Though the revised edition of A Theory of Justice, published in 1999, is the definitive statement of Rawls's view, so much of the extensive literature on Rawls's theory refers to the first edition. This reissue makes the first edition once again available for scholars and serious students of Rawls's work.

One of the most important and contentious policy issues surrounding genetics is whether genetic information should be treated separately from other medical information. The view that genetics raises distinct issues is what Thomas Murray labeled “genetic exceptionalism,” borrowing from the earlier term “HIV exceptional-ism.” The issue of whether the use of genetic information should be addressed separately from other health information is not merely an academic concern, however. Since the Human Genome Project began in 1990, nearly every state has enacted (...) legislation prohibiting genetic discrimination in health insurance; two-thirds of the states have enacted laws prohibiting genetic discrimination in employment, and other state laws have been enacted dealing with genetic discrimination in life insurance, genetic privacy, and genetic testing. Bills in Congress also would prohibit genetic discrimination in health insurance and employment. (shrink)

In the bioethical literature, discrimination in insurance on the basis of genetic risk factors detected by genetic testing has been defended and opposed on various ethical grounds. One important argument in favour of the practice is offered by those who believe that it is not possible to distinguish between genetic and non-genetic information, at least not for practical policy purposes such as insurance decision-making. According to the argument from indistinguishability, the use of genetic test information for insurance purposes should be (...) permitted, because genetic test information is no different from non-genetic medical information in any relevant respect, therefore it would be inconsistent to prohibit the former whilst permitting the latter. This paper discusses and defends this argument and suggests a new, more tenable foundation. (shrink)

John Mackie's stimulating book is a complete and clear treatise on moral theory. His writings on normative ethics-the moral principles he recommends-offer a fresh approach on a much neglected subject, and the work as a whole is undoubtedly a major contribution to modern philosophy.The author deals first with the status of ethics, arguing that there are not objective values, that morality cannot be discovered but must be made. He examines next the content of ethics, seeing morality as a functional device, (...) basically the same at all times but changing significantly in response to changes in the human condition. He sketches a practical moral system, criticizing but also borrowing from both utilitarian and absolutist views. Thirdly, the frontiers of ethics, areas of contact with psychology, metaphysics, theology, law and politcs, are explored.Throughout, his aim is to discuss a wide range of questions that are both philosophical and practical, working within a distinctive version of subjectivism-an "error" theory of the apparent objectivity of values. John Mackie has drawn on the contributions of such classic thinkers as Plato, Aristotle, Hobbes, Hume, Kant and Sidgwick, and on more recent discussions, to produce a thought-provoking account that will inspire both the general reader and the student of philosophy. (shrink)

In this book, T. M. Scanlon offers new answers to these questions, as they apply to the central part of morality that concerns what we owe to each other.

: Can passing antidiscrimination laws ever be a bad idea? Yes, if broad policy reform is abandoned in favor of genetic-specific legislation. But in spite of its serious flaws, both in concept and in practice, genetic-specific legislation is sometimes worth passing anyway—sometimes a bad idea is reasonable.

: Prenatal and preconceptual testing and screening programs provide information on the basis of which people can choose to avoid the birth of children likely to face disabilities. Some disabilities advocates have objected to such programs and to the decisions made within them, on the grounds that measures taken to avoid the birth of children with disabilities have an "expressive force" that conveys messages disrespectful to people with disabilities. Assessing such a claim requires careful attention to general considerations relating meaning, (...) intention, and social practices; it has only begun to receive such attention. Building on work by Allen Buchanan, who has challenged this claim, I further consider the disabilities advocates' objection, ultimately concluding that it is misplaced; neither individual actions nor general practices of this type necessarily express disrespectful messages. (shrink)

Can passing antidiscrimination laws ever be a bad idea? Yes, if broad policy reform is abandoned in favor of genetic‐specific legislation. But in spite of its serious flaws, both in concept and in practice, genetic‐specific legislation is sometimes worth passing anyway.

Deciding whether genetic differences among individuals are morally relevant to health insurance requires us to ask, What kind of good is health care? and, What principles should govern its distribution? There are good reasons to doubt that “actuarial fairness” is an adequate description of genuine fairness in health insurance.

Genetic-specific nondiscrimination laws have been enacted in most states, but the laws are ineffective and increase the stigma of genetic conditions. Whether these laws are better than no new legislation depends on their consequences and a recognition of their limitations.

In the bioethical literature, discrimination in insurance on the basis of genetic risk factors detected by genetic testing has been defended and opposed on various ethical grounds. One important argument in favour of the practice is offered by those who believe that it is not possible to distinguish between genetic and non-genetic information, at least not for practical policy purposes such as insurance decision-making. According to the argument from indistinguishability, the use of genetic test information for insurance purposes should be (...) permitted, because genetic test information is no different from non-genetic medical information in any relevant respect, therefore it would be inconsistent to prohibit the former whilst permitting the latter. This paper discusses and defends this argument and suggests a new, more tenable foundation. (shrink)

Genetic discrimination is becoming an increasingly important problem in the United States. Information acquired from genetic tests has been used by insurance companies to reject applications for insurance policies and to refuse payment for the treatment of illnesses. Numerous states and the United States Congress have passed or are considering passage of laws that would forbid such use of genetic information by health insurance companies. Here we argue that much of this legislation is severely flawed because of the difficulty in (...) distinguishing genetic from nongenetic tests. In addition, barring the use by insurance companies of a genetic test but not a nongenetic test (conceivably for the same multifactorial disease) raises issues of fairness in health insurance. These arguments suggest that ultimately the problems arising from genetic discrimination cannot be solved by narrowly focused legislation but only by a modification of the entire health care system. (shrink)