This paper argues that rectificatory justice should supplement distributive justice in allocating priority of access to scarce medical resources. Where a patient is at fault for the scarcity of healthy organs a principle of restitution requires that she should give priority to the faultless. Such restitution is non-punitive, and is akin to reparation in civil law, not criminal law. However, it is doubtful whether such a principle can be fairly applied within the present culture of governmental complicity in cigarette advertising.

The notion of “consent” is frequently referred to as “informed consent” to emphasise the informational component of a valid consent. This article considers aspects of that informational component. One misuse of the language of informed consent is highlighted. Attention is then directed to some features of the situation in which consent would not have been offered had certain information been disclosed. It is argued that whether or not such consent is treated as sufficiently informed must, from a moral point of (...) view, take account of four conditions. When these are applied to the operation of consent in relation to criminal responsibility for HIV transmission, the approach in some recent cases is shown to be morally questionable. (shrink)

This paper examines whether there are moral differences between the mitochondrial replacement techniques that have been recently developed in order to help women afflicted by mitochondrial DNA diseases to have genetically related children absent such conditions: maternal spindle transfer and pronuclear transfer. Firstly, it examines whether there is a moral difference between MST and PNT in terms of the divide between somatic interventions and germline interventions. Secondly, it considers whether PNT and MST are morally distinct under a therapy/creation optic. Finally, (...) it investigates whether there is a moral difference between MST and PNT from a human embryo destruction point of view. I conclude, contra recent arguments, that regarding the first two points there is no moral differences between PNT and MST; and that regarding the third one MST is morally preferable to PNT, but only if we hold a gradualist account of the moral value of human embryos where zygotes have slight moral value. (shrink)

Harris argues that if QALYs are used only 50% of the population will be eligible for survival, whereas if random methods of allocation are used 100% will be eligible. We argue that this involves an equivocation in the use of "eligible", and provides no support for the random method. There is no advantage in having a 100% chance of being "eligible" for survival behind a veil of ignorance if you still only have a 50% chance of survival once the veil (...) is lifted. A 100% chance of a 50% chance is still only a 50% chance. We also argue that Harris provides no plausible way of dealing with the criticism that his random method of allocation may result in the squandering of resources. (shrink)

With no statutory definition of death, the accepted medical definition relies on brain stem death criteria as a definitive measure of diagnosing death. However, the use of brain stem death criteria in this way is precarious and causes widespread confusion amongst both medical and lay communities. Through critical analysis, this paper considers the insufficiencies of brain stem death. It concludes that brain stem death cannot be successfully equated with either biological death or the loss of integrated bodily function. The overemphasis (...) of the brain-stem and its consequences leaves the criteria open to significant philosophical critique. Further, in some circumstances, the use of brain stem death criteria causes substantial emotional conflict for families and relatives. Accordingly, a more holistic and comprehensive definition of death is required. (shrink)

The dilemma of whether to allow relatives to see or even touch their loved one while she undergoes cardiopulmonary resuscitation has been discussed for roughly four decades. However, Family Presence During Adult Resuscitation is still not widely implemented. In this paper, I espouse relational autonomy to make a case for a clinical approach of family-centered care and FPDR. In recent years, family-centered care has gained increasing support. I argue that relational autonomy provides a conceptual framework for both FCC and FPDR. (...) In turn, FCC provides a plausible clinical approach to justify FPDR, while the empirical evidence that supports FPDR provides a useful example to justify FCC. (shrink)

Picture this. You are having your regular medical checkup, when, all of a sudden, the physician turns to you and says: “Oh, did I remember to mention that you can now live forever?” You look at the doctor enquiringly and she goes on: “Well, it’s not actual immortality, you know, but they’ve invented this treatment—I don’t have the full details—that stops aging, getting physically older. It might not be for everyone, but you seem to be a suitable candidate. You could (...) still die of accidents and illness, of course, but they’ve calculated that with care and any luck you should live to be a thousand, as opposed to the hundred or so that you would now have. And in a millennium, techniques will advance further, so there could be more in store for you after that.”. (shrink)

Anne Maclean has written a book which purports to identify and then definitively to reject the claims which she perceives to be the claims of bioethics. If she is right, then the enterprise to which this journal is dedicated is misconceived and worthless. In this paper, I attempt to show why so far from being not right she is comprehensively wrong, both in her understanding of the nature of bioethics and in the specific moral claims she makes about those she (...) terms 'bioethicists'. Since much of her book-length study is devoted to a criticism of my own work, this paper analyses the extent to which Maclean's criticisms of me, and by extension, of other bioethicists, are sustainable. (shrink)

This paper is focused on the analysis of two documents (the Council of Europe's Bioethics Convention and the Additional Cloning Protocol) inasmuch as they refer to the relationship between human dignity and human genetic engineering. After presenting the stipulations of the abovementioned documents, I will review various proposed meanings of human dignity and will try to identify which of these seem to be at the core of their underlying assumptions. Is the concept of dignity proposed in the two documents coherent? (...) Is it morally legitimate? Is it, as some might assume, of Kantian origin? Does it have any philosophical roots? (shrink)

An ethics concerned with health care developments and systems must be historically continuous, especially as it concerns the application to managed structures of key moral-epistemic concepts such as care, love and empathy. These concepts are traditionally most at home in the personal, individual domain. Human beings have non-instrumental worth just because they are human beings and not by virtue of their capacities. Managed health care systems tend to abstract from this worth in respect of both individuals' distinctness and individual identity. (...) The first, a common feature of quantitative approaches to health care assessment and delivery, is avoidable. The second, by contrast, is necessarily sacrificed in impersonally managed structures. Failure to distinguish the two encourages confusion and distress, and the demand for impossible medico-moral relationships. (shrink)

Several authors have discussed and defended what is sometimes called the Asymmetry Thesis in social epistemology: that while reliance on testimony is essentially incontrovertible in epistemology, it is uniquely problematic for moral knowledge. This conclusion results, I argue, from considering the wrong sort of moral testimony: namely, ‘third-personal’ rather than ‘first-personal’ testimony. First-personal moral testimony is an inescapable part of the constitution of legitimate moral norms, and its role cannot be deflated as a form of mere information to be taken (...) up in private deliberation. The consequences of this argument for forms of hypothetical contractualism, in particular, are profound. (shrink)