Why has autonomy been a leading idea in philosophical writing on bioethics, and why has trust been marginal? In this important book, Onora O'Neill suggests that the conceptions of individual autonomy so widely relied on in bioethics are philosophically and ethically inadequate, and that they undermine rather than support relations of trust. She shows how Kant's non-individualistic view of autonomy provides a stronger basis for an approach to medicine, science and biotechnology, and does not marginalize untrustworthiness, while also explaining why (...) trustworthy individuals and institutions are often undeservingly mistrusted. Her arguments are illustrated with issues raised by practices such as the use of genetic information by the police or insurers, research using human tissues, uses of new reproductive technologies, and media practices for reporting on medicine, science and technology. Autonomy and Trust in Bioethics will appeal to a wide range of readers in ethics, bioethics and related disciplines. (shrink)

Two recent cases raise the question: Should the body be considered a form of property? Patients generally do not share in the profits derived from the applications of research on their body parts and products. Nor is their consent for research required so long as the body part is unidentified and is removed in the course of treatment. A market in body parts and products would require consent to all categories of research and ensure that patients are protected from coercion (...) and given the chance to be paid fairly for their contributions. Such a market might force us to rethink our policies prohibiting organ sales. Donors, recipients, and society will benefit from a market in body parts so long as owners—and no one else—retain control over their bodies. (shrink)

The Making of British Bioethics provides the first in-depth study of how philosophers, lawyers and other 'outsiders' came to play a major role in discussing and helping to regulate issues that used to be left to doctors and scientists. It details how British bioethics emerged thanks to a dynamic interplay between sociopolitical concerns and the aims of specific professional groups and individuals who helped create the demand for outside involvement and transformed themselves into influential 'ethics experts'. Highlighting this interplay helps (...) us appreciate how issues such as embryo research and assisted dying became high-profile 'bioethical' concerns in the late twentieth century, and why different groups now play a critical role in developing regulatory standards and leading public debates. The book draws on a wide range of original sources and will be of interest to historians of medicine and science, general historians and bioethicists. (shrink)

The reappearance of the question of moral judgments by historians makes a reappraisal of the issues timely. Almost all that has been written on the subject addresses only the propriety of moral judgments in the written texts historians produce. However, historians have to make moral choices when selecting a subject upon which to write; and they make a tacit moral commitment to write and teach honestly. Historians usually dislike making explicit moral evaluations, and have little or no training in how (...) to do so. They can argue it’s not their job; they are only finders of fact. Historians holding a determinist view of actions do not think it appropriate to blame people for doing what they couldn’t help doing; for those believing there is an overall pattern to history, individual morality is beside the point. Finally, since earlier cultures had values different from ours, it seems unjust to hold them to contemporary standards. This essay modifies or rejects these arguments. Some historians have manifested ambivalence, acknowledging it is difficult or impossible to avoid making moral evaluations . Ordinary-language philosophers, noting that historiography has no specialized vocabulary, see it as saturated by the values inherent in everyday speech and thought. I argue that the historicist argument about the inevitably time-bound limitation of all values is exaggerated. Historians who believe in the religious grounding of values obviously disagree with it; but even on a secular level, morals are often confused with mores. If historians inevitably make moral evaluations, they should examine what philosophical ethicists—virtue ethicists, deontologists, and consequentialists—have said about how to make them; and even if they find no satisfactory grounding for their own moral attitudes, it is a brute fact that they have them. I end with an argument for “strong evaluations”—neither treating them as a troublesome residue in historiography nor, having despaired of finding a solid philosophical ground for moral evaluations, concluding that they are merely matters of taste. I believe historians should embrace the role of moral commentators, but that they should be aware that their evaluations are, like all historical judgments, subject to the criticisms of their colleagues and readers. Historians run little risk of being censorious and self-righteous; the far greater danger is acquiescing in or contributing to moral confusion and timidity. (shrink)