The argument for children's rights in health care has been long in the making. The success of this position is reflected in the 1995 American Academy of Pediatrics recommendations for the role of children in health care decisionmaking, which suggest that children be given greater voice as they mature. But there are good moral and practical reasons for exercising caution in these health care situations, especially when the child and parents disagree. Parents need the moral and legal space within which (...) to make decisions that will facilitate their child's long‐term autonomy, not only her present‐day autonomy. Moreover, third‐party intrusion, by physicians or the state, should be resisted unless negligent and abusive decisions are in the making. (shrink)

Two different discussions in John Rawls' A Theory of Justice lead naturally to a rather conservative position on the moral status of the human embryo. When discussing paternalism, he claims that the parties in the original position would seek to protect themselves in case they end up as incapacitated or undeveloped human beings when the veil of ignorance is lifted. Since human embryos are examples of such beings, the parties in the original position would seek to protect themselves from their (...) embryonic stages onward. When discussing the basis of equality, Rawls claims that the parties in the original position would guarantee basic rights for all those with the capacity to take part in this original position. To guarantee the basic rights of infants and young children, he goes on to interpret this capacity as a "potentiality that is ordinarily realized in due course." Since human embryos have this potentiality, they too should have basic rights. (shrink)

Western society today is less unified by a set of core values than ever before. Undoubtedly, the concept of moral consensus is a difficult one in a liberal, democratic and pluralistic society. But it is imperative to avoid a rigid majoritarianism where sensitive personal values are at stake, as in bioethics. Bioethics has become an influential part of public and professional discussions of health care. It has helped frame issues of moral values and medicine as part of a more general (...) effort to find consensus about some of the most perplexing questions of our time. But why is it thought that a moral consensus is important or that it deserves respect? How does moral consensus acquire legitimacy in a society that includes diverse value systems? How is moral consensus possible and how do small groups help create or distort consensus processes? Written by a medical school professor trained in philosophy, this timely work tackles these questions from philosophical, historical, and social scientific standpoints. It begins by describing the traditional ambivalence about consensus in Western culture as well as the uncertain relationship in modernity between consensus and expertise. After outlining the current bioethical consensus, the book gives philosophical and political analyses of the idea of consensus, then assesses the role of consensus in national ethics commissions and in the ethics committee movement. Moreno constructs an original, naturalistic philosophy of moral consensus, referred to as "bioethical naturalism", and then applies sociology and social psychology to actual consensus processes. The book concludes with an account of bioethics as a consensus-oriented social reform movement. This insightful volume will be essential reading for bioethicists, philosophers, physicians, members of ethics committees, and all those concerned with ethical and social issues in health care. (shrink)

Proponents of children's liberation (CL) argue that there are no morally relevant differences between children and adults. Consequently, special protective laws that limit children's freedom are unjustified, and should be abolished. Protectionists reject the premise of this argument, and hence also the conclusion. Proponents of CL mostly fix upon the capacity for instrumental reasoning as the criterion that should separate autonomous from non-autonomous individuals. I argue that most children are substantially worse at instrumental reasoning than most adults, and although drawing (...) a line between the two categories has an arbitrary element, outstanding exceptions on both sides can be justly accommodated. Furthermore, the capacity for instrumental reasoning is a necessary but not sufficient basis for equal rights. A morally decent society is more demanding of individuals than the skeptical or libertarian one that most plausibly grounds CL. To construct and live in such a society requires both prudence and morality. But there is evidence that children need protection and limits to develop these traits. So there are morally relevant differences between children and adults after all, and the argument from justice fails. The utilitarian arm of the argument also fails: because of these morally relevant differences, CL would have worse consequences than those envisioned by its supporters. Parents would lose important authority, and there would be more homeless children. Consequently, the gap between advantaged and disadvantaged persons would become larger and more irreversible. (shrink)