According to what one might call ‘indirect” forms of utilitarian thinking, the proper end of all human action is the greatest happiness of the greatest number of individuals, but due to the fallibility of moral agents this end cannot, and must not, be directly pursued. Instead, according to at least one version of the indirect theory, moral agents have a duty to act in conformity with a set of general rules which, in their turn, have been designed to promote the (...) greatest happiness of humankind. But acts which conform to such general rules can under exceptional circumstances occasion more suffering than happiness. This is clearly problematical to indirect utilitarians. If they follow the rules regardless of the evil consequences, it can be argued that they have abandoned the basic principles of utilitarianism. If, on the other hand, they refuse to follow the rules which normally promote the general good, their view can be seen to collapse into the direct form of the creed. (shrink)

There is a growing feeling in many Western countries that every human being has a right to health, or a right to health care. This feeling is reflected in a declaration of the World Health Organization (WHO) from 1976, which states: The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. Our intention in the following is to use the WHO (...) declaration as a basis for considering the allocation of resources in health care. We shall first argue that most of the criteria suggested as grounds for fair allocation of scarce medical resources have their difficulties if one tries to apply them one by one to medical practices. We shall then go on to claim that, if we take the right of all human beings to health or health care even moderately seriously, increasing the resources would in most cases be more ethical than attempting to allocate them ‘fairly’. (shrink)

ABSTRACT The authors analyse and assess the Universal Draft Declaration on Bioethics and Human Rights published by UNESCO. They argue that the Draft has two main weaknesses. It unnecessarily confines the scope of bioethics to life sciences and their practical applications. And it fails to spell out the intended role of human dignity in international ethical regulation.

ABSTRACT This paper examines the logic and morality of the German Stem Cell Act of 2002. After a brief description of the law's scope and intent, its ethical dimensions are analysed in terms of symbolic threats, indirect consequences, and the encouragement of immorality. The conclusions are twofold. For those who want to accept the law, the arguments for its rationality and morality can be sound. For others, the emphasis on the uniqueness of the German experience, the combination of absolute and (...) qualified value judgments, and the lingering questions of indirect encouragement of immoral activities will probably be too much. (shrink)

Except for the lines of argument we have sketched above, there are not many general conclusions that can be drawn from the ethical and philosophical AIDS discussion at the moment. It may happen that a medical research team comes forward tomorrow or next week with an effective cure for all immunodeficiency-related diseases, including full-blown AIDS, and most of our reflections turn out to be useless from the practical viewpoint. But the formulation of ethical guidelines for medical and social practice is (...) not all there is to moral philosophy. Even after each and every one of the problems dealt with in our study has lost all direct ordinary-life relevance, the principles and their application in new practical situatons remain. Therefore, let us hope that no moral philosopher will be reluctant to participate in the AIDS discussion out of the hopefully well-grounded but rather unethical fear that the problem in its primary medical form will cease to exist in the relatively near future. (shrink)

Antinatalism is an emerging philosophy and practice that challenges pronatalism, the prevailing philosophy and practice in reproductive matters. We explore justifications of antinatalism—the arguments from the quality of life, the risk of an intolerable life, the lack of consent, and the asymmetry of good and bad—and argue that none of them supports a concrete, understandable, and convincing moral case for not having children. We identify concentration on possible future individuals who may or may not come to be as the main (...) culprit for the failure and suggest that the focus should be shifted to people who already exist. Pronatalism’s hegemonic status in contemporary societies imposes upon us a lifestyle that we have not chosen yet find almost impossible to abandon. We explicate the nature of this imposition and consider the implications of its exposure to different stakeholders with varying stands on the practice of antinatalism. Imposition as a term has figured in reproductive debates before, but the argument from postnatal, mental, and cultural imposition we launch is new. It is the hitherto overlooked and underdeveloped justification of antinatalism that should be solid and comprehensible enough to be used even by activists in support of their work. (shrink)

ABSTRACT Public health authorities sometimes have to make decisions about the use of preventive medical measures—e.g. vaccination programmes—which could, if realised, save millions of lives, but could also kill a certain (small) number of those subjected to the measures. According to a rough‐and‐ready utilitarian calculation, such measures should be taken, but there are also possible objections to this view. A liberal objection to the use of mandatory preventive measures which might harm human beings is that people have a right to (...) decide for themselves whether or not they want to participate in the programme. A further objection is based on the claims that first, the authorities are directly killing those who die because of, say, vaccination programmes, and second, directly killing human beings is forbidden (since every human being has a right to live). The latter objection is discussed at length in the present paper. The validity of three doctrines, the doctrines of the double effect, of acts and omissions, and of killing and letting die, are considered with reference to the use of preventive measures, and found inapplicable. The objection is, however, refuted by comparing some hypothetical examples, and the initial utilitarian calculation is reinforced. (shrink)

With the considerable attention given to UNESCO's Universal Declaration on the Human Genome and Human Rights, the time has come to take another look at the concept of dignity, on which this document is morally founded. The term “dignity” now appears in many national constitutions and international bioethical statements. It has also become popular among Continental European ethicists, many of whom wish to challenge the particularly American and overtly individualistic principles of “autonomy,” “justice,” “beneficence,” and “nonmaleficence.” a.

Health care services are constantly assessed by their ability to accommodate values popular in contemporary societies. Autonomy, justice, and human dignity have for some time been among such values in the affluent West. Relative newcomers in the field are the notions of and which seem to attract, in particular, Continental European ethicists. a.

ABSTRACT Can philosophers come up with persuasive reasons to allow or to ban human reproductive cloning? Yes. Can philosophers agree, locally and temporarily, which practices related to cloning should be condoned and which should be rejected? Some of them can. Can philosophers produce universally convincing arguments for or against different kinds of human cloning? No. This paper analyses some of the main arguments presented by philosophers in the cloning debate, and some of the most important objections against them. The clashes (...) between the schools of thought suggest that philosophers cannot be trusted to provide the public authorities, or the general public, a unified, universally applicable view of the morality of human reproductive cloning. (shrink)

_Liberal Utilitarianism and Applied Ethics_ explores the foundations of early utilitarianism and, at the same time, the theoretical bases of social ethics and policy in modern Western welfare states. Matti Hayry sees the main reason for utilitarianism's growing disrepute among moral philosophers is that its principles cannot legitimately be extended to situations where the basic needs of the individuals involved are in conflict. He is able to formulate a solution to this fundamental problem by arguing convincingly that by (...) combining a limited version of liberal utilitarianism and the methods of applied ethics, we are able to define our moral duties and rights. _Liberal Utilitarianism and Applied Ethics_ will appeal to students and teachers of philosophy who are interested in the doctrine of utilitarianism or in ethical decison-making. (shrink)

_Liberal Utilitarianism and Applied Ethics_ explores the foundations of early utilitarianism and, at the same time, the theoretical bases of social ethics and policy in modern Western welfare states. Matti Hayry sees the main reason for utilitarianism's growing disrepute among moral philosophers is that its principles cannot legitimately be extended to situations where the basic needs of the individuals involved are in conflict. He is able to formulate a solution to this fundamental problem by arguing convincingly that by (...) combining a limited version of liberal utilitarianism and the methods of applied ethics, we are able to define our moral duties and rights. _Liberal Utilitarianism and Applied Ethics_ will appeal to students and teachers of philosophy who are interested in the doctrine of utilitarianism or in ethical decison-making. (shrink)

Relativism is usually a derogatory word in philosophical bioethics in the West. If people make the mistake of trying to understand radically “different” points of view, an accusation of relativism is quickly forthcoming. But why should this be an accusation? My aim in this paper is to demonstrate that it should not.

Concepts that refer to trends like globalization and medicalization have, of late, become a hallmark of public debates. The logic of such concepts is that the same word can refer both to good and bad developments, partly depending on the chosen viewpoint. Hardly anyone opposes the global enforcement of human rights, but the global liberation of trade is sometimes viewed with suspicion. In a similar vein, advances in medicine are seldom seen as a bad thing, but medical solutions to social (...) issues can be seen as problematic. (shrink)

Health care services are constantly assessed by their ability to accommodate values popular in contemporary societies. Autonomy, justice, and human dignity have for some time been among such values in the affluent West. Relative newcomers in the field are the notions of “precaution” and “solidarity,” which seem to attract, in particular, Continental European ethicists. a.

There is no longer any doubt that the coming decades will bring serious threats to humanity from anthropogenic climate change. As we have suggested elsewhere, horrible scenarios are far more realistic than non-horrible ones, and science and technology are incapable, especially in our non-ideal world, of equitably distributing wealth, access to resources and adaptations to climate change. In this article, we offer an alternative to these inevitable horrible scenarios. The alternative is to implement either an anti-natalist policy, or procreative beneficence (...) and reproductive rights policies aimed at radically reducing the birth rate. These alternatives, however, are potentially unfair and quite possibly unthinkable to most of humanity. (shrink)

This article presents a revised version of negative utilitarianism. Previous versions have relied on a hedonistic theory of value and stated that suffering should be minimized. The traditional rebuttal is that the doctrine in this form morally requires us to end all sentient life. To avoid this, a need-based theory of value is introduced. The frustration of the needs not to suffer and not to have one’s autonomy dwarfed should, prima facie, be decreased. When decreasing the need frustration of some (...) would increase the need frustration of others, the case is deferred and a fuller ethical analysis is conducted. The author’s perceptions on murder, extinction, the right to die, antinatalism, veganism, and abortion are used to reach a reflective equilibrium. The new theory is then applied to consumerism, material growth, and power relations. The main finding is that the burden of proof should be on those who promote the status quo. (shrink)

ABSTRACT The authors analyse and assess the Universal Draft Declaration on Bioethics and Human Rights published by UNESCO. They argue that the Draft has two main weaknesses. It unnecessarily confines the scope of bioethics to life sciences and their practical applications. And it fails to spell out the intended role of human dignity in international ethical regulation.

Relativism is usually a derogatory word in philosophical bioethics in the West. If people make the mistake of trying to understand radically “different” points of view, an accusation of relativism is quickly forthcoming. But why should this be an accusation? My aim in this paper is to demonstrate that it should not.

Should we make people healthier, smarter, and longer-lived if genetic and medical advances enable us to do so? Matti Häyry asks this question in the context of genetic testing and selection, cloning and stem cell research, gene therapies and enhancements. The ethical questions explored include parental responsibility, the use of people as means, the role of hope and fear in risk assessment, and the dignity and meaning of life. Taking as a starting point the arguments presented by Jonathan Glover, (...) John Harris, Ronald M. Green, Jürgen Habermas, Michael J. Sandel, and Leon R. Kass, who defend a particular normative view as the only rational or moral answer, Matti Häyry argues that many coherent rationalities and moralities exist in the field, and that to claim otherwise is mistaken"--Provided by publisher. (shrink)

Blumenthal-Barby et al. (2022) present a nuanced and convincing case for the continued presence of moral and political philosophers in bioethics. We agree with the authors that philosophers should have a role in bioethical inquiry. However, we partly disagree on what that role should be. We assess the case taking our clues from a concern the authors mention – and another one that they do not directly address.

Utilitarianism could still be a viable moral and political theory, although an emphasis on justice as distributing burdens and benefits has hidden this from current conversations. The traditional counterexamples prove that we have good grounds for rejecting classical, aggregative forms of consequentialism. A nonaggregative, liberal form of utilitarianism is immune to this rejection. The cost is that it cannot adjudicate when the basic needs of individuals or groups are in conflict. Cases like this must be solved by other methods. This (...) is not a weakness in liberal utilitarianism, on the contrary. The theory clarifies what we should admit to begin with: that ethical doctrines do not have universally acceptable solutions to all difficult problems or hard cases. The theory also reminds us that not all problems are in this sense difficult or cases hard. We could alleviate the plight of nonhuman animals by reducing meat eating. We could mitigate climate change and its detrimental effects by choosing better ways of living. These would imply that most people’s desire satisfaction would be partly frustrated, but liberal utilitarianism holds that this would be justified by the satisfaction of the basic needs of other people and nonhuman animals. (shrink)

This paper analyses the various effects of threats and offers on freedom. Both threats and offers are related to social power. Threats are part of coercion and they are constraints. We try to say why this is so. Offers are more problematic. We identify soft and hard offers, or offers that can be refused and those that cannot. Hard offers have several interesting features, especially in relation to individual preference orders and sets of action alternatives. This paper studies problems which (...) are implicit in Thomas Wartenberg’s study of the various forms of social power in this issue of Analyse & Kritik. (shrink)

Many bioethical disputes are conceptual. This means that people quarrel about the use of words that they see as important. The underlying idea is that whoever wins the verbal argument will also be ethically right.

:Justice can be approached from many angles in ethical and political debates, including those involving healthcare, biomedical research, and well-being. The main doctrines of justice are liberal egalitarianism, libertarianism, luck egalitarianism, socialism, utilitarianism, capability approach, communitarianism, and care ethics. These can be further elaborated in the light of traditional moral and social theories, values, ideals, and interests, and there are distinct dimensions of justice that are captured better by some tactics than by others. In this article, questions surrounding these matters (...) are approached with the hermeneutic idea of a distinction between “American” and “European” ways of thinking. (shrink)

Climate change poses a challenge to bioethics due to overpopulation and a declining quality of life, among other factors. In this article, we discuss four scenarios of possible human development in the near future. Two of them are horrible scenarios. One of them assumes that living conditions will significantly deteriorate and people will live in great poverty. The second of the horrible scenarios is one in which a large part of humanity will die. Two other, non-horrible scenarios offer more optimism, (...) either because of faith in technological capabilities, or because of faith in the development of human solidarity and social justice. In this article, we show why rational calculation suggests considering the horrible scenarios as the most realistic. (shrink)

Moral and political philosophers no longer condemn harm inflicted on nonhuman animals as self-evidently as they did when animal welfare and animal rights advocacy was at the forefront in the 1980s, and sentience, suffering, species-typical behavior, and personhood were the basic concepts of the discussion. The article shows this by comparing the determination with which societies seek responsibility for human harm to the relative indifference with which law and morality react to nonhuman harm. When harm is inflicted on humans, policies (...) concerning negligence and duty of care and principles such as the ‘but for’ rule and the doctrine of double effect are easily introduced. When harm is inflicted on nonhumans, this does not happen, at least not any more. As an explanation for the changed situation, the article offers a shift in discussion and its basic terminology. Simple ethical considerations supported the case for nonhuman animals, but many philosophers moved on to debate different views on political justice instead. This allowed the creation of many conflicting views that are justifiable on their own presuppositions. In the absence of a shared foundation, this fragments the discussion, focuses it on humans, and ignores or marginalizes nonhuman animals. (shrink)

Governmental reactions to crises like the COVID-19 pandemic can be seen as ethics communication. Governments can contain the disease and thereby mitigate the detrimental public health impact; allow the virus to spread to reach herd immunity; test, track, isolate, and treat; and suppress the disease regionally. An observation of Sweden and Finland showed a difference in feasible ways to communicate the chosen policy to the citizenry. Sweden assumed the herd immunity strategy and backed it up with health utilitarian arguments. This (...) was easy to communicate to the Swedish people, who appreciated the voluntary restrictions approach and trusted their decision makers. Finland chose the contain and mitigate strategy and was towards the end of the observation period apparently hesitating between suppression and the test, track, isolate, and treat approach. Both are difficult to communicate to the general public accurately, truthfully, and acceptably. Apart from health utilitarian argumentation, something like the republican political philosophy or selective truth telling are needed. The application of republicanism to the issue, however, is problematic, and hiding the truth seems to go against the basic tenets of liberal democracy. (shrink)

Is there such a thing as corona solidarity? Does voluntary mutual aid solve the problems caused by COVID-19? I argue that the answer to the first question is “yes” and to the second “no.” Not that the answer to the second question could not, in an ideal world, be “yes,” too. It is just that in this world of global capitalism and everybody looking out for themselves, the kind of communal warmth celebrated by the media either does not actually exist (...) or is too weak to rule out the uglier manifestations of group togetherness, driven partly by the pandemic. I make my point by offering two approaches to understanding what solidarity is. According to the first, it is essentially partiality: “us” against “them.” According to the second, it can be many things, including the impartial promotion of the good of others. I show that the second reading would make it possible for mutual aid to solve the problems caused by COVID-19 and other crises. This would happen at the expense of conceptual clarity, but that is a minor concern. The major concern is that the more natural manifestations of group togetherness are incited by negative feelings. This is par for the course within the narrower reading of solidarity, but it means that the potentially positive ideas of identity, care, communal values, and special relations are displayed in violent confrontation instead of a calm recognition of the threats that most of us face together. (shrink)

The role of bioethicists amidst crises like the COVID-19 pandemic is not well defined. As professionals in the field, they should respond, but how? The observation of the early days of pandemic confinement in Finland showed that moral philosophers with limited experience in bioethics tended to apply their favorite theories to public decisions, with varying results. Medical ethicists were more likely to lend support to the public authorities by soothing or descriptive accounts of the solutions assumed. These are approaches that (...) Tuija Takala has called the firefighting and window dressing models of bioethics. Human rights lawyers drew attention to the flaws of the government’s regulative thinking. Critical bioethicists offered analyses of the arguments presented and the moral and political theories that could be used as the basis of good and acceptable decisions. (shrink)

Abortions are legally permitted in most Western societies if there is a reasonable expectation that the child, if born, would be physically or mentally disabled. Even late-term abortions, which would not be allowed in the case of healthy fetuses, are accepted on the basis of foreseen disability.

In this article, I present what I believe to be the core of Jürgen Habermas’s views on the morality, ethics, and regulation of emerging genetic and reproductive technologies in his book The Future of Human Nature.

When humanity has either suppressed coronavirus disease 2019 or learned to come to terms with its continued existence, governments and corporations probably return to their prepandemic stances. Solutions to the world’s problems are sought from technology and business innovations, not from considerations of equality and well-being for all. This is in stark contrast with the pandemic-time situation. Many governments, at least initially, listened to the recommendations of expert advisers, most notably public health authorities, who proceeded from considerations of equality and (...) common good. I suggest that we should continue on this path when the immediate threat of the disease is over. Other crises are already ongoing—poverty, conflicts, climate change, financial bubbles, and so on—and it would be good to use expert knowledge rather than interests and ideologies in dealing with them. To assist in this, I outline the characteristics of a new kind of counsellor, impartial adviser, who is normatively motivated by a sense of copathy and who takes into account all views, nice and not-so-nice alike. I illustrate the nature and ideological orientation of copathic impartial advisers by placing them on a map of justice and examining their relationships with the main political moralities of our time. (shrink)

Are sociologists always critical about genetics? Are philosophers always more supportive? This is the impression of many sociologists in the United Kingdom who argue that contemporary British philosophers criticise genetic technologies and applications in ways that scientists and medical doctors can deal with. They emphasise matters like informed consent, but pay less or no attention to the wider social consequences of technologies, practices and policies. Philosophers in their turn may see sociologists as irrationally hostile to science and medical practice. Some (...) of them refuse to criticise genetics, arguing that there is nothing to criticise. Others feel that their criticisms are in fact more accurate than the concerns raised by sociologists. And yet others point out that the impression of uncritical support can only be true of a certain specific group. Philosophers have so many internal disagreements among themselves that the generalisation can hardly be justified. In this paper an attempt is made by a sociologist and a philosopher to understand how sociological and philosophical perspectives on bioethics may differ in discussions about genetics. The paper, which proceeds in dialogue form, is based on our email correspondence on the advantages and disadvantages of genetic technologies and their applications, and on the idea of social consequences as understood by scholars from two different disciplines. (shrink)

I present a qualified new defense of antinatalism. It is intended to empower potential parents who worry about their possible children’s life quality in a world threatened by environmental degradation, climate change, and the like. The main elements of the defense are an understanding of antinatalism’s historical nature and contemporary varieties, a positional theory of value based on Epicurean hedonism and Schopenhauerian pessimism, and a sensitive guide for reproductive decision-making in the light of different views on life’s value and risk-taking. (...) My conclusion, main message, to the concerned would-be parents is threefold. If they believe that life’s ordinary frustrations can make it not worth living, they should not have children. If they believe that a noticeably low life quality makes it not worth living and that such life quality can be reasonably expected, they should not have children, either. If they believe that a noticeably low life quality is not reasonably to be expected or that the risk is worth taking, they can, in the light of their own values and beliefs, have children. The conclusion is supported by a combination of the extant arguments for reproductive abstinence, namely the arguments from consent, moral asymmetry, life quality, and risk. (shrink)

Rights, autonomy, privacy, and confidentialityare concepts commonly used in discussionsconcerning genetic information. When theseconcepts are thought of as denoting absolutenorms and values which cannot be overriden byother considerations, conflicts among themnaturally occur.In this paper, these and related notions areexamined in terms of the duties and obligationsmedical professionals and their clients canhave regarding genetic knowledge. It issuggested that while the prevailing idea ofautonomy is unhelpful in the analysis of theseduties, and the ensuing rights, an alternativereading of personal self-determination canprovide a firmer (...) basis for ethical guidelinesand policies in this field. (shrink)