Imagine a world where everyone is healthy, intelligent, long living and happy. Intuitively this seems wonderful albeit unrealistic. However, recent scienti c breakthroughs in genetic engineering, namely CRISPR/Cas bring the question into public discourse, how the genetic enhancement of humans should be evaluated morally. In 2001, when preimplantation genetic diagnosis (PGD) and in vitro fertilisation (IVF), enabled parents to select between multiple embryos, Julian Savulescu introduced the principle of procreative bene cence (PPB), stating that parents have the obligations (...) to choose the child that is expected to have the best life. In this paper I argue that accepting the PPB and the consequentialist principle (CP) that two acts with the same consequences are morally on par, commits one to accepting the parental obligation of genetically enhancing one's children. (shrink)

Principles of procreative beneficence (PPBs) hold that parents have good reasons to select the child with the best life prospects. Sparrow (2010) claims that PPBs imply that we should select only female children, unlesswe attach normative significance to “normal” human capacities. We argue that this claim fails on both empirical and logical grounds. Empirically, Sparrow’s argument for greater female wellbeing rests on a selective reading of the evidence and the incorrect assumption that an advantage for females would persist (...) even when a serious gender imbalance is obtained. Logically, PPBs cite only pro tanto reasons and allow that the good of an individual child could be outweighed by other morally relevant considerations, such as those which take collectively suboptimal outcomes into account. There is thus no need to attach value to the “normal.”. (shrink)

The view that it is better for life to be created free of disability is pervasive in both common sense and philosophy. We cast doubt on this view by focusing on an influential line of thinking that manifests it. That thinking begins with a widely-discussed principle, Procreative Beneficence, and draws conclusions about parental choice and disability. After reconstructing two versions of this argument, we critique the first by exploring the relationship between different understandings of well-being and disability, (...) and the second by more briefly focusing on the idea of a significant reason. By placing these results against the broader historical and ongoing contexts in which the lives of those with disabilities have been deemed of inferior quality, we conclude with a call for greater humility about disability and well-being in thought and practice. (shrink)

If it is within our power to provide a significantly better world for future generations at a comparatively small cost to ourselves, we have a strong moral reason to do so. One way of providing a significantly better world may involve replacing our species with something better. It is plausible that in the not‐too‐distant future, we will be able to create artificially intelligent creatures with whatever physical and psychological traits we choose. Granted this assumption, it is argued that we should (...) engineer our extinction so that our planet's resources can be devoted to making artificial creatures with better lives. (shrink)

The argument of Julian Savulescu’s 2001 paper, “Procreative Beneficence: Why We Should Select the Best Children” is flawed in a number of respects. Savulescu confuses reasons with obligations and equivocates between the claim that parents have some reason to want the best for their children and the more radical claim that they are morally obligated to attempt to produce the best child possible. Savulescu offers a prima facie implausible account of parental obligation, as even the best parents typically (...) fail to do everything they think would be best for their children let alone everything that is in fact best for their children. The profound philosophical difficulties which beset the attempt to formulate a plausible account of the best human life constitute a further independent reason to resile from Savulescu’s conclusion. Savulescu’s argument also requires parents to become complicit with racist and homophobic oppression, which is yet another reason to reject it. Removing the equivocation from Savulescu’s argument allows us to see that the assertion of an obligation to choose the “best child” has much more in common with the “old” eugenics than Savulescu acknowledges. (shrink)

My objective of this paper is to suggest and workout a more credible form of the Principle of Beneficence from the common essential elements of the three major ethical theories (Deontology, Utilitarianism and Virtue Ethics) that will try to overcome the over-demanding objection of Utilitarianism and the rigorism of Kant’s Deontology. After analyzing these three moral systems, I find that beneficence lies within the very essence of humanity. Human beings are superior to other creatures in the world (...) due to rationality and humanity. From the humanitarian ground, a common goodness lies within every human. Beneficence, as a moral principle, is derived from this inner humanity of every individual. Despite their initial differences, utilitarianism, deontology and virtue ethics recognize this fundamental humanitarian disposition of doing good for all as a part of being a morally better person. The principle of beneficence as I suggest, is different from its consequential utilitarian notion suggested by Mill. This version of beneficence is more credible as it does not impose excessive demands upon an individual to develop any maximum beneficial outcome following utilitarian calculation of beneficence over cost, and it also strives to overcome the rigorous duty-based theory of Kantian deontology by appealing to the fundamental virtue of humanity. Finally, the credibility of this form of beneficence comes from the underlying transcendental humanism which is the chief feature of Indian tradition. (shrink)

Theoretical ethics includes both metaethics (the meaning of moral terms) and normative ethics (ethical theories and principles). Practical ethics involves making decisions about every day real ethical problems, like decisions about euthanasia, what we should eat, climate change, treatment of animals, and how we should live. It utilizes ethical theories, like utilitarianism and Kantianism, and principles, but more broadly a process of reflective equilibrium and consistency to decide how to act and be.

This paper is an examination of the ethical principles of effective altruism as they are articulated by Peter Singer in his book The Most Good You Can Do. It discusses the nature and the plausibility of the principles that he thinks both guide and ought to guide effective altruists. It argues in § II pace Singer that it is unclear that in charitable giving one ought always to aim to produce the most surplus benefit possible and in § III that (...) there is a more attractive set of principles than the ones Singer outlines that ought to guide effective altruists in their philanthropic practices and in their lives more generally. These principles fit better with his practical ambitions and with plausible attitudes about the limits of beneficence. (shrink)

Can robots have significant moral status? This is an emerging topic of debate among roboticists and ethicists. This paper makes three contributions to this debate. First, it presents a theory – ‘ethical behaviourism’ – which holds that robots can have significant moral status if they are roughly performatively equivalent to other entities that have significant moral status. This theory is then defended from seven objections. Second, taking this theoretical position onboard, it is argued that the performative threshold that robots need (...) to cross in order to be afforded significant moral status may not be that high and that they may soon cross it (if they haven’t done so already). Finally, the implications of this for our procreative duties to robots are considered, and it is argued that we may need to take seriously a duty of ‘procreative beneficence’ towards robots. (shrink)

This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely “imperfect” duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from (...) political philosophy has at times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of “specific” beneficence that should be reflected in a society’s health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature. (shrink)

Herjeet Kaur Marway recently proposed the Principle of Procreative Justice, which says that reproducers have a strong moral obligation to avoid completing race and colour injustices through their selection choices. In this article, we analyze this principle and argue, appealing to a series of counterexamples, that some of the implications of Marway's Principle of Procreative Justice are difficult to accept. This casts doubt on whether the principle should be adopted. Also, we show that there (...) are some more principled worries regarding Marway's idea of a strong pro tanto duty not to complete injustices through one's procreative choices. Nonetheless, we believe Marway's arguments point in the right general direction regarding duties and structural injustice. Thus, in the final part, we suggest a positive proposal on how it would be possible to respond to the cases we raise. More specifically, we explore the suggestion that agents have a pro tanto duty to participate in eliminating structural injustice. Importantly, this duty can be satisfied, not only in procreation choices but in multiple ways. (shrink)

Philosophers who defend a person’s right, under certain circumstances, to end his own life or to have a physician end it for him typically appeal both to respect for patient autonomy and to considerations of beneficence. Neither autonomy alone nor beneficence alone can ground a persuasive case for euthanasia. I argue, however, that the standard argument for euthanasia is unsound. It is not possible to combine the principles of autonomy and beneficence in such a way as to (...) justify euthanasia for those who request it and are either incurably ill, in irremediable pain, or fearful of future incapacity, while excluding both involuntary euthanasia and assisted death for those who request it despite being neither incurably ill, in irremediable pain nor fearful of future incapacity. (shrink)

A background assumption in much contemporary political philosophy is that justice is the first virtue of social institutions, taking priority over other values such as beneficence. This assumption is typically treated as a methodological starting point, rather than as following from any particular moral or political theory. In this paper, I challenge this assumption. To frame my discussion, I argue, first, that justice doesn’t in principle override beneficence, and second, that justice doesn’t typically outweigh beneficence, since, (...) in institutional contexts, the stakes of beneficence are often extremely high. While there are various ways one might resist this argument, none challenge the core methodological point that political philosophy should abandon its preoccupation with justice and begin to pay considerably more attention to social beneficence—that is, to beneficence understood as a virtue of social institutions. Along the way, I also highlight areas where focusing on social beneficence would lead political philosophers in new and fruitful directions, and where normative ethicists focused on personal beneficence might scale up their thinking to the institutional case. GPI Working Paper No. 11-2022. (shrink)

This article explores the Nuffield Council on Bioethics’ recent report about non-invasive prenatal testing. Given that such testing is likely to become the norm, it is important to question whether there should be some ethical parameters regarding its use. The article engages with the viewpoints of Jeff McMahan, Julian Savulescu, Stephen Wilkinson and other commentators on prenatal ethics. The authors argue that there are a variety of moral considerations that legitimately play a significant role with regard to (prospective) parental decision-making (...) in the context of NIPT, for example, views on the morality of abortion and understandings of the impact of disability on quality of life. The variable nature of such considerations, both singularly and combined, suggests that any approach to NIPT should be sensitive to and understanding of similarly variable parental assessments and decisions. The implications of the approach developed for current and future policies in this area are explored, along with the impact of such arguments on ideas about procreative beneficence. (shrink)

Artificial Intelligence (AI) is already having a major impact on society. As a result, many organizations have launched a wide range of initiatives to establish ethical principles for the adoption of socially beneficial AI. Unfortunately, the sheer volume of proposed principles threatens to overwhelm and confuse. How might this problem of ‘principle proliferation’ be solved? In this paper, we report the results of a fine-grained analysis of several of the highest-profile sets of ethical principles for AI. We assess whether (...) these principles converge upon a set of agreed-upon principles, or diverge, with significant disagreement over what constitutes ‘ethical AI.’ Our analysis finds a high degree of overlap among the sets of principles we analyze. We then identify an overarching framework consisting of five core principles for ethical AI. Four of them are core principles commonly used in bioethics: beneficence, non-maleficence, autonomy, and justice. On the basis of our comparative analysis, we argue that a new principle is needed in addition: explicability, understood as incorporating both the epistemological sense of intelligibility (as an answer to the question ‘how does it work?’) and in the ethical sense of accountability (as an answer to the question: ‘who is responsible for the way it works?’). In the ensuing discussion, we note the limitations and assess the implications of this ethical framework for future efforts to create laws, rules, technical standards, and best practices for ethical AI in a wide range of contexts. (shrink)

Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was adopted recently by a team of informaticists designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, especially when (...) principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and non-maleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper we show how using ethical principles can help in the design of EHRs by first, explaining how ethical principles can and should be used generally, and then by, discuss how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting further ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest. (shrink)

This article proposes that, in line with moral-cosmopolitan theorists, affluent nations have an obligation, founded in justice and not merely altruism or beneficence, to share the responsibility of the burden of public health implementation in low-income contexts. The current Ebola epidemic highlights the fact that countries with under-developed health systems and limited resources cannot cope with a significant and sudden health threat. The link between burden of disease, adverse factors in the social environment and poverty is well established and (...) confirmed by the 2008 World Health Organization (WHO)’s Social Determinants of Health Commission report. Well-resourced nations generally consider that they have some humanitarian obligation to assist where possible, but this obligation is limited. The following questions are considered: Is reliance on the principle of beneficence to address the global disparities in the social determinants of health and life expectancy at birth good enough? Do well-resourced nations have some obligation from justice, which is stronger than from beneficence, and which cannot be as easily cast aside or diminished, to address these issues? In a globalised world, shaped by centuries of historical injustice and where first-world economies are now so intertwined and reliant on third-world labour, beneficence is not a strong enough principle on which to base an obligation to achieve the WHO vision of ‘health equity through action on the social determinants of health’. (shrink)

The human factor in information systems is a large vulnerability when implementing cybersecurity, and many approaches, including technical and policy driven solutions, seek to mitigate this vulnerability. Decisions to apply technical or policy solutions must consider how an individual’s values and moral stance influence their responses to these implementations. Our research aims to evaluate how individuals prioritise different ethical principles when making cybersecurity sensitive decisions and how much perceived choice they have when doing so. Further, we sought to use participants’ (...) responses to cybersecurity scenarios to create profiles that describe their values and individual factors including personality. Participants (n = 193) in our study responded to five different ethically sensitive cybersecurity scenarios in random order, selecting their action in that scenario and rating and ranking of the ethical principles (i.e., Beneficence, Non-Maleficence, Justice, Autonomy, Explicability) behind that action. Using participants’ demographics, personality, values, and cyber hygiene practices, we created profiles using machine learning to predict participants’ choices and the principle of most importance to them across scenarios. Further, we found that, generalising, for our participants Autonomy was the most important ethical principle in our scenarios, followed by Justice. Our study also suggests that participants felt they had some agency in their decision making and they were able to weigh up different ethical principles. (shrink)

Euthanasia and assisted suicide have proved to be very contentious topics in medical ethics. Some ethicists are particularly concerned that allowing physicians to carry out these procedures will undermine their professional obligations and threaten the very goals of medicine. However, I maintain that the fundamental goals of medicine not only do not preclude the practice of euthanasia and assisted suicide by physicians, but can in fact be seen to support these practices in some instances. I look at two influential views (...) of the goals of medicine, one based on the broad guiding principles of autonomy, beneficence and nonmaleficence, and the other focusing on several more concrete aims, concluding that both approaches can be seen to support euthanasia and assisted suicide. I then turn to the popular concern that allowing physicians to carry out euthanasia and assisted suicide will lead to widespread abuse. I argue that the possibility for abuse can be minimised if we make the patient's autonomous consent an essential requirement of the practice. (shrink)

Biomarker-based predictive tests for subjectively asymptomatic Alzheimer’s disease (AD) are utilized in research today. Novel applications of artificial intelligence (AI) promise to predict the onset of AD several years in advance without determining biomarker thresholds. Until now, little attention has been paid to the new ethical challenges that AI brings to the early diagnosis in asymptomatic individuals, beyond contributing to research purposes, when we still lack adequate treatment. The aim of this paper is to explore the ethical arguments put forward (...) for AI aided AD prediction in subjectively asymptomatic individuals and their ethical implications. The ethical assessment is based on a systematic literature search. Thematic analysis was conducted inductively of 18 included publications. The ethical framework includes the principles of autonomy, beneficence, non-maleficence, and justice. Reasons for offering predictive tests to asymptomatic individuals are the right to know, a positive balance of the risk-benefit assessment, and the opportunity for future planning. Reasons against are the lack of disease modifying treatment, the accuracy and explicability of AI aided prediction, the right not to know, and threats to social rights. We conclude that there are serious ethical concerns in offering early diagnosis to asymptomatic individuals and the issues raised by the application of AI add to the already known issues. Nevertheless, pre-symptomatic testing should only be offered on request to avoid inflicted harm. We recommend developing training for physicians in communicating AI aided prediction. (shrink)

Gender affirming hormone treatment is an important part of the care of trans adolescents which enables them to develop the secondary sexual characteristics congruent with their identified genders. There is an increasing amount of empirical evidence showing the benefits of gender affirming hormone treatment for psychological health and social well-being in this population. However, in several countries, access to gender affirming hormone treatment for trans adolescents has recently been severely restricted. While much of the opposition to gender affirming hormone treatment (...) for trans adolescents has in part been ideologically motivated, it also reflects a debate about whether there are harms that outweigh the benefits of the treatment. Accordingly, a systematic and comprehensive philosophical analysis of the ethics of gender affirming hormone treatment for trans adolescents is needed. Herein, I offer such an analysis that draws on the four principles of biomedical ethics by Tom Beauchamp and James Childress. Based on the considerations of beneficence, nonmaleficence, autonomy, and justice, I argue that the provision of access to gender affirming hormone treatment for consenting trans adolescents is ethically required and that the current restrictions to such treatment are ethically wrong. (shrink)

For decades, student ratings of university faculty have been used by administrators in high stakes faculty employment decisions such as tenure, promotion, contract renewal and reappointment, and merit pay. However, virtually no attention has been paid to the ethical questions of using ratings in employment decisions. Instead, the ratings literature is generally limited to psychometric issues such as whether a given student ratings instrument exhibits the statistical properties of reliability and validity. There is no consensus understanding of teaching effectiveness, the (...) very attribute that students are alleged to “evaluate.” What students are actually doing when they complete a ratings form—whether measuring, evaluating, reporting, judging, opining, etc.—remains unsettled in the ratings literature. If ratings are surveys of student satisfaction, they have no logical or ethical connection with teaching expertise. I argue that the administrative use of student ratings in faculty employment decisions violates basic moral principles including nonmaleficence, beneficence, professional autonomy and clinical independence, and multiple aspects of justice including due care, truthfulness, and equitable treatment. These ethical violations rule against any administrative use of student ratings in faculty employment decisions, including the “use with caution in conjunction with other evaluative methods” deployment of student ratings. My conclusion is that such use should be immediately and universally terminated. Formative use of student questionnaires as part of ordinary instructional communication and feedback between instructor and students is a separate issue and outside of the scope of this paper. (shrink)

Assisted reproductive technologies have greatly increased our control over reproductive choices, leading some bioethicists to argue that we face unprecedented moral obligations towards progeny. Several models attempting to balance the principle of procreative autonomy with these obligations have been proposed. The least demanding is the minimal threshold model (MTM), according to which every reproductive choice is permissible, except creating children whose lives will not be worth living. Hence, as long as the future child is likely to have a (...) life worth living, prospective parents may be allowed to use preimplantation genetic diagnosis (PGD) to select embryos with genetic diseases or disabilities. Assuming a consequentialist person‐affecting view of morality, this paper investigates whether the MTM is an appropriate tool to guide procreative decisions given the continuous development of reproductive genetic technologies. In particular, I consider germline genome editing (GGE) and I argue that its application in human reproduction, unlike PGD, should be conceived as person‐affecting towards future progeny. I claim that even if we assume the plausibility of the MTM within PGD, we are committed to accepting that a greater moral obligation towards progeny should guide procreative decisions if GGE were available. In this case, the MTM should no longer be considered an appropriate instrument to guide procreative choices. Finally, I investigate when we face this greater moral obligation, concluding that it applies only when prospective parents have already engaged in the in vitro fertilization process. (shrink)

This chapter addresses the close association between withholding and withdrawing futile life-sustaining medical treatments and assisting patients with hastening ending their lives. Section 12.2 sets forth a definition of medical futility and places this concept in the broader context of bioethical principles of autonomy, beneficence, nonmaleficence and justice. Section 12.3 draws out futility’s ethical implications and considers the view that physicians are ethically permitted to refrain from medically futile treatments, should be encouraged to refrain, or have a duty to (...) refrain. Section 12.4 examines ethical arguments that physicians also have a positive duty to assist patients with terminal conditions who are imminently dying to end their lives. It explores ethical arguments for assisted dying that appeal to the physicians’ significant responsibility and relationship with patients, the claimed moral equivalence of actions and omissions, and the medical goal of helping patients have a peaceful and dignified death. (shrink)

Significant disagreement remains in ethics about the duties we have towards wild animals. This paper aims to mediate those disagreements by exploring how they are supported by, or diverge from, the common-sense ethical principles of non-maleficence, beneficence, autonomy and justice popular in medical ethics. We argue that these principles do not clearly justify traditional conservation or a ‘hands-off ’ approach to wild-animal welfare; instead, they support natural negative duties to reduce the harms that we cause as well as natural (...) positive duties to promote the welfare of wild animals. (shrink)

Machine intelligence already helps medical staff with a number of tasks. Ethical decision-making, however, has not been handed over to computers. In this proof-of-concept study, we show how an algorithm based on Beauchamp and Childress’ prima-facie principles could be employed to advise on a range of moral dilemma situations that occur in medical institutions. We explain why we chose fuzzy cognitive maps to set up the advisory system and how we utilized machine learning to train it. We report on the (...) difficult task of operationalizing the principles of beneficence, non-maleficence and patient autonomy, and describe how we selected suitable input parameters that we extracted from a training dataset of clinical cases. The first performance results are promising, but an algorithmic approach to ethics also comes with several weaknesses and limitations. Should one really entrust the sensitive domain of clinical ethics to machine intelligence? (shrink)

Principles of distributive justice bind macro-level institutional agents, like the state. But what does justice require in non-ideal circumstances, where institutional agents are unjust or do not e...

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, remdesivir (...) and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions. (shrink)

Some experts have argued that patients should routinely be told the specific magnitude and absolute probability of potential risks and benefits of screening tests. This position is motivated by the idea that framing risk information in ways that are less precise violates the ethical principle of respect for autonomy and its application in informed consent or shared decisionmaking. In this Perspective, we consider a number of problems with this view that have not been adequately addressed. The most important challenges (...) stem from the danger that patients will misunderstand the information or have irrational responses to it. Any initiative in this area should take such factors into account and should consider carefully how to apply the ethical principles of respect for autonomy and beneficence. (shrink)

Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

Background: Smart sensors have been developed as diagnostic tools for rehabilitation to cover an increasing number of geriatric patients. They promise to enable an objective assessment of complex movement patterns. -/- Objective: This research aimed to identify and analyze the conflicting ethical values associated with smart sensors in geriatric rehabilitation and provide ethical guidance on the best use of smart sensors to all stakeholders, including technology developers, health professionals, patients, and health authorities. -/- Methods: On the basis of a systematic (...) literature search of the scientific databases PubMed and ScienceDirect, we conducted a qualitative document analysis to identify evidence-based practical implications of ethical relevance. We included 33 articles in the analysis. The practical implications were extracted inductively. Finally, we carried out an ethical analysis based on the 4 principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice. The results are reported in categories based on these 4 principles. -/- Results: We identified 8 conflicting aims for using smart sensors. Gains in autonomy come at the cost of patient privacy. Smart sensors at home increase the independence of patients but may reduce social interactions. Independent measurements performed by patients may result in lower diagnostic accuracy. Although smart sensors could provide cost-effective and high-quality diagnostics for most patients, minorities could end up with suboptimal treatment owing to their underrepresentation in training data and studies. This could lead to algorithmic biases that would not be recognized by medical professionals when treating patients. -/- Conclusions: The application of smart sensors has the potential to improve the rehabilitation of geriatric patients in several ways. It is important that patients do not have to choose between autonomy and privacy and are well informed about the insights that can be gained from the data. Smart sensors should support and not replace interactions with medical professionals. Patients and medical professionals should be educated about the correct application and the limitations of smart sensors. Smart sensors should include an adequate representation of minorities in their training data and should be covered by health insurance to guarantee fair access. (shrink)

Ask most philosophers for an example of a moral rationalist, and they will probably answer “Kant.” And no wonder. Kant’s first great work of moral philosophy, Groundwork of the Metaphysics of Morals, opens with a clarion call for rationalism, proclaiming the need to work out for once a pure moral philosophy, a metaphysics of morals. That this metaphysics includes the first principle of ethics, the moral law, is obvious. But what about the second principles, particular moral laws, such as (...) duties of truthfulness, beneficence, etc.? Are these principles metaphysical too? Many have thought not, since they make essential use of empirical and anthropological considerations. I argue otherwise; the second principles are metaphysical and this matters. I do this by taking seriously the metaphysics of the metaphysics of morals—more specifically, by understanding the metaphysics of morals alongside the metaphysics of nature. For, qua metaphysics, both employ a common two-stage methodology, the first stage of which is wholly a priori but the second stage of which is partly empirical. As I explain, appreciating this common methodology sheds new light on how the second principles are to be established, as well as on the reach of Kant’s rationalism. (shrink)

The procreative justice debate asks whether justice, and in particular, whether a principle of fair play, requires that non-parents share in the costs of procreation and child-rearing. The principle of fair play demands that persons who benefit from the cooperative labor of others share in the burdens of producing that benefit. Non-parents should share in the costs of procreation and child-rearing if reproductive and parental labor count as cooperative labor, but they are not obligated to share in (...) those costs if parents incur those costs as part of a personal project. I argue that parental labor counts as cooperative labor because becoming a parent involves knowingly assuming a social role whereby one incurs new moral and legal obligations. Even if parents are ultimately motived by personal reasons, they nevertheless constrain their liberty in order to comply with the rules of a cooperative scheme, and, in doing so, their labor plausibly counts as cooperative. Parents have a claim of justice on others, then, to consider whether the benefits and burdens of procreating and child-rearing are fairly distributed. (shrink)

In this paper, I argue that the principle of respect for autonomy can serve as the basis for laws that significantly limit conduct, including orders mandating isolation and quarantine. This thesis is fundamentally at odds with an overwhelming consensus in contemporary bioethics that the principle of respect for autonomy, while important in everyday clinical encounters, must be 'curtailed', 'constrained', or 'overridden' by other principles in times of crisis. I contend that bioethicists have embraced an indefensibly 'thin' notion of (...) autonomy that uproots the concept from its foundations in Kantian ethics. According to this thin conception, respect for autonomy, if unconditioned by competing principles (beneficence, justice, non-maleficence) would give competent adults the right to do anything they desired to do so long as they satisfied certain baseline psychological conditions. I argue that the dominant 'principlist' model of bioethical reasoning depends on this thin view of autonomy and show how it deprives us of powerful analytical tools that would help us to think seriously about the foundations of human rights, justice, and law. Then, I offer a brief sketch of a 'thick', historically grounded notion of autonomy and show what we could gain by taking it seriously. (shrink)

This article questions the commonly held view that professional ethics is grounded in general ethical principles, in particular, respect for client (or patient) autonomy and beneficence in the treatment of clients (or patients). Although these are admirable as general ethical principles, we argue that there is considerable logical difficulty in applying them to the professional-client relationship. The transition from general principles to professional ethics cannot be made because the intended conclusion applies differently to each of the parties involved, whereas (...) the premise is a general principle that applies equally to both parties. It is widely accepted that professionals are required to recognize that clients or patients possess rights to autonomy that are more than the general rights to personal autonomy accepted in ordinary social life, and that professionals are expected to display beneficence toward their clients that is more than the beneficence expected of anyone in ordinary social life. The comparative component of professional ethics is an intrinsic feature of the professional situation, and thus it cannot be bypassed in working out a proper professional ethics. Thus, we contend, the proper professional treatment of clients or patients has not been explained by appeal to general ethical principles. (shrink)

The primary aim of this paper is to critically evaluate the deductive model of ethical applications, which is based on normative ethical theories like deontology and consequentialism, and to show why a number of models have failed to furnish appropriate resolutions to practical moral problems. Here, for the deductive model, I want to call it a “Linear Mechanical Model” because the basic assumption of this model is that if a normative theory is sacrosanct, then the case is as it is. (...) The conclusion derived from the case will also be correct, true and acceptable. However, traditional ethicists used to apply their ethical theories, but they did not know which moral theory was effective on the ground level of reality. The study will show readers how ethical theories are in conflict with each other in the case of euthanasia. In more precise words, “which ethical theories are said to be applied, meta-ethical or normative, or both for the resolution of ethical problems? If normative theories are said to be applied, how the application can take place when it is contrary to our experience, that (then) in a situation of moral crises, no one really applies a theory?” For that, my argument is the linear model has failed because it is rigid, often ignores the agents’ intrinsic values, and has no space to amend it, no matter how bizarre the consequence is. Its alternative is the Inductive model. For that, the paper will take three moral principles (autonomy, beneficence including maleficence, and justice) of Beauchamp & Childress. This suggests us for resolving value-laden moral problems, we should consider some steps such as a) recognising moral issues to start with; b) developing the moral imagination; c) sharpening analytical/critical skills; d) testing out disagreements; e) effecting decisions and behavior; and f) implementation, closure, and process are of vital importance, in other words, it starts with the free and informed consensus of all interested parties, but this model also has been failed because the model could not give a systematic organization to their way of resolution. Here, my argument is that the inductive model provides resolution of the practical problem but ignores what is ethically obligatory, permissible, or wrong in that situation, and there are no appropriate suggestions in the case of a moral crisis. (shrink)

“Violence” and “nonviolence” are, increasingly, misleading translations for the Sanskrit words hiṃsā and ahiṃsā—used by Gandhi as the basis for his philosophy of satyāgraha. I argue for rereading hiṃsā as “maleficence” and ahiṃsā as “beneficence.” These two more mind-referring English words capture the primacy of intention implied by Gandhi’s core principles. Reflecting a political turn in moral accountability detectable through linguistic data, both the scope and the usage of the word “violence” have expanded dramatically, making it harder to convincingly (...) characterize people and actions as “nonviolent.” New terminology could clarify the distinction between hiṃsā and ahiṃsā, and, thereby, prevent misunderstandings of Gandhi. Training in beneficence would reflect Gandhi’s psychological path to reducing avoidable harm: ego-detachment, universal love, and seeking truth by experiment. -/- NOTE: An extended, unpublished version, with additional arguments and evidence, is also available on PhilPapers as "The Primacy of Intention and the Duty to Truth: A Gandhi-Inspired Argument for Retranslating Hiṃsā and Ahiṃsā, with Connections to History, Ethics, and Civil Resistance". (shrink)

The words "violence" and "nonviolence" are increasingly misleading translations for the Sanskrit words hiṃsā and ahiṃsā -- which were used by Gandhi as the basis for his philosophy of satyāgraha. I argue for re-reading hiṃsā as “maleficence” and ahiṃsā as “beneficence.” These two more mind-referring English words – associated with religiously contextualized discourse of the past -- capture the primacy of intention implied by Gandhi’s core principles, better than “violence” and “nonviolence” do. Reflecting a political turn in moral accountability (...) detectable through linguistic data, both the scope and the usage of the word “violence” have expanded dramatically. The expanded scope of “violence” reflects greater consciousness of the various forms that serious harm can take, but also makes it harder to convincingly characterize people and actions as “nonviolent.” New translations could clarify the distinction between hiṃsā and ahiṃsā, and thereby prevent some misunderstandings of Gandhi. Training in beneficence would reflect Gandhi’s psychological path to reducing avoidable harm: detachment from the ego, learning to love universally, and seeking truth by experiment. (shrink)

Respect for autonomy and beneficence are frequently regarded as the two essential principles of medical ethics, and the potential for these two principles to come into conflict is often emphasised as a fundamental problem. On the one hand, we have the value of beneficence, the driving force of medicine, which demands that medical professionals act to protect or promote the wellbeing of patients or research subjects. On the other, we have a principle of respect for autonomy, which (...) demands that we respect the self-regarding decisions of individuals. As well as routinely coming into opposition with the demands of beneficence in medicine, the principle of respect for autonomy in medical ethics is often seen as providing protection against beneficial coercion (i.e. paternalism) in medicine. However, these two values are not as straightforwardly opposed as they may appear on the surface. In fact, the way that we understand autonomy can lead us to implicitly sanction a great deal of paternalistic action, or can smuggle in paternalistic elements under the guise of respect for autonomy. -/- This paper is dedicated to outlining three ways in which the principle of respect for autonomy, depending on how we understand the concept of autonomy, can sanction or smuggle in paternalistic elements. As the specific relationship between respect for autonomy and beneficence will depend on how we conceive of autonomy, I begin by outlining two dominant conceptions of autonomy, both of which have great influence in medical ethics. I then turn to the three ways in which how we understand or employ autonomy can increase or support paternalism: firstly, when we equate respect for autonomy with respect for persons; secondly, when our judgements about what qualifies as an autonomous action contain intersubjective elements; and thirdly, when we expect autonomy to play an instrumental role, that is, when we expect people, when they are acting autonomously, to act in a way that promotes or protects their own wellbeing. I then provide a proposal for how we might work to avoid this. I will suggest that it may be impossible to fully separate paternalistic elements out from judgements about autonomy. Instead, we are better off looking at why we are motivated to use judgements about autonomy as a means of restricting the actions of patients or research subjects. I will argue that this is a result of discomfort about speaking directly about our beneficent motivations in medical ethics. Perhaps we can reduce the incentive to smuggle in these beneficent motivations under the guise of autonomy by talking directly about beneficent motivations in medicine. This will also force us to recognise paternalistic motivations in medicine when they appear, and to justify paternalism where it occurs. (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)

This paper develops transfinite extensions of transitivity and acyclicity in the context of population ethics. They are used to argue that it is better to add good lives, worse to add bad lives, and equally good to add neutral lives, where a life's value is understood as personal value. These conclusions rule out a number of theories of population ethics, feed into an argument for the repugnant conclusion, and allow us to reduce different-number comparisons to same-number ones. Challenges to these (...) arguments are addressed, including the issue of comparing existence and non-existence in terms of personal value, the possibility of minimal quanta of time and life, and the meaningfulness of measuring closeness between outcomes with different population sizes. An asymmetry is uncovered between transfinite cycles of worseness and betterness, supporting a version of the weak procreative asymmetry. Transfinite transitivity principles are also favourably compared to the better-known principles of continuity. (shrink)

I provide an alternative to the two prevailing accounts of justice in immigration policy, the free migration view and the state discretion view. Against the background of an internationalist conception of domestic and global justice that grounds special duties of justice between co-citizens in their shared participation in a distinctive scheme of social cooperation, I defend three principles of justice to guide labor immigration policy: the Difference Principle, the Duty of Beneficence, and the Duty of Assistance. I suggest (...) how these principles are to be applied in both ideal and nonideal circumstances. Finally, I argue that the potential conflict between these principles has often been overstated, and propose priority rules for genuine cases of conflict. (shrink)

Artificial Social Agents (ASAs), which are AI software driven entities programmed with rules and preferences to act autonomously and socially with humans, are increasingly playing roles in society. As their sophistication grows, humans will share greater amounts of personal information, thoughts, and feelings with ASAs, which has significant ethical implications. We conducted a study to investigate what ethical principles are of relative importance when people engage with ASAs and whether there is a relationship between people’s values and the ethical principles (...) they prioritise. The study uses scenarios, embedded with the five AI4People ethical principles (Beneficence, Non-maleficence, Autonomy, Justice, and Explicability), involving ASAs taking on roles traditionally played by humans to understand whether these roles and behaviours (including dialogues) are seen as acceptable or unacceptable. Results from 268 participants reveal the greatest sensitivity to ASA behaviours that relate to Autonomy, Justice, Explicability, and the privacy of their personal data. Models were created using Schwartz’s Refined Values as a possible indicator of how stakeholders discern and prioritise the different AI4People ethical principles when interacting with ASAs. Our findings raise issues around the ethical acceptability of ASAs for nudging and changing behaviour due to participants’ desire for autonomy and their concerns over deceptive ASA behaviours such as pretending to have memories and emotions. (shrink)

The ethical issues raised by cybersecurity practices and technologies are of critical importance. However, there is disagreement about what is the best ethical framework for understanding those issues. In this paper we seek to address this shortcoming through the introduction of a principlist ethical framework for cybersecurity that builds on existing work in adjacent fields of applied ethics, bioethics, and AI ethics. By redeploying the AI4People framework, we develop a domain-relevant specification of five ethical principles in cybersecurity: beneficence, non-maleficence, (...) autonomy, justice, and explicability. We then illustrate the advantages of this principlist framework by examining the ethical issues raised by four common cybersecurity contexts: penetration testing, distributed denial of service attacks (DDoS), ransomware, and system administration. These case analyses demonstrate the utility of this principlist framework as a basis for understanding cybersecurity ethics and for cultivating the ethical expertise and ethical sensitivity of cybersecurity professionals and other stakeholders. (shrink)

According to the Principle of Sufficient Reason (henceforth ‘PSR’), everything has an explanation or sufficient reason. This paper addresses three questions. First, how continuous is the contemporary notion of grounding with the notion of sufficient reason endorsed by Spinoza, Leibniz, and other rationalists? In particular, does a PSR formulated in terms of ground retain the intuitive pull and power of the PSR endorsed by the rationalists? Second, to what extent can the PSR avoid the formidable traditional objections levelled against (...) it if it is formulated in terms of ground? And finally, how might historical discussion of the PSR shed light on the contemporary notion of grounding? (shrink)

Animal-derived constituents are frequently used in anaesthesia and surgery, and patients are seldom informed of this. This is problematic for a growing minority of patients who may have religious or secular concerns about their use in their care. It is not currently common practice to inform patients about the use of animal-derived constituents, yet what little empirical data does exist indicates that many patients want the opportunity to give their informed consent. First, we review the nature and scale of the (...) problem by looking at the groups who may have concerns about the use of animal-derived constituents in their care. We then summarise some of the products used in anaesthesia and surgery that can contain such constituents, such as anaesthetic drugs, surgical implants and dressings. Finally, we explore the problem of animal-derived constituents and consent using Beauchamp and Childress’ four principles approach, examining issues of autonomy, beneficence, nonmaleficence and justice. Disclosing the use of animal-derived constituents in anaesthesia and surgery is warranted under Beauchamp and Childress’ four principles approach to the problem. Although there exist systemic and practical challenges to implementing this in practice, the ethical case for doing so is strong. The Montgomery ruling presents additional legal reason for disclosure because it entails that patients must be made aware of risks associated with their treatment that they attach significance to. (shrink)

Common-sense morality has it that parents are morally justified in acting partially toward their own children. More controversial, however, is the form of partiality that obtains between prospective parents and their yet-to-be-conceived future children – or ‘pre-parental partiality’, for short. Is pre-parental partiality morally justified? On one hand, our intuitions seem to tell us that it is. On the other hand, we have philosophers like Douglas (2019) and Podgorski (2021) seeking to undermine its moral justifiability by arguing that we possess (...) no reasons of special concern at all to engage in pre-parental partiality. This paper aims to rescue the moral justifiability of pre-parental partiality in light of these arguments. In particular, a novel account of our pre-parental partiality obligations is developed; one which sees our special reasons (as prospective parents) for engaging in pre-parental partiality as arising from the special reasons for engaging in standard parental partiality that we come to possess (as parents) in the future. The result is a compelling moral justification for pre-parental partiality that amends itself to a whole platitude of views of what our standard parental obligations of partiality amount to. (shrink)

THE PRINCIPLE OF SUPERPOSITION. The need for a quantum theory Classical mechanics has been developed continuously from the time of Newton and applied to an ...