case of letting die. However, the subject who lets die has both the ability to kill and the ability to let die (...) while the subject who kills lacks the ability to let die. Modifying the latter example so that the killer has both abilities yields a pair of cases with morally different acts. The hypothesis that killing is worse than letting die is the best explanation of this difference. (shrink)

The doctrine of double effect, together with other moral principles that appeal to the intentions of moral agents, has come under attack from many directions in recent years, as have a variety of rationales that have been given in favor of it. In this paper, our aim is to develop, defend, and provide a new theoretical rationale for a secular version of the doctrine. Following Quinn (1989), we distinguish between Harmful Direct Agency and Harmful Indirect Agency. We propose the following (...) version of the doctrine: that in cases in which harm must come to some in order to achieve a good (and is the least costly of possible harms necessary), the agent foresees the harm, and all other things are equal, a stronger case is needed to justify Harmful Direct Agency than to justify Harmful Indirect Agency. We distinguish between two Kantian rationales that might be given for the doctrine, a “dependent right” rationale, defended by Quinn, and an “independent right” rationale, which we defend. We argue that the doctrine and the “independent right” rationale for it are not vulnerable to counterexamples or counterproposals, and conclude by drawing implications for the larger debate over whether agents' intentions are in any way relevant to permissibility and obligation. (shrink)

Although much has been written on the dead-donor rule in the last twenty-five years, scant attention has been paid to how it should be formulated, what its rationale is, and why it was accepted. The DDR can be formulated in terms of either a Don’t Kill rule or a Death Requirement, the former being historically rooted in absolutist ethics and the latter in a prudential policy aimed at securing trust in the transplant enterprise. I contend that the moral core of (...) the rule is the Don’t Kill rule, not the Death Requirement. This, I show, is how the DDR was understood by the transplanters of the 1960s, who sought to conform their practices to their ethics—unlike today’s critics of the DDR, who rethink their ethics in a question-begging fashion to accommodate their practices. A better discussion of the ethics of killing is needed to move the debate forward. (shrink)

There are a number of cases where, collectively, groups cause harm, and yet no single individual’s contribution to the collective makes any difference to the amount of harm that is caused. For instance, though human activity is collectively causing climate change, my individual greenhouse gas emissions are neither necessary nor sufficient for any harm that results from climate change. Some (e.g., Sinnott-Armstrong) take this to indicate that there is no individual moral obligation to reduce emissions. There is a collective action (...) problem here, to which I offer a solution. My solution rests on an argument for a (sometimes) bare moral difference between intending harm and foreseeing with near certainty that harm will result as an unintended side-effect of one’s action. I conclude that we have a moral obligation to reduce our individual emissions; and, more broadly, an obligation to not participate in many other harmful group activities (e.g., factory-farming). (shrink)

The dead donor rule (DDR) originally stated that organ donors must not be killed by and for organ donation. Scholars later added the requirement that vital organs should not be procured before death. Some now argue that the DDR is breached in donation after circulatory determination of death (DCDD) programs. DCDD programs do not breach the original version of the DDR because vital organs are procured only after circulation has ceased permanently as a consequence of withdrawal of life-sustaining therapy. We (...) hold that the original rendition of the DDR banning killing by and for organ donation is the fundamental norm that should be maintained in transplantation ethics. We propose separating the DDR from two other fundamental normative rules: the duties to prevent harm and to obtain informed consent. (shrink)

We readily claim that great moral catastrophes such as the Holocaust involve evil in some way, although it' not clear what this amounts to in a secular context. This paper seeks to provide a secular account of what evil is. It examines what is intuitively the most plausible account, namely that the evil act involves the production of great suffering (or other disvalue), and argues that such outcomes are neither necessary nor sufficient for an act to be evil. Only an (...) appeal to distinctive patterns of motivation, so it is argued, will allow us to accommodate our intuitionsabout which acts are evil, and hence will provide an adequate account of the nature of evil. (shrink)

In recent decades, the intertwining ideas of self-determination and well-being have received tremendous support in bioethics. Discussions regarding self-determination, or autonomy, often focus on two dimensions—the capacity of the patient and the freedom from external coercion. The practice of obtaining informed consent, for example, has become a standard procedure in therapeutic and research medicine. On the surface, it appears that patients now have more opportunities to exercise their self-determination than ever. Nonetheless, discussions of patient autonomy in the bioethics literature, which (...) focus on individual patients making particular decisions, neglect the social structure within which health-care decisions are made. Looking through the lens of disability and informed by the feminist conception of relational autonomy, this essay argues that the issue of autonomy is much more complex than the individualist model suggests. The social system and the ableist ideology impose various forms of pressure or oppressive power that can affect people’s ability to choose according to their value system. Even if such powers are not directly coercive, they influence potential parents’ decisions indirectly—they structure their alternatives in such a way that certain options are never considered as viable and other decisions must be made. This paper argues that, instead of only focusing on the individual act of decision-making, we need to pay attention to the social structure that frames people’s decision. (shrink)

Ethical analyses, professional guidelines and legal decisions support the equivalence thesis for life-sustaining treatment: if it is ethical to withhold treatment, it would be ethical to withdraw the same treatment. In this paper we explore reasons why the majority of medical professionals disagree with the conclusions of ethical analysis. Resource allocation is considered by clinicians to be a legitimate reason to withhold but not to withdraw intensive care treatment. We analyse five arguments in favour of non-equivalence, and find only relatively (...) weak reasons to restrict rationing to withholding treatment. On the contrary, resource allocation provides a strong argument in favour of equivalence: non-equivalence causes preventable death in critically ill patients. We outline two proposals for increasing equivalence in practice: (1) reduction of the mortality threshold for treatment withdrawal, (2) time-limited trials of intensive care. These strategies would help to move practice towards more rational treatment limitation decisions. (shrink)

Controversial and provocative, To Be Real is a blueprint for the creation of a new political force.

The Doctrine of Double Effect (DDE) is an influential non-consequentialist principle positing a role for intention in affecting the moral permissibility of some actions. In particular, the DDE focuses on the intend/foresee distinction, the core claim being that it is sometimes permissible to bring about as a foreseen but unintended side-effect of one’s action some harm it would have been impermissible to aim at as a means or as an end, all else being equal. This article explores the meaning and (...) application of the DDE along with current debates over the nature of the intend/foresee distinction and its moral significance. How is the line between intended effects and merely foreseen but unintended side-effects to be drawn, and how are problem cases best handled? What is an appropriate methodology for debating the tenability of the DDE? How might the DDE interact with other non-consequentialist principles, and how might it be modified to capture other related factors (resulting perhaps in a Doctrine of Triple Effect) or to avoid certain problem cases? Does the DDE make permissibility turn on the actual intentions of particular agents, as critics such as Thomson and Scanlon assume, or is the role of intention more abstract? (shrink)

Alongside a revival of interest in Thomism in philosophy, scholars have realised its relevance when addressing certain contemporary issues in bioethics. This book offers a rigorous interpretation of Aquinas's metaphysics and ethical thought, and highlights its significance to questions in bioethics. Jason T. Eberl applies Aquinas’s views on the seminal topics of human nature and morality to key questions in bioethics at the margins of human life – questions which are currently contested in the academia, politics and the media such (...) as: When does a human person’s life begin? How should we define and clinically determine a person’s death? Is abortion ever morally permissible? How should we resolve the conflict between the potential benefits of embryonic stem cell research and the lives of human embryos? Does cloning involve a misuse of human ingenuity and technology? What forms of treatment are appropriate for irreversibly comatose patients? How should we care for patients who experience unbearable suffering as they approach the end of life? _Thomistic Principles and Bioethics_ presents a significant philosophical viewpoint which will motivate further dialogue amongst religious and secular arenas of inquiry concerning such complex issues of both individual and public concern. (shrink)

Frances Kamm's aptly titled Intricate Ethics is a tour de force of what Peter Unger calls the ‘preservationist’ approach to ethical theory. Here is some of what she says about her methodology: Consider as many case-based judgments of yours as prove necessary. Do not ignore some case-based judgments, assuming they are errors, just because they conflict with simple or intuitively plausible principles that account for some subset of your case-based judgments. Work on the assumption that a different principle can account (...) for all of the judgments. Be prepared to be surprised at what this principle is . . . . I say, consider your case-based judgments, rather than a survey of everyone's judgments. This is because I believe that much more is accomplished when one person considers her judgments and then tries to analyze and justify their grounds than if we do mere surveys. (shrink)

This article analyses proportionality as a potential element of a theory of morally justified surveillance, and sets out a teleological account. It draws on conceptions in criminal justice ethics and just war theory, defines teleological proportionality in the context of surveillance, and sketches some of the central values likely to go into the consideration. It then explores some of the ways in which deontologists might want to modify the account and illustrates the difficulties of doing so. Having set out the (...) account, however, it considers whether the proportionality condition is necessary to a theory of morally justified surveillance. The article concludes that we need and should apply only a necessity condition, but notes that proportionality considerations may retain some use in in practice, as a form of coarse‐grained filter applied before assessing necessity when deliberating the permissibility of potential forms of surveillance. (shrink)

One widely-endorsed argument in the experimental philosophy literature maintains that intuitive judgments are unreliable because they are influenced by the order in which thought experiments prompting those judgments are presented. Here, we explicitly state this argument from ordering effects and show that any plausible understanding of the argument leads to an untenable conclusion. First, we show that the normative principle is ambiguous. On one reading of the principle, the empirical observation is well-supported, but the normative principle is false. On the (...) other reading, the empirical observation has only weak support, and the normative principle, if correct, would impugn the reliability of deliberative reasoning, testimony, memory, and perception, since judgments in all these areas are sensitive to ordering in the relevant sense. We then reflect on what goes wrong with the argument. (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)

Although the most common understanding of suicide is intentional self-killing, this conception either rules out someone who lacks mental capacity being classed as a suicide or, if acting intentionally is meant to include this sort of case, then what it means to act intentionally is so weak that intention is not a necessary condition of suicide. This has implications in health care, and has a further bearing on issues such as assisted suicide and health insurance. In this paper, I argue (...) that intention is not a necessary condition of suicide at all. Rather, I develop a novel approach that deploys the structure of a homicide taxonomy to classify and characterise suicides to arrive at a conceptually robust understanding of suicide. According to my analysis of suicide, an agent is the proximate cause of his death. Suicide is ‘self-killing,’ rather than ‘intentional self-killing.’ Adopting this understanding of suicide performs several functions: We acquire an external standard to assess diverging analyses on specific cases by appealing to homologous homicides. Following such a taxonomy differentiates types of suicides. This approach has application in addressing negative connotations about suicide. As a robust view, adding intention is an unnecessary complication. It is more consistent with psychological and sociological assessments of suicide than ‘intentional self-killing.’ It has useful applications in informing public policy. This paper’s focus is on classifying types of suicides, rather than on the moral permissibility or on underlying causes of suicidal ideation and behaviour. (shrink)

This article defends the use of fanciful examples within the method of wide reflective equilibrium. First, it characterizes the general persuasive role of described cases within that method. Second, it suggests three criteria any example must meet in order to succeed in this persuasive role; fancifulness has little or nothing to do with whether an example is able to meet these criteria. Third, it discusses several general objections to fanciful examples and concludes that they are objections to the abuse of (...) described cases; they identify no special problem with fanciful examples. (shrink)

In his article “Nudging and Informed Consent,” Shlomo Cohen (2013) argues, among other things, that 1) “to the extent that the nudge-influenced decision making is rational—in whatever sense,” there...

Though sometimes maligned, “trolleyology” offers an effective means of opening and framing, not only classes in ethics, but indeed any introductory philosophy course taking a broadly “puzzle-based” approach. When properly sequenced, a subset of the thought experiments that are trolleyology’s stock-in-trade can generate a series of puzzles illustrating the shortcomings of our untutored moral intuitions, and which thus motivate the very enterprise of moral theorizing. Students can be engaged in the attempt to resolve said puzzles, inasmuch as they’re accessible and (...) compelling, and their resolutions generally easy to achieve. Once thus engaged, students can be directed to the fact that they had already rolled up their sleeves and begun “doing philosophy.” In this way, engagement with trolleyological puzzles can serve as a “microcosm” for philosophy more broadly, illustrating the processes of critical thinking that are likewise the stock-in-trade of philosophers across many different domains of inquiry. (shrink)

It has sometimes been suggested that people represent the structure of action in terms of an action tree. A question now arises about the relationship between this action tree representation and people’s moral judgments. A natural hypothesis would be that people first construct a representation of the action tree and then go on to use this representation in making moral judgments. The present paper argues for a more complex view. Specifically, the paper reports a series of experimental studies that appear (...) to show that people’s moral judgments can actually impact their representations of the action tree itself. (shrink)

Thought experiments have played a pivotal role in many debates within ethics—and in particular within applied ethics—over the past 30 years. Nonetheless, despite their having become a commonly used philosophical tool, there is something odd about the extensive reliance upon thought experiments in areas of philosophy, such as applied ethics, that are so obviously oriented towards practical life. Herein I provide a moderate defence of their use in applied philosophy against those three objections. I do not defend all possible uses (...) of thought experiments but suggest that we should distinguish between legitimate and illegitimate uses. Their legitimate uses are determined not so much by the modal content of any actual thought experiment itself, but by the extent to which the argument in which it is nested follows basic tenets of informal logic and respects the fundamental contingency of applied ethical problems. In pursuing these ideas, I do not so much provide a set of criteria for their legitimate use, but more modestly present two significant ways in which their use can go awry. (shrink)

The recent Covid-19 pandemic has brought a broad range of ethical problems to the forefront, raising fundamental questions about the role of government in response to such outbreaks, the scarcity and allocation of health care resources, the unequal distribution of health risks and economic impacts, and the extent to which individual freedom can be restricted. In this clear introduction to the topic Iwao Hirose explores these ethical questions and analyzes the central issues in the ethics of pandemic response and preparedness (...) such as: The general nature of pandemics and the ethics of preparedness Ethical questions about general goals of pandemic response and preparedness The distribution of scarce resources, e.g., ventilators, hospital beds, antiviral drugs and vaccines Restrictions on individual freedom Ethical questions in the wake of pandemics, including contact-tracing, vaccine passports and socioeconomic inequalities. With the use of real-life examples and a clear philosophical approach, The Ethics of Pandemics is a much-needed introduction to some of the most important ethical issues surrounding pandemics. It is essential reading for students of ethics, bioethics, and political philosophy and will also be of interest to those working in related areas such as public policy, public health, health law, nursing and life sciences. (shrink)

In this thesis, I will defend a new kind of compatibilist account of free action, indirect conscious control compatibilism (or indirect compatibilism for short), and argue that some of our actions are free according to it. My argument has three components, and involves the development of a brand new tool for experimental philosophy, and the use of cognitive neuroscience. The first component of the argument shows that compatibilism (of some kind) is a conceptual truth. Contrary to the current orthodoxy in (...) the free will literature, which is that our concept of free will is an incompatibilist concept - a concept according to which we have free will only if determinism is false - I will show that our concept of free will is in fact a compatibilist concept - a concept according to which we can have free will even if determinism is true - and I do so using a new experimental philosophy methodology inspired by two-dimensional semantics. -/- Of course, even if our concept of free will is a compatibilist concept, this does not mean that there are any free actions in the world: the current empirical evidence from the brain sciences appears to show that there might be no, or very few, free actions in the world, even on many compatibilist understandings of what it would take for there to be free will. The second component of the argument addresses this concern by extending our understanding of compatibilism. Agents act freely either when their actions are caused by compatibilistically acceptable psychological processes, or are indirectly caused by those same processes. Hence the name of my account: indirect compatibilism. -/- The final component of the argument defends my new account against some interesting objections and provides evidence from cognitive neuroscience that some of our actions count as free by the lights of indirect compatibilism. (shrink)

In their account of passive euthanasia, Garrard and Wilkinson present arguments that might lead one to overlook significant moral differences between killing and letting die. To kill is not the same as to let die. Similarly, there are significant differences between active and passive euthanasia. Our moral duties differ with regard to them. We are, in general, obliged to refrain from killing each and everyone. We do not have a similar obligation to try to prevent each and everyone from dying. (...) In any case, to be morally obliged to persist in trying to prevent their deaths would be different from being morally obliged to refrain from killing all other people even if we had both obligations. (shrink)

In January 2012, the Journal of Medical Ethics published online Giubilini and Minerva's paper, ‘After-birth abortion. Why should the baby live?’.1 The Journal publishes articles based on the quality of their argument, their contribution to the existing literature, and relevance to current medicine. This article met those criteria. It created unprecedented global outrage for a paper published in an academic medical ethics journal. In this special issue of the Journal, Giubilini and Minerva's paper comes to print along with 31 articles (...) from some of the best scholars in the world, from the broadest range of perspectives on abortion and infanticide, including those strongly critical of Giubilini and Minerva.The killing of a baby is among the most shocking of human practices. I am strongly opposed to the legalisation of infanticide along the lines discussed by Giubilini and Minerva. But I would like to explain why a journal of medical ethics published an article examining infanticide and now devotes a special issue to bringing a wide range of perspectives for further examination of these issues.Infanticide has been practised throughout human history for various reasons and continues to be practised today throughout the world. In rare cases, infanticide can be practised openly and legally—for example, as specified under the ‘Groningen Protocol’, in the Netherlands. The Groningen Protocol allows doctors to end the life of neonates at the request of their parents if the infant is experiencing hopeless and unbearable suffering.2But medical infanticide arguably occurs elsewhere other than in the Netherlands today.In neonatal intensive care, it is not uncommon for a doctor to withdraw artificial ventilation with the consequence that a baby dies.3 If anyone else performed that act, including the parents of the child, it would be viewed as an act of homicide, in some cases …. (shrink)

We explore the ethics of deliberately exposing consenting adults to SARS-CoV-2 to induce immunity to the virus (“DEI” for short). We explain what a responsible DEI program might look like. We explore a consequentialist argument for DEI according to which DEI is a viable harm-reduction strategy. Then we consider a non-consequentialist argument for DEI that draws on the moral significance of consent. Additionally, we consider arguments for the view that DEI is unethical on the grounds that, given that large-scale DEI (...) would be highly likely to result in some severe illnesses and deaths, DEI amounts to a form of killing. Our thesis is that incorporating a DEI program alongside the status-quo “calibrate-the-curve” responses could have significant advantages at the early stages of pandemics. These potential advantages mean that, at a minimum, research into DEI would have been justified early in the COVID-19 pandemic, and that DEI programs should be explored as potential additions to our overall approach to emerging pandemics in the future. (shrink)

Most theorists working on moral obligations to refugees conceive of western states as innocent bystanders with duties to aid refugees if they can do so at little cost to themselves. This paper challenges this dominant theoretical framing of global displacement by highlighting for the first time certain practices of western states in response to refugee flows such as border violence, detention, encampment and containment which may make us question whether states who engage in such practices are indeed innocent. This paper (...) provides the first normative analysis of these practices by seeking to classify them as either doing or allowing harm and invoking the fundamental moral imperative central to core common moral commitments - not to harm innocent people - to suggest that certain western states are not merely failing to aid refugees and allowing harm to come to them, but are instead responding to their calls for aid by harming them. (shrink)

According to the Doctrine of Doing and Allowing, the distinction between doing and allowing harm is morally significant. Doing harm is harder to justify than merely allowing harm. This paper is the second of a two paper critical overview of the literature on the Doctrine of Doing and Allowing. In this paper, I consider the moral status of the distinction between doing and allowing harm. I look at objections to the doctrine such as James’ Rachels’ Wicked Uncle Case and Jonathan (...) Bennett’s argument that any acceptable analysis of the distinction leaves it implausible that the distinction is morally relevant. I consider putative defences of the Doctrine from Philippa Foot and Warren Quinn. I argue that neither Foot not Quinn provides a satisfactory justification of the Doctrine of Doing and Allowing, but that the idea of self-ownership discussed by Quinn can be developed to provide a justification of the doctrine. (shrink)

The U.S. Code of Federal Regulations governing federally funded research on human subjects assumes that harmful research is sometimes morally justifiable because the beneficiaries of that research share a particular vulnerability with its subjects. In this article, I argue against this assumption, which occurs in every subpart of the Code of Federal Regulations that deals with specific vulnerable populations . I argue that shared vulnerability is no exception to the general principle that harming one person in order to benefit another (...) is no more justifiable if the two people have traits in common. Further, shared vulnerability is not a reasonable proxy for any morally relevant desideratum of research, in particular the desire to benefit the worst off, the desire to avoid exploitation, and the desire to use vulnerable populations in research only when necessary. (shrink)

Some brain injured patients are left in a permanent vegetative state, i.e., they have irreversibly lost their capacity for consciousness but retained some autonomic physiological functions, such as breathing unaided. Having discussed the controversial nature of the permanent vegetative state as a diagnostic category, we turn to the question of the patients’ ontological status. Are the permanently vegetative alive, dead, or in some other state? We present empirical data from interviews with relatives of patients, and with experts, to support the (...) view that the ontological state of permanently vegetative patients is unclear: such patients are neither straightforwardly alive nor simply dead. Having defended this view from counter-arguments we turn to the practical question as to how these patients ought to be treated. Some relatives and experts believe it is right for patients to be shifted from their currently unclear ontological state to that of being straightforwardly dead, but many are concerned or even horrified by the only legally sanctioned method guaranteed to achieve this, namely withdrawal of clinically assisted nutrition and hydration. A way of addressing this distress would be to allow active euthanasia for these patients. This is highly controversial; but we argue that standard objections to allowing active euthanasia for this particular class of permanently vegetative patients are weakened by these patients’ distinctive ontological status. (shrink)

One of the most recent controversies to arise in the field of bioethics concerns the ethics for the Groningen Protocol: the guidelines proposed by the Groningen Academic Hospital in The Netherlands, which would permit doctors to actively euthanise terminally ill infants who are suffering. The Groningen Protocol has been met with an intense amount of criticism, some even calling it a relapse into a Hitleresque style of eugenics, where people with disabilities are killed solely because of their handicaps. The purpose (...) of this paper is threefold. First, the paper will attempt to disabuse readers of this erroneous understanding of the Groningen Protocol by showing how such a policy does not aim at making quality-of-life judgements, given that it restricts euthanasia to suffering and terminally ill infants. Second, the paper illustrates that what the Groningen Protocol proposes to do is both ethical and also the most humane alternative for these suffering and dying infants. Lastly, responses are given to some of the worries expressed by ethicists on the practice of any type of non-voluntary active euthanasia. (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)

In this article I am concerned with analogical reasoning in ethics. There is no doubt that the use of analogy can be a powerful tool in our ethical reasoning. The importance of this mode of reasoning is therefore commonly accepted, but there is considerable debate concerning how its structure should be understood and how it should be assessed, both logically and epistemically. In this paper, I first explain the basic structure of arguments from analogy in ethics. I then discuss the (...) diversity of analogical arguments that can be found in ethics. I analyse their structure, assess them from a logical viewpoint, and show how they can be epistemically challenged and defended. The result of this investigation is that, contrary to a commonly held view, analogical reasoning can be a logically valid type of ethical reasoning that can provide reasons for action that are not worse than the reasons provided by any other kind of practical reasoning. (shrink)

According to the Doctrine of Doing and Allowing, it is more difficult to justify doing harm than it is to justify allowing harm. Enabling harm consists in withdrawing an obstacle that would, if left in place, prevent a pre-existing causal sequence from leading to foreseen harm. There has been a lively debate concerning the moral status of enabling harm. According to some (e.g. McMahan, Vihvelin and Tomkow), many cases of enabling harm are morally indistinguishable from doing harm. Others (e.g. Foot, (...) Hanser) support the Equivalence Hypothesis, according to which enabling harm is morally equivalent to allowing harm. Here I argue that there is every reason to embrace, and no reason to reject, the Equivalence Hypothesis. (shrink)

Recent developments in experimental philosophy (‘x-phi’) suggest that there is a new way in which the empirical and normative dimensions of bioethics can be brought into successful dialogue with one another. It revolves around conceptual analysis – though not the kind of conceptual analysis one might perform in an armchair. Following Édouard Machery, this is Conceptual Analysis Rebooted. In short, morally-pertinent medical concepts like ‘treatment’, ‘euthanasia’ and ‘sanctity of life’ can each have several meanings that underwrite inferences with different moral (...) implications. X-phi shows us that an experimental approach to conceptual analysis can make explicit the implicit structures that underpin our thinking about such concepts. By presenting concrete examples, I aim to offer a glimpse of an empirically-grounded, practically-normative 'bioxphi' that demystifies and distinguishes medical concepts, assesses the normative inferences these concepts dispose us to draw and revises those inferences that are deficient. (shrink)

What proper role should considerations of risk, particularly to research subjects, play when it comes to conducting research on human enhancement in the military context? We introduce the currently visible military enhancement techniques (1) and the standard discussion of risk for these (2), in particular what we refer to as the ‘Assumption’, which states that the demands for risk-avoidance are higher for enhancement than for therapy. We challenge the Assumption through the introduction of three categories of enhancements (3): therapeutic, preventive, (...) and pure enhancements. This demands a revision of the Assumption (4), alongside which we propose some further general principles bearing on how to balance risks and benefits in the context of military enhancement research. We identify a particular type of therapeutic enhancements as providing a more responsible path to human trials of the relevant interventions than pure enhancement applications. Finally, we discuss some possible objections to our line of thought (5). While acknowledging their potential insights, we ultimately find them to be unpersuasive, at least provided that our proposal is understood as fully non-coercive towards the candidates for such therapeutic enhancement trials. (shrink)