ABSTRACT Belgium legalised voluntary euthanasia in 2002, thus ending the long isolation of the Netherlands as the only country in which doctors could openly give lethal injections to patients who have requested help in dying. Meanwhile in Oregon, in the United States, doctors may prescribe drugs for terminally ill patients, who can use them to end their life – if they are able to swallow and digest them. But despite President Bush's oft‐repeated statements that his philosophy is to ‘trust individuals (...) to make the right decisions’ and his opposition to ‘distant bureaucracies’, his administration is doing its best to prevent Oregonians acting in accordance with a law that its voters have twice ratified. The situation regarding voluntary euthanasia around the world is therefore very much in flux. This essay reviews ethical arguments regarding voluntary euthanasia and physician‐assisted suicide from a utilitarian perspective. I shall begin by asking why it is normally wrong to kill an innocent person, and whether these reasons apply to aiding a person who, when rational and competent, asks to be killed or given the means to commit suicide. Then I shall consider more specific utilitarian arguments for and against permitting voluntary euthanasia. (shrink)

Analytic moral philosophy's strong divide between empirical and normative restricts facts to providing information for the application of norms and does not allow them to confront or challenge norms. So any genuine attempt to incorporate experience and empirical research into bioethics – to give the empirical more than the status of mere 'descriptive ethics'– must make a sharp break with the kind of analytic moral philosophy that has dominated contemporary bioethics. Examples from bioethics and science are used to illustrate the (...) problems with the method of application that philosophically prevails in both domains and with the conception of rationality that underlies this method. Cues from how these problems can be handled in science then introduce summaries of richer, more productive naturalist and constructivist accounts of reason and normative knowledge. Liberated by a naturalist approach to ethics and an enlarged conception of rationality, empirical work can be recognized not just as essential to bioethics but also as contributing to normative knowledge. (shrink)

Practical Reason and Norms focuses on three problems: In what way are rules normative, and how do they differ from ordinary reasons? What makes normative systems systematic? What distinguishes legal systems, and in what consists their normativity? All three questions are answered by taking reasons as the basic normative concept, and showing the distinctive role reasons have in every case, thus paving the way to a unified account of normativity. Rules are a structure of reasons to perform the required act (...) and an exclusionary reason not to follow some competing reasons. Exclusionary reasons are explained, and used to unlock the secrets of orders, promises, and decisions as well as rules. Games are used to exemplify normative systems. Inevitably, the analysis extends to some aspects of normative discourse, which is truth-apt, but with a diminished assertoric force. (shrink)

Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

The Right and the Good, a classic of twentieth-century philosophy by the eminent scholar Sir David Ross, is now presented in a new edition with a substantial introduction by Philip Stratton-Lake, a leading expert on Ross. Ross's book is the pinnacle of ethical intuitionism, which was the dominant moral theory in British philosophy for much of the nineteenth and early twentieth century. Intuitionism is now enjoying a considerable revival, and Stratton-Lake provides the context for a proper understanding of Ross's great (...) work today. (shrink)

The traditional conception of ethical theory sees it as the project of developing a coherent set of rules from which one can infer all determinate moral verdicts. I am not optimistic about the prospects for constructing such a theory. To explain this pessimism, we need to understand what moral rules are and what roles they might play in ethical theory.

According to the Harm Principle, roughly, the state may coerce a person only if it can thereby prevent harm to others. Clearly, this principle depends crucially on what we understand by harm. Thus, if any sort of negative effect on a person may count as a harm, the Harm Principle will fail to sufficiently protect individual liberty. Therefore, a more subtle concept of harm is needed. I consider various possible conceptions and argue that none gives rise to a plausible version (...) of the Harm Principle. Whether we focus on welfare, quantities of welfare or qualities of welfare, we do not arrive at a plausible version of this principle. Instead, the concept of harm may be moralized. I consider various ways this may be done as well as possible rationales for the resulting versions of the Harm Principle. Again, no plausible version of the principle turns up. I also consider the prospect of including the Harm Principle in a decision-procedure rather than in a criterion of rightness. Finally, in light of my negative appraisal, I briefly discuss why this principle has seemed so appealing to liberals. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

According to radical moral particularists such as Jonathan Dancy, there are no substantive moral principles. And yet, few particularists wish to deny that something very like moral principles do indeed play a significant role in our everyday moral practice. Loathe at dismissing this as mere error on the part of everyday moral agents, particularists have proposed a number of alternative accounts of the practice. The aim of all of these accounts is to make sense of our appeal to general moral (...) truths in both reaching and justifying our particular moral judgments without thereby violating the particularists' stricture against substantive moral principles. In this paper, I argue that the most prominent non-substantive accounts of moral generalities appealed to by radical particularists – the heuristic account and default reasons accounts – fail in this aim. (shrink)

I examine the positive and negative features of synthetic biology (‘SynBio’) from a utilitarian ethical perspective. The potential beneficial outcomes from SynBio in the context of medicine are substantial; however it is not presently possible to predict precise outcomes due to the nascent state of the field. Potential negative outcomes from SynBio also exist, including iatrogenesis and bioterrorism; however it is not yet possible to quantify these risks. I argue that the application of a ‘precautionary’ approach to SynBio is ethically (...) fraught, as is the notion that SynBio-associated knowledge ought to be restricted. I conclude that utilitarians ought to support a broadly laissez-faire stance in respect of SynBio. (shrink)

There is evidence to the effect that exposing children to alcohol consumption in the media increases the chances that they will consume alcohol as minors or as adults, and since alcohol consumption is associated with numerous public health issues, calls for stricter regulation can be heard from many quarters. This article argues that with the available research we cannot conclude that exposure to portrayals of alcohol consumption plays a genuine causal role in bringing about the things with which it is (...) associated, that the strength of the correlation is too weak to justify regulation and that the sorts of things with which it is associated only rarely count as genuine harms from a liberal point of view. This article also argues that even if genuine harms were caused, no justification for regulation would directly follow because alcohol in the media could still be protected by freedom of speech and expression. Yet, the article argues that regulation is defensible if it can be shown that the harmful consequences arise in ways that bypass autonomy, or if it can be shown that the harmful consequences are unacceptable from the point of view of so-called ‘proleptic’ autonomy. (shrink)

Many medical interventions have both negative and positive effects. When health care professionals cannot achieve a particular desired good result without bringing about some bad effects also they often rely on double-effect reasoning to justify their decisions. The principle of double effect is therefore an important guide for ethical decision-making in medicine. At the same time, however, it is a very controversial tool for resolving complex ethical problems that has been criticized by many authors. For these reasons, I examine in (...) this paper whether the principle of double effect can serve as a basis for ethical decisions in medicine. The conclusion reached in this article is that even though this principle has desirable effects on clinical conduct, it is only an unreliable guide and physicians and nurses cannot feel secure in continuing to use this principle for ethical guidance. (shrink)

This article confines itself largely within boundaries of normative bioethics. It examines major types of principle-based methods, case-based methods, virtue ethics, ethics of care, and communitarian perspectives, along with some critical points from feminist perspectives and from rule-based theories. One cautionary note is in order: most of these types of method, theory, or perspective encompass a number of approaches that involve some degree of family resemblance. Since it will be impossible to examine all of these approaches in detail, the article (...) highlights some major themes and criticisms, discusses a few representative positions in more detail, and sketches a few of their implications for practical decision-making about physician-assisted suicide and active euthanasia, topics addressed by proponents of all these methods, theories, and perspectives. (shrink)