This book attempts to place a realist view of ethics (the claim that there are facts of the matter in ethics as elsewhere) within a broader context. It starts with a discussion of why we should mind about the difference between right and wrong, asks what account we should give of our ability to learn from our moral experience, and looks in some detail at the different sorts of ways in which moral reasons can combine to show us what we (...) should do in the circumstances. The second half of the book uses these results to mount an attack on consequentialism in ethics, arguing that there are more sorts of reasons around than consequentialists can even dream of. (shrink)

It was only a matter of time before the portmanteau term “genethics” would be coined and a whole field within bioethics delineated. The term can be dated back at least to 1984 and the work of James Nagle, who claims credit for inventing the word, which he takes “to incorporate the various ethical implications and dilemmas generated by genetic engineering with the technologies and applications that directly or indirectly affect the human species.” In Nagle’s phrase, “Genethic issues are instances where (...) medical genetics and biotechnology generate ethical problems that warrant societal deliberation.” The great promises and terrific threats of developments in scientific understanding of genetics, and the power to enhance, modify, or profit from the knowledge science breeds, naturally offer a huge range of issues to vex moral philosophers and social theorists. Issues as diverse as embryo selection and the quest for immortality continue to tax analysts, who offer reasons as varied as the matters that might be dubbed “genethical” for or against the morality of things that are actually possible, logically possible, and even just tenuously probable science fiction. (shrink)

Reviews of philosophical books run the risk of being either excessively and unconstructively critical or superficially praiseworthy. To avoid both these risks, we test the approach outlined by Häyry in his book Rationality and the Genetic Challenge: Making People Better? by applying it to an eighth genetic challenge, namely, a variation of the genetic enhancement challenge discussed by Häyry as it applies to sports. We assess whether genetic enhancement in sports should be conceived as an eighth wonder or an eighth (...) cardinal sin that stems from the interaction between genetics and society, question whether Häyry’s nonconfrontational approach is really useful for dealing with these issues, and discuss how his method can be improved. (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.

Should we make people healthier, smarter, and longer-lived if genetic and medical advances enable us to do so? Matti Häyry asks this question in the context of genetic testing and selection, cloning and stem cell research, gene therapies and enhancements. The ethical questions explored include parental responsibility, the use of people as means, the role of hope and fear in risk assessment, and the dignity and meaning of life. Taking as a starting point the arguments presented by Jonathan Glover, John (...) Harris, Ronald M. Green, Jürgen Habermas, Michael J. Sandel, and Leon R. Kass, who defend a particular normative view as the only rational or moral answer, Matti Häyry argues that many coherent rationalities and moralities exist in the field, and that to claim otherwise is mistaken"--Provided by publisher. (shrink)

The twenty-one chapters in this volume strive, through the use of high quality argument and analysis, to get a good deal clearer concerning a range of issues ...

The doctrine (or principle) of double effect is often invoked to explain the permissibility of an action that causes a serious harm, such as the death of a human being, as a side effect of promoting some good end. According to the principle of double effect, sometimes it is permissible to cause a harm as a side effect (or “double effect”) of bringing about a good result even though it would not be permissible to cause such a harm as a (...) means to bringing about the same good end. Does the principle of double effect play the important explanatory role that has been claimed for it? To consider this question, one must be careful to clarify just what the principle is supposed to explain. Three misinterpretations of the principle’s force or range of application are common. 1. To ensure that Double Effect is not misunderstood as principle issuing a blanket permission on causing any unintended harm that yields a benefit, applications must require that the agent seek to minimize the harm involved. 2. Since it is widely accepted that it is wrong to aim to produce harm to someone as an end, to rule this out is not part of double effect’s distinctive content. 3. Harms that were produced regretfully and only for the sake of producing a good end may be prohibited by double effect because they were brought about as part of the agent’s means to realizing the good end. (shrink)

From my flat on the eighth floor, I enjoy the panoramic view of the bay and beaches of Montevideo. Except for days of rain and stormy weather—which happen often in these months of winter—the beach is frequented by dogs and their masters and mistresses. I have a passion for dogs, and every morning and afternoon I take short breaks to watch from my window the playfulness of my four-feeted soulmates. They differ in race, color, and size, but from a bird’s-eye (...) view, these differences are negligible, as are the differences in their behavior: they all stop to sniff and deposit their “biological fingerprints” at exactly the same places, they leap and jump around, they move back and forward in different directions, always close to water—a few of them even risk brief visits into the water—and always ahead of their guardians, though not too far away from them. Only occasionally do I observe barking confrontations. Often, however, I see them joined in ceremonial acts aimed at repeatedly outshining each other with regard to “depositional” pace and outreach. (shrink)

Given previously successful interventions that already have shaken up the convention, it is puzzling that the feminist critique of bioethics should be slow to embrace the exciting new developments that have emerged in philosophy and critical cultural studies over the last fifteen years or so. Both in the arenas of poststructuralism and postmodernism and in the powerful revival of phenomenological thought, in which the stress on embodiment is highly appropriate to bioethics, there is much that might augment the adequacy of (...) our approach. Many of these resources have been developed productively by feminist thinkers to reflect not simply the differential lived experience of women, but also to mobilize a specifically feminist slant to theory itself. The encouragement to read Derrida, Lacan, Merleau-Ponty, or Deleuze results not in a turn back to the masculinist masters, but to a fuller appreciation of just how distinctive a feminist reworking can be. The most exciting feminist theorists are less concerned with an “authentic” representation of an existing oeuvre than in showing how it can be extended, distorted if necessary, and applied to areas far beyond its originally intended scope. In turning to the problem of heart transplantation, I hope to demonstrate such a move at work in a specific material context. (shrink)

We have a reason to use information which is available about such genes in our reproductive decision-making; (3) couples should selec.

Rationality and the Genetic Challenge by Matti Häyry is a well-written and thoughtful book about important issues in the contemporary ethical discussion of genetics. The book is well structured around seven practical themes that the author takes to exemplify “the genetic challenge.” He also refers to them as “seven ways of making people better,” which the subtitle of the book already puts into question form: Making People Better? In the first chapter of the book, Häyry introduces these seven themes and (...) he discusses each of them in Chapters 3–9. In the remaining two chapters, 2 and 10, he describes the main normative positions analyzed in the book and clarifies his own methodology and position. He chooses six authors, or three pairs of authors, whom he takes to “represent the three normative doctrines of Western Moral philosophy” in order to demonstrate six “divergent rationalities” or “methods of genethics.” In this way, Häyry both summarizes the main prescriptive positions in contemporary bioethical debate and contrasts them with his own “nonconfrontational notion of rationality,” which aims to show that there is a variety of divergent, not mutually exclusive normative views, the justification of which “depends ultimately on the choice of worldviews, attitudes, and ideas about the foundation of moral worth”. (shrink)

Bioethics as a distinctive field is undergoing a critical turn. It may be a quiet revolution, but a growing body of scholarship illustrates a perceived need for a rethink of the scope of the field and the approaches and priorities that have carried bioethicists through many heady years of success. Few areas of bioethical practice have been left unexamined, ranging from questions as to the sustainability of the discipline in its current form to the “expertise” of its practitioners; the legitimacy (...) of bioethics in the realms of policymaking; its relationship to philosophy; the purchase of empirical and interdisciplinary method; the relationship of bioethics to the real world; bioethical understandings of the concept of “health” ; its agenda, priorities, and inclusiveness right up to what might be the overarching question: “What is bioethics all about?” Unsurprisingly, these questions elicit varied responses. Scholars from various disciplines have critiqued fundamental tenets of the “ethics” business, albeit as claims of its “conservatism,” “corruption,” and its questionable “usefulness” suggest, not always with a charitable or constructive eye. But quite crucially and often overlooked, bioethics itself has not shied away from the question as to what bioethics is and what it should become; increasingly apparent is that this kind of self-conscious and reflexive theorizing is regarded as a key priority for taking contemporary ethics forward. (shrink)

Julian Savulescu has given clear expression to a principle—that of “procreative beneficence”—which underlies the thought of many contemporary writers on bioethics. The principle of procreative beneficence holds that parents or single reproducers are at least prima facie obliged to select the child, out of a range of possible children they might have, who will be likely to lead the best life. My aim in this paper is to argue that prospective parents, just by dint of their being prospective parents, are (...) in fact not obliged to act on PPB. That is, there is something about their filling the role of prospective parents that exempts them from selecting the child with the best life. I urge that it is more realistic to view prospective parents as bound by a principle of acceptable outlook, which holds that they ought not to select children whose lives will contain an unacceptable amount of suffering. (shrink)

If it is irrational to allow the worst outcome of our actions, and if it is immoral to cause suffering, then it is irrational and immoral to have children.I recently published in this journal a paper, entitled A rational cure for prereproductive stress syndrome, and was happy to see that three colleagues—Rebecca Bennett, Søren Holm, and Sahin Aksoy—had taken the time to critically examine it. This gave me an opportunity to briefly revisit the topic, and to clarify some of the (...) arguments I put forward.THE IRRATIONALITY OF HAVING CHILDRENIn my paper, A rational cure for prereproductive stress syndrome,1 I claimed that it is irrational to have children, if it is irrational to deliberately allow the worst outcome of our actions in a given situation, and if to have children allows this.I argued that having children allows the worst outcome of our reproductive choices , if it makes good sense to restrict the analysis to the comparative value of life versus non-existence of possible future individuals, as experienced by themselves, and if there are individuals who genuinely would prefer non-existence to their own life.My practical conclusion in the paper was modest: “Possible parents could be told that, according to at least one philosopher, it would be all right for them not to reproduce at all.”1 This was my suggested “rational cure for prereproductive stress syndrome”.“NOT STRONGLY IRRATIONAL”Holm argues against that it is not irrational to deliberately allow a low probability of the worst outcome.2 He starts from the premise that to make my argument work I would need to regard the maximin rule—the rule specified in claim —as the only criterion of rationality. If I do so, however, I …. (shrink)

Since human reproduction is arguably both irrational and immoral, those who seek help before conceiving could be advised it is all right not to have children.

Relativism is usually a derogatory word in philosophical bioethics in the West. If people make the mistake of trying to understand radically “different” points of view, an accusation of relativism is quickly forthcoming. But why should this be an accusation? My aim in this paper is to demonstrate that it should not.

Is there such a thing as a social conception of disability? Recently two writers in this journal have suggested not only that there is a coherent social conception of disability but that all non-social conceptions, or “medical models” of disability are fatally flawed. One serious and worrying dimension of their claims is that once the social dimensions of disability have been resolved no seriously “disabling” features remain. This paper examines and rejects conceptions of disability based on social factors but notes (...) that physical and mental conditions which disadvantage the individual have social dimensions. (shrink)

This paper explores the historical idea of improving humanity. Developments in genetics and political thought have during the last century contributed to eugenic policies which have sometimes had adverse effects on people's lives. But European philosophy has seen attempts to make better human beings long before the current scientific advances. The paper explores these attempts by an examination of the doctrines of Plato, Aristotle, Condorcet, Herder, and Mill, as well as the technological Romanticism of Mary Shelley, before moving on to (...) the more recent eugenic policies inspired by Darwin and Galton. (shrink)

Bioethics is, as is moral philosophy in general, a field spanning a range of different philosophical approaches, normative standpoints, methods and styles of analysis, metaphysics, and ontologies. In discussing bioethics, it is often seen as useful to introduce some kind of order on the field by categorizing individual philosophers or specific arguments into a relatively small number of categories. Such categorization or classification has several functions. It may help to show the relationship between basic assumptions and specific arguments or it (...) may be used argumentatively by arguing not against a single philosopher or her arguments but against the category to which she or they belong or are claimed to belong. In this way, whole lines of argument can be disposed of in one fell swoop and whole groups of philosophers dismissed by showing that they belong to some category that can, in some way, be discounted because it is fallacious. Or, conversely, lines of arguments and groups of philosophers can be celebrated and appropriated as support for yet new arguments. (shrink)

The claim that the answers we give to many of the central questions in genethics will depend crucially upon the particular rationality we adopt in addressing them is central to Matti Häyry’s thorough and admirably fair-minded book, Rationality and the Genetic Challenge. That claim implies, of course, that there exists a plurality of rationalities, or discrete styles of reasoning, that can be deployed when considering concrete moral problems. This, indeed, is Häyry’s position. Although he believes that there are certain features (...) definitive of any type of thinking that can accurately be labeled rational, he maintains that nothing about that set of features compels us to conclude that there is a single rationality. What is more, and significantly for the way in which Häyry’s book develops, there is no Archimedean point from which we are licensed to pronounce one flavor of rational deliberation to be intrinsically superior to any other or to be justified to the exclusion of all others. To this belief that “there are many divergent rationalities, all of which can be simultaneously valid,” we can perhaps give the name “the Doctrine of the Plurality of Rationalities” or, for short, “DPR.”. (shrink)

Relativism is usually a derogatory word in philosophical bioethics in the West. If people make the mistake of trying to understand radically “different” points of view, an accusation of relativism is quickly forthcoming. But why should this be an accusation? My aim in this paper is to demonstrate that it should not.

First published in 1985. Routledge is an imprint of Taylor & Francis, an informa company.

Matti Häyry’s new book is deliberately challenging; it tells six contemporary bioethicists, and all who share their methodologies or even their general approach, that they have got it badly wrong. From the striking photograph of Häyry himself on the front cover to the very last line, the genetic challenge is issued and elaborated. Häyry has divided his protagonists into three pairs, of which I find myself a member, and this makes responding a duty as well as a pleasure. Although I (...) cannot speak for my partner in crime, Jonathan Glover, I am at least in the very best of all possible company. (shrink)

The most widely debated conception of democracy in recent years is deliberative democracy--the idea that citizens or their representatives owe each other mutually acceptable reasons for the laws they enact. Two prominent voices in the ongoing discussion are Amy Gutmann and Dennis Thompson. In Why Deliberative Democracy?, they move the debate forward beyond their influential book, Democracy and Disagreement.What exactly is deliberative democracy? Why is it more defensible than its rivals? By offering clear answers to these timely questions, Gutmann and (...) Thompson illuminate the theory and practice of justifying public policies in contemporary democracies. They not only develop their theory of deliberative democracy in new directions but also apply it to new practical problems. They discuss bioethics, health care, truth commissions, educational policy, and decisions to declare war. In "What Deliberative Democracy Means," which opens this collection of essays, they provide the most accessible exposition of deliberative democracy to date. They show how deliberative democracy should play an important role even in the debates about military intervention abroad.Why Deliberative Democracy? contributes to our understanding of how democratic citizens and their representatives can make justifiable decisions for their society in the face of the fundamental disagreements that are inevitable in diverse societies. Gutmann and Thompson provide a balanced and fair-minded approach that will benefit anyone intent on giving reason and reciprocity a more prominent place in politics than power and special interests. (shrink)

Matti Häyry’s new book Rationality and the Genetic Challenge discusses the ethics of human genetic modification and the bioethical rationalities that inform the different ethical conclusions authors have advanced. It is aimed at correcting the belief that “only one rationality exists or one morality exists; that those that disagree [with them] are unreasonable or evil.” Häyry argues that there are multiple rationalities, and that even though ethical issues may have solutions within individual rationalities, disagreements that have their root in separate (...) rational approaches cannot be universally solved by intellectual arguments. In debates about the ethics of using new biotechnologies to genetically modify human beings, the normal state is one of fundamental disagreement over almost all of the anticipated uses to which the technology could be put. Häyry’s point is that such a state of affairs is not necessarily due to a lack of reason because there are many, equally valid, ways of being reasonable. (shrink)

From the first initiatives in preimplantation genetic diagnosis and gene therapy through the advent of stem cell research to the development of mammalian cloning, the past two decades have witnessed remarkable advances in “reprogenetic” medicine: the union of assisted reproductive technologies with genetic control. This period has also been marked by intense debates within the bioethical literature and in national policy forums about the appropriate uses of these emerging human capabilities. We can now, in a limited way, select for genetic (...) traits, and the power to modify the genome or introduce new gene sequences is not far off. How should these new powers be used? (shrink)

_Liberal Utilitarianism and Applied Ethics_ explores the foundations of early utilitarianism and, at the same time, the theoretical bases of social ethics and policy in modern Western welfare states. Matti Hayry sees the main reason for utilitarianism's growing disrepute among moral philosophers is that its principles cannot legitimately be extended to situations where the basic needs of the individuals involved are in conflict. He is able to formulate a solution to this fundamental problem by arguing convincingly that by combining a (...) limited version of liberal utilitarianism and the methods of applied ethics, we are able to define our moral duties and rights. _Liberal Utilitarianism and Applied Ethics_ will appeal to students and teachers of philosophy who are interested in the doctrine of utilitarianism or in ethical decison-making. (shrink)

Since the birth of the first test-tube baby, Louise Brown, in 1977, we have seen truly remarkable advances in biotechnology. We can now screen the fetus for Down Syndrome, Spina Bifida, and a wide range of genetic disorders. We can rearrange genes in DNA chains and redirect the evolution of species. We can record an individual's genetic fingerprint. And we can potentially insert genes into human DNA that will produce physical warning signs of cancer, allowing early detection. In fact, biotechnology (...) has progressed to such a point that virtually any kind of genetic manipulation, if not already possible, is just around the corner. But these breakthroughs also raise serious ethical and moral dilemmas that we are only now beginning to confront. In Wonderwoman and Superman, noted medical ethicist John Harris offers the first thorough analysis of the moral dilemmas created by the revolution in molecular biology. Covering a wide array of recent innovations, Harris discusses, for example, the moral decisions involved and the consequences of creating egg and embryo banks. Who should be allowed to use such resources? Should recipients be screened? Should such banks be open for public or private use? And does it cheapen life to make embryos available for sale? In another chapter, Harris examines the question of conceiving children chiefly for organ donation, focusing on the recent case of a woman who wanted to have a second child to provide a bone marrow donor for her first child sick with leukemia (she intended to abort the fetus if its bone marrow did not genetically match that of her living child). In this case, the medical staff had to decide whether they should perform in-vitro fertilization, knowing that the mother did not satisfy the clinic's criteria (there was no father), and also knowing the potential for abortion. Discussing the ethics of the mother's choice and the clinic's choice, Harris asks whether it is morally correct to create a child as an organ donor, whether the future child would suffer, whether it is worth any suffering to be born, and who has the right to weigh the various factors (both moral and physiological) involved in making these decisions. Delving into a multitude of issues such as when life begins, when suffering is needless, and whether we should play God, Wonderwoman and Superman provides not only a thought-provoking inquiry into the potential and actual ethical dilemmas created by the many advances in biotechnology, but challenges us to learn to choose responsibly and to face the moral implications of the choices that confront us. (shrink)

Edited by four leading members of the new generation of medical and healthcare ethicists working in the UK, respected worldwide for their work in medical ethics, Principles of Health Care Ethics, Second Edition_is a standard resource for students, professionals, and academics wishing to understand current and future issues in healthcare ethics. With a distinguished international panel of contributors working at the leading edge of academia, this volume presents a comprehensive guide to the field, with state of the art introductions to (...) the wide range of topics in modern healthcare ethics, from consent to human rights, from utilitarianism to feminism, from the doctor-patient relationship to xenotransplantation. This volume is the Second Edition of the highly successful work edited by Professor Raanan Gillon, Emeritus Professor of Medical Ethics at Imperial College London and former editor of the Journal of Medical Ethics, the leading journal in this field. Developments from the First Edition include:_ The focus on ‘Four Principles Method’ is relaxed to cover more different methods in health care ethics. More material on new medical technologies is included, the coverage of issues on the doctor/patient relationship is expanded, and material on ethics and public health is brought together into a new section. (shrink)

Recent developments in biotechnology and genetic research are raising complex ethical questions concerning the legitimate scope and limits of genetic intervention. As we begin to contemplate the possibility of intervening in the human genome to prevent diseases, we cannot help but feel that the human species might soon be able to take its biological evolution in its own hands. 'Playing God' is the metaphor commonly used for this self-transformation of the species, which, it seems, might soon be within our grasp. (...) In this important new book, Jurgen Habermas - the most influential philosopher and social thinker in Germany today - takes up the question of genetic engineering and its ethical implications and subjects it to careful philosophical scrutiny. His analysis is guided by the view that genetic manipulation is bound up with the identity and self-understanding of the species. We cannot rule out the possibility that knowledge of one's own hereditary factors may prove to be restrictive for the choice of an individual's way of life and may undermine the symmetrical relations between free and equal human beings. In the concluding chapter - which was delivered as a lecture on receiving the Peace Prize of the German Book Trade for 2001 - Habermas broadens the discussion to examine the tension between science and religion in the modern world, a tension which exploded, with such tragic violence, on September 11th. (shrink)