If bioethical questions cannot be resolved in a widely acceptable manner by rational argument, and if they can be regulated only on the basis of political decision-making, then bioethics belongs to the political sphere. The particular kind of politics practiced in any given society matters greatly: it will determine the kind of bioethical regulation, legislation, and public policy generated there. I propose approaching bioethical questions politically in terms of decisions that cannot be “correct” but that can be “procedurally legitimate.” Two (...) procedures in particular can deliver legitimate bioethical decisions, once combined: expert bioethics committees and deliberative democracy. Bioethics so understood can exceed bioethics as a moral project or as a set of administrative principles to regulate medical practice; it can now aspire to a democratic project that involves ordinary citizens as far as reasonably possible. I advance this argument in four steps: (1) using the example of human germline gene editing, (2) I propose a general understanding of proceduralism, and (3) then combine two types and (4) conclude with a defense of majoritarian proceduralism. I develop this argument in terms of one example: germline gene editing. (shrink)

This paper presents an overview of the key ethical questions of performing gene editing research on military service members. The recent technological advance in gene editing capabilities provided by CRISPR/Cas9 and their path towards first-in-human trials has reinvigorated the debate on human enhancement for non-medical purposes. Human performance optimization has long been a priority of military research in order to close the gap between the advancement of warfare and the limitations of human actors. In spite of this focus on temporary (...) performance improvement, biomedical enhancement is an extension of these endeavours and the ethical issues of such research should be considered. In this paper, we explore possible applications of CRISPR to military human gene editing research and how it could be specifically applied towards protection of service members against biological or chemical weapons. We analyse three normative areas including risk–benefit analysis, informed consent, and inequality of access as it relates to CRISPR applications for military research to help inform and provide considerations for military institutional review boards and policymakers. (shrink)

Para el transhumanismo, la humanidad es una etapa que, guiada por la evolución biológica, estuvo precedida por otras anteriores y a la que seguirán otras nuevas. Según el transhumanismo hemos de romper la inercia de causas ciegas que gobierna la evolución y, a través de la biotecnología, alcanzar lo que denominan una “vida mejor”. Los autores afines a esta corriente desarrollan sus propuestas negando la existencia de una naturaleza humana, pero sin abandonar la convicción de que resulta posible definir en (...) qué consiste una “vida mejor”. En este artículo analizamos la claridad y el rigor con la que presentan el fin último de su propuesta, la relación entre el fin y los medios planteados para alcanzarlo, y, finalmente, pondremos de manifiesto algunas inconsistencias derivadas de su rechazo de que la naturaleza humana pueda tener valor normativo. (shrink)

BackgroundMultidisciplinary study groups have produced documents in an attempt to support decisions regarding whether to resuscitate "at risk" newborns or not. Moreover, there has been an increasingly insistent request for juridical regulation of neonatal resuscitation practices as well as for clarification of the role of parents in decisions regarding this kind of assistance. The crux of the matter is whether strict guidelines, reference standards based on the parameter of gestational age and authority rules are necessary.DiscussionThe Italian scenario reflects the current (...) animated debate, illustrating the difficulty intrinsic in rigid guidelines on the subject, especially when gestational age is taken as a reference parameter for the medical decision.SummaryConcerning the decision to interrupt or not to initiate resuscitation procedures on low gestational age newborns, physicians do not need rigid rules based on inflexible gestational age and birth weight guidelines. Guidance in addressing the difficult and trying issues associated with infants born at the margins of viability with a realistic assessment of the infant's clinical condition must be based on the infant's best interests, with clinicians and parents entering into what has been described as a "partnership of care". (shrink)

It is commonly thought that when a patient is unable to make a treatment decision for herself, patient autonomy should be respected by consulting the views of a patient surrogate, normally either the next-of-kin or a person previously designated by the patient. On one view, the task of this surrogate is to make the treatment decision that the patient would have made if competent. But this so-called ‘substituted judgment standard’ (SJS) has come in for has come in for a good (...) deal of criticism recently. For instance, some question whether surrogates are able to reliably predict what the patient would have chosen. Others wonder how respecting a patient's counter-factual, rather than actual, choices is supposed to respect her autonomy. Such concerns have lead some to reject the SJS and argue for alternative characterisations of the role of surrogate decision-makers. (shrink)

Existing debate on procreative selection focuses on the well-being of the future child. However, selection decisions can also have significant effects on the well-being of others. Moreover, these effects may run in opposing directions; some traits conducive to the well-being of the selected child may be harmful to others, whereas other traits that limit the child’s well-being may preserve or increase that of others. Prominent selection principles defended to date instruct parents to select a child, of the possible children they (...) could have, likely to have a good (or nonbad) life, but they do not instruct parents to independently take the well-being of others into account. We refer to these principles as individualistic selection principles. We propose a new selection principle—Procreative Altruism—according to which parents have significant moral reason to select a child whose existence can be expected to contribute more to (or detract less from) the well-being of others than any alternative child they could have. We present the case for adopting Procreative Altruism alongside any of the major individualistic selection principles proposed to date and defend this two-principle model against a range of objections. (shrink)

This article brings together two debates in bioethics more substantively than has been the case until now. One is the methodological debate over "principlism," i.e., the theoretical framework for analyzing and solving ethical problems proposed by Beauchamp and Childress in Principles of Biomedical Ethics. The other is the normative debate about reproductive ethics, i.e., procreative rights and obligations in a time of pervasive opportunities for making detailed choices about the properties and capacities of future people. The obvious point of bringing (...) the debates together is to show how they can illuminate each other in fruitful ways consistent with the method of reflective equilibrium endorsed in PBE. Furthermore, discussions of reproductive ethics is almost absent in PBE, making it an interesting "test case" on how principlist theory can have an impact on and be affected by confrontations with new practices and considerations in biomedicine. Reproductive ethics is especially interesting due to the so-called non-identity considerations, which pose a challenge to common morality views on harm to and respect for persons. My focus is mainly on some methodological points about the import of concrete normative discussions for formulating basic normative principles. However, I unfold a number of substantial points in order to demonstrate this. It is my impression that most writers on principlism underestimate the effect of engaging with concrete problems. Specifically, I conclude that reflecting on procreative obligations provides strong reasons for specifying the basic principles in ways that uncover new dimensions of them and not just new applications. _Key words: _principlism, reproductive ethics, non-identity problem, nonmaleficence, respect for persons. (shrink)

This thesis is about the moral reasons we have to do less than best. It consists of six chapters. Part I of the thesis proposes, extends, and defends reasons to do less than best. In Chapter One (“The Conditional Obligation”) I outline and reject two recent arguments from Joe Horton and Theron Pummer for the claim that we have a conditional obligation to bring about the most good. In Chapter Two (“Agglomeration and Agent-Relative Costs”) I argue that agent-relative costs can (...) justify permissions to less than best in a far greater range of decisions contexts than we currently believe. In Chapter Three (“Risk and Aggregation”) I discuss how anti-aggregative moral theories deal with risk, whilst proposing an argument in favour of ex-post moral theories. -/- In Part II of the thesis, I discuss longtermism, presenting a series of reasons to believe we have both significant permissions and obligations to prioritise those in the short-term. In Chapter Four (“Listening to Future People”) I criticise a recent argument presented by Andreas Mogensen for the claim we cannot have obligations grounded in the wellbeing of future people. I then show that, even permitting the existence of obligations to future people, we still have significant reasons to resist longtermism on the grounds of partiality. In Chapter Five (“The Complaints of Future People”) I argue that scepticism about aggregation is inconsistent with an obligation, or indeed even a permission, to help far future people. In Chapter Six (“Leaving the Present Behind”) I explore the moral significance of “dooming”, whilst arguing that we have a pro tanto reason of fairness to prioritise aiding those currently in existence. (shrink)

O artigo analisa o caso em que os pais querem ter um filho com alguma deficiência em especial, a surdez. Em primeiro lugar, são apresentados os dois principais argumentos contra essa tentativa, as ideias de que isso prejudicaria o filho e de que os pais não estariam buscando o melhor para ele. Em seguida são apresentados três contra-argumentos a favor da escolha dos pais, que se baseiam nas considerações de que a surdez não é uma deficiência, de que essa escolha (...) aumentaria o vínculo entre pais e filhos e de que ela serviria como uma ação afirmativa a favor dos portadores de deficiências. A seção seguinte contém uma análise do que significa ter uma deficiência, a qual serve de base para o a discussão final que procura mostrar que a escolha dos pais é imoral, pois, limita propositalmente as oportunidades do filho. (shrink)

Many people view disabilities as misfortunes, call this the standard view. In this paper, I examine one criticism that has been launched against the Standard View. Rather than determine in advance whether having a disability is good or bad for a person, some critics argue that the Standard View is reflective of and brings about inappropriate emotional responses toward people with disabilities and their circumstances. For instance, philosophers have recently argued that in holding the standard view, we become prone to (...) a destructive kind of unwarranted pity or that the view leads us to hold certain untenable or inappropriate hopes for our children and for our society. I think this sort of challenge to the Standard View has a lot of appeal, but I worry that if it is not properly articulated, the approach is vulnerable to what has been known as “The Wrong Kind of Reason” problem. The paper highlights and addresses this worry. (shrink)

A number of thinkers have been wondering about the moral obligations humans have, or will have, to intelligent technologies. An underlying assumption is that “moral machines” are decades in the offing, and thus we have no pressing obligations now. But, in the context of technology, we are yet to consider that we might owe moral consideration to something that is not a member of the moral community but eventually will be as an outcome of human action. Do we have current (...) actual obligations to technologies that do not currently exist? If there are obligations to currently non-existing technologies, we must confront what might be called the Non-Identical Machines Problem. Can we harm or benefit an entity by making it one way rather than another? This paper presents the problem and argues that it is more challenging than the standard Non-Identity Problem. (shrink)

When it originated in the late 19th century, psychometrics was a field with both a scientific and a social mission: psychometrics provided new methods for research into individual differences, and at the same time, these psychometric instruments were considered a means to create a new social order. In contrast, contemporary psychometrics - due to its highly technical nature and its limited involvement in substantive psychological research - has created the impression of being a value-free discipline. In this article, we develop (...) a contrasting characterization of contemporary psychometrics as a value-laden discipline. We expose four such values: that individual differences are quantitative (rather than qualitative), that measurement should be objective in a specific sense, that test items should be fair, and that utility of a model is more important than its truth. Our goal is not to criticize psychometrics for employing these values, but rather to bring them into the open and to show that these values are not inevitable and are in need of systematic evaluation. (shrink)

Annotated bibliography on eugenics and philosophy.

In this article, I critically deal with Savulescu’s suggestion that human beings have a “moral obligation to create children with the best chance of the best life”, p. 274). I progress as follows. In part one, I will briefly describe the procedures with which Savulescu is concerned, and I will present Savulescu’s argument in favour of the principle of procreative beneficence which is the basis of his argumentation in favour of the aforementioned moral obligation. In part two, I will show (...) that the principle is inconsistent and that it violently attacks human beings who disagree with it which is the reason why I regard it as an immoral principle. In the conclusion, I will put forward some reasons for regarding the principle of procreative autonomy as morally more plausible than Savulescu’s principle of procreative beneficence concerning the questions he deals with. (shrink)

Human Enhancement Technology ranges from the commonplace, such as education, to the futuristic, with possible future developments including genetic modification or direct computer-brain interfaces. Public policies governing the supply of these technologies have the potential to greatly increase or mitigate economic inequality. Due to this potential harm, many have suggested prohibition of further developments of enhancement technologies. However, prohibition would in ineffective at preventing this harm and also would also prevent many positive aspects of enhancement technologies. On the other hand, (...) due to the expected benefits, many have suggested allowing access and development within a free-market system. However, this has the potential to increase inequality beyond acceptable levels. Consequently, Government policies must provide appropriate funding and regulation in order for these technologies to be distributed fairly to provide the most benefits and prevent the worst outcomes. (shrink)

Having and raising children is widely regarded as one of the most valuable projects a person can choose to undertake. Yet many disabled people find it difficult to share in this value because of obstacles that arise from widespread social attitudes about disability. A common assumption is that having a disability tends to make someone unfit to parent. This assumption may seem especially relevant as a factor in decisions about whether to allow, encourage and assist disabled people to reproduce and (...) raise children. Yet there are reasons to doubt whether there is such a close connection between having a disability and lacking the ability to raise a child well. The aims of this paper are, first, to identify and clarify some values that are relevant to questions about allowing, encouraging and assisting disabled people to procreate and raise children, second, to give an overview of how these values can help us to address certain legal questions that arise for disabled people who aim to procreate and parent, third, to raise concerns about how to properly assess the parenting capacities of people with disabilities, and fourth, to suggest some ways in which having a disability can actually make someone a better parent. (shrink)