Living related organ transplantation is morally problematic for two reasons. First, it requires surgeons to perform nontherapeutic, even dangerous procedures on healthy donors—and in the case of children, without their consent. Second, the transplant donor and recipient are often intimately related to each other, as parent and child, or as siblings. These relationships challenge our conventional models of medical decisionmaking. Is there anything morally problematic about a parent allowing the interests of one child to be risked for the sake of (...) another? What exactly are the interests of the prospective child donor whose sibling will die without an organ? Is the choice of a parent to take risks for the sake of her child truly free, or is the specter of coercion necessarily raised? (shrink)

There is a broad philosophical consensus that both children’s and prospective parents’ interests are relevant to the justification of a right to parent. Against this view, I argue that it is impermissible to sacrifice children’s interests for the sake of advancing adults’ interest in childrearing. Therefore, the allocation of the moral right to parent should track the child’s, and not the potential parent’s, interest. This revisionary thesis is moderated by two additional qualifications. First, parents lack the moral right to exclude (...) others from associating with the child. Second, children usually come into the world as part of a relationship with their gestational mother; often, this relationship deserves protection. (shrink)

Hypothetical consent is puzzling. On the one hand, it seems to make a moral difference across a wide range of cases. On the other hand, there seem to be principled reasons to think that it cannot. In this article I put forward reasonably precise formulations of these general suspicions regarding hypothetical consent; I draw several distinctions regarding the ways in which hypothetical consent may make a moral difference; I distinguish between two autonomy-related concerns, nonalienation and sovereignty; and, utilizing these distinctions, (...) I show that—and in a preliminary way, when—the objections to the moral significance of hypothetical consent fail. (shrink)

Perhaps the greatest determinant of individual and societal welfare is who raises children and with what degree of discretion. Philosophers have endeavored in myriad ways to provide normative justification for ascribing a right to be a legal parent and to possess particular legal powers as a parent. This Article shows why they fail and offers an alternative theoretical framework for delimiting parental rights. The prevailing tendency in philosophical writing on the topic is to begin with observations and intuitions specific to (...) parent-child relationships. Against that tendency, this Article demonstrates the need to begin with principles at a high level of generality, covering a broad range of human relationships. This yields a much more limited moral right in connection with parenthood than do accounts that fail to generalize. (shrink)

Parents resemble trustees, conservators, and other fiduciaries; they exercise broad discretion while making choices for vulnerable people. Like other fiduciaries, parents can be tempted to neglect their duties or pursue self-interest at the expense of those they should protect. This article argues against treating parents as fiduciaries for three reasons. First, the scope of parental fiduciary duties cannot be narrowed enough to make them tolerable. Arguments limiting fiduciary duties to cases where parents exercise delegated powers or act within parenting roles (...) fail. Most parental decisions involve dual powers or roles. Efforts to address these dual-role cases produce principles that are unduly demanding, complex, arbitrary, and morally unappealing. Second, we could limit parental fiduciary duties by designing parental roles to benefit children. Since children need devoted, happy, well-rounded parents, the principle of designing parental roles to benefit children would produce rules that leave room for parents to flourish. However, this principle does not justify specific legal or moral fiduciary norms. Third, we could redefine fiduciary duties so parents can balance their interests against children’s interests, making fiduciary duties less burdensome. However, expanding the definition of fiduciary threatens to encompass many duties within the fiduciary category, rendering the description almost meaningless. (shrink)

For the majority of scholars concerned with the ethics of living organ donation, inflicting moderate harms on competent volunteers in order to save the lives or increase the life chances of others is held to be justifiable provided certain conditions are met. These conditions tend to include one, or more commonly, some combination of the following: The living donor provides valid consent to donation. Living donation produces an overall positive balance of harm–benefit for donors and recipients which cannot be obtained (...) in a less harmful manner. Donation is not liable to cause significant and long-term morbidity to, or the death of, the donor. This paper critically examines the suggestion that these criteria are not sufficient to offer a general account of justified living organ donation in the context of competent volunteers and that key to justified living organ donation is that donors receive sufficient benefits from their donation that these outweigh the harms they suffer. However, although this view—termed here ‘The Donor Benefit Standard’—directs welcome attention to the many and complex motives which may underlie living organ donation, this paper ultimately concludes that given the threats this position poses to individual autonomy and the lives of those in need of organ transplants ‘The Donor Benefit Standard’ should ultimately be rejected. (shrink)

In a just society, who should be liable for the significant costs associated with creating and raising children? Patrick Tomlin has recently argued that children themselves may be liable on the grounds that they benefit from being raised into independent adults. This view, which Tomlin calls ‘Kids Pay’, depends on the more general principle that a beneficiary can incur an obligation to share in the cost of an essential benefit that the benefactor is responsible for her requiring. I argue in (...) this paper that this principle is both generally false and particularly suspect in the kinds of cases that Tomlin needs it to be true, namely, cases in which a benefactor has created the need to be benefitted to satisfy a self-regarding interest in providing the benefit. In a nutshell, I argue that because parents electively put their children into a needy circumstance for the purpose of satisfying a self-regarding interest in meeting their children’s needs, they lack a legitimate claim against their children to share in its associated costs. (shrink)