The concept of personhood has been central to bioethics debates about abortion, the treatment of patients in a vegetative or minimally conscious states, as well as patients with advanced dementia. More recently, the concept has been employed to think about new questions related to human-brain organoids, artificial intelligence, uploaded minds, human-animal chimeras, and human embryos, to name a few. A common move has been to ask what these entities have in common with persons (in the normative sense), and then draw (...) conclusions about what we do (or do not) owe them. This paper argues that at best the concept of “personhood” is unhelpful to much of bioethics today and at worst it is harmful and pernicious. I suggest that we (bioethicists) stop using the concept of personhood and instead ask normative questions more directly (e.g., how ought we to treat this being and why?) and use other philosophical concepts (e.g., interests, sentience, recognition respect) to help us answer them. It is time for bioethics to end talk about personhood. (shrink)

The concept of personhood has been central to bioethics debates about abortion, the treatment of patients in a vegetative or minimally conscious states, as well as patients with advanced dementia. More recently, the concept has been employed to think about new questions related to human-brain organoids, artificial intelligence, uploaded minds, human-animal chimeras, and human embryos, to name a few. A common move has been to ask what these entities have in common with persons (in the normative sense), and then draw (...) conclusions about what we do (or do not) owe them. This paper argues that at best the concept of “personhood” is unhelpful to much of bioethics today and at worst it is harmful and pernicious. I suggest that we (bioethicists) stop using the concept of personhood and instead ask normative questions more directly (e.g., how ought we to treat this being and why?) and use other philosophical concepts (e.g., interests, sentience, recognition respect) to help us answer them. It is time for bioethics to end talk about personhood. (shrink)

A substantial proportion of human embryos spontaneously abort soon after conception, and ethicists have argued this is problematic for the pro-life view that a human embryo has the same moral status as an adult from conception. Firstly, if human embryos are our moral equals, this entails spontaneous abortion is one of humanity’s most important problems, and it is claimed this is absurd, and a reductio of the moral status claim. Secondly, it is claimed that pro-life advocates do not act as (...) if spontaneous abortion is important, implying they are failing to fulfill their moral obligations. We report that the primary cause of spontaneous abortion is chromosomal defects, which are currently unpreventable, and show that as the other major cause of prenatal death is induced abortion, pro-life advocates can legitimately continue efforts to oppose it. We also defend the relevance of the killing and letting die distinction, which provides further justification for pro-life priorities. (shrink)

There is a significant debate over the moral status of human embryos. This debate has important implications for practices like abortion and IVF. Some argue that embryos have the same moral status as infants, children, and adults. However, critics claim that the frequency of pregnancy loss/miscarriage/spontaneous abortion shows a moral inconsistency in this view. One line of criticism is that those who know the facts about pregnancy loss and nevertheless attempt to conceive children are willing to sacrifice embryos lost for (...) the healthy children they ultimately have. I respond to this criticism and argue that on the most plausible accounts of well-being, these embryos are not made worse off and thus not “sacrifices.” I then make some more general remarks about what people’s typical views about pregnancy loss show about their views toward the moral status of embryos. (shrink)

It is often claimed that from the moment of conception embryos have the same moral status as adult humans. This claim plays a central role in many arguments against abortion, in vitro fertilization, and stem cell research. In what follows, I show that this claim leads directly to an unexpected and unwelcome conclusion: that natural embryo loss is one of the greatest problems of our time and that we must do almost everything in our power to prevent it. I examine (...) the responses available to those who hold that embryos have full moral status and conclude that they cannot avoid the force of this argument without giving up this key claim. (shrink)

Some people (e.g., Drs. Paul and Susan Lim) and, with them, organizations (e.g., the National Embryo Donation Center) believe that, morally speaking, the death of a frozen human embryo is a very bad thing. With such people and organizations in mind, the question to be addressed here is as follows: if one believes that the death of a frozen embryo is a very bad thing, ought, morally speaking, one prevent the death of at least one frozen embryo via embryo adoption? (...) By way of a three‐premise argument, one of which is a moral principle first introduced by Peter Singer, my answer to this question is: at least some of those who believe this ought to. (Just who the “some” are is identified in the paper.) If this is correct, then, for said people, preventing the death of a frozen embryo via embryo adoption is not a morally neutral matter; it is, instead, a morally laden one. Specifically, their intentional refusal to prevent the death of a frozen embryo via embryo adoption is, at a minimum, morally criticizable and, arguably, morally forbidden. Either way, it is, to one extent or another, a moral failing. (shrink)

This essay defends the asymmetry between the badness of spontaneous and induced abortions in order to explain why anti-abortionists prioritize stopping induced abortions over preventing spontaneous abortions. Specifically, it argues (1) the distinction between killing and letting-die is of more limited use in explaining the asymmetry than has sometimes been presumed, and (2) that accounting for intentions in moral agency does not render performances morally inert. Instead, anti-abortionists adopt a pluralist, nonreductive account of moral analysis which is situated against a (...) backdrop that sees the limits of our ability to control the process of fertility as themselves valuable. Although this view is complex, the paper concludes by arguing that it has the advantage of explaining features of the anti-abortion outlook that have sometimes been overlooked. First, it accounts for why the pre-Roe regime of abortion restrictions primarily imposed penalties on doctors who induced abortions rather than the women who seek them. Second, it explains why the advent of ectogestation will not prompt anti-abortionists to compromise on ‘disconnect abortions,’ which putatively let the embryo die by extracting it from the mother’s womb. (shrink)

Rob Lovering has developed an interesting new critique of views that regard embryos as equally valuable as other human beings: the moral argument for frozen human embryo adoption. The argument is aimed at those who believe that the death of a frozen embryo is a very bad thing, and Lovering concludes that some who hold this view ought to prevent one of these deaths by adopting and gestating a frozen embryo. Contra Lovering, we show that there are far more effective (...) strategies for preserving the lives of frozen embryos than adoption. Moreover, we point out that those who regard the deaths of frozen embryos as a very bad thing will generally regard the deaths of all embryos as a very bad thing, whether they are discarded embryos, aborted embryos or embryos that spontaneously abort. This entails these other embryos must be taken into account when considering moral obligations, as well as other human lives at risk from preventable causes. (shrink)

In his article, The Substance View: a critique, Rob Lovering argues that the substance view – according to which the human embryo is a person entitled to human rights – leads to such implausible implications that this view should be abandoned. In this article I respond to his criticism by arguing that either his arguments fail because the proponents of the substance view are not obligated to hold positions which may be considered absurd, or because the positions which they are (...) assumed to be obligated to hold, are not absurd at all. (shrink)

It is a commonplace that liberalism and religious belief conflict. Liberalism, its proponents and critics maintain, requires the privatization of religious belief, since liberals often argue that citizens of faith must repress their fundamental commitments when participating in public life. Critics of liberalism complain that privatization is objectionable because it requires citizens of faith to violate their integrity. The liberal political tradition has always sought to carve out social space for individuals to live by their own lights. If liberalism requires (...) citizens to violate their integrity, liberals have cause for concern. I seek to rebut this integrity objection to liberalism. I focus on the dominant form of philosophical liberalism: public reason liberalism. I argue that the integrity objection undermines the mainstream conception of public reason liberalism, but not public reason liberalism itself. The paper opens by outlining the structure of public reason liberalism and the integrity objection (§§2 and 3). It then analyses two versions of the objection and argues that the second version is successful against the mainstream conception of public reason (§4). I argue in response that public reason liberalism need not endorse principles of restraint—the civic restrictions on religious expression typically associated with it. I then sketch a conception of public reason liberalism that eschews principles of restraint (§5). This alternative promises to reconcile public reason liberals and their faith-friendly critics by putting the integrity objection to rest. (shrink)

Brain death has been accepted worldwide medically and legally as the biological state of death of the organism. Nevertheless, the literature has described persistent problems with this acceptance ever since brain death was described. Many of these problems are not widely known or properly understood by much of the medical community. Here we aim to clarify these issues, based on the two intractable problems in the brain death debates. First, the metaphysical problem: there is no reason that withstands critical scrutiny (...) to believe that BD is the state of biological death of the human organism. Second, the epistemic problem: there is no way currently to diagnose the state of BD, the irreversible loss of all brain functions, using clinical tests and ancillary tests, given potential confounders to testing. We discuss these problems and their main objections and conclude that these problems are intractable in that there has been no acceptable solution offered other than bare assertions of an ‘operational definition’ of death. We present possible ways to move forward that accept both the metaphysical problem - that BD is not biological death of the human organism - and the epistemic problem - that as currently diagnosed, BD is a devastating neurological state where recovery of sentience is very unlikely, but not a confirmed state of irreversible loss of all [critical] brain functions. We argue that the best solution is to abandon the dead donor rule, thus allowing vital organ donation from patients currently diagnosed as BD, assuming appropriate changes are made to the consent process and to laws about killing. (shrink)

The annual cost of healthcare in the United States reached $2.5 trillion in 2009 (about 17.6% of GDP) with projections to 2019 of about $4.5 trillion (about 20% of likely GDP).

In his article ‘The substance view: A critique’, Rob Lovering argues that the substance view –according to which a human person comes into existence at the moment of conception – leads to such implausible implications that this view should be abandoned. I responded to his reductio arguments in ‘A critique of Rob Lovering's criticism of the substance view’ and concluded that his arguments did not justify a rejection of the substance view. Now Lowering and William Simkulet have both responded to (...) my criticism, claiming that my criticism of Lovering's article did not refute his original arguments. In this article I respond to their criticism and conclude that, while the substance view has some less plausible implications, none of them justify a complete refutation of this view. (shrink)

In the debate regarding the moral status of human embryos, the Embryo Rescue Case has been used to suggest that embryos are not rightholders. This case is premised on the idea that in a situation where one has a choice between saving some number of embryos or a child, it seems wrong to save the embryos and not the child. If so, it seems that embryos cannot be rightholders. In this paper, I argue that the Embryo Rescue Case does not (...) independently show that embryos are not rightholders. (shrink)