Innovative practice occurs when a clinician provides something new, untested, or nonstandard to a patient in the course of clinical care, rather than as part of a research study. Commentators have noted that patients engaged in innovative practice are at significant risk of suffering harm, exploitation, or autonomy violations. By creating a pathway for harmful or nonbeneficial interventions to spread within medical practice without being subjected to rigorous scientific evaluation, innovative practice poses similar risks to the wider community of patients (...) and society as a whole. Given these concerns, how should we control and oversee innovative practice, and in particular, how should we coordinate innovative practice and clinical research? In this article, I argue that an ethical approach to overseeing innovative practice must encourage the early transition to rigorous clinical research without delaying or deferring the development of beneficial innovations or violating the autonomy rights of clinicians and their patients. (shrink)

The Demandingness Objection is the objection that a moral theory or principle is unacceptable because it asks more than we can reasonably expect. David Sobel, Shelley Kagan and Liam Murphy have each argued that the Demandingness Objection implicitly – and without justification – appeals to moral distinctions between different types of cost. I discuss three sets of cases each of which suggest that we implicitly assume some distinction between costs when applying the Demandingness Objection. We can explain each set of (...) cases, but each set requires appeal to a separate dimension of the Demandingness Objection. (shrink)

The case (Dawson et al. 2024) describes an Institutional Review Board (IRB) chair who seeks consultation about waiving the requirement that investigators obtain prospective, informed consent for collection of microbiome samples by swabbing the perianal region of severely burned patients shortly after their admission to an intensive care unit (ICU). We argue that it is ethically permissible to waive informed consent requirements for the perianal swab and that the IRB should approve a waiver as permitted by regulations.

It is a philosophy of patient care, and is therefore open to critique and evaluation.Using the Oxford Textbook of Palliative Medicine Third Edition as their ...

The case describes researchers who are seeking ethics guidance on communicating with participants in a phase-1 COVD-19 vaccine trial about FDA-authorized COVID-19 vaccines (Wilfond, Duenas, and Johnson 2023). The researchers want help choosing among three options they have identified for encouraging participants to obtain one of the authorized vaccines. We argue that research ethics consultants should consider going beyond this question to address another ethics concern the researchers might have overlooked.

L.A. Paul argues that interesting issues for rational choice theory are raised by epistemically transformative experiences: experiences which provide access to knowledge that could not be known without the experience. Consideration of the epistemic effects of pregnancy has important implications for our understanding of epistemically transformative experiences and for debate about the ethics of abortion and applied ethics more generally. Pregnancy is epistemically transformative both in Paul’s narrow sense and in a wider sense: those who have not been pregnant face (...) significant barriers to acquiring the knowledge made accessible through pregnancy. This knowledge is crucial for engaging with the ethics of abortion. The epistemically transformativeWIDE nature of pregnancy may require us to use new methods to try to partially grasp what pregnancy is like such as for example, significant engagement with narrative literature. Because pregnancy is also epistemically transformative in a narrow sense, we need to work out how to engage in ethical reasoning when relevant knowledge is not fully accessible to all. This argument has implications beyond the debate about abortion. Philosophers in many areas of applied ethics will need to work out how to respond appropriately to epistemically transformative experiences. (shrink)

Our pollution of the environment seems set to lead to widespread problems in the future, including disease, scarcity of resources, and bloody conflicts. It is natural to think that we are required to stop polluting because polluting harms the future individuals who will be faced with these problems. This natural thought faces Derek Parfit’s famous Non-Identity Problem ( 1984 , pp. 361–364). The people who live on the polluted earth would not have existed if we had not polluted. Our polluting (...) behaviour does not make these individuals worse off. It may therefore seem that we do not harm them by polluting. Parfit argues that we should replace person-affecting principles with an impersonal principle of beneficence, Principle Q ( 1984 , p. 360.). I argue that Principle Q cannot give an adequate account of our duties to refrain from polluting. I consider attempts to solve the Non-Identity Problem by denying that to harm someone an agent must make them worse off. I argue that such responses provide a partial solution to the Non-Identity Problem. They do show that we harm future individuals in a morally relevant sense by polluting. Nonetheless, this is only a partial solution. The Non-Identity Problem still suggests that our harm-based reasons not to pollute are less strong than we intuitively believe. Thus on its own an appeal to the claim that we harm future individuals is not able to give a fully satisfactory account of why we are required not to pollute. (shrink)

I defend the Doctrine of Doing and Allowing: the claim that doing harm is harder to justify than merely allowing harm. A thing does not genuinely belong to a person unless he has special authority over it. The Doctrine of Doing and Allowing protects us against harmful imposition – against the actions or needs of another intruding on what is ours. This protection is necessary for something to genuinely belong to a person. The opponent of the Doctrine must claim that (...) nothing genuinely belongs to a person, even his own body. (shrink)

This paper provides a categorization of cross-modal experiences. There are myriad forms. Doing so allows us to think clearly about the nature of different cross-modal experiences and allows us to clearly formulate competing hypotheses about the kind of experiences involved in different cross-modal phenomena.

Discussion of the behaviour of pregnant women and mothers, in academic literature, medical advice given to mothers, mainstream media and social media, assumes that a mother who fails to do something to benefit her child is liable for moral criticism unless she can provide sufficient countervailing considerations to justify her decision. I reconstruct the normally implicit reasoning that leads to this assumption and show that it is mistaken. First, I show that the discussion assumes that if any action might benefit (...) her child, the mother has a defeasible duty to perform that action. I suggest that this assumption is implicitly supported by two arguments but that each argument is unsound. The first argument conflates moral reasons and defeasible duties; the second misunderstands the scope of a defeasible duty to benefit. This argument has important practical and theoretical implications: practically, it provides a response to a highly damaging discourse on maternal behaviour; theoretically, it provides the framework for a clearer understanding of the scope and nature of defeasible duties to benefit. (shrink)

This Ideas and Opinions article revisits an argument from Judith Jarvis Thomson in her essay “A Defense of Abortion” that abortion can be an ethical choice even if we assume that fetuses have full moral personhood and moral rights. The authors examine the implications of laws that require a pregnant person to care for another with their body and what other impositions states may also require of citizens to care for others.

The main aim of Lupyan’s paper is to claim that perception is cognitively penetrated and that this is consistent with the idea of perception as predictive coding. In these remarks I will focus on what Lupyan says about whether perception is cognitively penetrated, and set aside his remarks about epistemology. I have argued (2012) that perception can be cognitively penetrated and so I am sympathetic to Lupyan’s overall aim of showing that perception is cognitively penetrable. However, I will be critical (...) of some of Lupyan’s reasoning in arguing for this position. I will also call for clarification of that reasoning. First, I will discuss what is meant by cognitive penetration and, in light of this, the sort of evidence that can be used to establish its existence. Second, I will question whether Lupyan establishes that all cases of cross-modal effects are cases of cognitive penetration. In doing so, I will suggest a form of cognitive penetration that has heretofore not been posited, and give an example of how one might test for its existence. Third, I will question whether Lupyan puts forward convincing evidence that categorical knowledge and language affect perception in a way that conclusively shows that cognitive penetration occurs. Fourth, I will closely examine Lupyan’s reply to the argument against cognitive penetration from illusion. I show that his reply is not adequate and that he misses a more straightforward reply that one could give. Fifth, I briefly concur with the remarks that Lupyan makes about the role of attention with respect to cognitive penetration. And finally, sixth, I spell out exactly what I think the relationship is between the thesis that predictive coding is the correct model of perception and the thesis that there is cognitive penetration. (shrink)

Breastfeeding advocates have criticised the phrase ‘breast is best’ as mistakenly representing breastfeeding as a departure from the norm rather than the default for infant feeding. Breastfeeding mothers have an interest in representing breastfeeding as the default, for example, to counteract criticism of breastfeeding outside the home. This connects to an increasing trend to frame feeding babies formula as harmful, which can be seen in research papers, public policy and information presented to parents and prospective parents. Whether we frame infant-feeding (...) decisions in terms of harming or benefit, protection or risk matters because these distinctions are generally morally significant and thus holding that those who decide to use formula ‘harm’, ‘risk harm’ to their babies or describing formula feeding as ‘dangerous’ is likely to contribute to guilt associated with formula feeding and thus to undermine the well-being of vulnerable women. It may undermine attempts to improve breastfeeding rates by leading women to reject information about health outcomes surrounding infant-feeding decisions. However, these distinctions do not apply easily to infant-feeding decisions, in part because of difficulties in determining whether we should treat breastfeeding as the normative baseline for infant feeding. I show that neither the descriptive ‘facts of the matter’ nor moral or pragmatic considerations provide an easy answer before discussing how to respond to these considerations. (shrink)

According to the Doctrine of Doing and Allowing, the distinction between doing and allowing harm is morally significant. Doing harm is harder to justify than merely allowing harm. This paper is the first of a two paper critical overview of the literature on the Doctrine of Doing and Allowing. In this paper, I consider the analysis of the distinction between doing and allowing harm. I explore some of the most prominent attempts to analyse this distinction:. Philippa Foot’s sequence account, Warren (...) Quinn’s action/ inaction account, and counterfactual test accounts put forward by Shelly Kagan and Jonathan Bennett. I also discuss Jeff McMahan’s account of the removal of barriers to harm. I argue that analysis of the distinction has often been made more difficult by two mistaken assumption: (1) the assumption that when an agent does or allows harm his behaviour makes the difference to whether or not the harm occurs (2) the assumption that the distinction between doing and allowing and the distinction between action and inaction are interchangeable. I suggest that Foot’s account is the most promising account of the doing/allowing distinction, but that it requires further development. (shrink)

The distinction between doing and allowing appears to have moral significance, but the very nature of the distinction is as yet unclear. Philippa Foot's ‘pre-existing threats’ account of the doing/allowing distinction is highly influential. According to the best version of Foot's account an agent brings about an outcome if and only if his behaviour is part of the sequence leading to that outcome. When understood in this way, Foot's account escapes objections by Warren Quinn and Jonathan Bennett. However, more analysis (...) is required to show what makes a relevant condition part of a sequence. Foot's account is promising, but incomplete. (shrink)

Clinical researchers should help respect the autonomy and promote the well-being of prospective study participants by helping them make voluntary, informed decisions about enrollment. However, participants often exhibit poor understanding of important information about clinical research. Bioethicists have given special attention to “misconceptions” about clinical research that can compromise participants’ decision-making, most notably the “therapeutic misconception.” These misconceptions typically involve false beliefs about a study’s purpose, or risks or potential benefits for participants. In this article, we describe a misconception involving (...) false beliefs about a study’s potential benefits for non-participants, or its expected social value. This social value misconception can compromise altruistically motivated participants’ decision-making, potentially threatening their autonomy and well-being. We show how the social value misconception raises ethical concerns for inherently low-value research, hyped research, and even ordinary research, and advocate for empirical and normative work to help understand and counteract this misconception’s potential negative impacts on participants. (shrink)

For many women experiencing motherhood for the first time, the message they receive is clear: mothers who do not breastfeed ought to have good reasons not to; bottle feeding by choice is a failure of maternal duty. We argue that this pressure to breastfeed arises in part from two misconceptions about maternal duty: confusion about the scope of the duty to benefit and conflation between moral reasons and duties. While mothers have a general duty to benefit, we argue that this (...) does not imply a duty to carry out any particular beneficent act. Therefore, the expectation that mothers should breastfeed unless they have sufficient countervailing reasons not to is morally unwarranted. Recognising the difference between reasons and duties can allow us to discuss the benefits of breastfeeding and the importance of supporting mothers who wish to breastfeed without subjecting mothers who bottle feed to guilt, blame and failure. (shrink)

This volume presents ten new essays on the nature of perceptual imagination and perceptual memory, framed by an introductory overview of these topics. How do perceptual imagination and memory resemble and differ from each other and from other kinds of sensory experience? And what role does each play in perception and in the acquisition of knowledge? These are the two central questions that the contributors seek to address.

I argue that dreams can contain perceptual elements in multifarious, heretofore unthought-of ways. I also explain the difference between dreams that contain perceptual elements, perceptual experiences that contain dream elements, and having a dream and a perceptual experience simultaneously. I then discuss two applications of the resulting view. First, I explain how my taxonomy of perception in dreams will allow “dream engineers”—who try to alter the content of people’s dreams—to accurately classify different dreams and explore creating new forms of perception (...) in dreams. Second, I consider the consequences of the view for the role of memory in dreaming and imagination. I argue that not every element of dreams or sensory imaginations must rely on memory. The resultant view of sensory imagination provides a counterexample to Hume’s account of sensory imagination, according to which sensory imagination must be built up from faint copies of sensory impressions stored in memory. (shrink)

According to the Doctrine of Doing and Allowing, the distinction between doing and allowing harm is morally significant. Doing harm is harder to justify than merely allowing harm. This paper is the second of a two paper critical overview of the literature on the Doctrine of Doing and Allowing. In this paper, I consider the moral status of the distinction between doing and allowing harm. I look at objections to the doctrine such as James’ Rachels’ Wicked Uncle Case and Jonathan (...) Bennett’s argument that any acceptable analysis of the distinction leaves it implausible that the distinction is morally relevant. I consider putative defences of the Doctrine from Philippa Foot and Warren Quinn. I argue that neither Foot not Quinn provides a satisfactory justification of the Doctrine of Doing and Allowing, but that the idea of self-ownership discussed by Quinn can be developed to provide a justification of the doctrine. (shrink)

In Responding to Global Poverty: Harm, Responsibility, and Agency, Christian Barry and Gerhard Øverland address the two types of argument that have dominated discussion of the responsibilities of the affluent to respond to global poverty. The second type of argument appeals to ‘contribution-based responsibilities’: the affluent have a duty to do something about the plight of the global poor because they have contributed to that plight. Barry and Øverland rightly recognize that to assess contribution-based responsibility for global poverty, we need (...) to understand what it is for an agent to contribute to harm rather than merely failing to prevent it. Barry and Øverland argue that we should replace the traditional bipartite distinction doing and allowing with a bipartite distinction between doing, allowing and enabling. I argue that their discussion represents a significant contribution to this debate. However, more detail on their key ideas of ‘relevant action’ and ‘complete causal process’ is needed. Moreover, in cases involving the removal of barriers, the non-need based claims of those involved matter. (shrink)

Provides an overview and examples of what impossible figures are, and explains their interest to many different disciplines including philosophy, psychology, art and mathematics.

It is hoped that modern sensory substitution and augmentation devices will be able to replace or expand our senses. But to what extent has this been achieved to date? To what extent are the experiences created by sensory substitution devices like the sensory experiences that we are trying to replace? To what extent can we augment people’s senses providing them with new information and new experiences? The first aim of this introduction is to delve deeply into this question to discover (...) the usefulness of these devices, to outline the different sorts of experience that might be created, and what the evidence tells us about these experiences. While there are some reasons to be hopeful about the powers of sensory substitution devices, there are also reasons to wonder whether they will ever really have the practical applications that we hope they might have. The second aim is to look to see whether the study of modern sensory substitution and augmentation devices can shed light on the nature of our senses and perception in general. Much of the philosophical, psychological, and neuroscientific work that takes place concerning sensory substitution and augmentation is keenly aware of the possibility that it might help our understanding and it seeks to comprehend many different aspects of perception. (shrink)

Many philosophers display relaxed scepticism about the Doctrine of Doing and Allowing and the Doctrine of Double Effect, suspecting, without great alarm, that one or both of these Doctrines is indefensible. This relaxed scepticism is misplaced. Anyone who aims to endorse a theory of right action with Nonconsequentialist implications should accept both the DDA and the DDE. First, even to state a Nonconsequentialist theory requires drawing a distinction between respecting and promoting values. This cannot be done without accepting some deontological (...) distinction. Second, if someone is going to accept any deontological distinction she should accept either the DDE or the DDA or some replacement. Finally, anyone who accepts either the DDE or the DDA should accept both doctrines or a replacement of each. Unless both Doctrines can be defended or given a defensible replacement, any Nonconsequentialist is in trouble. (shrink)

This paper uses a dilemma presented by David Benatar to explore the challenges that ‘Sexual Liberals’ face in giving a satisfactory account of sexual ethics. A satisfactory Sexual Liberal account of sexual ethics must be able to fully explain the wrongness of sexual assault without implying that sexual activity should be restricted to those in love. The assumption that this is impossible may be due to mistakes in our thinking about sexual assault. However, even when such mistakes are resolved, producing (...) a satisfactory account of sexual ethics requires Sexual Liberals to confront the significance of the sexual in human life. I describe an account of sexual desire that explains the significance of the sexual in human life without forcing us to endorse a restrictive sexual ethics. (shrink)

Murdoch and Levinas both believe that our humanity requires us to suppress our natural egoism and to be morally responsive to others. Murdoch insists that while such a morality presupposes a ’transcendent background’, God should be kept out of the picture altogether. By contrast, Levinas argues that, in responding morally to others, we make contact with God (though not the God of traditional Christianity) and that in doing so we become more God-like. I attempt to clarify their agreements and differences, (...) and I offer some criticisms of their conception of humanity, God, and the relationship between them. (shrink)

I show that the indeterminacy problem for computational structuralists is in fact far more problematic than even the harshest critic of structuralism has realised; it is not a bullet which can be bitten by structuralists as previously thought. Roughly, this is because the structural indeterminacy of logic-gates such as AND/OR is caused by the structural identity of the binary computational digits 0/1 themselves. I provide a proof that pure computational structuralism is untenable because structural indeterminacy entails absurd consequences - namely, (...) that there is only one binary computational digit. I conclude that accounting for individuation is a more important desiderata for a theory of computation than even that of triviality. -/- . (shrink)

I recently told my uncle that I thought I had come up with a way of showing that a mother who saw her child about to be stung by a wasp should try to intervene. I’d been working on this for several months. My uncle did not look very impressed. To be fair, it doesn’t sound like a very impressive result. Surely it is just utterly obviously that mothers should protect their children from wasps? So why had this taken me (...) months of work? I am trying to come up with a moderate account of maternal duties. Maternal duties pick out what a mother is morally required to do for her children. In doing so, I’ve discovered that it is harder than it might at first appear to come up with a moderate account of maternal duties that recognises ‘obvious’ duties like the duty not to let your child be stung by a wasp. I’ve also found that in the context of maternal duties, even more than in other contexts, we need be cautious before we accept our judgments about what seems obvious. Yet, it is absolutely vital to come up with a good moderate account of maternal duties – because doing so is necessary to protect vulnerable women and children. (shrink)

The Procreation Asymmetry holds that we have strong moral reasons not to create miserable people for their own sakes, but no moral reasons to create happy people for their own sakes. To defend this conjunction against an argument that it leads to inconsistency, I show how recognizing ‘creation’ as a temporally extended process allows us to revise the conjuncts in a way that preserves their intuitive force. This defense of the Procreation Asymmetry is preferable to others because it does not (...) require us to take on controversial metaphysical or metaethical commitments – in other words, it has the theoretical virtue of portability. (shrink)

How does visual imagination differ from visual perceptual experience? And how should we describe experiences of visual imagery? Moreover how can people who have visual imagery convey what it is like to have it to those who have never had it – congenital aphantisics? This paper addresses these questions using examples of illusions and other perceptual phenomena to hone in on the answers.

Several philosophers have recently argued that policies aimed at reducing human fertility are a practical and morally justifiable way to mitigate the risk of dangerous climate change. There is a powerful objection to such “population engineering” proposals: even if drastic fertility reductions are needed to prevent dangerous climate change, implementing those reductions would wreak havoc on the global economy, which would seriously undermine international antipoverty efforts. In this article, we articulate this economic objection to population engineering and show how it (...) fails. We argue, first, that the economic objection paints an inaccurate picture of the complicated relationship between demographic change and economic growth, and second, that any untoward economic effects of fertility reduction can be mitigated with additional policies. Specifically, we argue that supplementing fertility reduction with policies that facilitate the emigration of younger people from developing nations to developed nations could allow for both global reductions in GHG emissions and continued economic stability. Further, we show that moral arguments against such unprecedented increases in immigration are unsuccessful. We conclude that population engineering is a practical and morally justifiable tool for addressing the twin evils of climate change and global poverty. (shrink)

The Body Ownership Thesis states that each person owns her body. I address a prominent objection, the Generation Problem: the Body Ownership Thesis apparently implies that parents own their children: as we own the fruit of our property, if a parent owns her own body, she must own her child and her child's body. I argue that a person does not own the fruit of her property when that fruit is a person or the body of a person. Persons have (...) conclusive title to their bodies, but only defeasible title to the fruits of their bodies. (shrink)

Frances Kamm’s Intricate Ethics1 lives up to its title. It presents the methods and contents of Kamm’s nonconsequentialist ethical theory with discussion of some alternatives, both substantive and methodological. The main focus is on the distinctions that non- consequentialist ethical theory draws between different ways of bringing about states of affairs. This is presented in Kamm’s char- acteristic style. Readers should expect highly complex, subtle arguments as Kamm draws out fine-grained distinctions from intuitive responses to cases. Those who find their (...) intuitions less than firm at such a level of detail may find Intricate Ethics frustrat- ing at times. Nonetheless, it is a highly significant work. It dis- cusses issues at the heart of nonconsequentialist ethical theory with prodigious insight and clarity of thought. Even those whose intuitions prevent them from following Kamm to her conclusions will find the discussion along the way richly rewarding. (shrink)

We arrived at the neighborhood in Antwerp where our accommodation, Adagio Aprthotel, was located. The presence of immigrants was the one of the first things that caught my attention. They are everywhere. Enroute to the shops past the train station after dropping off our bags, Amiel and I passed a synagogue, and at McDonald’s (yup, my first meal in Belgium was french fries!), seated at the next table were two Filipinos. Overhearing their chatter, I surmised that they have been living (...) in Antwerp for some time. While intently exploring the surrounding streets, it became obvious that there is a profusion of migrant communities in Antwerp offering a multifaceted panorama of cultural diversity. This iss underscored by the conspicuous presence of Orthodox Jews, Arabs, Africans, and Chinese, the latter ensconced in their own Chinatown. Our neighborhood afforded immersion within a milieu teeming with migrant-owned enterprises, from butcher shops and corner stores to quaint cafés and eateries, predominantly overseen by Middle Easterners and Jews. Our first communal meal was, in fact, at an Arabic restaurant just across our accommodations. (shrink)

An important strand in the debate on abortion focuses on the moral status of fetuses. Knowledge of the moral value of fetuses is needed to assess fetuses’ moral status. As Errol Lord argues, acquaintance plays a key role in moral and aesthetic knowledge. Many pregnant persons have acquaintance with their fetus that provides privileged access to knowledge about that fetus’ moral value. This knowledge is (a) very difficult to acquire without being pregnant and (b) relevant for assessing the moral status (...) of fetuses. This has implications for public debate on abortion and the research methods of philosophers working on abortion. (shrink)

This paper provides an introduction to, and overview of, the Philosophy of Perception.

Although researchers generally take great care to ensure that human subjects do not suffer very serious harms from their involvement in research, the situation is different for nonhuman animal subjects. Significant progress has been made in reducing unnecessary animal suffering in research, yet researchers still inflict severe pain and distress on tens of thousands of animals every year for scientific purposes. Some bioethicists, scientists, and animal welfare advocates argue for placing an upper limit on the suffering researchers may impose on (...) animal subjects, with rare exceptions for research that promises critical social benefits. In this article, I argue against such an upper limit on harm on the grounds that researchers often can compensate animal subjects for their suffering, even severe and long-lasting suffering. If animal subjects receive adequate compensation for the harms they suffer, then there is no general limit on how much suffering researchers may impose on them for scientific purposes. (shrink)

Many contemporary ethical debates turn on claims about the nature and extent of our alleged procreative moral rights: moral rights to procreate or not to procreate as we choose. In this article, I argue that there are no procreative moral rights, in that generally we do not have a distinctive moral right to procreate or not to procreate as we choose. However, interference with our procreative choices usually violates our nonprocreative moral rights, such as our moral rights to bodily autonomy (...) or to privacy. My argument presents hypothetical cases in which a state interferes with a person's procreative choices in order to promote aggregate social welfare, but this interference does not violate any of the person's nonprocreative moral rights. These cases not only undermine frequently made claims that widely recognized nonprocreative moral rights entail procreative moral rights, they also challenge the intuitively plausible claim that interference with our procreative choices as such violates our moral rights. What at first appear to be substantive moral rights are in fact a kind of illusion created by the frequent overlap of other rights, but lacking in substance beyond that overlap. While this argument against the existence of procreative moral rights has substantive implications for ongoing debates in reproductive ethics, I ultimately suggest that it is consistent with a progressive approach to reproductive justice. (shrink)

I became a philosopher because I was fascinated by the ethics of abortion. Not only is abortion a crucial practical issue – a matter of life or death – but it forces us to grapple with some of the hardest and yet most significant philosophical questions: If we agree that all human beings have a right to life, what entities do we count as human beings? What characteristics, if any, are necessary? What happens when one entity’s life clashes with another’s (...) bodily integrity? What are the roles of responsibility, consent and fore-knowledge? (shrink)

Infant feeding decisions are highly emotionally charged. I argue elsewhere that many problems surrounding infant feeding decisions result from a moralized context created by mistakes in our assumptions about maternal duties including the mistaken assumption that mothers have a defeasible moral duty to breastfeed. Mothers have a reason, but not a moral duty to breastfeed. Even those who are convinced by my argument in the case of full-term babies, might find it harder to accept in the case of premature babies. (...) It might seem that mothers do have a defeasible moral duty to breastfeed or, as is more likely to be appropriate in such cases, to express breastmilk. Here, I explain why preterm neonates present a tricky case for the right not to breastfeed. I show why, nonetheless, moral pressure for mothers to express breastmilk in the neonatal unit is neither permissible nor pragmatically advisable. I argue that instead we should address structural barriers to providing breastmilk and support donor milk initiatives. (shrink)

It may be tempting for breastfeeding advocates to respond to challenges to breastfeeding older children or breastfeeding in public by pointing out the nutritional or developmental benefits of breastfeeding or by noting that breastfeeding is often extremely discreet. Such responses may concede more than they should: by focusing on rebutting the empirical claim, breastfeeding supporters may end up implicitly accepting two presuppositions about breastfeeding: first, the presupposition that breastfeeding requires justification in terms of health or developmental benefits to the child; (...) second, the presupposition that breastfeeding in public is only acceptable if assumed standards of discretion are met. -/- This paper aims to use the methods of analytic philosophy to: (a) show how, if left unchallenged, these implicit assumptions can become part of the pragmatic presuppositions of the conversation, so that the discussion proceeds taking their acceptance for granted; (b) argue that we can expect these presuppositions to have negative effects on all mothers, no matter how they feed their babies, and on the tenor of public discussion of infant feeding; (c) reconstruct the reasoning that might underlie these presuppositions and show that this reasoning is mistaken; (d) show that recognising breastfeeding as a family way of life and a loving interaction between parent and child gives rise to a moral right to breastfeed in public without social sanction, whether one is able to breastfeed discreetly or not. (shrink)

They say that argumentative writing skills are best learned through writing argumentative essays. I say that while this is excellent practice for argumentative writing, an important exercise to practice structuring such essays and build critical thinking skills simultaneously is what I call the four-sentence paper. The exercise has the template They say..., I say..., one might object..., I reply... One might object that the assignment oversimplifies argumentative writing, stifles creativity, promotes an adversarial attitude, or that students can’t consider objections well (...) anyway. I reply that a simplified form of argumentative writing is fine for beginners, especially since the template is ubiquitous in philosophy; that any assignment template has room for creativity; that considering objections is consistent with good manners; and that despite some pitfalls of trying to defend a thesis and consider objections, students are capable of considering objections well with proper instruction and practice. (shrink)

When a mother deliberately harms her child, it is tempting to assume that she must be either insane or lacking the "natural" love of a mother for her children. We want to believe that such mothers have almost nothing in common with "good" mothers. Drawing extensively on empirical research, Sarah LaChance Adams' Mad Mothers, Bad Mothers, and What A "Good" Mother Would Do shows that maternal ambivalence, simultaneous desires to nurture and violently reject one's children, is both common and reasonable, (...) the result of genuine conflicts between mothers' interests and those of their children. Both appropriate support and deliberative agency are necessary to avoid maternal ambivalence... (shrink)

© The Author 2017. Published by Oxford University Press on behalf of The Analysis Trust. All rights reserved. For Permissions, please email: [email protected] Boonin’s The Non-Identity Problem and the Ethics of Future People and Rivka Weinberg’s The Risk of a Lifetime: How, When and Why Procreation May Be Permissible are both important books for those interested in procreative ethics. Each argues for surprising and controversial conclusions: Boonin argues that we should solve the non-identity problem by accepting its apparently unacceptable conclusion (...) that actions cannot be wrong due to their effects on future people whose lives are worth living and who would not exist were the actions not performed; Weinberg argues that there is no non-identity problem, that future children have no interest in existing, but significant interest in avoiding harm and that procreation is, therefore, a much more morally risky business than we tend to think. Even if... (shrink)

The distinction between action and omission is of interest in both theoretical and practical philosophy. We use this distinction daily in our descriptions of behaviour and appeal to it in moral judgements. However, the very nature of the act/omission distinction is as yet unclear. Jonathan Bennett’s account of the distinction in terms of positive and negative facts is one of the most promising attempts to give an analysis of the ontological distinction between action and omission. According to Bennett’s account, an (...) upshot is the result of an agent’s action if and only if the relevant fact about her conduct is positive. A proposition about an agent’s conduct is positive if and only if most possible movements of the agent would not have made that proposition true. However, Bennett’s account will fail unless it is possible to make sense of claims about ‘most possible movements of the agent’. We need a way of comparing the size of subsets of the behaviour space (the set of possible movements). I argue that Bennett’s own method of comparison is unsatisfactory. I present an alternative method of comparing subsets of the behaviour space. (shrink)

As its title indicates, Philip Pettit’s “Three Mistakes about Doing Good (and Bad)” identifies and rejects three common claims restricting what can count as a good (or bad ) effect of action. The key question here is how do we work out how much good you have brought about by your action? The first common claim is that only causal effects or consequences of action can count as goods that are brought about by an action. The second, that we can (...) only count behavioural effects of action. The third, that we can only count consequences of “an all-or-nothing or on-off or discrete kind”. Pettit argues that all three of these claims are mistaken: the first claim is mistaken because our actions can bring about goods that are constitutive consequences of those actions; the second claim is mistaken because the good consequences of an action can depend upon the agent having acted out of certain dispositions; the third claim is mistaken because the good consequences of an action can include the extra effects of pursuing more basic good consequences (such as benefits to others) in a more deliberate or reliable manner. (shrink)

Attempts to defend the moral significance of the distinction between doing and allowing harm directly have left many unconvinced. I give an indirect defence of the moral significance of the distinction between doing and allowing, focusing on the agent's duty to reason in a way that is responsive to possible harmful effects of their behaviour. Due to our cognitive limitations, we cannot be expected to take all harmful consequences of our behaviour into account. We are required to be responsive to (...) harmful consequences that have some feature that makes it easy for us to become aware of them. I show that, under Jonathan Bennett's analysis of the doing/allowing distinction, harm that is incidentally done has such a feature, which is not shared by harm that is incidentally allowed. Any plausible analysis of the doing/allowing distinction will entail a similar asymmetry. It follows that, prima facie, an agent who incidentally does harm has violated a moral requirement (the deliberative requirement) which an agent who incidentally allows harm has not violated. 1. (shrink)

One of the Belmont Report’s most important contributions was the clear and serviceable distinction it drew between standard medical practice and biomedical research. A less well-known achievement of the Report was its conceptualization of innovative practice, a type of medical practice that is often mistaken for research because it is new, untested, or experimental. Although the discussion of innovative practice in Belmont is brief and somewhat cryptic, this does not reflect the significant progress its authors made in understanding innovative practice (...) and the distinctive ethical issues it raises. This article explores the history and broader context of Belmont’s conception of innovative practice, its strengths and weaknesses, and its contemporary relevance for scholars working in bioethics and health policy. While this conception of innovative practice deserves our attention, it is inherently limited in some important ways. (shrink)

Innovative practice involves medical interventions that deviate from standard practice in significant ways. For many patients, innovative practice offers the best chance of successful treatment. Because little is known about most innovative treatments, clinicians who engage in innovative practice might consider including extra procedures, such as scans or blood draws, to gather information about the innovation. Such information-gathering interventions can yield valuable information for modifying the innovation to benefit future patients and for designing scientific studies of the innovation. However, existing (...) guidelines do not say when or whether it is appropriate to add potentially risky information-gathering interventions for these purposes. As a result, clinicians may assume that information-gathering interventions are ethically inappropriate and should not be used in innovative practice. This assumption can lead to seriously negative consequences, such as increasing the likelihood that harmful or ineffective innovations will be adopted and creating new barriers to the development of genuinely beneficial treatments. We argue that health care institutions need to promote the responsible use of information-gathering interventions as an adjunct to innovative practice, and that these interventions are not clinical research and should not be subject to research oversight. (shrink)