Some opponents of abortion claim that fetuses are persons from the moment of conception. Following Berg (2017), let us call these individuals “Personhood-At-Conception” (or PAC), opponents of abortion. Berg argues that if fetuses are persons from the moment of conception, then miscarriage kills far more people than abortion. As such, PAC opponents of abortion face the following dilemma: They must “immediately” and “substantially” shift their attention, resources, etc., toward preventing miscarriage or they must admit that they do not actually believe (...) that fetuses are persons from the moment of conception (or, at least, they must recognize that they are not acting in ways that are consistent with this belief). In this essay, I show that Berg’s argument fails at each step. Specifically, after outlining her argument (in section 1), I consider the central claim of Berg’s style of argument: That “miscarriage…is much deadlier than abortion.” In section 2, I argue that this claim is false (when taken literally) and misleading otherwise. In section 3, I show that Berg’s style of argument is identical in structure to a criticism that is sometimes levied against the recent “Black Lives Matter” movement. In the latter context, the argument has been vehemently rejected. I argue that Berg’s style of argument should be rejected for the same reasons. Finally, in section 4, I show that Berg’s suggestion that opponents of abortion should divert “substantial” amounts of money and attention to miscarriage prevention faces two problems. First, these claims are made without any evidence regarding the actual priorities and spending habits of PAC opponents of abortion. If we are told “not enough is being done,” one wonders: What is being done and how much counts as “enough”? Berg gives no answer to either question. Second, even if it is true that opponents of abortion do not pay substantial attention to miscarriage prevention, Berg fails to notice that this may be for good reason. I conclude that PAC opponents of abortion do not face the dilemma that Berg presents. (shrink)

Is the mammalian embryo/fetus a part of the organism that gestates it? According to the containment view, the fetus is not a part of, but merely contained within or surrounded by, the gestating organism. According to the parthood view, the fetus is a part of the gestating organism. This paper proceeds in two stages. First, I argue that the containment view is the received view; that it is generally assumed without good reason; and that it needs substantial support if it (...) is to be taken seriously. Second, I argue that the parthood view derives considerable support from a range of biological and physiological considerations. I tentatively conclude in favour of the parthood view, and end by identifying some of the interesting questions it raises. (shrink)

The literature on health and diseases is usually presented as an opposition between naturalism and normativism. This article argues that such a picture is too simplistic: there is not one opposition between naturalism and normativism, but many. I distinguish four different domains where naturalist and normativist claims can be contrasted: (1) ordinary usage, (2) conceptually clean versions of “health” and “disease,” (3) the operationalization of dysfunction, and (4) the justification for that operationalization. In the process I present new arguments in (...) response to Schwartz (2007) and Hausman (2012) and expose a link between the arguments made by Schwartz (2007) and Kingma (2010). Distinguishing naturalist claims at these four domains will allow us to make progress by (1) providing more nuanced, intermediate positions about a possible role for values in health and disease; and (2) assisting in the addressing of relativistic worries about the value-ladenness of health and disease. (shrink)

Voluntary active euthanasia and physician assisted suicide should not be legalised because too much that is important about living and dying will be lostIn the first of this two part series, I unpack the historical philosophical distinction between killing and allowing a patient to die in order to clear up the confusion that exists. Historically speaking the two kinds of actions are morally distinct because of older notions of causality and human agency. We no longer understand that distinction primarily because (...) we have shifted our notions of causality from a traditional formulation to a modern formulation of causality and thus of moral assessment that focuses on the effects of an action. In this essay, I prepare the ground for a companion essay by showing that the traditional formulation allows us to maintain notions of meaning and purpose to human living and dying that are precluded in the efficiency paradigm of modernity. Taken together with the companion essay, I am claiming that voluntary active euthanasia and physician assisted suicide should not be legalised because too much that is important about dying and living will be lost.TWO LIESIt would be naïve to think that euthanasia, in either the VAE sense, or in the more passive sense of PAS, does not happen. It would even be naïve to think that it does not occur in a non-voluntary form. It would be equally naïve, however, to think it could be controlled through governmental regulation. The real question with regard to PAS/VAE, put so eloquently by Martha Minow, is which lie do you countenance: the lie that euthanasia does not already happen, or the lie that it can be controlled without having repercussions well beyond the limits of procedural mastery?1 With this two part paper series, I will argue that the …. (shrink)

When does a human being begin to exist? We argue that it is possible, through a combination of biological fact and philosophical analysis, to provide a definitive answer to this question. We lay down a set of conditions for being a human being, and we determine when, in the course of normal fetal development, these conditions are first satisfied. Issues dealt with along the way include: modes of substance-formation, twinning, the nature of the intra-uterine environment, and the nature of the (...) relation between fetus and mother (connection, parthood, dependence). (shrink)

Bioethicists involved in end‐of‐life debates routinely distinguish between ‘killing’ and ‘letting die’. Meanwhile, previous work in cognitive science has revealed that when people characterize behaviour as either actively ‘doing’ or passively ‘allowing’, they do so not purely on descriptive grounds, but also as a function of the behaviour’s perceived morality. In the present report, we extend this line of research by examining how medical students and professionals (N = 184) and laypeople (N = 122) describe physicians’ behaviour in end‐of‐life scenarios. (...) We show that the distinction between ‘ending’ a patient’s life and ‘allowing’ it to end arises from morally motivated causal selection. That is, when a patient wishes to die, her illness is treated as the cause of death and the doctor is seen as merely allowing her life to end. In contrast, when a patient does not wish to die, the doctor’s behaviour is treated as the cause of death and, consequently, the doctor is described as ending the patient’s life. This effect emerged regardless of whether the doctor’s behaviour was omissive (as in withholding treatment) or commissive (as in applying a lethal injection). In other words, patient consent shapes causal selection in end‐of‐life situations, and in turn determines whether physicians are seen as ‘killing’ patients, or merely as ‘enabling’ their death. (shrink)

Conventional medical ethics and the law draw a bright line distinguishing the permitted practice of withdrawing life-sustaining treatment from the forbidden practice of active euthanasia by means of a lethal injection. When clinicians justifiably withdraw life-sustaining treatment, they allow patients to die but do not cause, intend, or have moral responsibility for, the patient's death. In contrast, physicians unjustifiably kill patients whenever they intentionally administer a lethal dose of medication. We argue that the differential moral assessment of these two practices (...) is based on a series of moral fictions – motivated false beliefs that erroneously characterize withdrawing life-sustaining treatment in order to bring accepted end-of-life practices in line with the prevailing moral norm that doctors must never kill patients. When these moral fictions are exposed, it becomes apparent that conventional medical ethics relating to end-of-life decisions is radically mistaken. (shrink)

The physical and/or intrinsic connection approach to causation has become prominent in the recent literature, with Salmon, Dowe, Menzies, and Armstrong among its leading proponents. I show that there is a type of causation, causation by disconnection, with no physical or intrinsic connection between cause and effect. Only Hume-style conditions approaches and hybrid conditions-connections approaches appear to be able to handle causation by disconnection. Some Hume-style, extrinsic, absence-relating, necessary and/or sufficient condition component of the causal relation proves to be needed.

When did we begin to exist? Barry Smith and Berit Brogaard argue that a new human organism comes into existence neither earlier nor later than the moment of gastrulation: 16 days after conception. Several critics have responded that the onset of the organism must happen earlier; closer to conception. This article makes a radically different claim: if we accept Smith and Brogaard’s ontological commitments, then human organisms start, on average, roughly nine months after conception. The main point of contention is (...) whether the fetus is or is not part of the maternal organism. Smith and Brogaard argue that it is not; I demonstrate that it is. This claim in combination with Smith and Brogaard’s own criteria commits to the view that human organisms begin, precisely, at birth. (shrink)

In a recent article, William Simkulet has argued against the anti-abortion view by invoking the fact that many human fetuses die from spontaneous abortion. He argues that this fact poses a dilemma for proponents of the anti-abortion view: either they must abandon their anti-abortion view or they must engage in preventing spontaneous abortion significantly more than at present—either to the extent that they try to prevent induced abortion or at least significantly more than they do today. In this reply, I (...) acknowledge that, if the latter would follow, the anti-abortionist view would imply implausibly strong obligations. My aim with this reply is to demonstrate that anti-abortionists can hold on to their view without having implausibly strong obligations to prevent spontaneous abortion. My conclusion is that Simkulet clearly overstates his position by not sufficiently considering the differences between the act of killing versus death by natural causes and between positive and negative rights. (shrink)

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The paper by Magill and Neaves in this issue of the Journal attempts to rebut the "natural potency" position, based on recent advances in direct reprogramming of somatic cells to yield "induced pluripotent stem" (iPS) cells. As stated by the authors, the natural potency position holds that because "a human embryo directs its own integral organismic function from its beginning . . . there is a whole, albeit immature, and distinct human organism that is intrinsically valuable with the status of (...) inviolability and deserving full moral respect" (p. 26). The authors boldly assert that "The recent production of iPS . . . highlights a prima facie absurdity for the natural potentiality argument" (p. 29). Yet the argument against natural potency is both logically flawed and based on a characterization of the scientific evidence that is factually inaccurate. (shrink)