Why has autonomy been a leading idea in philosophical writing on bioethics, and why has trust been marginal? In this important book, Onora O'Neill suggests that the conceptions of individual autonomy so widely relied on in bioethics are philosophically and ethically inadequate, and that they undermine rather than support relations of trust. She shows how Kant's non-individualistic view of autonomy provides a stronger basis for an approach to medicine, science and biotechnology, and does not marginalize untrustworthiness, while also explaining why (...) trustworthy individuals and institutions are often undeservingly mistrusted. Her arguments are illustrated with issues raised by practices such as the use of genetic information by the police or insurers, research using human tissues, uses of new reproductive technologies, and media practices for reporting on medicine, science and technology. Autonomy and Trust in Bioethics will appeal to a wide range of readers in ethics, bioethics and related disciplines. (shrink)

"Most modern philosophers attempt to solve the problem of morality from within the epistemological assumptions that define the dominant cultural perspective of our age. Alan Gewirth's Reason and Morality is a major work in this ongoing enterprise. Gewirth develops, with patience and skill, what he calls a 'modified naturalism' in which morality is derived by logic alone from the concept of action.... I think that the publication of Reason and Morality is a major event in the history of moral philosophy. (...) It develops with great power a new and exciting position in ethical naturalism. No one, regardless of philosophical stance, can read this work without an enlargement of mind. It illuminates morality and agency for all."—E. M. Adams, The Review of Metaphysics "This is a fascinating study of an apparently intractable problem. Gewirth has provided plenty of material for further discussion, and his theory deserves serious consideration. He is always aware of possible rejoinders and argues in a rigorous manner, showing a firm grasp of the current state of moral and political philosophy."—Mind. (shrink)

Public health ethics, like the field of public health it addresses, traditionally has focused more on practice and particular cases than on theory, with the result that some concepts, methods, and boundaries remain largely undefined. This paper attempts to provide a rough conceptual map of the terrain of public health ethics. We begin by briefly defining public health and identifying general features of the field that are particularly relevant for a discussion of public health ethics.Public health is primarily concerned with (...) the health of the entire population, rather than the health of individuals. Its features include an emphasis on the promotion of health and the prevention of disease and disability; the collection and use of epidemiological data, population surveillance, and other forms of empirical quantitative assessment; a recognition of the multidimensional nature of the determinants of health; and a focus on the complex interactions of many factors—biological, behavioral, social, and environmental—in developing effective interventions. (shrink)

In this book, Stuart Hampshire argues that no individual and no modern society can avoid conflicts between incompatible moral interests.

In a community that takes rights seriously, consent features pervasively in both moral and legal discourse as a justifying reason: stated simply, where there is consent, there can be no complaint. However, without a clear appreciation of the nature of a consent-based justification, its integrity, both in principle and in practice, is liable to be compromised. This book examines the role of consent as a procedural justification, discussing the prerequisites for an adequate consent -- in particular, that an agent with (...) the relevant capacity has made an unforced and informed choice, that the consent has been clearly signalled, and that the scope of the authorisation covers the act in question. It goes on to highlight both the Fallacy of Necessity (where there is no consent, there must be a wrong) and the Fallacy of Sufficiency (where there is consent, there cannot be a wrong). Finally, the extent to which the authority of law itself rests on consent is considered. If the familiarity of consent-based justification engenders confusion and contempt, the analysis in this book acts as a corrective, identifying a range of abusive or misguided practices that variously under-value or over-value consent, that fictionalise it or that are fixated by it, and that treat it too casually or too cautiously. In short, the analysis in Consent in the Law points the way towards recognising an important procedural justification for precisely what it is as well as giving it a more coherent application. (shrink)

The philosophical debate about the concept of Law is dominated by two traditions: Legal Positivism and Natural-Law Theory. Within Anglo-American Jurisprudence, Legal Positivism is unquestionably the more popular approach. Whilst in recent years there have been a number of assaults upon this ruling view, opposition to Legal Positivism is still very much at the margins of contempory Jurisprudence, The authors of this major work argue, however, that Legal Positivism should be rejected, contending that it is incorrect not in some minor (...) detail but in what they take to be its central tenet, the thesis that the concept of law is morally neutral. Their contention amounts to a rejection of Legal Positivism in favour of Natural-Law Theory. Law as a Moral Judgment is an important and controversial contribution to Jurisprudence. It puts forward a coherent and well argued case which will have to be answered by those of opposed opinion. (shrink)

Genetic database initiatives have given rise to considerable debate about their potential harms and benefits. The question arises as to whether existing ethical frameworks are sufficient to mediate between the competing interests at stake. One approach is to strengthen mechanisms for obtaining informed consent and for protecting confidentiality. However, there is increasing interest in other ethical frameworks, involving solidarity — participation in research for the common good — and the sharing of the benefits of research.

American healthcare -- Bioterror and bioart -- State of emergency -- Licensed to torture -- Hunger strikes -- War -- Cancer -- Drug dealing -- Toxic tinkering -- Abortion -- Culture of death -- Patient safety -- Global health -- Statue of security -- Pandemic fear -- Bioidentifiers -- Genetic genocide.

This article considers how we should frame the ethical issues raised by current proposals for large-scale genebanks with on-going links to medical and lifestyle data, such as the Wellcome Trust and Medical Research Council's 'UK Biobank'. As recent scandals such as Alder Hey have emphasised, there are complex issues concerning the informed consent of donors that need to be carefully considered. However, we believe that a preoccupation with informed consent obscures important questions about the purposes to which such collections are (...) put, not least that they may be only haphazardly used for research —an end that would not fairly reflect the original altruistic motivation of donors, and the trust they must invest. We therefore argue that custodians of such databases take on a weighty pro-active duty, to encourage public debate about the ends of such collections and to sponsor research that reflects publicly agreed priorities and provides public benefits. (shrink)

DNA identification methods are such an established part of our law enforcement and criminal justice systems it is hard to believe that the technologies were developed as recently as the mid-1980s, and that the databases of law enforcement profiles were established in the 1990s. Although the first databases were limited to the DNA profiles of convicted rapists and murderers, the success of these databases in solving violent crimes provided the impetus for Congress and state legislatures to expand the scope of (...) the databases with little critical examination of each expansion's value to law enforcement or cost to privacy and civil liberties.We are now entering a new stage of DNA forensics, in which successive database expansions over the last decade have raised the possibility of creating a population-wide repository. In addition, new applications of DNA profiling, including familial and low stringency searches, have been added to DNA dragnets, the use of medical samples for forensic analysis, and other measures to create a series of crucial, yet largely unexplored, second-generation legal and policy issues. (shrink)

Sweden is probably one of the most secularized nations in the world. Therefore religious arguments tend to play a smaller role in the public bioethical debate than in most other countries. Issues such as abortion, stem-cell research, and therapeutic cloning have been far less controversial in Sweden than elsewhere. Instead, other issues have dominated recent bioethical debates in Sweden, in particular those concerning privacy and the control over biological information about individuals.

This book is a critical, forward-looking and interdisciplinary text. Its chief aim is to advance understanding of medical law by reference both moral theory and the regulatory context. The first chapter seeks to map competing approaches within moral objectivism and outline the pressures created by the impact of market forces and medical tourism, political interests, medical and professional interests, changing perceptions of medicine, developing technologies, limited resources and the impact of increasingly direct (international and domestic) recognition of human rights. Chapters (...) 2 to 16 apply the analytical tools presented in chapter 1 to the topics of medical law and seek to demonstrate the need for a moral epistemology of the type defended in chapter 17. (shrink)

Alan Gewirth extends his fundamental principle of equal and universal human rights, the Principle of Generic Consistency, into the arena of social and political philosophy, exploring its implications for both social and economic rights. He argues that the ethical requirements logically imposed on individual action hold equally for the supportive state as a community of rights, whose chief function is to maintain and promote the universal human rights to freedom and well-being. Such social afflictions as unemployment, homelessness, and poverty are (...) basic violations of these rights, which the supportive state is required to overcome. A critical alternative to both "liberal" and "communitarian" views, this book will command the attention of anyone engaged in the debate over social and economic justice. (shrink)