This book is the most comprehensive treatment available of one of the most urgent - and yet in some respects most neglected - problems in bioethics: decision-making for incompetents. Part I develops a general theory for making treatment and care decisions for patients who are not competent to decide for themselves. It provides an in-depth analysis of competence, articulates and defends a coherent set of principles to specify suitable surrogate decisionmakers and to guide their choices, examines the value of advance (...) directives, and investigates the role that considerations of cost ought to play in decisions concerning incompetents. Part II applies this theoretical framework to the distinctive problems of three important classes of individuals, many of whom are incompetent: minors, the elderly and psychiatric patients. The authors' approach combines a probing analysis of fundamental issues in ethical theory with a sensitive awareness of the concrete realities of health care institutions and the highly personal and individual character of difficult practical problems. Its broad scope will appeal to health professionals, moral philosophers and lawyers alike. (shrink)

This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and practice. The (...) book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

In Beyond Humanity a leading philosopher offers a powerful and controversial exploration of urgent ethical issues concerning human enhancement.

This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and practice. The (...) book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

This is a systematic evaluation of the main arguments for and against the market as an instrument of social organization, balancing efficiency and justice. It links the distinctive approaches of philosophy and economics to this evaluation.

Much of the debate about the ethics of enhancement has proceeded according to two framing assumptions. The first is that although enhancement carries large social risks, the chief benefits of enhancement are to those who are enhanced (or their parents, in the case of enhancing the traits of children). The second is that, because we now understand the wrongs of state-driven eugenics, enhancements, at least in liberal societies, will be personal goods, chosen or not chosen in a market for enhancement (...) services. This article argues that both framing assumptions must be rejected, once it is understood that some enhancements— especially those that are most likely to garner resources and become widespread— will increase human productivity. Once one appreciates the productivity-increasing potential of enhancements, one can begin to see that enhancement need not be primarily a zero sum affair, that the social costs of forgoing enhancements may be great, and that the state may well take an interest in facilitating biomedical enhancements, just as it does in facilitating education and other productivity-increasing traditional enhancements. Appreciating the productivity-increasing potential of enhancements also makes it possible to view the enhancement debate in a new light, through the lens of the ethics of development. (shrink)

The Nobel prize-winning molecular biologist Walter Gilbert described the mapping and sequencing of the human genome as “the grail of molecular biology.” The implication, endorsed by enthusiasts for the new genetics, is that possessing a comprehensive knowledge of human genetics, like possessing the Holy Grail, will give us miraculous powers to heal the sick, and to reduce human suffering and disabilities. Indeed, the rhetoric invoked to garner public support for the Human Genome Project appears to appeal to the best of (...) the Western tradition's enthusiasm for progress: the idea of improving human lives through the practical application of scientific knowledge. (shrink)

Appeals to the idea of human nature are frequent in the voluminous literature on the ethics of enhancing human beings through biotechnology. Two chief concerns about the impact of enhancements on human nature have been voiced. The first is that enhancement may alter or destroy human nature. The second is that if enhancement alters or destroys human nature, this will undercut our ability to ascertain the good because, for us, the good is determined by our nature. The first concern assumes (...) that altering or destroying human nature is in itself a bad thing. The second concern assumes that human nature provides a standard without which we cannot make coherent, defensible judgments about what is good.I will argue (1) that there is nothing wrong, per se, with altering or destroying human nature, because, on a plausible understanding of what human nature is, it contains bad as well as good characteristics and there is no reason to believe that eliminating some of the bad would so imperil the good as to make the elimination of the bad impermissible, and (2) that altering or destroying human nature need not result in the loss of our ability to make judgments about the good, because we possess a conception of the good by which we can and do evaluate human nature. I will argue that appeals to human nature tend to obscure rather than illuminate the debate over the ethics of enhancement and can be eliminated in favor of more cogent considerations. (shrink)

1. There is no dearth of objections to Rawls's A Theory of justice. Scores of articles and several books begin by praising the rigor and depth of Rawls's book — and end by concluding that it is thoroughly mistaken. In the present essay I will not add to the list of negative responses to A Theory of Justice. Instead I will attempt to reply to Rawls's critics in a way which makes a positive contribution to his theory.2. Among the many (...) objections that have been raised against Rawls's theory, two are of paramount importance. It is these two objections I shall attempt to meet. They may be formulated as follows. (shrink)

Abstract:Liberal thinkers of the Enlightenment understood that surplus moral constraints, imposed by invalid moral norms, are a serious limitation on liberty. They also recognized that overcoming surplus moral constraints — what we call proper de-moralization — is an important dimension of moral progress. Contemporary philosophical theorists of liberty have largely neglected the threat that surplus moral constraints pose to liberty and the importance of proper de-moralization for human emancipation. This essay examines the phenomena of surplus moral constraints and proper de-moralization, (...) utilizing insights from biological and cultural evolutionary thinking. (shrink)

Theorizing about the legitimacy of international institutions usually begins with a framing assumption according to which the legitimacy of the state is understood solely in terms of the relationship between the state and its citizens, without reference to the effects of state power on others. In contrast, this article argues that whether a state is legitimate vis-a-vis its own citizens depends upon whether its exercise of power respects the human rights of people in other states. The other main conclusions are (...) as follows. First, a state’s participation in international institutions can contribute to its legitimacy in several ways. Second, when international institutions contribute to the legitimacy of states, their doing so can contribute to their own legitimacy. Third, a theory of international legitimacy ought to recognize reciprocal legitimation between states and international institutions. (shrink)

The concept of exploitation plays a key role in Marx's attack on capitalism. No one denies this. Yet there is much confusion as to just what Marx's concept of exploitation is.Recent discussions tend to fall into two groups. In the first are those which offer extensive analyses of Marx's concept of alienation, but seldom mention ‘exploitation’. When writers in this first group do mention ‘exploitation’ they mistakenly assume that the concept is transparent and unproblematic.The second group has little to say (...) about alienation, but does attempt an account of exploitation. These writers mistakenly confine Marx's concept of exploitation to the labor process itself. Both approaches fail to articulate important connections between alienation and exploitation. (shrink)

This chapter takes issue with a common argument linking democracy, understood as popular sovereignty, and rights to secession. Buchanan argues that the justifications for democracy and for recognizing a group's right to secede are quite distinct, and that a commitment to democracy is consistent with a constrained stance on secession.

Next SectionBiodefence, broadly understood as efforts to prevent or mitigate the damage of a bioterrorist attack, raises a number of ethical issues, from the allocation of scarce biomedical research and public health funds, to the use of coercion in quarantine and other containment measures in the event of an outbreak. In response to the US bioterrorist attacks following September 11, significant US policy decisions were made to spur scientific enquiry in the name of biodefence. These decisions led to a number (...) of critical institutional changes within the US federal government agencies governing scientific research. Subsequent science policy discussions have focused largely on ‘the dual use problem’: how to preserve the openness of scientific research while preventing research undertaken for the prevention or mitigation of biological threats from third parties. We join others in shifting the ethical debate over biodefence away from a simple framing of the problem as one of dual use, by demonstrating how a dual use framing distorts the debate about bioterrorism and truncates discussion of the moral issues. We offer an alternative framing rooted in social epistemology and institutional design theory, arguing that the ethical and policy debates regarding ‘dual use’ biomedical research ought to be reframed as a larger optimisation problem across a plurality of values including, among others: (1) the production of scientific knowledge; (2) the protection of human and animal subjects; (3) the promotion and protection of public health (national and global); (4) freedom of scientific enquiry; and (5) the constraint of government power. (shrink)

What does the prospect of being able to alter a human being's “natural assets” by genetic engineering imply for our understanding of the requirements of justice, and of equal opportunity in particular? Although their proponents are reluctant to admit it, some of the most prominent contemporary theories of justice yield a quite radical conclusion: If safe and effective intervention in the genetic “natural lottery” becomes feasible, there will be at least a strong prima facie case for doing so in the (...) name of equality of opportunity , if this is the most effective way to meet the demands of justice. (shrink)

There are several reasons for the current prominence of global health issues. Among the most important is the growing awareness that some risks to health are global in scope and can only be countered by global cooperation. In addition, human rights discourse and, more generally, the articulation of a coherent cosmopolitan ethical perspective that acknowledges the importance of all persons, regardless of where they live, provide a normative basis for taking global health seriously as a moral issue. In this paper (...) we begin the task of translating the vague commitment to doing something to improve global health into a coherent set of more determinate obligations. One chief conclusion of our inquiry is that the responsibilities of states regarding global health are both more determinate and more extensive than is usually assumed. We also argue, however, that institutional innovation will be needed to achieve a more comprehensive, fair distribution of concrete responsibilities regarding global health and to provide effective mechanisms for holding various state and nonstate actors accountable for fulfilling them. (shrink)

Is there anything peculiarly "photographic" about photography—something which sets it apart from all other ways of making pictures? If there is, how important is it to our understanding of photographs? Are photographs so unlike other sorts of pictures as to require unique methods of interpretation and standards of evaluation? These questions may sound artificial, made up especially for the purpose of theorizing. But they have in fact been asked and answered not only by critics and photographers but by laymen. Furthermore, (...) for most of this century the majority of critics and laymen alike have tended to answer these questions in the same way: that photographs and paintings differ in an important way and require different methods in interpretation precisely because photographs and paintings come into being in different ways. These answers are interesting because, even within the rather restricted classes of critics, photographers, and theorists, they are held in common by a wide variety of people who otherwise disagree strongly with each other—by people who think that photographs are inferior to paintings and people who believe they are superior; by people who think that photographs ought to be "objective" and those who believe they should be "subjective"; by those who believe that it is impossible for photographers to "create" anything and by those who believe that they should at least try. Joel Snyder teaches criticism and history of photography at the University of Chicago and is presently compiling a book of his own photographs. His contributions to Critical Inquiry include "Picturing Vision" and "Reflexions on Las Meninas: Paradox Lost", written with Ted Cohen in the Winter 1980 issue. Neil Walsh Allen produces educational audio-visual materials and has designed eight permanent exhibits on the history and applications of photography for the Smithsonian Institution. (shrink)

There is a puzzling disconnect between recent philosophical literature on equality and the modern theory and practice of human rights. This disconnect is puzzling because the modern human rights movement is arguably the most salient and powerful manifestation of the commitment to equality in our time. One likely source of this disconnect is the tendency of contributors to the philosophical literature on equality to focus on justice within the state, considered in isolation. This article begins the task of connection. Section (...) II outlines a philosophical conception of human rights, the Modest Objectivist View, according to which the list of human rights is grounded in descriptive and normative egalitarian assumptions about what is required to help ensure that every individual has the opportunity for a minimally good or decent human life. Next, I explore the resources of the Modest Objectivist View for rationally reconstructing the conventional conception of human rights. Section III examines challenges to the Modest Objectivist View’s egalitarian assumptions. Section IV explores the question of whether the minimal egalitarianism of the Modest Objectivist View is compatible with the more robust egalitarianisms advanced in recent philosophical literature. I conclude that the minimalist egalitarianism of human rights is compatible with more robust egalitarian principles, once we understand the distinctive function of human rights as standards of transnational justice. Key Words: basic interests • decent human life • egalitarianism • equality • minimally good life • Modest Objectivist View • minimalism • opportunity for a decent life • transnational justice. (shrink)

This essay demonstrates that the management and contestability of power is central to Dewey's understanding of democracy and provides a middle ground between two opposite poles within democratic theory: Either the masses become the genuine danger to democratic governance (à la Lippmann) or elites are described as bent on controlling the masses (à la Wolin). Yet, the answer to managing the relationship between them and the demos is never forthcoming. I argue that Dewey's response to Lippmann for how we ought (...) to conceive of the relationship between citizens and elites if power is not to become arbitrary is located within a larger framework that avoids the problematic distinction Wolin draws between the demos and representative government. For Dewey, the legitimacy of decision-making, and, indeed, the security of freedom, is determined not merely by our actual involvement, but the extent to which non-participation does not preclude the future contestability of power. (shrink)

Peter Chaadaev (1794-1856) is rightfully considered to be one of the forerunners of modern Russian philosophy. There is a famous scene from his life that may help us to understand both his own thought as well as the whole subsequent tradition of Russian religious philosophy. When Chaadaev finished his studies of Kant's Critique of Pure Reason, he crossed out the title on the cover and wrote beneath it Apologete adamitischer Vernunft (An Apology for Adamic Reason). Russian religious philosophy was supposed (...) to be a critique of such secular reason. In this book we seek a contemporary interpretation of Chaadaev's thought and its influence. Our authors, including such scholars as Andrzej Walicki and Boris Tarasov, investigate his views on religion, society, history, politics, and Russian fate. Chaadaev turns out to be a crucial figure who continues to influence Russian religious philosophy to this day. ""Nicolas Berdiaev credited Chaadaev with 'the awakening of independent original Russian thought.' Indeed, his main themes have ever since been at the center of Russian philosophy. As a Christian philosopher Chaadaev cherished love of truth over love of fatherland, which, he said, 'feeds national hatreds' and 'sometimes covers the earth with mourning.' This volume is an important contribution to the study of his enduring legacy, for Russia and the world."" --Randall A. Poole, Professor of History, College of St. Scholastica ""Modern Russian religious thought begins with Chaadaev. While his output was small, its impact was far-reaching. Khomiakov, Kireevsky, Herzen, Soloviev, Berdiaev and many others were indebted to Chaadaev in one way or another. He merits the careful attention the authors of this volume devote to him."" --Paul Valliere, Professor Emeritus, Butler University Artur Mrowczyński-Van Allen is Professor at the International Center for the Study of the Christian Orient and Instituto de Filosofia ""Edith Stein,"" Granada, Spain. He is the author of Between the Icon and the Idol: The Human Person and the Modern State in Russian Literature and Thought (Cascade, 2013). Teresa Obolevitch is Professor at the Pontifical University of John Paul II in Krakow, Poland. Recently she published La philosophie religieuse russe (2014) in French and Semen Frank: Shtrikhi k portretu filosofa in Russian (2017). Pawel Rojek is Assistant Lecturer at the Jagiellonian University in Krakow, Poland. (shrink)

In a world that peers over the brink of disaster more often than not it is difficult to find specific assignments for the scholarly community. One speaks of peace and brotherhood only to realize that for many the only real hope of making a contribution may seem to be in a field of scientific specialization seemingly irrelevant to social causes and problems. Yet the history of man since the beginnings of science in the days of the Greeks does not support (...) this gloomy thesis. Time and again we have seen science precipitate social trends or changes in the humanistic beliefs that have a significant effect on the scientific community. Not infrequently the theoretical scientist, triggered by society's changing goals and understandings, finds ultimate satisfaction in the work of his colleagues in engineering and the other applied fields. Thus the major debate in mid-nineteenth century in which the evidence of natural history and geology at variance with the Biblical feats provided not only courage to a timid Darwin but the kind of audience that was needed to fit his theories into the broad public dialogue on these topics. The impact of "Darwinism" was felt far beyond the scientific community. It affected social thought, upset religious certainties and greatly affected the teaching of science. (shrink)