As with most other areas of reproduction, surrogacy is highly regulated. But the legislation and policies on surrogacy are written in such ways that make large (and possibly mistaken) assumptions about the metaphysical relationship between the mother and the fetus – whether the fetus is a part of, or contained by, the mother. It is the purpose of this chapter to highlight these assumptions, and to demonstrate the impact that alternative metaphysical views can have on our conceptualization of surrogacy. With (...) that in mind, I recommend that our public policies on surrogacy be at least neutral or otherwise responsive to metaphysics rather than presupposing it, such that the regulation and legislation of surrogacy will be metaphysically informed. (shrink)

Bioethics has increasingly become a standard part of medical school education and the training of healthcare professionals more generally. This is a promising development, as it has the potential to help future practitioners become more attentive to moral concerns and, perhaps, better moral reasoners. At the same time, there is growing recognition within bioethics that nonideal theory can play an important role in formulating normative recommendations. In this chapter we discuss what this shift toward nonideal theory means for ethical curricula (...) within healthcare education. In particular, we contend that more attention to the particularities of historical and social context needs to be incorporated into bioethics training. To make this argument, we focus on two examples: teaching units on race and medicine and those that focus on stigma and coercion in mental health. For both, we show how a pedagogical approach in which educators focus on social injustice could influence how practitioners engage in ethics in the clinic. This chapter, then, demonstrates what a commitment to nonideal theory can mean practically when it comes to bioethics education. (shrink)

The commercial trading of human organs, along withvarious related activities (for example, advertising)was criminalised throughout Great Britain under theHuman Organ Transplants Act 1989.This paper critically assesses one type of argumentfor this, and similar, legal prohibitions:commodification arguments.Firstly, the term `commodification' is analysed. Thiscan be used to refer to either social practices or toattitudes. Commodification arguments rely on thesecond sense and are based on the idea that having acommodifying attitude to certain classes of thing(e.g. bodies or persons) is wrong. The commodifyingattitude consists (...) of three main elements: denial ofsubjectivity, instrumentality, and fungibility.Secondly, in the light of this analysis, the claimthat organ sale involves commodifying the human bodyis examined. This claim is found to be plausible butinsufficient to ground an argument against organ sale,because the very same commodifying attitude is likelyto be present in cases of (unpaid) organ donation. Itis also argued that commodifying bodies per semay not be wrong.Thirdly, the view that organ sale involvescommodifying persons is examined. Although this andthe claim that it is wrong to commodify persons areprobably true, there is – it is argued – littlereason to regard organ sale as worse in this respectthan other widely accepted practices, such as thebuying and selling of labour.The conclusion is that although commodification is auseful ethical concept and although commodificationarguments may sometimes be successful, thecommodification argument against organ sale is notpersuasive. This is not to say, though, that thereare no arguments for prohibition – simply that thisparticular justificatory strategy is flawed. (shrink)

In several works, Jason Brennan and Peter Martin Jaworski defend the following thesis: If it is permissible to have, use, or exchange something for free, then it is permissible to have, use, or exchange that thing for money. In this paper, I argue that No Limits is false. Moreover, the reasons why it is false reflect many of the complaints made against markets. The paper will proceed as follows: In §1, I summarize Brennan and Jaworski’s position to clarify exactly what (...) a challenge to No Limits requires. In §2, I raise just such a challenge, one which also captures the concern behind some “semiotic objections.” In §3, I offer a modification to No Limits that avoids my objection but, as a result, re-opens the question of whether markets in some of the goods Brennan and Jaworski discuss are permissible. I conclude in §4 by considering a possible response and some thoughts on the dialectic as it stands. (shrink)

One powerful argument against self-ownership is that it degrades personhood by leading individuals to view themselves and others as mere instrumental goods, alienable commodities to be exchanged in markets like other products and services. In general terms, this line of criticism (called the “commodification argument”) maintains that a direct and causal relationship exists between certain legal institutions (self-ownership) and certain attitudes (instrumentalism) and that the undesirability of the latter justifies restrictions on the former. In this article, I will critically examine (...) Margaret Jane Radin’s book Contested Commodities (1996), which presents a well-developed, compelling version of the commodification argument. I will advance three central points over the course of the article: first, the purported causal connection between self-ownership and instrumentalism is either weak or nonexistent; second, the commodification argument does little independent moral work, tending instead to be parasitic on arguments against economic, racial, and gender inequality; and third, what independent moral work it does do seems to be directed not so much at self-ownership as at liberal neutrality. I will conclude by showing that the weaknesses of Radin’s diverse defenses of the commodification argument cast doubt upon the anticommodificationist enterprise as a whole. (shrink)

This essay suggests some links between concern about the decline of ‘the family’, or of ‘family values’, the use of reproductive technology, and the claim that some people have children for the ‘wrong reasons’. It is argued that where conceiving and bringing a child to term is a matter of choice, a person must have a reason or reasons for doing so and further, that those reasons are of moral significance. By appealing to Kant's Categorical Imperative: ‘Act in such a (...) way that you always treat humanity … never simply as a means, but always at the same time as an end’, a distinction is made between morally desirable and morally undesirable reasons, on the grounds of the extent to which the parent or parents will be able or likely to treat the child as an end in herself. In conclusion it is argued that whilst ‘the family’is vital to the health of children, and to the health of society, it is not so much the form that the family takes that is significant, but the extent to which it allows for the development and maintainance of a certain sort of relationship. (shrink)

Although the critique of reification is a core commitment of critical theories, there is no widely accepted account of its normative foundation. In Lukács’s original analysis, this foundation is provided by a strong concept of practice which is, however, not acceptable from a contemporary point of view. I argue that the systematic character of reification theory can only be upheld if this concept is replaced by a more intersubjective notion of normative practices. Reification can then be analysed as a second-order (...) pathology of social practices, as an inhibition of reflexivity by their normative shape. The normative justification of such critique, however, turns out to be more context-dependent than it is usually imagined. (shrink)

The ‘limits of markets’ debate broadly concerns the question of when it is (im)permissible to have a market in some good. Markets can be of tremendous benefit to society, but many have felt that certain goods should not be for sale (e.g., sex, kidneys, bombs). Their sale is argued to be corrupting, exploitative, or to express a form of disrespect. InMarkets without Limits, Jason Brennan and Peter Jaworski have recently argued to the contrary: For any good, as long as it (...) is permissible to give it for free, then it is permissible to give it for money. Their thesis has led to a number of engaging objections, and I leverage recent work on the nature of feasibility within political philosophy to offer a new challenge.I argue that feasibility offers a constraint on which markets can be permissibly implemented. Though it may be possible to create a morally acceptable version of an otherwise repugnant market, some of these markets may be infeasible, and so we are not permitted to implement them. After laying out this challenge, I consider several replies. They concern the relevance of feasibility, and whether any markets really are infeasible. This provides an opportunity to explore the dangers of pursuing the infeasible and with markets generally. I conclude by considering what might lead us to pursue these markets despite their infeasibility, or how knowledge of infeasibility may prove useful regardless. (shrink)

In recent years feminists have begun arguing for various political conceptions of ‘care’. I have argued, by contrast, for the intimate connection between the women’s movement of the last half century, and the growing realization of the necessity of civic friendship as a condition for genuine justice. I only repeat the outlines of my argument here, for my goal is to look at various institutions which might help realize not merely ‘public care’ – contemporary theories of which I argue need (...) a far more careful normative account – but a civic friendship between all citizens. Indeed, I argue that the ideal of civic friendship provides that normative account of political care lacking in contemporary theories. (shrink)

The datafication and digitalization of health and medicine has engendered a proliferation of new collaborations between public health institutions and data corporations like Google, Apple, Microsoft and Amazon. Critical perspectives on these new partnerships tend to frame them as an instance of market transgressions by tech giants into the sphere of health and medicine, in line with a “hostile worlds” doctrine that upholds that the borders between market and non-market spheres should be carefully policed. This article seeks to outline the (...) limitations of this common framing for critically understanding the phenomenon of the Googlization of health. In particular, the mobilization of a diversity of non-market value statements in the justification work carried out by actors involved in the Googlization of health indicates the co-presence of additional worlds or spheres in this context, which are not captured by the market vs. non-market dichotomy. It then advances an alternative framework, based on a multiple-sphere ontology that draws on Boltanski and Thevenot’s orders of worth and Michael Walzer’s theory of justice, which I call a normative pragmatics of justice. This framework addresses both the normative deficit in Boltanski and Thevenot’s work and provides an important emphasis on the empirical workings of justice. Finally, I discuss why this framework is better equipped to identify and to address the many risks raised by the Googlization of health and possibly other dimensions of the digitalization and datafication of society. (shrink)

Jason Brennan and Peter Jaworski argue in recent work that “semiotic” or “symbolic” objections to markets are unsuccessful. I counter-argue that there are indeed some semiotic limits on markets and that anti-commodification theorists are not merely expressing disgust when they disapprove of markets in certain goods on those grounds. One central argument is that, contrary to what Brennan and Jaworski claim, semiotic arguments against markets do not depend fundamentally on meanings that prevail about markets. Rather, they depend on the meanings (...) that attach to various goods, meanings that give us moral bases on which to make judgments about their prospective commodification. (shrink)

Those objecting to human DNA patenting frequently do so on the grounds that the practice violates or threatens human dignity. For example, from 1993 to 1994, more than thirty organizations representing indigenous peoples approved formal declarations objecting to the National Institutes of Health's bid to patent viral DNA taken from subjects in Papua New Guinea and the Solomon Islands. Although these were not patents on human DNA, the organizations argued that the patents could harm and exploit indigenous peoples and violate (...) their cultural values. NIH eventually dropped one of its patent applications.On May 18, 1995, 180 religious leaders, led by biotechnology critic Jeremy Rifkin, held a press conference objecting to DNA patenting in Washington, D.C. In their “Joint Appeal against Human and Animal Patenting,” these leaders decried any attempt to patent nature. Some of the more outspoken members of the Joint Appeal likened DNA patenting to slavery, while others objected to treating human beings as marketable commodities. In his recent book, The Biotech Century, Rifkin rehashed the objections to DNA patenting voiced by members of the Joint Appeal. (shrink)

Anti-commodification theorists condemn liberal political philosophers for not being able to justify restricting a market transaction on the basis of what is sold, but only on the basis of how it is sold. The anti-commodification theorist is correct that if this were all the liberal had to say in the face of noxious markets, it would be inadequate: even if everyone has equal bargaining power and no one is misled, there are some goods that should not go to the highest (...) bidder. In this paper, I respond to the anti-commodification critique of liberalism by arguing that the political liberal has the wherewithal to account not only for the conditions under which goods should not be sold, but also for what kinds of goods should not be for sale in a market economy. The political liberal can appeal to a principle of equal basic rights, and to one of sufficiency in basic needs and the social bases of self-respect, I argue, to account for what’s problematic about markets in civic goods, necessary goods, and physical goods including body parts and intimate services. (shrink)

Surrogacy is one of the desired reproductive technologies for family formation, yet surrogate mothers are subjected to unethical treatments and unbalanced power relations in India. Such treatment obscures women’s free decision-making and can be detrimental to their maternal self. Recently, the Surrogacy Act, 2021, has received the President’s approval to regulate surrogacy practices by limiting them for the altruistic motives which have again provoked the burning debates regarding reproductive technologies, women’s emancipation and procreative labour. The paper thus explores women’s agency, (...) maternal freedom and surrogate arrangements in Indian society. The complexity of the implementation of the law, vulnerability of surrogate labour, woman’s bodily autonomy and reproductive choices have been analysed. This has been done through comprehensive feminist discussions on motherhood experience in terms of enforced vs. voluntary to find the way to protect women’s freedom and subjectivity in the task of ‘mothering as empowerment’. (shrink)

In this paper I develop a theory of the acquisition of parental rights. According to this investment theory, parental rights are generated by the performance of parental work. Thus, those who successfully parent a child have the right to continue to do so, and to exclude others from so doing. The account derives from a more general principle of desert that applies outside the domain of parenthood. It also has some interesting implications for the attribution of moral parenthood. In particular, (...) it implies that genetic relationships per se are irrelevant to parental rights and that it is possible to have more than two moral parents. (shrink)

This article explores the controversial practice of transnational gestational surrogacy and poses a provocative question: Does it have to be exploitative? Various existing models of exploitation are considered and a novel exploitation-evaluation heuristic is introduced to assist in the analysis of the potentially exploitative dimensions/elements of complex health-related practices. On the basis of application of the heuristic, I conclude that transnational gestational surrogacy, as currently practiced in low-income country settings , is exploitative of surrogate women. Arising out of consideration of (...) the heuristic's exploitation conditions, a set of public education and enabled choice, enhanced protections, and empowerment reforms to transnational gestational surrogacy practice is proposed that, if incorporated into a national regulatory framework and actualized within a low income country, could possibly render such practice nonexploitative. (shrink)

Are there any viable semiotic objections to commodification? A semiotic objection holds that even if there is no independent consequentialist or deontic objection to the marketing of a good—such as that it is exploitative or causes third party harm—there remains a problem with what is said by participating in that market. Recent discussion of semiotic objections have suffered from a basic ambiguity in such talk. As Grice pointed out, there is a difference between saying that smoke on the horizon means (...) fire, and saying that it means there will be war tomorrow. We could say that in the former case smoke indicates fire because of its causal connection with fire, while in the latter case smoke expresses a call to war because that is the non-natural meaning given to it by convention or by its place in a communicative practice. The recent defenses of semiotic objections presented by Anthony Booth, Jacob Sparks, and Mark Wells do not survive this distinction, as they either complain about non-semiotic facts that are indicated rather than expressed by markets, or they complain about semiotic features of markets, but these complaints inevitably collapse into weak consequentialist objections. But this result is not bad for anticommodificationists, as semiotic objections have dialectical disadvantages. (shrink)

Reproductive medical technology has revolutionized the natural order of human procreation. Accordingly, some have celebrated its advent as a new and liberating determinant of kinship at the global level and advocate it as a right to reproductive health while others have frowned upon it as a vehicle for “guiltless exchange of sexual fluid” and commodification of human gametes. Religious voices from both Christianity and Islam range from unthinking adoption to restrictive use. While utilizing this technology to enable the married couple (...) to have children through the use of their own sexual material is welcome, the use of third party, surrogacy, and reproductive cloning are not in keeping with the sacrosanct principles of kinship, procreation through licit sexual intercourse, and social cohesiveness for building a cohesive family as uphold by both Christianity and Islam. To examine such larger issues emanating from these new ways of human procreation, beyond the question of legality, is a point which legal scholars in both Christianity and Islam, when issuing religious decrees, have not anticipated sufficiently. The article proposes to be an attempt to that end through a qualitative critical content analysis of selected literature written on the subject. (shrink)

Many activities formerly not in the market are being “marketized,” and women's labor is increasingly in the market. I consider the grounds on which to decide what should and what should not be “in” the market. I distinguish work that is paid from work done under “market norms,” and argue that market values should not have priority in education, childcare, healthcare, and many other activities. I suggest that a feminist ethics of care is more promising than Kantian ethics or utilitarianism (...) for recommending social decisions concerning limits on markets. (shrink)

: Many activities formerly not in the market are being "marketized," and women's labor is increasingly in the market. I consider the grounds on which to decide what should and what should not be "in" the market. I distinguish work that is paid from work done under "market norms," and argue that market values should not have priority in education, childcare, healthcare, and many other activities. I suggest that a feminist ethics of care is more promising than Kantian ethics or (...) utilitarianism for recommending social decisions concerning limits on markets. (shrink)

“Das Adam Smith Problem” is the name given by eighteenth-century German scholars to the question of how to reconcile the role of self-interest in the Wealth of Nations with Smith’s advocacy of sympathy in Theory of Moral Sentiments. As the discipline of economics developed, it focused on the interaction of selfish agents, pursuing their private interests. However, behavioral economists have rediscovered the existence and importance of multiple motivations, and a new Das Adam Smith Problem has arisen, of how to accommodate (...) self-regarding and pro-social motivations in a single system. This question is particularly important because of evidence of motivation crowding, where paying people can backfire, with payments achieving the opposite effects of those intended. Psychologists have proposed a mechanism for the crowding out of “intrinsic motivations” for doing a task, when payment is used to incentivize effort. However, they argue that pro-social motivations are different from these intrinsic motivations, implying that crowding out of pro-social motivations requires a different mechanism. In this essay I present an answer to the new Das Adam Smith problem, proposing a mechanism that can underpin the crowding out of both pro-social and intrinsic motivations, whereby motivations are prompted by frames and motivation crowding is underpinned by the crowding out of frames. I explore some of the implications of this mechanism for research and policy. (shrink)

ABSTRACT Does genetic relatedness define who is a mother or father and who incurs obligations towards or entitlements over children? While once the answer to this question may have been obvious, advances in reproductive technologies have complicated our understanding of what makes a parent. In a recent publication Bayne and Kolers argue for a pluralistic account of parenthood on the basis that genetic derivation, gestation, extended custody and sometimes intention to parent are sufficient (but not necessary) grounds for parenthood.1 Bayne (...) and Kolers further suggest that definitions of parenthood are underpinned by the assumption that ‘being causally implicated in the creation of a child is the key basis for being its parent’.2 This paper examines the claim that genetic relatedness is sufficient grounds for parenthood based on a causal connection between genetic parents and their offspring. I argue that parental obligations are about moral responsibility and not causal responsibility because we are not morally accountable for every consequence to which we causally contribute. My account includes the conditions generally held to apply to moral responsibility, i.e. freedom and foreseeability. I argue that parental responsibilities are generated whenever the birth of a child is a reasonably foreseeable consequence of voluntary actions. I consider the implications of this account for third parties involved in reproductive technologies. I argue that under some conditions the obligations generated by freely and foreseeably causing a child to exist can be justifiably transferred to others. (shrink)

In a recent article in this journal, David Rondel argues that symbolic (or semiotic) objections to markets hold significant argumentative force. Rondel distinguishes between Incidental markets and Pervasive markets, where Incidental markets describe individual instances of exchange and Pervasive markets comprise the social management of goods by an institutional market arrangement. In this reply, I specify a key insight that buttresses Rondel’s distinction. The distinction as it is currently characterized fails to identify when Incidental markets become Pervasive. This opaqueness allows (...) scholars that defend markets without limits to question the analytical distinctiveness of Incidental and Pervasive markets. I show that by incorporating the market’s price mechanism as an indicator of a properly Pervasive market, Rondel’s distinction is not only able to tackle the aforementioned retort, but also allows for important reflections on what types of institutions should be considered markets at all. (shrink)

In the case of surrogacy, it is not new biotechnologies themselves that have challenged well-established principles in law and ethics, but rather political and social phenomena such as commodification of women’s reproductive tissue and labour, demands to allow new ways of forming families and (before Covid-19, at least) the comparative ease of international travel that enabled cross-border surrogacy to develop into a market valued at up to $2 billion annually in India alone as of 2016 (Dickenson 2016, citing an estimate (...) from The Indian National Commission for Women). This phenomenon stands the usual truth on its head: it is not new technologies but new pressures that have challenged the existing law and ethics of surrogate motherhood. (shrink)

The push of biomedical profits and pull of consumer desire for greater happiness and superior performance heralds a robust market in offspring enhancement. There are two reasons we might worry about the reach of commerce into the realm of selective reproduction. The first concern is that for-profit genetic enhancement, under conditions of economic necessity, would exploit the poor, by coercing them, in effect, to part with reproductive material they would prefer not to sell for money, if not for their desperate (...) situation. The second concern is that the market valuation and exchange of sperm, eggs, and embryos would distort the meaning, and degrade the worth, of those procreative goods. I argue that the concern about exploitation does not give reason to resist a market in pre-natal enhancement, but that the concern about degradation does. This degradation concern gives rise to two specific worries: one about altruism and another about commensurability. I conclude by sketching several policy recommendations to regulate the transfer of money in exchange for sperm and eggs with specified characteristics. (shrink)

ABSTRACTGlobal demand for human ova in in vitro fertilization has led to its expansion in countries with falling average incomes and rising female unemployment. Paid egg donation in the context of national, regional, and global inequalities has the potential to exploit women who are socioeconomically vulnerable, and indeed there is ample evidence that it does. Structural injustices that render women in middle-income countries – and even some high-income countries – economically vulnerable contribute to a context of ‘omissive coercion’ that is (...) morally troubling. When egg brokers or fertility clinics take advantage of these background structural injustices and prospective ova providers’ vulnerability in order to pay them less than they need to meet their livelihood needs, they engage in exploitation. Analyzing paid egg donation as a form of reproductive labor, however, can direct our attention to reforms that would reduce exploitative instances of this practice. In contrast to those who see... (shrink)

We develop an anti-commodification defense of ethical veganism which holds that common defenses of ethical veganism can benefit from treating the commodification of non-human animals as a serious, distinct moral wrong. Drawing inspiration from Elizabeth Anderson’s account of commodification, we develop an account of commodification that identifies most uses of animals in developed countries as forms of problematic commodification. We then show that this position can make significant contributions to both welfarist defenses of ethical veganism and animal rights theories.

The option of being ‘spiritual but not religious’ deserves much more philosophical attention. That is the aim here, taking the work of Robert Solomon as a starting point, with focus on the particular issues around viewing life as gift. This requires analysis of ‘existential gratitude’ to show that there can be gratitude for things without gratitude to someone for providing things, and also closer attention to the role that metaphor plays in cognition. I consider two main concerns with gift and (...) gratitude thinking, that the nonreligious justification is too instrumentalist in its approach and that viewing life as gift, whether in a religious or nonreligious way, is simply too optimistic. (shrink)

We emerge from certain activities with an altered sense of self. Whether returning from a warzone or from an experience as common as caring for an aging parent, one might remark, “I’m not the same person I was.” I argue that such transformations are relevant to debates about what morality requires of us. To undergo an alteration in one’s self is to make a special kind of sacrifice, a sacrifice of self. Since projects can be more or less morally obligatory (...) to the extent that they require more or less sacrifice, we must incorporate these unique sacrifices into any accounting of the contours and limits of moral obligation. But sacrifices of self pose a special difficulty for any such accounting, precisely because of their transformative nature. Unlike most other sacrifices, they cannot be analyzed entirely in terms of wellbeing. Using real-world case studies and examples, I argue for the existence of two types of sacrifice of self, involving changes in identity and moral agency. I argue that sacrifices of self require particular attention because they may be extra difficult to compare with other costs and with moral gains. (shrink)

Canada's Royal Commission on New Reproductive Technologies rejects all forms of surrogacy arrangement under the rubric of objecting to commercial surrogacy. Noncommercial surrogacy arrangements, however, can be defended against the commission's objections. They can be viewed as cases of giving a benefit or service to another in a way that expresses benevolence, and establishes a relationship between surrogates and prospective 'social' parents that allows mutual understanding and reciprocal personal interaction between them.

It is unclear what proper remuneration for surrogacy is, since countries disagree and both commercial and altruistic surrogacy have ethical drawbacks. In the presence of cross-border surrogacy, these ethical drawbacks are exacerbated. In this article, we explore what would be ethical remuneration for surrogacy, and suggest regulations for how to ensure this in the international context. A normative ethical analysis of commercial surrogacy is conducted. Various arguments against commercial surrogacy are explored, such as exploitation and commodification of surrogates, reproductive capacities, (...) and the child. We argue that, although commodification and exploitation can occur, these problems are not specific to surrogacy but should be understood in the broader context of an unequal world. Moreover, at least some of these arguments are based on symbolic rhetoric or they lack knowledge of real-world experiences. In line with this critique we argue that commercial surrogacy can be justified, but how and under what circumstances depends on the context. Surrogates should be paid a sufficient amount and regulations should be in order. In this article, the Netherlands and India are case examples of contexts that differ in many respects. In both contexts, surrogacy can be seen as a legitimate form of work, which requires the same wage and safety standards as other forms of labor. Payments for surrogacy need to be high enough to avoid exploitation by underpayment, which can be established by the mechanisms of either minimum wage, or Fair-Trade guidelines. An international treaty governing commercial surrogacy should be in place, and local professional bodies to protect the interests of surrogates should be required. Commercial surrogacy should be permitted across the globe, which would also reduce the need for intended parents to seek surrogacy services abroad. (shrink)

Because it is often argued that surrogacy should not be treated as contractual, the question arises in which terms this practice might then be couched. In this article, I argue that a phenomenology of surrogacy centering on the notion of trust provides a description that is illuminating from the moral point of view. My thesis is that surrogacy establishes a complex and extended reproductive unit––the “surrogacy triad” consisting of the surrogate mother, the child, and the intending parents––whose constituents are bound (...) together by mutual trustful commitments. Even though a trust-based approach does not provide an ultimate answer to whether surrogacy should be sanctioned or prohibited, it allows for at least some practical suggestions. In particular, I will argue that, under certain conditions, surrogacy is tenable within familial or other significant relationships, and I will stress the necessity of acknowledging the new relationships and moral commitments that result from this practice. (shrink)

Background/IntroductionInfertile couples that travel to another country for reproductive treatment do not refer to themselves as “reproductive tourists”. They might even be offended by this term. “Tourism” is a metaphor with hidden connotations. We will analyze these connotations in public media discourses on “reproductive tourism” in Israel and Germany. We chose to focus on these two countries since legal, ethical and religious restrictions give couples a similar motivation to travel for reproductive care, while the cultural backgrounds and conceptions of reproduction (...) are different. Results: Our research shows that the use of the metaphor “reproductive treatment” and its hidden messages depends on the writers’ intention and the target population. Although the phenomenon of patients travelling for reproductive treatment can fit into the definitions of tourism, the term emphasizes aspects that do not reflect patients’ reality. In both the German and the Israeli public media debate the term “reproductive tourism” is either used to criticize the economic aspects of the phenomenon or to attract patients as potential clients. Conclusions: Ethicists should be cautious when borrowing metaphors like “reproductive tourism” from the public debate. Our findings support Penning’s suggestion to use instead an unloaded term like cross-border reproductive care to describe the phenomenon in a more neutral way and to make it explicit whenever criticism is necessary. (shrink)

Antibiotic resistance is one of the most pressing public health problems humanity faces. Research into new classes of antibiotics and new kinds of treatments – including risky experimental treatments such as phage therapy and vaccines – is an important part of improving our ability to treat infectious diseases. In order to aid this research, we will argue that we should permit researchers to pay people any amount of money to compensate for the risks of participating in clinical trials, including ‘challenge (...) studies’ that involve deliberately infecting patients. We think that standard worries about paying for participation in risky research are reducible to concerns that can be addressed with the right screening mechanisms. (shrink)

In this paper, I aim to critically examine a set of assumptions that pervades human resource management and HR practices. I shall argue that they experience a remarkable ethics deficit, explain why this is so, and explore how the UN Global Compact labor principles may help taking ethics seriously in HRM. This paper contributes to the understanding and critical examination of the undisclosed beliefs underlying theory and practice in human resource management and to the examination of how the UN Global (...) Compact’s ideal of “decent work” may offer some promising avenues for the development of ethics in HRM. (shrink)

It has been a common claim that surrogacy is morally problematic since it involves harm to the child or the surrogate—the harm argument. Due to a growing body of empirical research, the harm argument has seen a decrease in popularity, as there seems to be little evidence of harmful consequences of surrogacy. In this article, two revised versions of the harm argument are developed. It is argued that the two suggested versions of the harm argument survive the current criticism against (...) the standard harm argument. The first version argues that the child is harmed by being separated from the gestational mother. The second version directs attention to the fact that surrogacy involves great incentives to keep the gestational mother’s level of maternal-fetal attachment low, which tend to increase the risk of harm to the child. While neither of the two arguments is conclusive regarding the moral status of surrogacy, both constitute important considerations that are often ignored. (shrink)

In this dissertation I examine ethical issues that concern fertility preservation (FP) technologies for women from a feminist perspective. FP technologies involve the removal, cryopreservation and subsequent storage of reproductive materials for future use. The aim of these technologies is to preserve the option of future genetic reproduction. FP technologies have been developed in the cancer context because infertility is one of the long-term side-effects of many cancers or cancer therapies. Many FP technologies are still experimental, but some technologies are (...) becoming available to healthy women who wish to guard against age-related infertility. Although FP technologies are expanding women’s reproductive options and benefitting some women by satisfying their desires for genetically-related children, these technologies pose numerous physical, emotional and financial risks to women. I maintain that a feminist examination of choice is necessary for the ethical provision of FP technologies within patriarchal contexts. My analysis begins by demarcating two oppressive social biases from one another: namely pronatalism and biologism. I argue that each of these biases can unduly influence women’s reproductive choices about FP technologies. I then consider how these biases might be identified and challenged in the FP decision-making context. I outline an ethical process of informed choice that is equipped to protect patient autonomy when such autonomy is threatened by these biases. I then consider whether the choice to use FP should be available to both women within and without the cancer contexts. I argue that both disease-related FP and age-related FP can be morally permissible. Finally, I consider whether there should be an upper age limit on women’s access to their stored reproductive materials. I argue that age can be morally relevant to reproduction and thus age limits on access to assisted reproduction are morally permissible. I conclude by suggesting how feminist insights might inform policies on FP technologies and related assisted reproductive technologies. In sum, my dissertation shows that a feminist analysis of choices about FP is essential for ensuring the ethical provision of FP technologies. (shrink)

This paper explores early Australasian philosophy in some detail. Two approaches have dominated Western philosophy in Australia: idealism and materialism. Idealism was prevalent between the 1880s and the 1930s, but dissipated thereafter. Idealism in Australia often reflected Kantian themes, but it also reflected the revival of interest in Hegel through the work of ‘absolute idealists’ such as T. H. Green, F. H. Bradley, and Henry Jones. A number of the early New Zealand philosophers were also educated in the idealist tradition (...) and were influential in their communities, but produced relatively little. In Australia, materialism gained prominence through the work of John Anderson, who arrived in Australia in 1927, and continues to be influential. John Anderson had been a student of Henry Jones, who might therefore be said to have influenced both main strands of Australian philosophical thought. (shrink)

Tässä artikkelissa tarkastelen feministisen bioetiikan näkökulmia sijaissynnyttämiseen. Keskityn erityisesti sijaissynnytykseen konstruoimiseen työksi, äitiyden käsitteeseen sekä kaupallisuuden ja sen määrittelemisen pohdintaan. Kysyn, onko sijaissynnyttäjälle maksettava palkkio riittävä tai välttämättä edes moraalisesti keskeisin eettisesti kestämättömän kaupallisuuden määrittäjä. Esitän, että sijaissynnyttämisen mieltäminen työksi voisi auttaa laatimaan eettisesti kestävää säätelyä, jota Suomessa ei tällä hetkellä ole. Sijaissynnyttämisen täyskielto Suomen kaltaisissa korkean reproduktioterveyden, globaalisti verraten pienten tuloerojen maissa ruokkii kolonialistista reproduktioturismia. Katson, että äitiyden käsitteellistä paikkaa sijaissynnytyskonstruktioissa ja sen vaikutuksia sijaissynnytyskäytenteisiin tulisi tarkastella kriittisesti. Nähdäkseni sijaissynnytystä (...) tulisi myös tarkastella suhteessa ammattikasvattamisen ja -hoivaamisen etiikkaan. (shrink)

Through the vehicle of Nicolas Sarkozy’s so-called “Dakar Address” we will analyse the West’s persisting lack of insight into the need for a Western decolonization. We will try to identify the dangers that come from this refusal, such as the abidance in colonial patterns, the enduring self-understanding as superior com-pared to Africa, and the persisting unwillingness to accept the colonial guilt. Decolonization has to be understood as a two-fold business. Decolonization is over-coming endured and perpetrated violence. It is not only (...) important that the colonial oppressed regain strength, it is equally important that the perpetrator of colonial violence understand their excess of violence and work on effecting its return impossible. We explain how Western thinking remains dangerous and untrustwor-thy if it refuses its own decolonization. Finally, we will draw attention to a fundamental pattern of Western thought that clashes with the fundamental values of the West: contempt. In a final step we suggest how this contempt can be overcome through desuperiorisation and the establishment of elative ethics. (shrink)

In this ethnography of transnational commercial surrogacy In a small clinic In India, the narratives of two sets of womenInvolved In this new form of reproductive travel - the transnational clients and the surrogates themselves - are evaluated. How do these women negotiate the culturally anomalous nature of transnational surrogacy within the unusual setting of India? It Is demonstrated that while both sets of women downplay the economic aspect of surrogacy by drawing on predictable cultural tools like 'gift', 'sisterhood' and (...) 'mission', they use these tools In completely unexpected ways. Previous ethnographies of surrogacy In other parts of the world have revealed that women Involved In surrogacy use these narratives to downplay the contractual nature of their relationship with each other. Ironically, when used In the context of transnational surrogacy 1n India, these narratives further highlight and often reify the Inequalities based on class, race and nationality between the clients and suppliers of reproductive tourism In India. (shrink)

Purpose: The objective of this study is to determine the importance of supplementary medical ethics course for resident physicians. In this study, we assessed the current state of their knowledge of medical ethics and aimed to improve and deepen their understanding of clinical scenarios to increase their awareness of the link between the practice of medicine and ethical issues. Methods: The course was held for groups of 10-12 people for 3 days a week for a total of 6 hours. Tests (...) given prior to and following completion of the course were used to assess the effectiveness of a medical ethics training course in which 120 resident physicians completed. The evaluation was made on the basis of the same pre-and post-tests (14 scenarios) and direct observation of participants. Result and Discussion: The average age was 28.23 ± 4.08 and 25% were female and 75% were male. Of the participants, 68.3% were training to be internists, 24.2% were training to be surgeons, and 7.5% were training in laboratory medicine. There was a significant statistical difference between the mean total scores of both tests (p=0.00). After completing the course, residents took into account the medical ethical principles while discussing ethical decisions. Conclusion: After finishing the course, participants defended their responses in regard to issues of medical ethics more carefully and articulated their thoughts more clearly. Our experience demonstrated that the trainees benefited from a structured curriculum in medical ethics. We believe that the development and implementation of our course may serve as a case study for training resident physicians in medical ethics. (shrink)