Greg Bognar has recently offered a prioritarian justification for ‘fair innings’ distributive principles that would ration access to healthcare on the basis of patients' age. In this article, I agree that Bognar's principle is among the strongest arguments for age-based rationing. However, I argue that this position is incomplete because of the possibility of ‘time-relative' egalitarian principles that could complement the kind of lifetime egalitarianism that Bognar adopts. After outlining Bognar's position, and explaining the attraction of time-relative egalitarianism, I suggest (...) various ways in which these two kinds of principle could interact. Since various options have very different implications for age-based rationing, proponents of such a rationing scheme must take a position on time-relative egalitarianism to complement a lifetime prioritarian view like Bognar's. (shrink)

Reproductive freedom plays a pivotal role in debates on the ethics of procreation. This moral principle protects people’s interests in procreative matters and allows them discretion over whether to have children, the number of children they have and, to a certain extent, the type of children they have. Reproductive freedom’s theoretical and political emphasis on people’s autonomy and well-being is grounded in an individual-centred framework for discussing the ethics of procreation. It protects procreators’ interests and significantly reduces the permissible grounds (...) for interference by third parties. In this article I show that procreative decisions have far-reaching effects on the composition and size of the population. The upshot of considering these effects allows for the appreciation of the inadequacy of a framework that solely considers individual (i.e. procreators’) interests to discuss the ethics of procreation. To address such inadequacy, I assess costs and benefits of past and present proposals to reflect on procreation in such a way as to consider its far-reaching effects. I conclude by arguing that reproductive freedom should be defended as an imperfect but instrumentally necessary tool. This framing would enable those participating in debates on the ethics of procreative decisions to work towards an ethical framework that accounts for the cumulative effects of these decisions. (shrink)

In Rationality and the Genetic Challenge: Making People Better? Matti Häyry provides a clear and informed discussion and analysis of a number of competing answers to the above questions. Häyry describes three main perspectives on the morality of prenatal genetic diagnosis , the “restrictive,” “moderate,” and “permissive” views, and his analysis illuminates that these views can be distinguished in terms of their different “rationalities”—their respective understanding of what counts as a reasonable choice for parents to make in light of PGD.

Non-medical sex selection is premised on the notion that the sexes are not interchangeable. Studies of individuals who undergo sex selection for non-medical reasons, or who have a preference for a son or daughter, show that they assume their child will conform to the stereotypical roles and norms associated with their sex. However, the evidence currently available has not succeeded in showing that the gender traits and inclinations sought are caused by a “male brain” or a “female brain”. Therefore, as (...) far as we know, there is no biological reason why parents cannot have the kind of parenting experience they seek with a child of any sex. Yet gender essentialism, a set of unfounded assumptions about the sexes which pervade society and underpin sexism, prevents parents from realising this freedom. In other words, unfounded assumptions about gender constrain not only a child’s autonomy, but also the parent’s. To date, reproductive autonomy in relation to sex selection has predominantly been regarded merely as the freedom to choose the sex of one’s child. This paper points to at least two interpretations of reproductive autonomy and argues that sex selection, by being premised on gender essentialism and/or the social pressure on parents to ensure their children conform to gender norms, undermines reproductive autonomy on both accounts. (shrink)

As I write this, in November 1971, people are dying in East Bengal from lack of food, shelter, and medical caxc. The suffering and death that are occurring there now axe not inevitable, 1101; unavoidable in any fatalistic sense of the term. Constant poverty, a cyclone, and a civil war have turned at least nine million people into destitute refugees; nevertheless, it is not beyond Lhe capacity of the richer nations to give enough assistance to reduce any further suffering to (...) very small proportions. The decisions arid actions of human beings can prevent this kind of suffering. Unfortunately, human beings have not made the necessary decisions. At the individual level, people have, with very few exceptions, not responded to the situation in any signihczmt way. Generally speaking, people have not given large sums to relief funds; they have not written t0 their parliamentaxy representatives demanding increased government assistance; they have not demonstrated in the streets, held symbolic fasts, or done anything else directed toward providing thc refugees with the means to satisfy their essential needs. At thc government level, no govcrmmcnt has given the sort of massive aid that would enable the refugees to survive fm: more than a few days. Britain, for instance, has given rather more than most countries. It has, to date, given £14,750,000. For comparative purposes, B1~itain’s share of thc nonreccverabla development costs of the Anglo-French Concorde project is already in excess of £275,000,000, and on present estimates will reach £440,000,¤00. The implication is that the British government values a supersonic transport more than thirty times as.. (shrink)

This chapter argues that there is a collective responsibility to have enough children in order to ensure that people will not, in the future, suffer great harm due to depopulation. Moreover, if people stopped having children voluntarily, it could be legitimate for states to incentivize and maybe even coerce individuals to bear and rear children. Various arguments against the enforceability of an individual duty to bear and rear children are examined. Coercing people to have children would come at significant moral (...) cost; however, none of the arguments against enforceability seem decisive. The existence of a collective responsibility to have children bears on the question of whether parents and non-parents ought to shoulder the costs of childbearing and child rearing together. (shrink)

What is the role of affective experience in explaining how our desires provide us with reasons for action? When we desire that p, we are thereby disposed to feel attracted to the prospect that p, or to feel averse to the prospect that not-p. In this paper, we argue that affective experiences – including feelings of attraction and aversion – provide us with reasons for action in virtue of their phenomenal character. Moreover, we argue that desires provide us with reasons (...) for action only insofar as they are dispositions to have affective experiences. On this account, affective experience has a central role to play in explaining how desires provide reasons for action. (shrink)

To desire is to be in a particular state of mind. It is a state of mind familiar to everyone who has ever wanted to drink water or desired to know what has happened to an old friend, but its familiarity does not make it easy to give a theory of desire. Controversy immediately breaks out when asking whether wanting water and desiring knowledge are, at bottom, the same state of mind as others that seem somewhat similar: wishing never to (...) have been born, preferring mangoes to peaches, craving gin, having world conquest as one's goal, having a purpose in sneaking out to the shed, or being inclined to provoke just for the sake of provocation. These varied states of mind have all been grouped together under the heading of ‘pro attitudes’, but whether the pro attitudes are fundamentally one mental state or many is disputed. (shrink)

ABSTRACT I argue, counter‐intuitively, that under certain conditions many people are under some moral requirement to attempt to bring children into being . There is only rarely a strict obligation to have children, but more moderate, inclining moral considerations in favour of having children, have a place in our moral world. I begin by considering a large number of arguments in favour and against the possibility of an obligation to have children. Then I examine when the weight of one set (...) of arguments is greater. And I conclude by pointing out some general lessons from the discussion. (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)

_ 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)

It is widely assumed that people have a moral right to procreate. This article explores recent arguments in opposition to procreation in some or all contexts. Some such views are concerned with the risks and harms of life that procreation imposes on non-consenting children. Others articulate concerns for third parties – the environmental damage or opportunity costs that procreation poses to already existing people. The article then surveys arguments that favor procreation despite the risks to the children created and third (...) parties. The best argument for procreation is based on the significant interest people have in forming the parent–child relationship. An important under-discussed middle ground is suggested – one that avoids the criticisms of the anti-natalist while fulfilling the best aims of procreation – viz. adoption. The duty to adopt is summarized and objections to it considered. Thoughtful people who deeply desire to become parents but do not wish to participate in the range of potential procreative harms should consider adoption as a first choice. (shrink)

Most discussions of racial fetish center on the question of whether it is caused by negative racial stereotypes. In this paper I adopt a different strategy, one that begins with the experiences of those targeted by racial fetish rather than those who possess it; that is, I shift focus away from the origins of racial fetishes to their effects as a social phenomenon in a racially stratified world. I examine the case of preferences for Asian women, also known as ‘yellow (...) fever’, to argue against the claim that racial fetishes are unobjectionable if they are merely based on personal or aesthetic preference rather than racial stereotypes. I contend that even if this were so, yellow fever would still be morally objectionable because of the disproportionate psychological burdens it places on Asian and Asian-American women, along with the role it plays in a pernicious system of racial social meanings. (shrink)

Neonatal intensive care units represent simultaneously one of the great success stories of modern medicine, and one of its most controversial developments. One particularly controversial issue is the resuscitation of extremely preterm infants. Physicians in the United States generally accept that they are required to resuscitate infants born as early as 25 weeks and that it is permissible to resuscitate as early as 22 weeks. In this article, I question the moral pressure to resuscitate by criticizing the idea that resuscitation (...) in this context “saves” a human life. Our radical medical advancements have allowed us to intervene in the life of a human before it makes sense to say that such an intervention “saves” someone; rather, what the physician does in resuscitating and treating an extremely preterm infant is to take over creating it. This matters, I argue, because “rescues” are much more morally urgent than “creations.”. (shrink)

The goal of this article is to evaluate the defensibility of wide-spread beliefs concerning the moral value of procreating. Very many of us are ‘pro-natal’ — that is, we have a positive moral view of making more people — but pro-natalism is under serious threat. In particular, I argue that combining several arguments in procreative ethics generates a powerful case for the Anti-Natal Pro-Adoption View, or the view that we are obligated not to procreate, but instead to satisfy any parenting (...) desires through adoption. Although this article ultimately serves as a defence against ANPA, it does so in a very limited way: while it is false that we are obligated to adopt-rather-than-procreate, I contend, this does not mean that we are off the moral hook altogether. Failing in our obligations is only one way to fail morality. Our procreative acts may yet be bad, dishonourable, selfish, and open to multiple other criticisms. And indeed, I'm afraid many of them are. (shrink)

The duty to rescue is a highly plausible and powerful ethical principle. It requires agents to assist others in extreme need in cases where doing so does not conflict with some weighty moral aim; requires little personal sacrifice; and is likely to significantly benefit the recipients.1 As a general obligation, it binds all persons simply qua persons, and it is owed to all persons simply qua persons. Clinical investigators working in low-income countries frequently encounter sick or destitute people to whom (...) they might possess a duty to rescue. Investigators may often ask themselves, what can I do, what should I do, to help? Such investigators often help people in the future by carrying out their... (shrink)

Can there be a duty to love someone? The kind of love we will consider is the kind of highly intense interaction that two human beings seek that involves not only strongly valuing another person for the person’s sake and wanting to promote the person’s well-being for the person’s sake, but also desiring to be physically and psychologically close to each other and desiring that the other person reciprocates our love. This kind of interaction features in romantic love, parental love, (...) love between friends, and the love of children for their parents. (shrink)

Promising is clearly a social practice or convention. By uttering the formula, “I hereby promise to do X,” we can raise in others the expectation that we will in fact do X. But this succeeds only because there is a social practice that consists (inter alia) in a disposition on the part of promisers to do what they promise, and an expectation on the part of promisees that promisers will so behave. It is equally clear that, barring special circumstances of (...) some kind, it is morally wrong for promisers to fail to do what they have promised to do. What is perhaps less clear is how the moral wrongness that is involved when promises are broken is related to the social practice that makes promising possible in the first place. (shrink)

In this piece, I argue that promises need not be kept just because they were made. This is not to say, however, that unwise, unhappy, and unfortunate promises do not generate obligations. When broken promises will result either in wrongful gains to promisors or wrongful losses to promisees, obligations of corrective justice will demand that such promises be kept if their breach cannot be fully repaired. Thus, when a broken promise will constitute a deliberate loss transfer for personal gain, the (...) duty not to exact unjust enrichment will require a promisor either to honor her promise or craft a means of ensuring that the promisee’s impoverishment is not traded for her enrichment. And when a broken promise will constitute the culpable imposition of a reliance-based injury on a nonculpable promisee, the duty to make others whole when one has purposefully, knowingly, or recklessly injured them will require one either to keep one’s promise or to fashion a remedy for its breach that ensures that the promisee is left no worse off than he would be had the promise not been made. This account explicitly parts ways with normative powers theories of promising. It places no weight at all on the raw fact that a promise has been made. Instead, it locates the gravamen of a promissory violation in the harm that is caused to a promisee who nonculpably relies upon and changes her position in anticipation of the prediction about the promisor’s future conduct that is embedded in his promise. Absent any adverse reliance on the part of a promisee, there is nothing that gives rise to an obligation of performance or repair on the part of the promisor. But this account is also to be distinguished from utilitarian theories that take promises to be instruments of wealth maximization that properly give way whenever the reason for honoring them speaks in favor of violating them. On my account, the balance of reasons for action that determines the morality of performance includes deontological rights and duties, agent-relative permissions, and Hohfeldian liberties. As I shall argue, even if one rightly concludes that one has no duty either to keep a promise or to craft a remedy for its breach, one must nevertheless remember that virtue requires one to be or become the kind of person who often goes beyond the call of duty. But the fact that virtue often requires us to do what we have no duty to do should not cause us to confuse its conditions with the conditions of right and wrong action. We have a duty to keep promises or to otherwise protect the reliance interests that they generate only when failing to do so will lead either to our own unjust enrichment or to others’ unjust injury. And this means that we have a duty to keep promises in far fewer circumstances than is commonly believed. (shrink)

ABSTRACT Recent developments in generating gametes via in vitro gametogenesis (IVG) from induced pluripotent stem cells (iPSCs) and their successful use for reproductive purposes in animals strongly suggest that soon these methods could also be used in human reproduction. At least two questions emerge in this context: (a) if a legislator should permit their use and (b) if ethical claims emerge that support their provision, e.g., by public health care systems. This urges an ethical reflection of the new reproductive options (...) this technique might offer. Since the concept of reproductive freedom is a key aspect for the ethical evaluation of artificial reproductive technologies (ARTs), it is necessary to analyze if the new possibilities emerging from IVG fall within the scope of this concept. The results may constitute a morally relevant difference between different imaginable applications of IVG and potentially justify differences in claims to access this technology. (shrink)

Effective altruism is a philosophy and a social movement that aims to revolutionise the way we do philanthropy. It encourages individuals to do as much good as possible, typically by contributing money to the best-performing aid and development organisations. Surprisingly, this approach has met with considerable resistance among activists and aid providers who argue that effective altruism is insensitive to justice insofar as it overlooks the value of equality, urgency and rights. They also hold that the movement suffers from methodological (...) bias, reaching mistaken conclusions about how best to act for that reason. Finally, concerns have been raised about the ability of effective altruism to achieve systemic change. This article weighs the force of each objection in turn, and looks at responses to the challenge they pose. (shrink)

Much philosophical attention has been paid to the question of whether, and why, one may divert a runaway trolley away from where it will kill five people to where it will kill one. But little attention has been paid to whether the reasons that ground a permission to divert thereby ground a duty to divert. This paper defends the Requirement Thesis, which holds that one is, ordinarily, required to act on lesser-evil justifications for harming for the sake of others. Cases (...) in which we have lesser-evil justifications of harming for the sake of others are rescue cases. Ordinarily, an agent is under a duty to rescue unless doing so imposes too great a cost on her, or violates someone else's rights. When neither of these defeating conditions obtain, one is required to rescue even if this involves causing harm to innocent people. (shrink)

All over the world millions of children are without parental care. As a consequence they are liable to suffer serious harm. I argue the general duty to assist those in need extends to children without parental care and that some people are under a moral duty to adopt rather than have biological children. I defend this claim against the following objections: (1) intimate decisions are excluded from the duty to assist, (2) adopting children is too costly to be required by (...) morality, (3) the duty to assist is a collective duty, (4) the duty to assist is an imperfect duty, and (5) there are, in fact, very few adoptable children. (shrink)

In this paper, I argue for a conditional parity thesis: if we are agents with respect to our intentions, we are agents with respect to our beliefs. In the final section, I motivate a categorical version of the parity thesis: we are agents with respect to belief and intention. My aim in this paper is to show that there is no unique challenge facing epistemic agency that is not also facing agency with respect to intention. My thesis is ambitious on (...) two fronts. First, the parity thesis is a substantive thesis about the nature of belief and intention. I argue that there is a structural parity of belief and intention; the status of whether they are agential stands and falls together. Second, the parity thesis illuminates the nature of agency. It constrains what counts as a satisfactory account of agency: either we must accept agency of both belief and intention, or we must reject both. In the final section, I argue that we have prima facie reason to accept agency of belief and intention. Finally, I diagnose why there has been such resistance to epistemic agency. Epistemic agency is problematic, but its problems are problems with agency, not problems with epistemic agency. (shrink)

In this paper, I will discuss the various ways in which intentions can be said to be conditional, with particular attention to the internal conditions on the intentions’ content. I will first consider what it takes to carry out a conditional intention. I will then discuss how the distinctive norms of intention apply to conditional intentions and whether conditional intentions are a weaker sort of commitments than the unconditional ones. This discussion will lead to the idea of what I call (...) the ‘deep structure’ of intentions. Roughly, this is the idea that the conditional nature of our intentions is only partially made explicit in the expressions we use to communicate our intentions and in the explicit form of our thinking about and reasoning with them. Most conditions that qualify our intentions are part of a deep functional structure that can be evinced by observing the actual psychological functioning of intentions and by considering the rational requirements that they engage. I will argue that the deep structure of intentions is characteristically conditional. Genuinely unconditional intentions are only limiting instances of conditional intentions and their contribution to agency can only be understood in light of this fact. I will conclude by showing that the characteristic conditional structure of intentions is intimately related to distinctive features of human agency, especially to its unity over time. (shrink)

Clinicians and researchers can often rescue patients or research participants from serious harms. Indeed, they often have a duty to do so—a duty to rescue. Duties to rescue are frequently discussed in the medical ethics literature, but according to Tina Rulli and Joseph Millum they are under-theorised and more problematic than is normally acknowledged. Rulli and Millum outline two widely discussed conceptions of rescue duties: a so-called duty of easy rescue, applying to all moral agents (including healthcare professionals), and the (...) rule of rescue, applying specifically to institutions. They raise concerns about both. (shrink)

Most people would agree that adoption is a good thing for children in need of a family. Yet adoption is often considered a second best or even last resort for parents in making their families. Against this assumption, I explore the unique value of adoption for prospective parents. I begin with a criticism of the selective focus on the value of adoption for only those people using assisted reproductive technologies. I focus on the value of adoption for all prospective parents, (...) reflecting on non-relative, non-procreative adoptions. First, adoption can meet the important need that a child has for a family, whereas procreation creates rather than meets needs. Second, adoption provides a morally noble opportunity to extend to a stranger benefits usually withheld for one's genetic kin. As such, adoption offers a unique possibility in which impartial concern for an other can be the starting point for a lifetime of love and care. Finally, adoptions can have transformative power over adoptive parents’ conception of family and self. In highlighting the unique value of adoption, I aim to challenge the widespread assumption that adoption has second best status to procreation. Indeed adoption can exemplify the human potential for moral compassion and impartial concern for the needs of others. (shrink)

My aim is to extend and complement the arguments that others have already made for the claim that women who are citizens of economically disadvantaged states and who have been trafficked into sex work in economically advantaged states should be considered candidates for asylum. Familiar arguments cite the sexual violence and forced labor that trafficked women are subjected to along with their well-founded fear of persecution if they’re repatriated. What hasn’t been considered is that reproductive rights are also at stake. (...) I explain how reproductive rights are implicated in sex trafficking. Moreover, I contend that sex traffickers’ abuse of women’s reproductive rights is persecutory and that that this persecutory abuse obliges destination states to offer asylum to transnational sex trafficking victims. I start by sketching reproductive human rights doctrine. I then examine studies of women who are in post-trafficking recovery programs in order to ascertain the impact of their past experience of forced sex work on their reproductive freedom and health. On the basis of these findings, I maintain that, among other outrages, sex trafficking systematically violates victims’ reproductive human rights. In view of this abuse, women trafficked into sex work might seem to be prime candidates for asylum in destination states. Yet, economically well-off destination states are not particularly receptive to this idea, and international law provides some justification for their chilliness. Preliminary to challenging them, I explicate four ways in which international anti-trafficking law and international refugee law interfere with viewing women trafficked into sex work as refugees and approving their applications for asylum. The second half of my paper aims to overcome those legal obstacles. In the interest of parsimony and because there are many continuities between U.S. refugee law and anti-trafficking law and the policies of similar destination states, I focus mainly on the U.S. in this part of the paper. To anchor my argument, I spotlight two precedents in refugee law for taking reproductive human rights seriously and several precedents for treating trafficked women as members of a distinct social group as required by refugee law. I then urge that a law enforcement gestalt has gained undue influence over U.S. legal practices where anti-trafficking law intersects with refugee protection law. A human rights gestalt is needed as a counterweight, for otherwise victims of sex trafficking and the reproductive abuse they’ve suffered are erased. Taking up a human rights perspective and mobilizing the precedents I’ve identified, I show that respecting the reproductive human rights of women who have been trafficked into sex work entails that affluent destination states must recognize their right to asylum. (shrink)