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Added by: Clotilde Torregrossa, Contributed by: Simon FoktPublisher's Note: The Blackwell Guide to Medical Ethics is a guide to the complex literature written on the increasingly dense topic of ethics in relation to the new technologies of medicine. Examines the key ethical issues and debates which have resulted from the rapid advances in biomedical technology Brings together the leading scholars from a wide range of disciplines, including philosophy, medicine, theology and law, to discuss these issues Tackles such topics as ending life, patient choice, selling body parts, resourcing and confidentiality Organized with a coherent structure that differentiates between the decisions of individuals and those of social policy
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Added by: Simon FoktIntroduction: The nonidentity problem focuses on the obligations we think we have in respect of people who, by our own acts, are caused both to exist and to have existences that are, though worth having, unavoidably flawed – existences, that is, that are flawed if those people are ever to have them at all. If a person’s existence is unavoidably flawed, then the agent’s only alternatives to bringing that person into the flawed existence are to bring no one into existence at all or to bring a different person – a nonidentical but better off person – into existence in place of the person whose existence is flawed. If the existence is worth having and no one else’s interests are at stake, it is unclear on what ground morality would insist that the choice to bring the one person into the flawed existence is morally wrong. And yet at the same time – as we shall see – it seems that in some cases that choice clearly is morally wrong. The nonidentity problem is the problem of resolving this apparent paradox. The problem raises the question whether the (usually significant) good that an agent confers along with existence counterbalances the (usually limited) bad that an agent confers along with any unavoidably flawed existence in such a way that our existence-inducing act (usually) will be deemed permissible. And if it isn’t – if we think instead that obligations are left unsatisfied despite the good that comes with existence – is the moral of the story that moral obligation extends beyond what we must do for people? If we agree, in other words, that it is our obligation to create additional good, is it enough that we create additional good for each and every existing and future person? Or does the nonidentity problem show that our focus should instead be on creating additional good for the universe? As we query how to evaluate existence-inducing acts for their moral permissibility – as well as outcomes or possible futures or worlds, for their moral betterness against still other worlds – we find that some of our most deeply held intuitions regarding the nature and structure of morality are thrown into doubt.
Comment: This text offers a comprehensive introduction to the nonidentity problem and lists several illustrative thought experiments and examples used in the literature. It is a very helpful introductory or further reading for any topic which touches on the nonidentity problem.
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Added by: Rochelle DuFordSummary: This paper develops the claim that indefinite detention (as used by the U.S. following the attacks on September 11, 2001) is justfied by an appeal to racialized fear. Roberts argues that the indefinite detention of suspected terrorists is both immoral and unjust--claiming that arguments in favor of it (such as the interest in interrogation, the consequentialist justification, and the preventative detention argument) fail to ground the permissibility of indefinite detention.
Comment: This text would be of use in a course discussing the ethics of war, criminal justice ethics, or the idea of terrorism. It presents a clear discussion, in an accessible way, of a number of arguments in favor of indefinite detention, ultimately arguing that such defenses are insufficient to ground its moral permissibility.
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Added by: Rochelle DuFordAbstract: My aim in this essay is to remove some of the rubbish that lies in the way of an appropriate understanding of rectificatory compensation, by arguing for the rejection of the counterfactual conception of compensation. Although there is a significant extent to which contemporary theorists have relied upon this idea, the counterfactual conception of compensation is merely a popular assumption, having no positive argument in support of it. Moreover, it can make rendering compensation impossible, and absurd notions of compensation can result from its use, results that may themselves constitute injustices. This latter difficulty is most troubling when the CCC is employed in large compensatory cases like the case of rectificatory compensation for the descendants of American slaves. I want to suggest that, taken together, the difficulties with the CCC yield sufficient reason for rejecting it as an acceptable rectificatory notion.
Comment: This text presents an interesting and accessible discussion of the counterfactual conception of compensation (most famously presented by Nozick, though one need not have read Nozick to understand this text) as a matter of rectificatory justice. It would be of use in courses concerning schemes or principles of distributive and rectificatory justice. As the text analyzes the justification for reparations to the decendents of African slaves in the U.S., it would also be of use in a course that covers questions of reparations for historical injustices (perhaps alongside Coates' well known "The Case for Reparations").
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Added by: Deryn Mair ThomasAbstract:
This article addresses the question whether a basic income will be a just social policy for women. The implementation of a basic income will have different effects for different groups of women, some of them clearly positive, some of them negative. The real issues that concern feminist critics of a basic income are the gender-related constraints on choices and the current gender division of labour, which are arguably both playing at the disadvantage of women. It is argued that those issues are not adequately addressed by a basic income proposal alone, and therefore basic income has to be part of a larger packet of social policy measures if it wants to maximise real freedom for all.
Comment: This paper explores questions as the intersection of feminism and the basic income literature, offering a take on one of the classic feminist critiques of basic income: namely, that the purported conditions of freedom that basic income is supposed to bring about are only really available to members of the population who do not belong to an oppressed or marginalised class. For those that do belong to such groups - in this case, women - the availability of such conditions of freedom will be highly dependent on existing gendered divisions of labour and restrictions on choice. As such, the author argues that proposals for basic income, if they are serious about ensuring real freedom for all, must take this into consideration. The author also challenges existing (at the time of writing) contradictions in the claims being made about the effect of basic income policy on women, as opposed to men. The paper would therefore be interesting to discuss in relation to feminist politics or a survey of the basic income literature, especially assigned in tandem with some of the foundational literature, such as Phillipe Van Parijs' work.
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Added by: Simon FoktAbstract:
Comment: This text offers an introduction to ecofeminism. It discusses the history of associating maleness with culture and femaleness with nature and identifies some of the issues which led to the current ecological crisis. The text has the potential to challenge received views and inspire a lively discussion, and as such it is best used as an introductory text in classes on environmental ethics and on feminist ethics.
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Added by: Simon Fokt, Contributed by: Rose Trappes
Publisher's Note: The first comprehensive treatment of environmental philosophy, going beyond ethics to address the philosophical concepts that underlie environmental thinking and policy-making today
- Encompasses all of environmental philosophy, including conservation biology, restoration ecology, sustainability, environmental justice, and more
- Offers the first treatment of decision theory in an environmental philosophy text
- Explores the conceptions of nature and ethical presuppositions that underlie contemporary environmental debates, and, moving from theory to practice, shows how decision theory translates to public policy
- Addresses both hot-button issues, including population and immigration reform, and such ongoing issues as historical legacies and nations' responsibility and obligation for environmental problems
- Anchors philosophical concepts to their practical applications, establishing the priority of the discipline's real-world importance
Comment: This book provides a clear and comprehensive introduction to major philosophical issues in environmental science, ethics and policy. There are handy 'boxes' with examples to illustrate the text. Chapters are fairly short and can be a bit dense, but they are good as overviews of the major issues when paired with related but more specific texts. It's also sensitive to indigenous and racial issues when it comes to conservation.
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Added by: Björn Freter, Contributed by: Anna Alexandrova
Abstract: This paper examines the morality of kidney markets through the lens of choice, inequality, and weak agency looking at the case for limiting such markets under both non-ideal and ideal circumstances. Regulating markets can go some way to addressing the problems of inequality and weak agency. The choice issue is different and this paper shows that the choice for some to sell their kidneys can have external effects on those who do not want to do so, constraining the options that are now open to them. I believe that this is the strongest argument against such markets.
Comment: A self-contained argument that introduces key concepts in philosophy of economics namely, liberty, externality, choice and markets, through the example of kidneys.
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Added by: Simon FoktAbstract: The view that lying is morally worse than merely misleading is a very natural one, which has had many prominent defenders. Nonetheless, here I will argue that it is misguided: holding all else fixed, acts of mere misleading are not morally preferable to acts of lying, and successful lying is not morally worse than merely deliberately misleading. In fact, except in certain very special contexts, I will suggest that – when faced with a felt need to deceive – we might as well just go ahead and lie.
Comment: This text can be used to inspire a discussion on general ethical issues and the practical application of moral theories. It is particularly useful in teaching applied professional ethics. It works well when used together with Clea F. Rees' "Better Lie!"
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Added by: Sara PeppeAbstract:
In this paper, I urge feminists to re-center fetal moral status in their theorizing about abortion. I argue that fundamental feminist normative commitments are at odds with efforts to de-emphasize fetal moral status: The feminist commitment to ensuring care for dependents supports surprising conclusions with regard to the ethics of abortion, and the feminist commitment to politicizing the personal has surprising conclusions regarding the politics of abortion. But these feminist insights also support the conclusion that, conditional on fetal moral status, care for unwanted fetuses would be a social obligation that only derivatively falls to women who are unwillingly pregnant.
Comment: Best discussed alongside Judith Thomson's "A Defense of Abortion" and Liam Murphy's "The Demands of Beneficence." Challenges a widely accepted intuition about the ethics of abortion and can be used to illustrate the vulnerabilities of thought experiments that appeal to intuitions. Demonstrates the useful argumentative move of assuming premise P for the sake of argument (even if you don't endorse P) in order to examine the implications that follow from P.
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Added by: Rochelle DuFordAbstract: Neoclassical economists have been telling us for years that if we behave in egoistic, individualistic ways, the invisible hand of the market will guide us to efficient and sustainable futures. Many contemporary Greens also have been assuring us that if we behave in holistic ways, the invisible hand of ecology will guide us to health and sustainable futures. This essay argues that neither individualism nor holism will provide environmental sustainability. There is no invisible hand, either in economics or in ecology. Humans have no guaranteed tenure in the biosphere. Likewise there is no philosophical quick fix for environmental problems, either through the ethical individualism of Feinberg, Frankena, and Regan, or through the ecological holism of Callicott and Leopold. The correct path is more complex and tortuous than either of these ways. The essay argues that the best way to reach a sustainable environmental future probably is through a middle path best described as "hierarchical holism.".
Comment: This text intervenes in the debate over holism and individualism in environmental ethics--specifically, as it concerns questions of environmental protection and conservation. It would fit well in a course on environmental ethics that discusses questions of either the metaphysics of nature or the nature of value.
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Added by: Simon FoktAbstract: Prenatal screening, consisting of maternal serum screening and nuchal translucency screening, is on the verge of expansion, both by being offered to more pregnant women and by screening for more conditions. The Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists have each recently recommended that screening be extended to all pregnant women regardless of age, disease history, or risk status. This screening is commonly justified by appeal to the value of autonomy, or women's choice. In this paper, I critically examine the value of autonomy in the context of prenatal screening to determine whether it justifies the routine offer of screening and the expansion of screening services. I argue that in the vast majority of cases the option of prenatal screening does not promote or protect women's autonomy. Both a narrow conception of choice as informed consent and a broad conception of choice as relational reveal difficulties in achieving adequate standards of free informed choice. While there are reasons to worry that women's autonomy is not being protected or promoted within the limited scope of current practice, we should hesitate before normalizing it as part of standard prenatal care for all.
Comment: The text introduces the notion of relational autonomy and argues that an increase in pre-natal screening can in fact act so as to restrict the autonomy of pregnant women. It is best used in teaching applied ethics modules on procreation and autonomy, and as a further reading offering a critique of approaches which do not take into account contextual features of particular situations in their moral assessment.
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Added by: Deryn Mair ThomasAbstract: In view of the explanatory significance of joblessness, some social scientists, policymakers, and commentators have advocated strong measures to ensure that the ghetto poor work, including mandating work as a condition of receiving welfare benefits. Indeed, across the ideological political spectrum, work is often seen as a moral or civic duty and as a necessary basis for personal dignity. And this normative stance is now instantiated in federal and state law, from the tax scheme to public benefits. This Article reflects critically on this new regime of work. I ask whether the normative principles to which its advocates typically appeal actually justify the regime. I conclude that the case for a pro tanto moral or civic duty to work is not as strong as many believe and that there are reasonable responses to joblessness that do not involve instituting a work regime. However, even if we grant that there is a duty to work, I maintain that the ghetto poor would not be wronging their fellow citizens were they to choose not to work and to rely on public funds for material support. In fact, I argue that many among the black urban poor have good reasons to refuse to work. Throughout, I emphasize what too few advocates of the new work regime do, namely, that whether work is an obligation depends crucially on whether background social conditions within the polity are just.
Comment (from this Blueprint): This text is useful for several reasons. First, it introduces an argument examining a civic obligation to work; second, it discusses that obligation in relation to structural injustices regarding socio-economic and racial inequality. It can be used to discuss the intersection of these topics more generally, or to further discuss philosophical questions concerning who should have access to good work and why.
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Added by: John BaldariAbstract: 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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Added by: John BaldariAbstract: On October 25, 1946, three weeks after the International Military Tribunal at Nuremberg entered its verdicts, the United States established Military Tribunal I for the trial of twenty-three Nazi physicians. The charges, delivered by Brigadier General Telford Taylor on December 9, 1946, form a seminal chapter in the history of medical ethics and, specifically, medical ethics in war. The list of noxious experiments conducted on civilians and prisons of war, and condemned by the Tribunal as war crimes and as crimes against humanity, is by now more or less familiar. That list included: high-altitude experiments; freezing experiments; malaria experiments; sulfanilamide experiments; bone, muscle, and nerve regeneration and bone transplantation experiments; sea water experiments; jaundice and spotted fever experiments; sterilization experiments; experiments with poison and with incendiary bombs. What remains less familiar is the moral mindset of doctors and health care workers who plied their medical skill for morally questionable uses in war. In his 1981 work, The Nazi Doctors, Robert Jay Lifton took up that question, interviewing doctors, many of whom for forty years continued to distance themselves psychologically from their deeds. The questions about moral distancing Lifton raised (though not the questions about criminal experiments) have immediate urgency for us now. Military medical doctors, psychiatrists and psychologists serve in U.S. military prisons in Guantánamo, Abu Ghraib, Kandahar, and, until very recently, in undisclosed CIA operated facilities around the world where medical ethics are again at issue. Moreover, they serve in top positions in the Pentagon, as civilian and military heads of command, who pass orders and regulations to military doctors in the field, and who are in charge of the health of enemy combatants, as well as U.S. soldiers. Because we recently marked the sixtieth anniversary of the judgment at Nuremberg, I want to awaken our collective memory to the ways in which doctors in war, even in a war very different from the one the Nazis fought, can insulate themselves from their moral and professional consciences.
Comment: This text is best used as an additional reading in bioethics, or in just war theory (post ad bellum).
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