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Bortolotti, Lisa, John Harris. Disability, Enhancement and the Harm-Benefit Continuum
2006, In John R. Spencer & Antje Du Bois-Pedain (eds.), Freedom and Responsibility in Reproductive Choice. Hart Publishers
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Added by: Simon Fokt, Contributed by: Nils-Hennes Stear
Abstract:

Suppose that you are soon to be a parent and you learn that there are some simple measures that you can take to make sure that your child will be healthy. In particular, suppose that by following the doctor’s advice, you can prevent your child from having a disability, you can make your child immune from a number of dangerous diseases and you can even enhance its future intelligence. All that is required for this to happen is that you (or your partner) comply with lifestyle and dietary requirements. Do you and your partner have any moral reasons (or moral obligations) to follow the doctor’s advice? Would it make a difference if, instead of following some simple dietary requirements, you consented to genetic engineering to make sure that your child was free from disabilities, healthy and with above average intelligence? In this paper we develop a framework for dealing with these questions and we suggest some directions the answers might take.

Comment: This is a paper that gives an account of enhancement and disability in terms of one's relative position on a harmed and benefitted continuum, and defends enhancement on completely general moral grounds according to which the pro tanto duty to enhance is the same as the pro tanto duty not to disable. It pairs well with criticisms of the 'new eugenics', such as Robert Sparrow's 'A Not-So-New Eugenics' (2011) and more generally with consequentialist or specifically harm-based accounts of moral obligation.

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Ciurria, Michelle. Is There a Duty to Use Moral Neurointerventions?
2017, Topoi 38(1): 37-47.
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Added by: Simon Fokt, Contributed by: Emma Gordon
Abstract: Do we have a duty to use moral neurointerventions to correct deficits in our moral psychology? On their surface, these technologies appear to pose worrisome risks to valuable dimensions of the self, and these risks could conceivably weigh against any prima facie moral duty we have to use these technologies. Focquaert and Schermer (Neuroethics 8(2):139–151, 2015) argue that neurointerventions pose special risks to the self because they operate passively on the subject-s brain, without her active participation, unlike ‘active- interventions. Some neurointerventions, however, appear to be relatively unproblematic, and some appear to preserve the agent-s sense of self precisely because they operate passively. In this paper, I propose three conditions that need to be met for a medical intervention to be considered low-risk, and I say that these conditions cut across the active/passive divide. A low-risk intervention must: (i) pass pre-clinical and clinical trials, (ii) fare well in post-clinical studies, and (iii) be subject to regulations protecting informed consent. If an intervention passes these tests, its risks do not provide strong countervailing reasons against our prima facie duty to undergo the intervention.

Comment: Proposes an account of low-risk medical interventions and argues that the risks attached to moral enhancements falling into this category are insufficient to provide us with strong reasons against our duty to undergo the intervention. Useful to read when exploring the issue of whether we are obligated to morally enhance (as e.g. Savulescu and Persson have argued).

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Huang, Pei-hua. Moral Enhancement, Self-Governance, and Resistance
2018, The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 43(5):547-567
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Added by: Sara Peppe, Contributed by: Pei-hua Huang
Abstract: John Harris recently argued that the moral bioenhancement proposed by Persson and Savulescu can damage moral agency by depriving recipients of their freedom to fall (freedom to make wrongful choices) and therefore should not be pursued. The link Harris makes between moral agency and the freedom to fall, however, implies that all forms of moral enhancement that aim to make the enhancement recipients less likely to “fall,” including moral education, are detrimental to moral agency. In this article, I present a new moral agency–based critique against the moral bioenhancement program envisaged by Persson and Savulescu. I argue that the irresistible influences exerted by the bioenhancement program harm our capabilities for conducting accurate self-reflection and forming decisions that truly express our will, subsequently undermining our moral agency.

Comment: This paper can be assigned as a further reading when teaching the moral enhancement debate. It provides students with a less explored perspective on moral agency in the debate (i.e. the feminist approach to autonomy and Confucianism). Students might find the discussion on the Confucian conception of moral saints in this paper especially interesting when contrasting the conception to the more western ones.

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Inmaculada de Melo-Martin. Rethinking Reprogenetics: Enhancing Ethical Analyses of Reprogenetic Technologies
2017, New York: Oxford University Press
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Added by: Björn Freter
Publisher's Note: Reprogenetic technologies, which combine the power of reproductive techniques with the tools of genetic science and technology, promise prospective parents a remarkable degree of control to pick and choose the likely characteristics of their offspring. Not only can they select embryos with or without particular genetically-related diseases and disabilities but also choose embryos with non-disease related traits such as sex. Prominent authors such as Agar, Buchanan, DeGrazia, Green, Harris, Robertson, Savulescu, and Silver have flocked to the banner of reprogenetics. For them, increased reproductive choice and reduced suffering through the elimination of genetic disease and disability are just the first step. They advocate use of these technologies to create beings who enjoy longer and healthier lives, possess greater intellectual capacities, and are capable of more refined emotional experiences. Indeed, Harris and Savulescu in particular take reprogenetic technologies to be so valuable to human beings that they have insisted that their use is not only morally permissible but morally required. Rethinking Reprogenetics challenges this mainstream view with a contextualised, gender-attentive philosophical perspective. De Melo-Martín demonstrates that you do not have to be a Luddite, social conservative, or religious zealot to resist the siren song of reprogenetics. Pointing out the flawed nature of the arguments put forward by the technologies' proponents, Rethinking Reprogenetics reveals the problematic nature of the assumptions underpinning current evaluations of these technologies and offers a framework for a more critical and sceptical assessment.

Comment: This book could be used in a variety of upper division undergraduate and graduate courses including those in bioethics, philosophy of technology, contemporary moral issues, science, technology, and society, and philosophy of medicine. It critically assesses the arguments of those who enthusiastically support reprogenetic technologies from a feminist perspective that takes science and technology to be value-laden and gendered.

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Kittay, Eva. At the Margins of Moral Personhood
2005, Ethics 116 (1):100-131.
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Added by: Carl Fox, Chris Howard
Summary: Considers the particular case of CSMR individuals in detail and makes a strong case for incorporating relational elements into an account of moral personhood.

Comment: Best used as a specialised or further reading addressing the topics of moral personhood and justice. This paper is sure to generate and discussion and debate, particularly when paired Jeff McMahan's work on the topic, to which the paper is responsive (see in particular McMahan, "Cognitive Disability, Misfortune, and Justice"). Some of Kittay's arguments rely on somewhat fine metaphysical distinctions, so some background in philosophy would be useful, but the distinctions aren't so fine that any additional reading would be required -- in-class discussion of the nature of the relevant distinctions should suffice.

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Kraemer, Felicitas. Authenticity Anyone? The Enhancement of Emotions via Neuro-Psychopharmacology
2011, Neuroethics 4(1): 51-64.
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Added by: Simon Fokt, Contributed by: Emma Gordon
Abstract: This article will examine how the notion of emotional authenticity is intertwined with the notions of naturalness and artificiality in the context of the recent debates about ‘neuro-enhancement- and ‘neuro-psychopharmacology.- In the philosophy of mind, the concept of authenticity plays a key role in the discussion of the emotions. There is a widely held intuition that an artificial means will always lead to an inauthentic result. This article, however, proposes that artificial substances do not necessarily result in inauthentic emotions. The literature provided by the philosophy of mind on this subject usually resorts to thought experiments. On the other hand, the recent literature in applied ethics on ‘enhancement- provides good reasons to include real world examples. Such case studies reveal that some psychotropic drugs such as antidepressants actually cause people to undergo experiences of authenticity, making them feel ‘like themselves- for the first time in their lives. Beginning with these accounts, this article suggests three non-naturalist standards for emotions: the authenticity standard, the rationality standard, and the coherence standard. It argues that the authenticity standard is not always the only valid one, but that the other two ways of assessing emotions are also valid, and that they can even have repercussions on the felt authenticity of emotions. In conclusion, it sketches some of the normative implications if not ethical intricacies that accompany the enhancement of emotions.

Comment: Discusses how the idea of authenticity relates to debates on enhancement. Best read after literature exploring different types of cognitive and emotional enhancement.

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Maclean, Anne. The Elimination of Morality: Reflections on Utilitarianism and Bioethics
1993, Routledge.
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Publisher's Note: The Elimination of Morality poses a fundamental challenge to the dominant conception of medical ethics. In this controversial and timely study, Anne Maclean addresses the question of what kind of contribution philosophers can make to the discussion of medico-moral issues and the work of health care professionals. She establishes the futility of bioethics by challenging the conception of reason in ethics which is integral to the utilitarian tradition. She argues that a philosophical training confers no special authority to make pronouncements about moral issues, and proposes that pure utilitarianism eliminates the essential ingredients of moral thinking. Maclean also exposes the inadequacy of a utilitarian account of moral reasoning and moral life, dismissing the claim that reason demands the rejection of special obligations. She argues that the utilitarian drive to reduce rational moral judgment to a single form is ultimately destructive of moral judgment as such. This vital discussion of the nature of medical ethics and moral philosophy will be important reading for anyone interested in the fields of health care ethics and philosophy.

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Sherman, Nancy. Afterwar: Healing the Moral Wounds of our Soldiers
2015, New York: Oxford University Press.
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Added by: John Baldari
Abstract: Movies like American Sniper and The Hurt Locker hint at the inner scars our soldiers incur during service in a war zone. The moral dimensions of their psychological injuries--guilt, shame, feeling responsible for doing wrong or being wronged-elude conventional treatment. Georgetown philosophy professor Nancy Sherman turns her focus to these moral injuries in Afterwar. She argues that psychology and medicine alone are inadequate to help with many of the most painful questions veterans are bringing home from war. Trained in both ancient ethics and psychoanalysis, and with twenty years of experience working with the military, Sherman draws on in-depth interviews with servicemen and women to paint a richly textured and compassionate picture of the moral and psychological aftermath of America's longest wars. She explores how veterans can go about reawakening their feelings without becoming re-traumatized; how they can replace resentment with trust; and the changes that need to be made in order for this to happen-by military courts, VA hospitals, and the civilians who have been shielded from the heaviest burdens of war. 2.6 million soldiers are currently returning home from war, the greatest number since Vietnam. Facing an increase in suicides and post-traumatic stress, the military has embraced measures such as resilience training and positive psychology to heal mind as well as body. Sherman argues that some psychological wounds of war need a kind of healing through moral understanding that is the special province of philosophical engagement and listening.

Comment: Use this text as an easy-reader alongside more rigorous texts to shore up arguments from case studies and example.

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Steinbock, Bonnie. Life Before Birth: The Moral and Legal Status of Embryos and Fetuses
1994, Ethics 104 (2):408-410.
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Abstract: This book provides a coherent framework for addressing bioethical issues in which the moral status of embryos and fetuses is relevant. It is based on the 'interest view,' which ascribes moral standing to beings with interests, and connects the possession of interests with the capacity for conscious awareness or sentience. The theoretical framework is applied to up-to-date ethical and legal topics, including abortion, prenatal torts, wrongful life, the crime of feticide, substance abuse by pregnant women, compulsory cesareans, assisted reproduction, and stem cell research. Along the way, difficult philosophical problems, such as identity and the nonidentity problem are thoroughly explored.

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Zutlevics, T. L.. Markets and the needy: Organ sales or aid?
2001,
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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Abstract: As organ shortages have become more accute, support for a market in organs has steadily increased. Whilst many have argued for such a market, it is Gerald Dworkin who most persuasively defends its ethics. As Dworkin points out, there are two possibilities here - a futures market and a current market. I follow Dworkin in focusing on a current market in the sale of organs from living donors, as this is generally considered to be the most difficult to justify. One of the most pressing concerns here is that such a market will exploit the poor. I outline this concern and scrutinise Dworkin's and others' rejection of it. Briefly, I argue that the arguments Dworkin employs for allowing the poor to sell their organs fail, and in fact better support an argument for increasing aid to the needy.

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