In general, we think that when it comes to the good of another, we respect that person’s will by acting in accordance with what he wills because he wills it. I argue that this is not necessarily true. When it comes to the good of another person, it is possible to disrespect that person’s will while acting in accordance with what he wills because he wills it. Seeing how this is so, I argue, enables us to clarify the distinct roles (...) that the wills of competent and incompetent people should play in third-party deliberations about their welfare. (shrink)

What, if anything, is wrong with acquiring moral beliefs on the basis of testimony? Most philosophers think that there is something wrong with it, and most point to a special problem that moral testimony is supposed to create for moral agency. Being a good moral agent involves more than bringing about the right outcomes. It also involves acting with "moral understanding" and one cannot have moral understanding of what one is doing via moral testimony. And so, adherents to this view (...) claim, relying on moral testimony is problematic. Importantly, the problem that afflicts moral testimony, according to this view, is not a problem for testimonial knowledge in general. Indeed, critics of moral testimony acknowledge that a vast amount of our knowledge comes, completely unproblematically, from testimony. Call this the Asymmetry Thesis. We argue that while the diagnosis of what is wrong with moral testimony (when there is something wrong with it) in terms of moral understanding is correct, the lesson many of its adherents draw from it, namely that there is a principled difference between moral an non-moral testimony which renders the first, but not the second, problematic, is not. In other words, we argue that the Asymmetry Thesis is false. (shrink)

The Significant Interest view entails that even if there were no medical reasons to have access to genetic knowledge, there would still be reason for prospective parents to use an identity-release donor as opposed to an anonymous donor. This view does not depend on either the idea that genetic knowledge is profoundly prudentially important or that donor-conceived people have a right to genetic knowledge. Rather, it turns on general claims about parents’ obligations to help promote their children’s well-being and the (...) connection between a person’s well-being and the satisfaction of what I call their “worthwhile significant subjective interests.” To put this view simply, the fact that a donor-conceived person—who knows she is donor-conceived—is likely to be very interested in acquiring genetic knowledge gives prospective parents a weighty reason to use an identity-release donor. This is because parents should promote their children’s well-being through the satisfaction of their children’s worthwhile significant interests. (shrink)

Each year, tens of thousands of children are conceived with donated gametes (sperm or eggs). By some estimates, there are over one million donor-conceived people in the United States and, of course, many more the world over. Some know they are donor-conceived. Some do not. Some know the identity of their donors. Others never will. -/- Questions about what donor-conceived people should know about their genetic progenitors are hugely significant for literally millions of people, including donor-conceived people, their parents, and (...) donors. But the practice of gamete donation also provides a vivid occasion for thinking about questions that matter to everyone. What is the value of knowing who your genetic progenitors are? How are our identities bound up with knowing where we come from? What obligations do parents have to their children? And what makes someone a parent in the first place? -/- In Conceiving People: Identity, Genetics and Gamete Donation, Daniel Groll argues that people who plan to create a child with donated gametes should choose a donor whose identity will be made available to the resulting child. This is not, Groll argues, because having genetic knowledge is fundamentally important. Rather, it is because donor-conceived people are likely to develop a significant interest in having genetic knowledge and parents must help satisfy their children's significant interests. In other words, because a donor-conceived person is likely to care about having genetic knowledge, their parents should care too. (shrink)

abstract Is it permissible for a doctor or nurse to knowingly administer a placebo in a clinical setting? There is certainly something suspicious about it: placebos are typically said to be ‘sham’ treatments, with no ‘active’ properties and so giving a placebo is usually thought to involve tricking or deceiving the patient who expects a genuine treatment. Nonetheless, some physicians have recently suggested that placebo treatments are sometimes the best way to help their patients and can be administered in an (...) honest way. These physicians conclude that placebo treatments are a perfectly acceptable, and ethically unproblematic, mode of treatment. While I grant the common idea that placebos are deceptive is correct, I argue that widespread misunderstandings concerning why this is so has led proponents of placebo treatments to respond to the charge of deception in a way that misses the mark entirely. My goal in this paper, then, is to develop a precise conception of what makes something a placebo, which in turn will clarify the central charge concerning the ethics of placebo treatment, viz. that it is deceptive. (shrink)

When, if ever, can healthcare provider's lay claim to knowing what is best for their patients? In this paper, I offer a taxonomy of clinical disagreements. The taxonomy, I argue, reveals that healthcare providers often can lay claim to knowing what is best for their patients, but that oftentimes, they cannot do so *as* healthcare providers.

Are there any deep or systematic connections between paternalism and people's rights? Perhaps the connection is definitional: part of what makes an action or policy paternalistic is that it violates a right. Or perhaps the connection is normative: paternalism is (always? often? only sometimes?) morally problematic because it violates people's rights (even if we don't define "paternalism" in terms of a rights violation). My main goal in this paper is to argue for the normative connection. Part of the task will (...) be to explain exactly what the normative connection is. That will involve answering the questions embedded in the claim as well as offering an account of the right(s) that is (are) connected to paternalism's normative status. (shrink)

In this article, I distinguish between 4 models for thinking about how to balance the interests of parents, families, and a sick child: (1) the oxygen mask model; (2) the wide interests model; (3) the family interests model; and (4) the direct model. The oxygen mask model – which takes its name from flight attendants' directives to parents to put on their own oxygen mask before putting on their child's – says that parents should consider their own interests only insofar (...) as doing so is, ultimately, good for the sick child. The wide interests model suggests that in doing well by my child I am at the very same time doing well by myself. My interests can, and plausibly do, encompass the interests of others; they are, to that extent, wide. There is, then, no sharp separation between the interests of the sick child and the interests of other family members. In the family interests model, families themselves are seen as having interests that are neither identical to the sum, nor a simple function, of the interests of individual family members. The family has goals, values, and aspirations that are essentially corporate rather than individual. According to this model, these family interests can explain why sacrifices can sometimes be demanded of some family members for the sake of others in a medical setting. Finally, the direct model takes a simpler view of family members' interests; it claims that these interests matter simply on their own and should be taken into account in making treatment decisions for a sick child. This model openly considers the competing interests that parents and other family members often have when caring for a sick child, and advocates for weighing those interests when making decisions for and about the sick child. While there is room for all four models at the bedside, I argue that the direct model should be highlighted in clinical decision-making. (shrink)

Medical clinicians – doctors, nurses, nurse practitioners etc. – are charged to act for the good of their patients. But not all ways of acting for a patient's good are on par: some are paternalistic; others are not. What does it mean to act paternalistically, both in general and specifically in a medical context? And when, if ever, is it permissible for a clinician to act paternalistically? In Medical Paternalism Part 1, I answered the first question. This paper answers the (...) second. The place of paternalism in clinical medicine is best understood, I argue, in terms of the potential for conflict between the autonomy principle and the beneficence principle. The first enjoins clinicians to respect the decisions of patients with respect to their (the patients') own care. The second enjoins clinicians to act for the good of their patients. Clinicians act paternalistically, I argue, when they act on the beneficence principle to the exclusion of the autonomy principle. Understanding just what these principles amount to (particularly the autonomy principle) reveals that the autonomy principle defeasibly trumps the beneficence principle and that, as a result, acting paternalistically (at least when it comes to competent patients) is presumptively impermissible. (shrink)

Cases of paternalism usually involve disagreement between the paternalist and the paternalized subject. But not all the disagreements that give rise to paternalism are of the same kind and, as a result, not all instances of paternalism are morally on a par. There is, in other words, a moral difference between different kinds of paternalism, which can be explained in terms of the nature of the disagreements that give rise to the paternalism in the first place. This paper offers a (...) novel account of how to characterize the nature of these disagreements such that we can explain this moral difference. (shrink)

Responses to Brad Skow, Reuven Brandt, Camisha Russell and Amanda Roth's commentaries on *Conceiving People*.

In discussions about the ethics of enhancement, it is often claimed that the concept of ‘human nature’ has no helpful role to play. There are two ideas behind this thought. The first is that nature, human nature included, is a mixed bag. Some parts of our nature are good for us and some are bad for us. The ‘mixed bag’ idea leads naturally to the second idea, namely that the fact that something is part of our nature is, by itself, (...) normatively inert. The Inert View claims that nothing normative follows from the mere fact that some trait is a part of our nature. If the Inert View is correct, then appeals to the value or importance of human nature in debates about enhancement are indeed misplaced. We argue that the Inert View is wrong, and that a certain concept of human nature – which we refer to as human form – does have an important role to play in debates about enhancement. (shrink)

Cases of non-traditional family-making offer a rich seam for thinking about normative parenthood. Gamete donors are genetically related to the resulting offspring but are not thought to be normative parents. Gestational surrogates are also typically not thought to be normative parents, despite having gestated a child. Adoptive parents are typically thought to be normative parents even though they are neither genetically nor gestationally related to their child. Philosophers have paid attention to these kinds of cases. But they have not paid (...) attention to what the people who have engaged in these forms of family-making have to say about what they’re doing and, more specifically, how they answer the questions: “Who is the normative parent? And why?” Paying attention to their answers reveals two things. First, accounts of parenthood from people involved in two forms of non-traditional family-making – reproduction with gestational surrogacy and reproduction with donated eggs – are mutually inconsistent. This is not surprising. What is surprising is that the contradictory aspects of the views evince a common commitment to, as I shall put it, naturalizing parenthood. The central goal of this paper is to explain what that means, but rough idea is that in naturalizing parenthood, prospective parents aim to put the features that make someone a normative parent beyond the reach of human agency. I conclude by briefly suggesting that we should think of the grounds of normative parenthood – and the very task of theorizing about the grounds of normative parenthood – in a way that avoids the need to naturalize altogether. (shrink)

The connections between medicine and well-being are myriad. This paper focuses on the place of well-being in clinical medicine. It is here that different views of well-being, and their connection to concepts like “autonomy” and “authenticity”, both illuminate and are illuminated by looking closely at the kinds of interactions that routinely take place between clinicians, patients, and family members. -/- In the first part of the paper, I explore the place of well-being in a paradigmatic clinical encounter, one where a (...) competent patient interacts with a clinician. The main question here is how, or even whether, the pursuit of patient well-being – however we construe it – figures into a paradigmatic clinical encounter. In the second part of the paper, I consider what I will call a marginal clinical encounter – one where the patient is, as Agnieska Jaworska (1999) puts it, at the “margins of agency” – to theorize about the nature of well-being and to show how different theories of well-being can have dramatic consequences for clinical decision-making. (shrink)

Medical clinicians – doctors, nurses, nurse practitioners etc. – are charged to act for the good of their patients. But not all ways of acting for a patient's good are on par: some are paternalistic; others are not. What does it mean to act paternalistically, both in general and specifically in a medical context? And when, if ever, is it permissible for a clinician to act paternalistically? -/- This paper deals with the first question, with a special focus on paternalism (...) in medicine. While it is easy to give a rough characterization of paternalism (i.e. acting for another's good against that person's will), it is surprisingly difficult to provide a unified account of the myriad of actions that seem to count as paternalistic. After surveying four accounts of paternalism, I argue that two – what I call the authority and beneficence accounts – are the strongest on offer. According to the authority account, a clinician acts paternalistically when, for her patient's good, she usurps his decision-making authority. According to the beneficence account, a clinician acts paternalistically when, for her patient's good, she acts only or overrindingly out of concern for his good. I show how the difference between these accounts matters (in part) for how we should think about the nature of surrogate decision making in medicine. I argue that there are reasons – albeit hardly decisive – to prefer the beneficence account to the authority account. I conclude by considering whether attempts by clinicians to rationally persuade their patients to pursue a particular course of action should be thought of as paternalistic. (shrink)

Letters in response to my article "What Healthcare Providers Know" and my response in turn.

What is the relationship between the position that anonymous gamete donation is wrong (i.e. the anti-anonymity position) and the position that all gamete donation is wrong (i.e. the anti-donation position)? Some argue that people who accept the anti-anonymity position should also accept the anti-donation position on the grounds that the two positions share the same main arguments. But that’s not true. One argument in favor of anti-anonymity does not generate genuine dialectical pressure to accept the anti-donation position. The other anti-anonymity (...) arguments do generate dialectical pressure, but not in a way that pushes toward the anti-donation position. Instead, they push toward what we might call the ‘pro-known-donation’ position. So, either there is no dialectical pressure or, where there is, it doesn’t flow toward the anti-donation position. (shrink)

This chapter considers an epistemological argument from disagreement which concludes that many of most people’s moral beliefs do not amount to knowledge. Various ways of understanding the argument are considered and it is argued that each relies on an epistemic principle that is under-motivated, overgeneralizes, and is indeed self-incriminating. These problems, it is suggested, infect many conciliationist theses in the epistemology of disagreement. Knowledge, it is argued, can withstand not only acknowledged peer disagreement, but also disagreement with the acknowledged experts. (...) If this is right, then the sort of epistemic principle that is required to move from moral disagreement to the conclusion that many of most people’s moral beliefs do not amount to knowledge has landed well off the mark. (shrink)

Parents respond to the death of a child in very different ways. Some parents may be violent or angry, some sad and tearful, some quiet and withdrawn, and some frankly delusional. We present a case in which a father’s reaction to his daughter’s death is a desire to protect his wife from the stressful information. The wife is in the second trimester of a high-risk pregnancy and so is particularly fragile. We asked pediatricians and bioethicists to discuss the ways in (...) which they might respond to the father’s understandable but troubling request. -/- The death of a young child is one of the most stressful events that can happen to parents. The stress of such a loss is compounded if the parents are in a foreign country, far from home, and without a network of family and friends to provide social support. The stress may be more difficult to deal with if the parents have acute health problems of their own. In this month’s “Ethics Rounds,” we present a case in which a father whose daughter died requested that the doctors delay telling his wife. His reason: She is pregnant, in the second trimester, and on bed rest because of preterm labor. He does not want to add to her stress. We asked both pediatricians and bioethicists to respond to this request. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction to the Symposium on Daniel Groll's Conceiving PeopleAlice MacLachlan (bio)The ethics of donor conception is often framed as a straightforward clash of rights: the right of would-be parents to procreate and parent, the right of donor-conceived children to know and be raised by their genetic parents, and the right of gamete (sperm and egg) donors to privacy. But in this thoughtful, wide-ranging discussion of Daniel (...) Groll's book Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation (2021), the ethical terrain is revealed to be far richer and more intricate. As contributor Camisha Russell puts it, the book attends to "the types of relationships that foster the emotional health of families" while remaining grounded in "the experiences and desires articulated by donor-conceived people themselves" as well as those who contribute to their creation and to their family. As a result, the pieces in this symposium not only take up crucial questions of genetics, identity, and bionormativity, they also ask what it means to frame family relationships as a philosophical problem—conceptual, ethical, and, ultimately, political.Groll's central claim is that those who intend to create a child using donated gametes should choose a donor whose identity will be available to the resulting child. This is not because, as David Velleman (2005) and others have argued, knowledge of one's genetic parentage is fundamentally important in some objective sense. Rather, Groll argues that whether such knowledge is actually important, donor-conceived children are likely to come to view it as crucial—developing what Groll calls a "significant interest" in knowing their donor's identity. Further, parents ought to help satisfy their children's significant interest assuming it is not morally problematic. This line of argument places Groll squarely in the realm of what feminists and anti-racist philosophers describe as "theorizing the non-ideal" (Tessman 2009); that is, making philosophical arguments that take as their starting point the world as it is, including the realities of social injustice. Following Charlotte Witt, Sally Haslanger, and other feminists, Groll acknowledges the dominance of the "bionormative conception of the family" (Witt 2014). He considers whether interest in knowing one's genetic parentage might express bionormative prejudice but concludes that, even if it does, [End Page 163] "interest in genetic knowledge can—in our world—be rationally grounded apart from the oppressive schema it is embedded in" (Groll 2021, 149). He further concludes that given a prospective child's likely significant interest in their genetic parentage, would-be parents ought to use an open (i.e., non-anonymous) donor. At the same time, he argues that there are good reasons to disrupt the bionormative schema on both a personal and policy level that may lead to a child's significant interest in the first place.If Groll walks the middle ground in this debate, his critics in this symposium are happy to turn his stroll into a balancing act. Both Reuven Brandt and Amanda Roth challenge Groll's significant interest approach. Brandt questions the extent to which parents owe children a truthful, detailed accounting of their origin, making the case for parental privacy. Roth questions whether the interest in genetic knowledge is rationally grounded beyond bionormative prejudice, offering as a counterexample the offspring of same-sex parents, raised in queer communities of largely nontraditional family configurations. Bradford Skow pushes from the opposite direction, challenging both the claim that bionormative prejudice is at work in the interest in genetic knowledge and, more broadly, that the so-called bionormative conception of the family has the prestige that Groll and others attribute to it in the first place.Also, Amanda Roth and Camisha Russell pressure Groll to go further in considering the nonideal circumstances in which families are formed and theorized. They specify that questions of family configuration and validity are not only conceptual and ethical, they are political. Roth challenges Groll to further consider the example of same-sex and other LGBTQ+ families as disruptive exemplars and recognize that there may be reasons to choose anonymous donation that he has not considered. She highlights the value of solidarity across families and resistance to the forces... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation by Daniel GrollMelissa MoschellaGROLL, Daniel. Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation. New York: Oxford University Press, 2021. 256 pp. Cloth, $74.00In Conceiving People, Daniel Groll argues that, generally speaking, those intending to conceive with the help of donor gametes have a moral obligation to use an (...) open donor rather than an anonymous one. This obligation is grounded on the likelihood that their children will have a significant future interest in acquiring genetic knowledge, defined as "knowledge of who one's genetic progenitors are." Groll labels this view the significant interest view, which he argues for largely on empirical grounds.Before beginning his defense of the significant interest view, Groll dedicates chapter 2 to arguing that parents who conceive with the help of donor gametes should not keep this a secret from their children. His position on this point reflects the current consensus on the subject, but he offers a novel argument for it, based on the claim that keeping "the secret" in itself harms the parent–child relationship by inherently compromising the intimacy proper to that relationship.Chapter 3 presents the significant interest view in greater detail, distinguishing it from two other approaches: (1) the "Profound Prudential Good view," taken from the work of David Velleman, according to which "genetic knowledge is a profound prudential good and people who lack it will have tremendous trouble figuring out who they are," and (2) the view that "people have a right to genetic knowledge." Unlike these competing approaches, Groll's view "does not directly depend on claims about the value of genetic knowledge" but is based primarily on the fact that "many donor-conceived people are subjectively interested in having genetic knowledge," combined with the claim that parents have an obligation to promote their children's well-being by satisfying their worthwhile significant subjective interests. Because Groll's argument depends on the worth and significance of genetic knowledge, it is vulnerable to what he calls the "sideshow objection"—that is, that the significant interest view is just a sideshow, and the worth of genetic knowledge is what actually does the important normative work. At the same time, Groll's view that the interest in genetic knowledge is worthwhile and significant also leaves him open to the "bionormativity objection," according to which the interest in genetic knowledge "is morally problematic in virtue of evincing and entrenching a kind of bionormative prejudice" that sees the biological family as a normative ideal. [End Page 141]Responding to these two objections is the task of chapters 4 and 5. Chapter 4 argues that genetic knowledge is an objective but "prudentially optional good," meaning that "its value is not fungible, but a life that lacks it is not thereby impoverished." This distinguishes Groll's view from the profound prudential good view, which he characterizes as a form of "genetic chauvinism." Groll argues that genetic knowledge is valuable because it can provide insight into personal identity by answering questions about how I came to be and who I am like, but that the genetic knowledge is not the only or best way to answer these questions (thus explaining why it is optional, and why the significant interest view is not just a sideshow).Chapter 5 addresses the "bionormativity objection," which includes both "heteronormativity" (privileging families headed by a mother and father) and "biogenetic normativity" (privileging genetically related families). Groll ultimately responds to this objection by arguing that, even if (as Groll believes) our current society overemphasizes the importance of genetic relationships, "the interest in genetic knowledge is rationally intelligible quite apart from the bionormative social milieu that surrounds it."Chapters 6 through 8 present the implications of the preceding argument. Chapter 6 argues that the reasons to use an open donor are generally conclusive, because most reasons parents might have to use an anonymous donor do not outweigh the child's significant interest in obtaining genetic knowledge. Chapter 7 considers the responsibilities of gamete donors, arguing that gamete donation is not morally objectionable because it is permissible for donors to transfer prospective parenthood responsibilities... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Groll on Bionormativity and the Value of Genetic KnowledgeBradford Skow (bio)1. IntroductionShould people who plan to use donated sperm and/or eggs to conceive a child use an open donor who agrees ahead of time that any resulting children may be told who the donor is? In Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation (Groll 2021), Daniel Groll answers yes. He (...) argues that using an anonymous donor would be wrong. Groll does not discuss adoption in detail, but his ideas also support the claim that people who adopt a child should adopt from parents who agree ahead of time that their child may be told who their biological parents are. It is not OK to have a closed adoption, in which information about the child's biological parents that would otherwise be public (for example, information on their original birth certificate) is kept secret by the government, and where (in some cases) the biological parents are promised that their children will never learn who they are. I was adopted in a closed adoption and met my biological family when I was twenty, and I think Groll's answer to his main question is right. That, however, does not mean I agree with all of his reasons. Here I examine those reasons and sketch some places where I would depart from them.2. The argument in outlineThe basic outline of Groll's argument, in simple terms, is as follows.1. If a child's knowing who their genetic parents are will likely benefit them—that is, if it will make their life go better, or increase their wellbeing—and if this is foreseeable, then that is a reason for parents to make the child's learning this possible (at some "appropriate" time).2. That knowledge will likely benefit the child …3.. … and this is foreseeable. [End Page 182]4. This reason favoring parents making genetic knowledge possible is strong enough that, except in maybe very special circumstances, parents should make this knowledge possible.The first point is hard to dispute. If the second point is true, then the third point is also plausible, since it is foreseeable that a child born from gamete donation (or an adopted child) will likely try to learn who their genetic (or biological) parents are. These searches are common and widely known to occur. Most of the action, therefore, is in the second point. Why think that knowing who your genetic or biological parents are is likely to make your life go better? Here the path diverges into a wood.3. First try: getting what you want makes your life go betterThe simplest way to argue that knowing who your genetic parents are is a benefit is to note that many, if not most, people conceived through gamete donation (or adoption) will, at some point, want—intensely want—to know who their genetic (or biological) parents are. One can then appeal to the idea that getting what you want makes your life go better, other things being equal.1Groll does not like this justification. His objection is that it does not show "that there is anything resembling a deep connection between genetic knowledge and well-being" (Groll 2021, 65). On Groll's view, knowing who your genetic (biological) parents are is a benefit, but this is not simply because it is something you want to know. I might know ahead of time that my child will want to live in a red house, and they might therefore be better off if they get to, and I might do my best to make that possible; but the reason I have to make genetic knowledge available to them is much stronger and much weightier than my reason to help them live in the right colored house. (It may be that this is where the fourth point of the argument, about the strength of reasons, comes in.)So why is the reason to provide genetic knowledge stronger? Groll, I think, holds that some things are more worth wanting than others. Getting what you want may benefit you, but getting what you want when what you want is something... (shrink)

Bioethics, Volume 36, Issue 8, Page 899-900, October 2022.

In lieu of an abstract, here is a brief excerpt of the content:Anonymous Versus Open Donation and Queerness as Political:Comments on Groll's Conceiving PeopleAmanda Roth (bio)1. IntroductionIn this commentary on Daniel Groll's 2021 book Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation, I examine a number of the book's major themes, especially around the idea that donor-conceived children have a significant interest in genetic knowledge and therefore, donor-conceiving parents are morally required to use (...) an open donor.1 I point to some concerns about Groll's case for this view and, in doing so, highlight the way in which taking up an LGBTQ+ perspective complicates and undermines the case against anonymous donation. The major theme of my comments is that the open versus anonymous decision is not merely an ethical decision, but a political one.My comments are organized around a few of the book's major themes, so I'll begin with laying out the most relevant themes in some detail. I then take up four points to consider in more depth. In so doing, I'll be drawing on my own scholarly perspective on issues of nontraditional reproduction, which is informed by my own social positionality in relation to family matters; this means that I (not so subtly) bring a queer perspective to the discussion of Groll's book. The through-line of my comments is this: While I agree with and appreciate much of Groll's approach, I want to stress the sense in which gamete donation is not just an ethical issue, but a political one, given its implication in bionormativity (and heteronormativity). I wonder if a deeper acknowledgment of the political nature of the issues might lead to moral conclusions that are different from those that Groll comes to, even assuming similar ethical values as starting points.2. Groll's major claims(1) Claim 1: Disclosure to donor-conceived offspring—in the usual case at least—is morally required given the intimacy argument: [End Page 166]The intimacy argument suggests that keeping "the secret" about donor conception involves intentional deception and undermines the proper intimacy of parent-child relationships (Groll 2021, 36–49).(2) Claim 2: Anonymous donor conception is (generally) morally impermissible because of the significant interest view.Donor-conceiving parents can reasonably foresee that their children will likely develop a significant interest in genetic knowledge. Significant interests "matte[r] quite a lot to the person who has [them]," "tak[e] up a space … in a person's mental economy" and/or "pla[y] a structuring role in a person's life and self-conception" (Groll 2021, 62–3). But not all donor-conceived people take such an interest in genetic information, and this information is not necessary for identity construction or psychological wellbeing (Groll 2021, 58, 61).2 Rather, multiple routes to self-identity exist, the genetic route being one among the options. Moreover, one needn't experience any loss in not taking this route; however, for those who take it up, genetic knowledge is objectively valuable and nonfungible (Groll 2021, 81–9). This is because genetic knowledge is uniquely relevant to the identity-related question "Who am I?" (Groll 2021, 112–3).3Groll argues that donor-conceiving parents should assume that their child will form such an interest because this is empirically a "good bet." Further, significant interests—at least when they are worthwhile (that is, not trivial and not morally objectionable)—are connected to one's wellbeing by the wellbeing principle: In satisfying a non-instrumental significant worthwhile interest, one's life goes better (Groll 2021, 62). It follows, then, that parents ought to choose open donors since (to simplify) parents are obligated to promote their children's wellbeing (ibid).4Counter to what one might expect, Groll does not take his ethical case against anonymous donor conception to justify prohibition of the practice. This is because wronging children in this way is within the realm of (unethical) choices we allow parents to make without societal interference.5 Moreover, to aim regulation at anonymous donor conception could reinforce bionormativity and target already marginalized families for special negative attention (Groll 2021, chapter 8).(3) "Claim" 3: Groll's own personal... (shrink)

A pioneering work in the philosophy of mind, Content and Consciousness brings together the approaches of philosophers and scientists to the mind--a connection that must occur if genuine analysis of the mind is to be made. This unified approach permits the most forbiddingly mysterious mental phenomenon--consciousness--to be broken down into several distinct phenomena, and these are each given a foundation in the physical activity of the brain. This paperback edition contains a preface placing the book in the context of recent (...) work in the area. (shrink)

In this book by the award-winning author of Just Healthcare, Norman Daniels develops a comprehensive theory of justice for health that answers three key questions: what is the special moral importance of health? When are health inequalities unjust? How can we meet health needs fairly when we cannot meet them all? Daniels' theory has implications for national and global health policy: can we meet health needs fairly in ageing societies? Or protect health in the workplace while respecting individual liberty? Or (...) meet professional obligations and obligations of justice without conflict? When is an effort to reduce health disparities, or to set priorities in realising a human right to health, fair? What do richer, healthier societies owe poorer, sicker societies? Just Health: Meeting Health Needs Fairly explores the many ways that social justice is good for the health of populations in developed and developing countries. (shrink)

In this book Daniel Wegner offers a novel understanding of the relation of consciousness, the will, and our intentional and voluntary actions. Wegner claims that our experience and common sense view according to which we can influence our behavior roughly the way we experience that we do it is an illusion.

How should medical services be distributed within society? Who should pay for them? Is it right that large amounts should be spent on sophisticated technology and expensive operations, or would the resources be better employed in, for instance, less costly preventive measures? These and others are the questions addreses in this book. Norman Daniels examines some of the dilemmas thrown up by conflicting demands for medical attention, and goes on to advance a theory of justice in the distribution of health (...) care. The central argument is that health care, both preventive and acute, has a crucial effect on equality of opportunity, and that a principle guaranteeing equality of opportunity must underly the distribution of health-care services. Access to care, preventive measures, treatment of the elderly, and the obligations of doctors and medical administrations are fully discussed, and the theory is shown to underwrite various practical policies in the area. (shrink)

Reasoning about situations we take to be impossible is useful for a variety of theoretical purposes. Furthermore, using a device of impossible worlds when reasoning about the impossible is useful in the same sorts of ways that the device of possible worlds is useful when reasoning about the possible. This paper discusses some of the uses of impossible worlds and argues that commitment to them can and should be had without great metaphysical or logical cost. The paper then provides an (...) account of reasoning with impossible worlds, by treating such reasoning as reasoning employing counterpossible conditionals, and provides a semantics for the proposed treatment. (shrink)

Précis for a book symposium, with contributions from Meg Wallace, Louis deRosset, and Chris Tillman and Joshua Spencer.

Our ability to locate moral responsibility is often thought to be a necessary condition for conducting morally permissible medical practice, engaging in a just war, and other high-stakes endeavors. Yet, with increasing reliance upon artificially intelligent systems, we may be facing a wideningresponsibility gap, which, some argue, cannot be bridged by traditional concepts of responsibility. How then, if at all, can we make use of crucial emerging technologies? According to Colin Allen and Wendell Wallach, the advent of so-called ‘artificial moral (...) agents’ (AMAs) is inevitable. Still, this notion may seem to push back the problem, leaving those who have an interest in developing autonomous technology with a dilemma. We may need to scale-back our efforts at deploying AMAs (or at least maintain human oversight); otherwise, we must rapidly and drastically update our moral and legal norms in a way that ensures responsibility for potentially avoidable harms. This paper invokes contemporary accounts of responsibility in order to show how artificially intelligent systems might be held responsible. Although many theorists are concerned enough to develop artificial conceptions ofagencyor to exploit our present inability to regulate valuable innovations, the proposal here highlights the importance of—and outlines a plausible foundation for—a workable notion ofartificial moral responsibility. (shrink)

This two-part volume collects the complete fragments and most important testimonies for the leading presocratic philosophers. The Greek and Latin texts are translated on facing pages and accompanied by a brief commentary for each philosopher.

In this paper I will present a puzzle about epistemic akrasia, and I will use that puzzle to motivate accepting some non-standard views about the nature of epistemological judgment. The puzzle is that while it seems obvious that epistemic akrasia must be irrational, the claim that epistemic akrasia is always irrational amounts to the claim that a certain sort of justified false belief—a justified false belief about what one ought to believe—is impossible. But justified false beliefs seem to be possible (...) in any domain, and it’s hard to see why beliefs about what one ought to believe should be an exception. I will argue that when we get clearer about what sort of psychological state epistemic akrasia is, we can resolve the puzzle in favor of the intuitive view that epistemic akrasia is always irrational. (shrink)

The potential to collect brain data more directly, with higher resolution, and in greater amounts has heightened worries about mental and brain privacy. In order to manage the risks to individuals posed by these privacy challenges, some have suggested codifying new privacy rights, including a right to “mental privacy.” In this paper, we consider these arguments and conclude that while neurotechnologies do raise significant privacy concerns, such concerns are—at least for now—no different from those raised by other well-understood data collection (...) technologies, such as gene sequencing tools and online surveillance. To better understand the privacy stakes of brain data, we suggest the use of a conceptual framework from information ethics, Helen Nissenbaum’s “contextual integrity” theory. To illustrate the importance of context, we examine neurotechnologies and the information flows they produce in three familiar contexts—healthcare and medical research, criminal justice, and consumer marketing. We argue that by emphasizing what is distinct about brain privacy issues, rather than what they share with other data privacy concerns, risks weakening broader efforts to enact more robust privacy law and policy. (shrink)

This book develops an Aristotelian account of the virtue of practical intelligence or "phronesis"--an excellence of deliberating and making choices--which ...

This paper proposes a new account of bounded or minimal doxastic rationality (in the sense of Cherniak 1986), based on the notion that beliefs are answers to questions (à la Yalcin 2018). The core idea is that minimally rational beliefs are linked through thematic connections, rather than entailment relations. Consequently, such beliefs are not deductively closed, but they are closed under parthood (where a part is an entailment that answers a smaller question). And instead of avoiding all inconsistency, minimally rational (...) believers only avoid blatant inconsistencies (where some beliefs are blatantly inconsistent when they contradict one another on a particular question). Rather than cohering into a single overall world view, beliefs are more loosely connected in what is best described as a web of questions. This view of minimally rational belief naturally gives rise to an account of deductive inquiry on which deductive reasoning is a matter of posing new questions. (shrink)

This collection of essays explores the metaphysical thesis that the living world is not made up of substantial particles or things, as has often been assumed, but is rather constituted by processes. The biological domain is organised as an interdependent hierarchy of processes, which are stabilised and actively maintained at different timescales. Even entities that intuitively appear to be paradigms of things, such as organisms, are actually better understood as processes. Unlike previous attempts to articulate processual views of biology, which (...) have tended to use Alfred North Whitehead’s panpsychist metaphysics as a foundation, this book takes a naturalistic approach to metaphysics. It submits that the main motivations for replacing an ontology of substances with one of processes are to be found in the empirical findings of science. Biology provides compelling reasons for thinking that the living realm is fundamentally dynamic, and that the existence of things is always conditional on the existence of processes. The phenomenon of life cries out for theories that prioritise processes over things, and it suggests that the central explanandum of biology is not change but rather stability, or more precisely, stability attained through constant change. This edited volume brings together philosophers of science and metaphysicians interested in exploring the consequences of a processual philosophy of biology. The contributors draw on an extremely wide range of biological case studies, and employ a process perspective to cast new light on a number of traditional philosophical problems, such as identity, persistence, and individuality. (shrink)

While the contemporary philosophical literature is replete with discussion of the control or freedom required for moral responsibility, only more recently has substantial attention been devoted to the knowledge or awareness required, otherwise called the epistemic condition. This area of inquiry is rapidly expanding, as are the various positions within it. This chapter introduces two major positions: the reasonable expectation view and the quality of will view. The chapter then explores two dimensions of the epistemic condition that serve as fault (...) lines along which these two views diverge. The first dimension concerns different kinds of ignorance. The second concerns what agents can be directly blameworthy for. The chapter closes by sketching a novel approach that incorporates advantages of opposing positions on this topic. (shrink)

Supporters of open borders sometimes argue that the state has no pro tanto right to restrict immigration, because such a right would also entail a right to exclude existing citizens for whatever reasons justify excluding immigrants. These arguments can be defeated by suggesting that people have a right to stay put. I present a new form of the exclusion argument against closed borders which escapes this “right to stay put” reply. I do this by describing a kind of exclusion that (...) has not been discussed in depth, which I call “territorial exclusion.” Territorial exclusion is the process according to which the group that wishes to exclude current citizens secedes from the territory in which those citizens reside. I argue that the wrongness of territorial exclusion explains why there is no pro tanto right for a state to exclude immigrants, because otherwise there would be a pro tanto right for the state to kick people out by seceding from the territory they inhabit. Because kicking people out like this is typically wrong, borders cannot be closed. (shrink)

I defend the cosmopolitan instrumentalist theory of secession, according to which a group has a right to secede only if this would promote cosmopolitan justice. I argue that the theory is preferable to other theories of secession because it is an entailment of cosmopolitanism, which is independently attractive, and because, unlike other theories of secession, it allows us to give the answers we want to give in cases like secession of the rich or secession that would make things worse for (...) minorities. I defend the view against the objections that it allows for colonialism and annexation, that it is not a distinct theory, and that it is impractical. (shrink)

This chapter introduces readers to the view that praise is a form of address, or is communicative in the sense of seeking uptake from its target. The proposal that praise is communicative will seem counterintuitive if we take blame to be our paradigm of what it is for a responsibility-response to be communicative. This is because blame is communicative in a manner that intuitively presupposes some normative failure; it involves calling its target to account (or answer) for some wrongdoing. But, (...) the ‘rightdoer’ already properly regarded the relevant reasons in acting praiseworthily. So, there is nothing for which the praiseworthy agent must similarly account or answer for. How then could praise be communicative in sense of seeking uptake from its target? This chapter develops the view that praise is communicative in that it invites the praiseworthy agent to accept credit by co-valuing their action in the evaluative terms supplied by the praiser. This proposal is defended against three objections, namely that it is descriptively inadequate regarding our actual practices, that it is morally mistaken about when we owe others a response, and that it implies redundant communication. (shrink)

This volume provides a detailed account of the syntax of expressive language, that is, utterances that express, rather than describe, the emotions and attitudes of the speaker... Daniel Gutzmann demonstrates that expressivity has strong syntactic reflexes that interact with the semantic and pragmatic interpretation of these utterances, and argues that expressivity is in fact a syntactic feature on a par with other established features such as tense and gender. Evidence for this claim is drawn from three detailed case studies (...) of expressive adjectives, intensifiers, and vocatives; their puzzling properties are accounted for through a minimalist approach to syntactic features and agreement, which shows that expressivity can partake in agreement operations, trigger movement, and be selected for syntactically. The analysis not only supports the hypothesis of expressive syntax, but also highlights the hidden role that grammar may play in phenomena that are traditionally considered to be solely semantic in nature" -- Publisher. (shrink)