The dominant, individualistic understanding of autonomy that features in clinical practice and research is underpinned by the idea that people are, in their ideal form, independent, self-interested and rational gain-maximising decision-makers. In recent decades, this paradigm has been challenged from various disciplinary and intellectual directions. Proponents of ‘relational autonomy’ in particular have argued that people’s identities, needs, interests – and indeed autonomy – are always also shaped by their relations to others. Yet, despite the pronounced and nuanced critique directed at (...) an individualistic understanding of autonomy, this critique has had very little effect on ethical and legal instruments in clinical practice and research so far. In this article, we use four case studies to explore to what extent, if at all, relational autonomy can provide solutions to ethical and practical problems in clinical practice and research. We conclude that certain forms of relational autonomy can have a tangibl... (shrink)

The Nobel prize-winning molecular biologist Walter Gilbert described the mapping and sequencing of the human genome as “the grail of molecular biology.” The implication, endorsed by enthusiasts for the new genetics, is that possessing a comprehensive knowledge of human genetics, like possessing the Holy Grail, will give us miraculous powers to heal the sick, and to reduce human suffering and disabilities. Indeed, the rhetoric invoked to garner public support for the Human Genome Project appears to appeal to the best of (...) the Western tradition's enthusiasm for progress: the idea of improving human lives through the practical application of scientific knowledge. (shrink)

_ Source: _Page Count 30 Millions of children worldwide could benefit from adoption. One could argue that prospective parents have a pro tanto duty to adopt rather than create children. For the sake of argument, I assume there is such a duty and focus on a pressing objection to it. Prospective parents may prefer that their children are genetically related to them. I examine eight reasons prospective parents have for preferring genetic children: for parent-child physical resemblance, for family resemblance, for (...) psychological similarity, for the sake of love, to achieve a kind of immortality, for the genetic connection itself, to be a procreator, and to experience pregnancy. I argue that, with the possible exception of the pregnancy desire, these reasons fail to defeat a duty to adopt a child rather than create one, even assuming that we do have some leeway to favor our own interests. (shrink)

This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and practice. The (...) book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

Progress in genetic and reproductive technology now offers us the possibility of choosing what kinds of children we do and don't have. Should we welcome this power, or should we fear its implications? There is no ethical question more urgent than this: we may be at a turning-point in the history of humanity. The renowned moral philosopher and best-selling author Jonathan Glover shows us how we might try to answer this question, and other provoking and disturbing questions to which it (...) leads. Surely parents owe it to their children to give them the best life they can? Increasingly we are able to reduce the number of babies born with disabilities and disorders. But there is a powerful new challenge to conventional thinking about the desirability of doing so: this comes from the voices of those who have these conditions. They call into question the very definition of disability. How do we justify trying to avoid bringing people like them into being? In 2002 a deaf couple used sperm donated by a friend with hereditary deafness to have a deaf baby: they took the view that deafness is not a disability, but a difference. Starting with the issues raised by this case, Jonathan Glover examines the emotive idea of 'eugenics', and the ethics of attempting to enhance people, for non-medical reasons, by means of genetic choices. Should parents be free, not only to have children free from disabilities, but to choose, for instance, the colour of their eyes or hair? This is no longer a distant prospect, but an existing power which we cannot wish away. What impact will such interventions have, both on the individuals concerned and on society as a whole? Should we try to make general improvements to the genetic make-up of human beings? Is there a central core of human nature with which we must not interfere? This beautifully clear book is written for anyone who cares about the rights and wrongs of parents' choices for their children, anyone who is concerned about our human future. Glover handles these uncomfortable questions in a controversial but always humane and sympathetic manner. (shrink)

In February 2016, the Institute of Medicine released a report, commissioned by the United States Food and Drug Administration, on the ethical and social‐policy implications of so‐called three‐parent in vitro fertilization. The IOM endorses commencement of clinical trials on three‐parent IVF, subject to some initial limitations. Also called mitochondrial replacement or transfer, three‐parent IVF is an intervention comprising two distinct procedures in which the genetic materials of three people—the DNA of the father and mother and the mitochondrial DNA of an (...) egg donor—can be used to create a child. Three‐parent IVF would enable a woman with mitochondrial disease to have a genetically related child without transmitting the disease to the child. The possibility for three‐parent children has prompted criticism from many corners. Critics have pointed to ethical issues including safety concerns and risks to children, genetic and germline engineering concerns, the potential exploitation of the third‐parent egg donor, donor anonymity and privacy, and objections to creating babies with three parents, which undermines natural and traditional conceptions of procreation. Additionally, developing the technology would involve experimenting on, manipulating, and disposing of embryos. Although the IOM report considers the ethical concerns about the value of the three‐parent IVF technology, the IOM failed to give due attention to an important objection to the development of this technology: three‐parent IVF lacks the social value necessary to make investment of public resources in it ethical.Unlike the other concerns, this objection is not based on conservativism about new reproductive technologies or default favoritism of the status quo. I argue that the technology does not meet a plausible social value standard to render public research investment into its development ethical. Proponents of three‐parent IVF make inaccurate and exaggerated claims that it will eradicate mitochondrial disease and save lives. Were these claims true, proponents would have a strong case for the social value of the technology. But three‐parent IVF alone will not eradicate mitochondrial disease, and it will not save lives. Rather, it can create healthy lives. As I discuss, the moral distinction is crucial. Most importantly, investment in three‐parent IVF comes at the opportunity cost of researching treatment for mitochondrial disease that would benefit actual, living disease sufferers. (shrink)

In contemporary Western society, people are more often called upon to justify the choice not to have children than they are to supply reasons for having them. In this book, Christine Overall maintains that the burden of proof should be reversed: that the choice to have children calls for more careful justification and reasoning than the choice not to. Arguing that the choice to have children is not just a prudential or pragmatic decision but one with ethical repercussions, Overall offers (...) a wide-ranging exploration of how we might think systematically and deeply about this fundamental aspect of human life. Writing from a feminist perspective, she also acknowledges the inevitably gendered nature of the decision; the choice has different meanings, implications, and risks for women than it has for men. After considering a series of ethical approaches to procreation, and finding them inadequate or incomplete, Overall offers instead a novel argument. Exploring the nature of the biological parent-child relationship -- which is not only genetic but also psychological, physical, intellectual, and moral -- she argues that the formation of that relationship is the best possible reason for choosing to have a child. (shrink)

Contrary to political and philosophical consensus, we argue that the threats posed by climate change justify population engineering, the intentional manipulation of the size and structure of human populations. Specifically, we defend three types of policies aimed at reducing fertility rates: choice enhancement, preference adjustment, and incentivization. While few object to the first type of policy, the latter two are generally rejected because of their potential for coercion or morally objectionable manipulation. We argue that forms of each policy type are (...) pragmatically and morally justified tools for preventing the harms of global climate change. (shrink)

A compelling argument for the morality of limitations on procreation in lessening the harmful environmental effects of unchecked populationWe live in a world where a burgeoning global population has started to have a major and destructive environmental impact. The results, including climate change and the struggle for limited resources, appear to be inevitable aspects of a difficult future. Mandatory population control might be a possible last resort to combat this problem, but is also a potentially immoral and undesirable violation of (...) human rights. Since so many view procreation as an essential component of the right to personal happiness and autonomy, the dominant view remains that the government does not have the right to impose these restrictions on its own citizens, for the sake of future people who have yet to exist.Sarah Conly is first to make the contentious argument that not only is it wrong to have more than one child in the face of such concerns, we do not even retain the right to do so. In One Child, Conly argues that autonomy and personal rights are not unlimited, especially if one's body may cause harm to anyone, and that the government has a moral obligation to protect both current and future citizens. Conly gives readers a thought-provoking and accessible exposure to the problem of population growth and develops a credible view of what our moral obligations really are, to generations present and future. (shrink)

In 1993, Professor of Jurisprudence, Ronald Dworkin of Oxford University and Professor of Law at New York University, delivered the Georgetown Law Center’s thirteenth Annual Philip A. Hart Memorial Lecture: "Life’s Dominion: An Argument About Abortion and Euthanasia." Dworkin is Professor of Philosophy and Frank Henry Sommer Professor of Law at New York University. He received B.A. degrees from both Harvard College and Oxford University, and an LL.B. from Harvard Law School and clerked for Judge Learned Hand. He was associated (...) with a law firm in New York (Sullivan and Cromwell) and was a professor of law at Yale University Law School from 1962-1969. He has been Professor of Jurisprudence at Oxford and Fellow of University College since 1969. He has a joint appointment at Oxford and at NYU where he is a professor both in the Law School and the Philosophy Department. He is a Fellow of the British Academy and a member of the American Academy of Arts and Sciences. Professor Dworkin is the author of many articles in philosophical and legal journals as well as articles on legal and political topics in the New York Review of Books. He has written Taking Rights Seriously (1977), A Matter of Principle (1985), Law’s Empire (1986), Philosophical Issues in Senile Dementia (1987), A Bill of Rights for Britain (1990), Life’s Dominion (1993), and Freedom’s Law (1996). (shrink)

Though the reputation of eugenics has been tarnished by history, eugenics per se is not necessarily a bad thing. Many advocate a liberal new eugenics—where individuals are free to choose whether or not to employ genetic technologies for reproductive purposes. Though genetic interventions aimed at the prevention of severe genetic disorders may be morally and socially acceptable, reproductive liberty in the context of enhancement may conflict with equality. Enhancement could also have adverse effects on utility. The enhancement debate requires a (...) shift in focus. What the equality and/or utility costs of enhancement will be is an empirical question. Rather than philosophical speculation, more social science research is needed to address it. Philosophers, meanwhile, should address head-on the question of how to strike a balance between liberty, equality, and utility in cases of conflict (in the context of genetics). (shrink)

To what extent should parents be allowed to use reproductive technologies to determine the characteristics of their future children? Is there something morally wrong with choosing what their sex will be, or with trying to 'screen out' as much disease and disability as possible before birth? Stephen Wilkinson offers answers to such questions.

It has sometimes been claimed (usually without evidence) that the harm caused by an individual's participation in a greenhouse-gas-intensive economy is negligible. Using data from several contemporary sources, this paper attempts to estimate the harm done by an average American. This estimate is crude, and further refinements are surely needed. But the upshot is that the average American is responsible, through his/her greenhouse gas emissions, for the suffering and/or deaths of one or two future people.

Striving to boldly redirect the philosophy of science, this book by renowned philosopher Philip Kitcher examines the heated debate surrounding the role of science in shaping our lives. Kitcher explores the sharp divide between those who believe that the pursuit of scientific knowledge is always valuable and necessary--the purists--and those who believe that it invariably serves the interests of people in positions of power. In a daring turn, he rejects both perspectives, working out a more realistic image of the sciences--one (...) that allows for the possibility of scientific truth, but nonetheless permits social consensus to determine which avenues to investigate. He then proposes a democratic and deliberative framework for responsible scientists to follow. Controversial, powerful, yet engaging, this volume will appeal to a wide range of readers. Kitcher's nuanced analysis and authorititative conclusion will interest countless scientists as well as all readers of science--scholars and laypersons alike. (shrink)

I argue it is inconsistent to believe that overconsumption is wrong or bad yet believe that having children is morally permissible, insofar as they produce comparable environmental impacts, are voluntary choices, and arise from similar desires. This presents a dilemma for "mainstream environmentalists": they do not want to abandon either of those fundamental beliefs, yet must give up one of them. I present an analogical argument supporting that conclusion. After examining four attempts to undermine the analogy, I conclude that none (...) of them successfully locates a significant, relevant difference between procreation and eco-gluttony (roughly, consumption exceeding that of the average American). Thus, in order to be consistent, one must be in favour of both or opposed to both. Mainstream environmentalism, then, is not an option, and should be replaced by radical environmentalism, the view that both overconsumption and (in most cases) having children are morally problematic in an overcrowded world. (shrink)

Suppose that we develop a medically safe and affordable means of enhancing human intelligence. For concreteness, we shall assume that the technology is genetic engineering (either somatic or germ line), although the argument we will present does not depend on the technological implementation. For simplicity, we shall speak of enhancing “intelligence” or “cognitive capacity,” but we do not presuppose that intelligence is best conceived of as a unitary attribute. Our considerations could be applied to specific cognitive abilities such as verbal (...) fluency, memory, abstract reasoning, social intelligence, spatial cognition, numerical ability, or musical talent. It will emerge that the form of argument that we use can be applied much more generally to help assess other kinds of enhancement technologies as well as other kinds of reform. However, to give a detailed illustration of how the argument form works, we will focus on the prospect of cognitive enhancement. (shrink)

For most of human history children have been a byproduct of sex rather than a conscious choice by parents to create people with traits that they care about. As our understanding of genetics advances along with our ability to control reproduction and manipulate genes, prospective parents have stronger moral reasons to consider how their choices are likely to affect their children, and how their children are likely to affect other people. With the advent of cheap and effective contraception, and the (...) emergence of new technologies for in vitro fertilization, embryo selection, and genetic engineering, it is becoming increasingly difficult to justify rolling the genetic dice by having children without thinking about the traits they will have. It is time to face up to the awesome responsibilities that accompany our reproductive choices. (shrink)

Eugenics is often referred to in debates on the ethics of reproductive technologies and practices, in relation to the creation of moral boundaries between acceptable and unacceptable technologies, and acceptable and unacceptable uses of these technologies. Historians have argued that twentieth century eugenics cannot be reduced to a uniform set of practices, and that no simple lessons can be drawn from this complex history. Some authors stress the similarities between past eugenics and present reproductive technologies and practices (what I define (...) throughout the paper as ‘the continuity view’) in order to condemn the latter. Others focus on the differences between past and present practices (what I define throughout the paper as ‘the discontinuity view’) in order to defend contemporary reproductive technologies. In this paper, I explore the meanings of the word ‘eugenics’ and the relationship between its past and present uses in terms of contemporary debates on reproductive technologies and practices. I argue that moral disagreement about present technologies originate in divergent views of condemnable and justifiable features of the past. (shrink)

ArgumentThe recent development of molecular genetics has created concern that society may experience a new eugenics. Notions about eugenics and what took place in the 1930s and 1940s are actively shaping questions about which uses of the new genetics should be considered illegitimate. Drawing upon a body of historiographical literature on Scandinavian eugenics, this paper argues that the dominant view of eugenics as morally and scientifically illegitimate is not tenable when it comes to the uses of compulsion, political motivation, and (...) scientific acceptability. In spite of a general condemnation of eugenics, health authorities today are trying to prevent individuals with deviant behavior from reproducing or at least from rearing children. This may not be argued with reference to the risk of transmitting defective genes, but rather the risk of producing undesirable social problems. Drawing on a Foucauldian approach, the paper concludes that eugenics and new genetics should be seen as two historically specific forms of biopower. (shrink)

It is commonly believed that disability disqualifies people from full participation in or recognition by society. This view is rooted in eugenic logic, which tells us that our world would be a better place if disability could be eliminated. In opposition to this position, I argue that that disability is inherent in the human condition and consider the bioethical question of why we might want to conserve rather than eliminate disability from our shared world. To do so, I draw together (...) an eclectic, rather than systematic, configuration of counter-eugenic arguments for conserving disability. The idea of preserving intact, keeping alive, and even encouraging to flourish denoted by conserve suggests that disabilities would be better understood as benefits rather than deficits. I present, then, a reading of disability as a potentially generative resource rather than unequivocally restrictive liability. In other words, what I consider here is the cultural and material contributions disability offers to the world. (shrink)

In the months preceding the writing of this review, bioethics has been in the news a great deal. In congressional and public policy debates surrounding stem cell research, human cloning, and the Human Genome Project, bioethics and bioethicists have gained national attention and been subject to public scrutiny. Commentators have asked who these self-appointed moral experts are to tell us what is right and wrong.

In this article, I consider recent debates on the notion of procreative liberty, to argue that reproductive freedom can be understood as a form of positive freedom—that is, the freedom to make oneself according to various ethical and aesthetic principles or values. To make this argument, I draw on Michel Foucault’s later work on ethics. Both adopting and adapting Foucault’s notion of ethics as a practice of the self and of liberty, I argue that reproductive autonomy requires enactment to gain (...) meaning within the life contexts of prospective parents. Thus, I propose a shift away from the standard negative model of freedom that sees it solely as a matter of noninterference or nonimpedance, a view advocated by major commentators such as John Harris and John Robertson. Instead, reproduction should be understood as a deeply personal project of self-making that integrates both negative and positive freedom. (shrink)

In Beyond Humanity a leading philosopher offers a powerful and controversial exploration of urgent ethical issues concerning human enhancement.

The Nobel prize-winning molecular biologist Walter Gilbert described the mapping and sequencing of the human genome as “the grail of molecular biology.” The implication, endorsed by enthusiasts for the new genetics, is that possessing a comprehensive knowledge of human genetics, like possessing the Holy Grail, will give us miraculous powers to heal the sick, and to reduce human suffering and disabilities. Indeed, the rhetoric invoked to garner public support for the Human Genome Project appears to appeal to the best of (...) the Western tradition's enthusiasm for progress: the idea of improving human lives through the practical application of scientific knowledge. (shrink)

The question is answered by introducing an ideal, the ideal of well‐ordered science In well‐ordered science the inquiries pursued are those that would have been selected by a well‐informed group of deliberators dedicated to working cooperatively with one another. Well‐ordered science is contrasted with vulgar democracy and with elitism. The chapter suggests various ways in which our current practice of the sciences falls short of the ideal.

According to the Intergovernmental Panel on Climate Change, human population growth is one of the two primary causes of increased greenhouse gas emissions and accelerating global climate change. Slowing or ending population growth could be a cost effective, environmentally advantageous means to mitigate climate change, providing important benefits to both human and natural communities. Yet population policy has attracted relatively little attention from ethicists, policy analysts, or policy makers dealing with this issue. In part, this is because addressing population matters (...) means wading into a host of contentious ethical issues, including family planning, abortion, and immigration. This article reviews the scientific literature regarding voluntary population control's potential contribution to climate change mitigation. It considers possible reasons for the failure of climate ethicists, analysts, and policy makers to adequately assess that contribution or implement policies that take advantage of it, with particular reference to the resistance to accepting limits to growth. It explores some of the ethical issues at stake, considering arguments for and against noncoercive population control and asking whether coercive population policies are ever morally justified. It also argues that three consensus positions in the climate ethics literature regarding acceptable levels of risk, unacceptable harms, and a putative right to economic development, necessarily imply support for voluntary population control. (shrink)

One of the country's most distinguished scholars presents a brilliantly original approach to the twin dilemmas of abortion and euthanasia, showing why they arouse such volcanic controversy and how we as a society can reconcile our values of life and individual liberty. "From the Trade Paperback edition.

The history of research on the genetics of intelligence is fraught with social bias. During the eugenics era, the hereditary theory of intelligence justified policies that encouraged the proliferation of favored races and coercively stemmed procreation by disfavored ones. In the 1970s, Berkeley psychologist Arthur Jensen argued that black students’ innate cognitive inferiority limited the efficacy of federal education programs. The 1994 controversial bestseller The Bell Curve, by Richard J. Herrnstein and Charles Murray, rehashed the claim that race and class (...) disparities stem from immutable differences in inherited intelligence, which could not be eliminated through social interventions. Today most scientists studying the genetics of intelligence distance themselves from this history of social bias by arguing that their research need not investigate intellectual differences between social groups. Rather, they argue, examining the heritability of intelligence can be socially neutral and may even help to reduce social inequities. I argue, however, that research on the genetics of intelligence cannot be socially neutral. Even if we divorce the heritability of intelligence from a eugenicist mission, measuring intelligence remains useful only as a gage of individuals’ appropriate positions in society. Research into the genetics of intelligence ultimately helps to determine individuals’ inherited capacity for particular social positions, even when researchers aim to modify the effects of inheritance. (shrink)

Eugenics casts a long shadow over contemporary genetics. Any measure, whether in clinical genetics or biotechnology, which is suspected of eugenic intent is likely to be opposed on that ground. Yet there is little consensus on what this word signifies, and often only a remote connection to the very complex set of social movements which took that name. After a brief historical summary of eugenics, this essay attempts to locate any wrongs inherent in eugenic doctrines. Four candidates are examined and (...) rejected. The moral challenge posed by eugenics for genetics in our own time, I argue, is to achieve social justice. (shrink)

This paper addresses the changing ideology regarding reproduction, an evolving American, and potentially worldwide, value system regarding children and parenthood. Children are increasingly being seen as products, and the new technology of reproduction, including the sale of reproductive material and services and especially prenatal diagnosis and selective abortion, encourage this commodification of the fetus. While the new technology does indeed offer new choices, it also creates new structures and new limitations on choice. In the contemporary American social structure, these choices (...) are inevitably couched in terms of production and commodification, and thus do not offer individuals genuine choice or control. (shrink)

Millions of children worldwide could benefit from adoption. One could argue that prospective parents have a pro tanto duty to adopt rather than create children. For the sake of argument, I assume there is such a duty and focus on a pressing objection to it. Prospective parents may prefer that their children are genetically related to them. I examine eight reasons prospective parents have for preferring genetic children: for parent-child physical resemblance, for family resemblance, for psychological similarity, for the sake (...) of love, to achieve a kind of immortality, for the genetic connection itself, to be a procreator, and to experience pregnancy. I argue that, with the possible exception of the pregnancy desire, these reasons fail to defeat a duty to adopt a child rather than create one, even assuming that we do have some leeway to favor our own interests. (shrink)

abstract In this paper we question the basis on which judgements are made about the ‘quality’ of the lives of people whose embodied experience is anomalous, specifically in cases of impairments. In moral and political philosophy it is often assumed that, suitably informed, we can overcome epistemic gaps through the exercise of moral imagination: ‘putting ourselves in the place of others’, we can share their points of view. Drawing on phenomenology and theories of embodied cognition, and on empirical studies, we (...) suggest that there are barriers to imagining oneself differently situated, or imagining being another person, arising in part from the way imagination is constrained by embodied experience. We argue that the role of imagination in moral engagement with others is to expand the scope of our sympathies rather than to enable us to put ourselves in the other's place. We argue for explicit acknowledgement that our assessments of others’ QOL are likely to be shaped by the specifics of our own embodiment, and by the assumptions we make as a consequence about what is necessary for a good quality of life. (shrink)

A proper understanding of the moral and political significance of migration requires a focus on global inequalities. More specifically, it requires a focus on those global inequalities that affect people’s ability to participate in the production of economic goods and non-economic goods. We call cooperative infrastructures the complex material and immaterial technologies that allow human beings to cooperate in order to generate human goods. By enabling migrants to access high-quality cooperative infrastructures, migration contributes to the diffusion of technical and socio-political (...) innovations. In this way, it positively affects the ability of individuals from poorer countries to participate in the production of human goods, to benefit from such production, and to contribute to human development. Migration can also damage the material and immateri al components of the cooperative infrastructures accessible in both the host and sending countries; these potential downsides of migration should not be ignored, although arguably they can often be neutralized, alleviated, or compensated. (shrink)

Three Generations, No Imbeciles: Eugenics, the Supreme Court and Buck v. Bell (Johns Hopkins University Press) tells the story of the 1927 U. S. Supreme Court case Buck v. Bell, which approved laws allowing states to perform surgery in order to prevent "feebleminded and socially inadequate" people from having children. In the Buck case the Supreme Court endorsed involuntary sterilization as a tool of government eugenic policy, setting the stage for similar laws in the majority of states. The case is (...) most often remembered by the Oliver Wendell Holmes Jr., opinion, which ended in the rhetorical climax: "Three generations of imbeciles are enough." Paul Lombardo sets out in this book to challenge the accuracy of the Holmes opinion, and recount in detail the events that brought Buck to the Supreme Court. The Introduction to the book retraces the author's path in discovering the major documents and records that revealed the story of the Buck case, and sets forth a summary of the book's thesis and direction. The Prologue provides a brief description of the trial of Carrie Buck, and the role of Arthur Estabrook as expert eugenic witness. (shrink)