In general, we think that when it comes to the good of another, we respect that person’s will by acting in accordance with what he wills because he wills it. I argue that this is not necessarily true. When it comes to the good of another person, it is possible to disrespect that person’s will while acting in accordance with what he wills because he wills it. Seeing how this is so, I argue, enables us to clarify the distinct roles (...) that the wills of competent and incompetent people should play in third-party deliberations about their welfare. (shrink)

The Significant Interest view entails that even if there were no medical reasons to have access to genetic knowledge, there would still be reason for prospective parents to use an identity-release donor as opposed to an anonymous donor. This view does not depend on either the idea that genetic knowledge is profoundly prudentially important or that donor-conceived people have a right to genetic knowledge. Rather, it turns on general claims about parents’ obligations to help promote their children’s well-being and the (...) connection between a person’s well-being and the satisfaction of what I call their “worthwhile significant subjective interests.” To put this view simply, the fact that a donor-conceived person—who knows she is donor-conceived—is likely to be very interested in acquiring genetic knowledge gives prospective parents a weighty reason to use an identity-release donor. This is because parents should promote their children’s well-being through the satisfaction of their children’s worthwhile significant interests. (shrink)

When, if ever, can healthcare provider's lay claim to knowing what is best for their patients? In this paper, I offer a taxonomy of clinical disagreements. The taxonomy, I argue, reveals that healthcare providers often can lay claim to knowing what is best for their patients, but that oftentimes, they cannot do so *as* healthcare providers.

Are there any deep or systematic connections between paternalism and people's rights? Perhaps the connection is definitional: part of what makes an action or policy paternalistic is that it violates a right. Or perhaps the connection is normative: paternalism is (always? often? only sometimes?) morally problematic because it violates people's rights (even if we don't define "paternalism" in terms of a rights violation). My main goal in this paper is to argue for the normative connection. Part of the task will (...) be to explain exactly what the normative connection is. That will involve answering the questions embedded in the claim as well as offering an account of the right(s) that is (are) connected to paternalism's normative status. (shrink)

abstract Is it permissible for a doctor or nurse to knowingly administer a placebo in a clinical setting? There is certainly something suspicious about it: placebos are typically said to be ‘sham’ treatments, with no ‘active’ properties and so giving a placebo is usually thought to involve tricking or deceiving the patient who expects a genuine treatment. Nonetheless, some physicians have recently suggested that placebo treatments are sometimes the best way to help their patients and can be administered in an (...) honest way. These physicians conclude that placebo treatments are a perfectly acceptable, and ethically unproblematic, mode of treatment. While I grant the common idea that placebos are deceptive is correct, I argue that widespread misunderstandings concerning why this is so has led proponents of placebo treatments to respond to the charge of deception in a way that misses the mark entirely. My goal in this paper, then, is to develop a precise conception of what makes something a placebo, which in turn will clarify the central charge concerning the ethics of placebo treatment, viz. that it is deceptive. (shrink)

In discussions about the ethics of enhancement, it is often claimed that the concept of ‘human nature’ has no helpful role to play. There are two ideas behind this thought. The first is that nature, human nature included, is a mixed bag. Some parts of our nature are good for us and some are bad for us. The ‘mixed bag’ idea leads naturally to the second idea, namely that the fact that something is part of our nature is, by itself, (...) normatively inert. The Inert View claims that nothing normative follows from the mere fact that some trait is a part of our nature. If the Inert View is correct, then appeals to the value or importance of human nature in debates about enhancement are indeed misplaced. We argue that the Inert View is wrong, and that a certain concept of human nature – which we refer to as human form – does have an important role to play in debates about enhancement. (shrink)

Cases of non-traditional family-making offer a rich seam for thinking about normative parenthood. Gamete donors are genetically related to the resulting offspring but are not thought to be normative parents. Gestational surrogates are also typically not thought to be normative parents, despite having gestated a child. Adoptive parents are typically thought to be normative parents even though they are neither genetically nor gestationally related to their child. Philosophers have paid attention to these kinds of cases. But they have not paid (...) attention to what the people who have engaged in these forms of family-making have to say about what they’re doing and, more specifically, how they answer the questions: “Who is the normative parent? And why?” Paying attention to their answers reveals two things. First, accounts of parenthood from people involved in two forms of non-traditional family-making – reproduction with gestational surrogacy and reproduction with donated eggs – are mutually inconsistent. This is not surprising. What is surprising is that the contradictory aspects of the views evince a common commitment to, as I shall put it, naturalizing parenthood. The central goal of this paper is to explain what that means, but rough idea is that in naturalizing parenthood, prospective parents aim to put the features that make someone a normative parent beyond the reach of human agency. I conclude by briefly suggesting that we should think of the grounds of normative parenthood – and the very task of theorizing about the grounds of normative parenthood – in a way that avoids the need to naturalize altogether. (shrink)

The connections between medicine and well-being are myriad. This paper focuses on the place of well-being in clinical medicine. It is here that different views of well-being, and their connection to concepts like “autonomy” and “authenticity”, both illuminate and are illuminated by looking closely at the kinds of interactions that routinely take place between clinicians, patients, and family members. -/- In the first part of the paper, I explore the place of well-being in a paradigmatic clinical encounter, one where a (...) competent patient interacts with a clinician. The main question here is how, or even whether, the pursuit of patient well-being – however we construe it – figures into a paradigmatic clinical encounter. In the second part of the paper, I consider what I will call a marginal clinical encounter – one where the patient is, as Agnieska Jaworska (1999) puts it, at the “margins of agency” – to theorize about the nature of well-being and to show how different theories of well-being can have dramatic consequences for clinical decision-making. (shrink)