Economic globalization has profound implications for health. The scale of injustice at a global level, reflected in inexorably widening disparities in wealth and health, also has critical implications for health related research – in particular when the opportunities for exploiting research subjects are carefully considered. The challenge of developing universal guidelines for international clinical research is addressed against the background of a polarizing, yet interdependent, world in which all are ultimately threatened by lack of social justice. It is proposed that (...) in such a world there is a need for new ways of thinking about research and its relevance to health at a global level. Responsibility to use knowledge and power wisely requires more radical changes to guidelines for research ethics than are currently under consideration. (shrink)

Nick Zangwill has argued that we have a moral duty to eat meat. His argument applies to the flesh of those domesticated animals who (a) would not have existed had it not been for the practice of killing and eating them; and (b) have lives that contain more good than bad—and thus, on his view, have “lives worth living.” In my reply, I point to various features of his argument that are unclear. I seek to render explicit the various premises (...) and inferences of his argument. I argue that there are problems with at least some of the premises. I also argue that his argument as a whole is liable to a reductio ad absurdum, which he considers, but to which he responds inadequately. I conclude that we ought to reject his argument. (shrink)

ABSTRACTA number of problems plague universal declarations. To the extent that those drafting and adopting the declaration represent a range of different views, consensus can only be obtained if the declaration makes minimalist claims that all can support, or makes claims that are vague enough that they can be interpreted to everybody's satisfaction. To the extent that a universal declaration avoids these problems, and takes an unequivocal and controversial stand, it does so by privileging the view that is hegemonic . (...) After discussing these problems I ask whether such declarations could nonetheless do any good. (shrink)

Clinical research has become a burgeoning activity in recent years, largely stimulated by the pharmaceutical industry's interest in new drugs with high marketing profiles. Several other forces fuel this thrust: the increasing dependence of academic medical institutions on research funding from industry; the need for large, efficient multicenter trials to obtain reliable and statistically significant results in the shortest possible time for drug registration purposes; and access to research subjects in countries. The intense interest in HIV/AIDS research and recent controversies (...) about revisions to the Helsinki Declaration, which have been seen by some to be motivated by the desire to facilitate exploitative research in countries, have stimulated renewed interest in the ethics of clinical research. (shrink)

ABSTRACT A number of problems plague universal declarations. To the extent that those drafting and adopting the declaration represent a range of different views, consensus can only be obtained if the declaration makes minimalist claims that all can support, or makes claims that are vague enough that they can be interpreted to everybody's satisfaction. To the extent that a universal declaration avoids these problems, and takes an unequivocal and controversial stand, it does so by privileging the view that is hegemonic (...) (at least among those responsible for the declaration). After discussing these problems I ask whether such declarations could nonetheless do any good. (shrink)

This book's thirty essays explore philosophically the nature and morality of sexual perversion, cybersex, masturbation, homosexuality, contraception, same-sex marriage, promiscuity, pedophilia, date rape, sexual objectification, teacher-student relationships, pornography, and prostitution. Authors include Martha Nussbaum, Thomas Nagel, Alan Goldman, John Finnis, Sallie Tisdale, Robin West, Alan Wertheimer, John Corvino, Cheshire Calhoun, Jerome Neu, and Alan Soble, among others. A valuable resource for sex researchers as well as undergraduate courses in the philosophy of sex.

Interviews with David Benatar and Thaddeus Metz about some core aspects of their views about meaning in life, including debate between them. Accessible to a generally educated audience. Edited by Mark Oppenheimer and Jason Werbeloff.

Opinion about neonatal male circumcision is deeply divided. Some take it to be a prophylactic measure with unequivocal and significant health benefits, while others consider it a form of child abuse. We argue against both these polar views. In doing so, we discuss whether circumcision constitutes bodily mutilation, whether the absence of the child's informed consent makes it wrong, the nature and strength of the evidence regarding medical harms and benefits, and what moral weight cultural considerations have. We conclude that (...) nontherapeutic circumcision of infant boys is a suitable matter for parental discretion. (shrink)

Opinion about neonatal male circumcision is deeply divided. Some take it to be a prophylactic measure with unequivocal and significant health benefits, while others consider it a form of child abuse. We argue against both these polar views. In doing so, we discuss whether circumcision constitutes bodily mutilation, whether the absence of the child's informed consent makes it wrong, the nature and strength of the evidence regarding medical harms and benefits, and what moral weight cultural considerations have. We conclude that (...) nontherapeutic circumcision of infant boys is a suitable matter for parental discretion. (shrink)

Recent decades have seen the emergence of two new fields of inquiry into ethical issues in medicine. These are the fields of bioethics and of health and human rights. In this critical review of these fields, the author argues that bioethics, partly because it has been construed so broadly, suffers from quality control problems. The author also argues that the field of health and human rights is superfluous because it does nothing that cannot be done by either bioethics of the (...) law. (shrink)

In a recent paper, Rob Lawlor argues that moral theories should not be taught in courses on applied ethics. The author contends that Dr Lawlor’s arguments overlook at least two important roles that some attention to ethical theories may play in practical ethics courses. The conclusion is not that moral theory must be taught, but rather that there is more to be said for it than Dr Lawlor’s arguments reveal.

Better Never to Have Been argues for a number of related, highly provocative, views: (1) Coming into existence is always a serious harm. (2) It is always wrong to have children. (3) It is wrong not to abort fetuses at the earlier stages of gestation. (4) It would be better if, as a result of there being no new people, humanity became extinct. These views may sound unbelievable--but anyone who reads Benatar will be obliged to take them seriously.

When presented with the claim of the moral vegetarian that it is wrong for us to eat meat, many people respond that because it is not wrong for lions, tigers and other carnivores to kill and eat animals, it cannot be wrong for humans to do so. This response is what Peter Alward has called the naive argument. Peter Alward has defended the naive argument against objections. I argue that his defence fails.

Are our lives meaningless? Is death bad? Would immortality be better? Alternatively, should we hasten our deaths by acts of suicide? Many people are tempted to offer comforting optimistic answers to these big questions. The Human Predicament offers a less sanguine assessment, and defends a substantial, but not unmitigated, pessimism.

The blinkered debate on organ donation neglects the widening gap between the developed and developing worldsThe current debate about organ donation and the associated advocacy for selling kidneys, while laudable for its concern about increasing the ability to save the lives of some people with chronic renal failure, is characterised by four features that locate the reasoning process within a narrow and inadequate framework. Firstly, the focus on saving lives is myopic, with the lives of the most privileged in the (...) world receiving most attention. Secondly, the debate is firmly set within a value system in which market values dominate. Thirdly, health is considered from a highly individualistic perspective with little understanding of the importance of social solidarity in health. Finally, a constricted moral vocabulary is used to discuss the ethics of organ sales.MYOPIC CONCERN FOR SAVING LIVESMany articles making pleas for more organs begin by describing the number of people waiting for donated organs, the number of donors who could give organs but are not doing so, and how many lives could be saved if more organs could be made available. Great concern is expressed about a few thousand …. (shrink)

Procreation and Parenthood offers new and original essays by leading philosophers on some of the main ethical issues raised by these activities.

In his review of my book, Better never to have been, Len Doyal suggests, contrary to my view, that rational beings in the original position might prefer coming into existence to the alternative of never existing, if their lives were to include enough good and not too much bad. I argue, in response, that Professor Doyal fails to make his case.

Since the early 20th century, bioethics in South Africa has moved through several stages, responding to the same forces and developments as elsewhere, for example in the United Kingdom and United States. In addition, some unique developments in South Africa, for example the death of Steve Biko, the HIV/AIDS pandemic, and a peaceful transition to democracy with increased focus on human rights have given bioethics in South Africa its own dimension. Bioethics in South Africa reflects the general concerns of the (...) field elsewhere, but it also stands at the intersection of the concerns of both developed and developing worlds. Thus, issues such as resource allocation, HIV/AIDS, and medical research take on an urgency and character that reflect South Africa's particular historical, geographical, and social conditions. (shrink)

I am very pleased to see the response by J S Taylor to my critique of the “organs debate”. He makes some notable and important points, but also some errors to which attention should be drawn.Taylor erroneously attributes to me concern that the organ debate excessively focuses on saving the lives of a few people. My concern was about the narrow framework within which the debate is embedded and that it focuses on the lives of a few privileged people—those who (...) can pay—while largely neglecting the lives of those who cannot. The fact that some attention has been paid to such issues in some journals does not negate the importance of my claim. Moreover, it is not that the question of millions of premature deaths has …. (shrink)

In Better Never to Have Been: The Harm of Coming into Existence, I argued that coming into existence is always a harm and that procreation is wrong. In this paper, I respond to those of my critics to whom I have not previously responded. More specifically, I engage the objections of Tim Bayne, Ben Bradley, Campbell Brown, David DeGrazia, Elizabeth Harman, Chris Kaposy, Joseph Packer and Saul Smilansky.

While procreation is ubiquitous, attention to the ethical issues involved in creating children is relatively rare. In Debating Procreation, David Benatar and David Wasserman take opposing views on this important question. David Benatar argues for the anti-natalist view that it is always wrong to bring new people into existence. He argues that coming into existence is always a serious harm and that even if it were not always so, the risk of serious harm is sufficiently great to make (...) procreation wrong. In addition to these "philanthropic" arguments, he advances the "misanthropic" one that because humans are so defective and cause vast amounts of harm, it is wrong to create more of them.David Wasserman defends procreation against the anti-natalist challenge. He outlines a variety of moderate pro-natalist positions, which all see procreation as often permissible but never required. After criticizing the main anti-natalist arguments, he reviews those pronatalist positions. He argues that constraints on procreation are best understood in terms of the role morality of prospective parents, considers different views of that role morality, and argues for one that imposes only limited constraints based on the well-being of the future child. He then argues that the expected good of a future child and of the parent-child relationship can provide a strong justification for procreation in the face of expected adversities without giving individuals any moral reason to procreate. (shrink)

Machine generated contents note: Preface; Introduction; Part I. Global Health, Definitions and Descriptions: 1. What is global health? Solly Benatar and Ross Upshur; 2. The state of global health in a radically unequal world: patterns and prospects Ron Labonte and Ted Schrecker; 3. Addressing the societal determinants of health: the key global health ethics imperative of our times Anne-Emmanuelle Birn; 4. Gender and global health: inequality and differences Lesley Doyal and Sarah Payne; 5. Heath systems and health Martin McKee; (...) Part II. Global Health Ethics, Responsibilities and Justice: Some Central Issues: 6. Is there a need for global health ethics? For and against David Hunter and Angus Dawson; 7. Justice, infectious disease and globalisation Michael Selgelid; 8. International health inequalities and global justice: toward a middle ground Norman Daniels; 9. The human right to health Jonathan Wolff; 10. Responsibility for global health? Allen Buchanan and Matt DeCamp; 11. Global health ethics: the rationale for mutual caring Solly Benatar, Abdallah Daar and Peter Singer; Part III. Analyzing Some Reasons for Poor Health: 12. Trade and health: the ethics of global rights, regulation and redistribution Meri Koivusalo; 13. Debt, structural adjustment and health Jeff Rudin and David Sanders; 14. The international arms trade and global health Salahaddin Mahmudi-Azer; 15. Allocating resources in humanitarian medicine Samia Hurst, Nathalie Mezger and Alex Mauron; 16. International aid and global health Anthony Zwi; 17. Climate change and health: risks and inequities Sharon Friel, Colin Butler and Anthony McMichael; 18. Animals, the environment and global health David Benatar; 19. The global crisis and global health Stephen Gill and Isabella Bakker; Part IV. Shaping the Future: 20. Health impact fund: how to make new medicines accessible to all Thomas Pogge; 21. Biotechnology and global health Hassan Masun, Justin Chakma and Abdallah Daar; 22. Food security and global health Lynn McIntyre and Krista Rondeau; 23. International taxation Gillian Brock; 24. Global health research: changing the agenda Tikki Pang; 25. Justice and research in developing countries Alex John London; 26. Values in global health governance Kearsley Stewart, Gerald T. Keusch and Arthur Kleinman; 27. Poverty, distance and two dimensions of ethics Jonathan Glover; 28. Teaching global health ethics James Dwyer; 29. Towards a new common sense: the need for new paradigms of global health Isabella Bakker and Stephen Gill; Index. (shrink)

_Does sexism against men exist? What it looks like and why we need to take it seriously_ This book draws attention to the "second sexism," where it exists, how it works and what it looks like, and responds to those who would deny that it exists. Challenging conventional ways of thinking, it examines controversial issues such as sex-based affirmative action, gender roles, and charges of anti-feminism. The book offers an academically rigorous argument in an accessible style, including the careful use (...) of empirical data, and includes examples and engages in a discussion of how sex discrimination against men and boys also undermines the cause for female equality. (shrink)

It has come to my attention that a number of formulations in the section “Disciplinary Landscape: Cytology and Genetics” of my article “Method as a Function of Disciplinary Landscape: C.D. Darlington and the History of Cytology 1925–1950,” Journal of the History of Biology, 39, 2006, pp. 165–197, do not provide due credit to a source. While Franz Schrader, “Three Quarter Centuries of Cytology,” Science 107 : 155–159, is cited in the article, his reminiscences and analysis of the historical development of (...) cytology provided a helpful historiographical context, as well as specific insights, for my article and should have been more fully acknowledged. (shrink)

Humour is worthy of serious ethical consideration. However, it is often taken far too seriously. In this paper, it is argued that while humour is sometimes unethical, it is wrong much less often than many people think. Non-contextual criticisms, which claim that certain kinds of humour are always wrong, are rejected. Contextual criticisms, which take issue with particular instances of humour rather than types of humour, are more promising. However, it is common to overstate the number of contexts in which (...) humour is wrong. Various mistakes of this kind are highlighted and cautioned against. (shrink)

Many people think that promiscuity is morally acceptable, but rape and pedophilia are heinous. I argue, however, that the view of sexual ethics that underlies an acceptance of promiscuity is inconsistent with regarding (1) rape as worse than other forms of coercion or assault, or (2) (many) sex acts with willing children as wrong at all. And the view of sexual ethics that would fully explain the wrong of rape and pedophilia would also rule out promiscuity. I intend this argument (...) neither as a case against promiscuity nor as either a mitigation of rape or a partial defense of pedophilia. My purpose is to highlight an inconsistency in many people's judgements. Whether one avoids the inconsistency by extending or limiting the range of practices one condemns, will depend on which underlying view of the ethics of sex one accepts. (shrink)

Opinion about neonatal male circumcision is deeply divided. Some take it to be a prophylactic measure with unequivocal and significant health benefits, while others consider it a form of child abuse. We argue against both these polar views. In doing so, we discuss whether circumcision constitutes bodily mutilation, whether the absence of the child's informed consent makes it wrong, the nature and strength of the evidence regarding medical harms and benefits, and what moral weight cultural considerations have. We conclude that (...) nontherapeutic circumcision of infant boys is a suitable matter for parental discretion. (shrink)

Following promulgation of the Nuremberg code in 1947, the ethics of research on human subjects has been a challenging and often contentious topic of debate. Escalation in the use of research participants in low-income countries over recent decades , has intensified the debate on the ethics of international research and led to increasing attention both to exploitation of vulnerable subjects and to considerations of how the 10:90 gap in health and medical research could be narrowed. In 2000, prompted by the (...) discussions over several years that led to the US NIH launching a capacity building programme on research ethics for members of research ethics committees in developing countries, we advanced a ‘new look’ for the ethics of international research.1 Since then progress has been made on several fronts.First, our ideas—considered somewhat radical and impractical at the time—have been provocatively addressed by scholars who have either contested them or advanced similar conceptions of what obligations international researchers have to research participants and communities in low income countries before, during and after clinical trials. Second, those researchers who have been sympathetic to our ideas have either endeavoured to put these into practice or have investigated the feasibility of doing so. Third, the intractability of the 10/90 gap and the escalation of interest in global health have sensitised many to the need to amplify the uptake of these ideas in practice.Here, we briefly review the conceptual and practical developments in international research ethics. While much conceptual progress has been made (and the concepts are now appearing …. (shrink)

Disturbing international inequalities in health abound. Life expectancy in Swaziland is half that in Japan. A child unfortunate enough to be born in Angola has 73 times as great a chance of dying before age 5 as a child born in Norway. A mother giving birth in southern sub-Saharan Africa has 100 times as great a chance of dying from her labor as one birthing in an industrialized country. For every mile one travels outward toward the Maryland suburbs from downtown (...) Washington, DC on its underground rail system, life expectancy rises by a year – reflecting the race and class inequities in American health. Are the glaring, even larger, international health inequalities also unjust? -/- All of us no doubt think they are grossly unfortunate. Many of us think they are unfair or unjust. Why should some people be at such a health disadvantage through no fault of their own, losers in a natural and social lottery assigning them birth in an unhealthy place? Others of us are troubled by the absence of the kinds of human relationships that ordinarily give rise to the claims of egalitarian justice that we make on each other – for example, being fellow citizens or even interacting in a cooperative scheme. Who has obligations of justice to reduce these international inequalities? And do those obligations hold regardless of how the inequalities came about? What institutions are accountable for addressing them? (shrink)

Many people are resistant to the conclusions for which I argued in Better Never to Have Been . I have previously responded to most of the published criticisms of my arguments. Here I respond to a new batch of critics (and to some fellow anti-natalists) who gathered for a conference at the University of Johannesburg and whose papers are published in this special issue of the South African Journal of Philosophy . I am also taking the opportunity to respond to (...) two other critics whose articles have previously been published in South African philosophy journals. Clearly I cannot respond to all the arguments in each of these papers and thus I shall focus on what I take to be some of the central issues in each. None of the arguments to which I shall respond have caused me to revise my views. However, I am pleased to have the opportunity to show why this is the case. (shrink)

Peter Singer has argued that the affluent have very extensive duties to the world’s poor. His argument has some important implications for procreation, most of which have not yet been acknowledged. These implications are explicated in this paper. First, the rich should desist from procreation and instead divert to the poor those resources that would have been used to rear the children that would otherwise have been produced. Second, the poor should desist from procreation because doing so can prevent the (...) very bad things that would otherwise have befallen the children they would have brought into existence. Third, the rich sometimes have a duty to prevent the poor from procreating. Fourth, the rich sometimes have a right to prevent the poor from reproducing. Although these implications may not amount to a categorical prohibition on all procreation, they do significantly restrict the permissibility of procreation. They are, in that sense, anti-natalist. (shrink)