In a recent article in Health Care Analysis (Vol. 8, No. 1),Campbell misrepresents our specific arguments about commercialsurrogate motherhood (C.S.M.) and our general philosophical andpolitical views by saying or suggesting that we are `Millsian'liberals and consequentialists. He gives too the false impressionthat we do not oppose, in principle, slavery and child purchase.Here our position on C.S.M. is re-expressed and elaborated uponin order to eliminate possible confusion. Our general ethical andphilosophical framework is also outlined and shown to be otherthan Campbell says (...) that it is. In particular, a moral philosophythat it is based on neither consequentialism nor Kantianism ispresented. C.S.M., it is argued, is not child purchase. It is like it insome respects and unlike it in others. It is unlike it in therespects which, relative to the present discussion, matter. (shrink)

Various authors, for instance Elizabeth Anderson, Rosemary Tong, Mary Warnock and Margaret Brazier have argued that commercial surrogate motherhood is exploitative and that it should be prohibited. Their arguments are unconvincing. Exploitation is a more complex notion than it is usually presented as being. Unequal bargaining power can be a cause of exploitation but the exercise of unequal bargaining power is not inevitably or inherently exploitative. Exploitation concerns unfair and/or unjust strategies - rather than the exercise of power as such. (...) Commercial surrogate motherhood is not necessarily exploitative. Furthermore, not all transactions which are exploitative should be made illegal. (shrink)

This is a continuation of and a development of a debate between John Keown and me. The issue discussed is whether, in Britain, an unpaid system of blood donation promotes and is justified by its promotion of altruism. Doubt is cast on the notions that public policies can, and, if they can, that they should, be aimed at the promotion and expression of altruism rather than of self-interest, especially that of a mercenary sort. Reflections upon President Kennedy's proposition, introduced into (...) the debate by Keown, that we should ask not what our country can do for us but what we can do for our country is pivotal to this casting of doubt. A case is made for suggesting that advocacy along the lines which Keown presents of an exclusive reliance on a voluntary, unpaid system of blood donation encourages inappropriate attitudes towards the provision of health care. Perhaps, it is suggested, and the suggestion represents, on my part, a change of mind as a consequence of the debate, a dual system of blood provision might be preferable. (shrink)

In line with article 3.4 of EC directive 89/381, Keown has presented an ethical case in support of the policy of voluntary, unpaid donation of blood. Although no doubt is cast on the desirability of the policy, that part of Keown's argument which pertains to the suggested laudability of altruism and of its encouragment by social policy is examined and shown to be dubious.