And in this book the distinguished scholar Amartya Sen offers a powerful critique of the theory of social justice that, in its grip on social and political ...

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)

Bioethical discourse on organ donation and transplantation medicine covers a wide range of topics, from informed consent procedures and scarcity issues up to transplant tourism and organ trade. Over the past decades, this discourse evolved into a stream of documents of bewildering proportions, encompassing thousands of books, papers, conferences, blogs, consensus meetings, policy reports, media debates and other outlets. Beneath the manifest level of discourse, however, a more latent dimension can be discerned, revolving around issues of embodiment, the moral status (...) of the human body and the concept of bodily integrity. This publication aims to bring these “deeper” questions to the fore. What is envisioned is a “depth” ethics (the moral equivalent of a depth psychology) focussing on the tensions, conflicts and ambiguities at work in bioethical deliberations on organ transplantation, fuelling the viewpoints articulated on the more manifest levels of discourse. Organ donation reopens the question of the status of the body as something which we have, but at the same time are, and as something which constitutes a whole, while at the same time being a set of replaceable elements or parts. (shrink)

Medical crowdfunding has raised many ethical concerns, among them that it may undermine privacy, widen health inequities, and commodify health care. One motivation for medical crowdfunding has received particular attention among ethicists. Recent studies have shown that many individuals are using crowdfunding to finance access to scientifically unsupported medical treatments. Recently, GoFundMe prohibited campaigns for antivaccination groups on the grounds that they “promote misinformation about vaccines” and for treatment at a German clinic offering unproven cancer treatments due to “the need (...) to make sure people are equipped to make well‐informed decisions.” GoFundMe has not taken any additional actions to regulate the much larger presence of campaigns seeking to fund unproven medical interventions on the platform. In this article, we make the ethical case for intervention by GoFundMe and other crowdfunding platforms. (shrink)

Inequality is widely regarded as morally objectionable: T. M. Scanlon investigates why it matters to us. He considers the nature and importance of equality of opportunity, whether the pursuit of greater equality involves objectionable interference with individual liberty, and whether the rich can be said to deserve their greater rewards.

Many potential therapeutic agents are discarded before they are tested in humans. These are not quack medications. They are drugs and other interventions that have been developed by responsible scientists in respectable companies or universities and are often backed up by publications in peer-reviewed journals. These possible treatments might ease suffering and prolong the lives of innumerable patients, yet they have been put aside. In this paper, we outline a novel mechanism—the Plutocratic Proposal—to revive such neglected research and fund early (...) phase clinical trials. The central idea of the Proposal is that any patient who rescues a potential therapeutic agent from neglect by funding early phase clinical trials should be offered a place on the trial. (shrink)

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.

Theories of distributive justice tend to focus on the issue of what constitutes a fair division of 'external' goods and opportunities; things like wealth and income, opportunities for education and basic liberties and rights. However, rapid advances in the biomedical sciences have ushered in a new era, one where the 'genetic lottery of life' can be directly influenced by humans in ways that would have been considered science fiction only a few decades ago. How should theories of justice be modified (...) to take seriously the prospect of new biotechnologies, especially given the health challenges posed by global aging? Colin Farrelly addresses a host of topics, ranging from gene therapy and preimplantation genetic diagnosis, to an 'anti-aging' intervention and the creation and evolution of patriarchy. This book aims to foster the interdisciplinary dialogue needed to ensure we think rationally and cogently about science and science policy in the twenty-first century. (shrink)

In 1972, the young philosopher Peter Singer published "Famine, Affluence and Morality," which rapidly became one of the most widely discussed essays in applied ethics. Through this article, Singer presents his view that we have the same moral obligations to those far away as we do to those close to us. He argued that choosing not to send life-saving money to starving people on the other side of the earth is the moral equivalent of neglecting to save drowning children because (...) we prefer not to muddy our shoes. If we can help, we must--and any excuse is hypocrisy. Singer's extreme stand on our moral obligations to others became a powerful call to arms and continues to challenge people's attitudes towards extreme poverty. Today, it remains a central touchstone for those who argue we should all help others more than we do. As Bill and Melinda Gates observe in their foreword, in the age of today's global philanthropy, Singer's essay is as relevant now as it ever was. This attractively packaged, concise edition collects the original article, two of Singer's more recent popular writings on our obligations to others around the world, and a new introduction by Singer that discusses his current thinking. (shrink)

How should medical services be distributed within society? Who should pay for them? Is it right that large amounts should be spent on sophisticated technology and expensive operations, or would the resources be better employed in, for instance, less costly preventive measures? These and others are the questions addreses in this book. Norman Daniels examines some of the dilemmas thrown up by conflicting demands for medical attention, and goes on to advance a theory of justice in the distribution of health (...) care. The central argument is that health care, both preventive and acute, has a crucial effect on equality of opportunity, and that a principle guaranteeing equality of opportunity must underly the distribution of health-care services. Access to care, preventive measures, treatment of the elderly, and the obligations of doctors and medical administrations are fully discussed, and the theory is shown to underwrite various practical policies in the area. (shrink)

In late August 2002, a general practitioner in London, Dr Bhagat Singh Makkar, 62, was struck off the medical register after he was discovered to have bragged to an undercover journalist about being able to obtain a kidney from a live donor in exchange for a fee. He told the journalist, who posed as the son of a patient with renal failure: “No problem, I can fix that for you. Do you want it done here, do you want it done (...) in Germany or do you want it done in India?” The price he quoted included payment to the donor and “my administration costs”. Dr Makkar said he regretted giving “stupid answers” to the journalist. He had been “tired, confused, and upset after a long day dealing with emotional patients”.1Deliberation about ethics is often muddied by the personalities involved in a particular issue. Many people are uninspired by Richard Seed or Jack Kevorkian. This contaminates their view about the much broader and important issues such as cloning or euthanasia that Seed and Kevorkian, whom some people might describe as mavericks, have shoved their finger in.Discussion of the sale of organs is …. (shrink)