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)

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)

The rapid spread of the Acquired Immune Deficiency Syndrome (AIDS) and its causative agent, the Human Immunodeficiency Virus (HIV), has posed people with difficult ethical questions. Philosophically, one of the most interesting problems is whether or not there is a right to remain in ignorance about one's own HIV infection.Being informed about a positive HIV test result has caused many people anguish and led some to suicidal thoughts. On these grounds a prima facte right not to know could be constructed. (...) Paternalistic arguments have been put forward to refute the alleged right, but these arguments are invalid, as is shown in the paper.However, by a utilitarian argument it can be shown that the prima facie right to remain in ignorance is overridden by other people's rights not to be infected. With certain qualifications, even a non-voluntary testing programme for HIV is justifiable. (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)

In his book The Principles of Art Robin George Collingwood presents a theory of art as the expression of emotion. The connection between his view and the theories of the Italian neo-idealists Benedetto Croce and Giovanni Gentile is both well known and well documented. What seems to be less known, however, is the intellectual link R. G. Collingwood’s father, William Gershom Collingwood, formed between his son and John Ruskin, the great Victorian essayist, critic and reformer. There are some references in (...) the literature to the fact that W. G. Collingwood was Ruskin’s friend, pupil, assistant and private secretary, later on his intellectual interpreter and biographer. It has also been argued that since R. G. Collingwood was until the age of thirteen exclusively educated by his father, there must have been an educational link between Ruskin and the younger Collingwood. But when it has come to pointing out theoretical similarities between the aesthetic theories of Ruskin and Collingwood, philosophers of art have, by and large, kept a remarkably low profile. (shrink)

_The Limits of Medical Paternalism_ defines and morally assesses paternalistic interventions, especially in the context of modern medicine and health care, particular emphasis is given to the analysis of the conceptual background of the paternalism issue. In this book an anti-paternalistic view is presented and defended.

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)

In different countries responses to important bioethical issues are different, as exemplified by the attitudes towards the voluntary and active forms of medical euthanasia. But why is this the case? My suggestion is that the roots of the variety are, to a considerable degree, ideological. The most important present‐day political ideologies all have their roots in the prevailing doctrines of moral and social philosophy. In the paper these doctrines are outlined and the predicted response towards active voluntary euthanasia within each (...) model is sketched. The conclusion reached is that while it would in some countries be dangerous to allow euthanasia in the prevailing circumstances, the solution is not to hinder the legalization process but to alter the circumstances. (shrink)

H. L. A. Hart in his Law, Liberty, and Morality (1963) defended the view that legal paternalism and legal moralism can be clearly distinguished from each other. Hart also stated that while legal moralism is always unacceptable, paternalistic laws are often justifiable. In this paper it is argued that Hart held the right view for the wrong reasons. Hart defended legal paternalism by claiming, against J. S. Mill, that for various psychological reasons individuals do not know their own interests best. (...) It will be shown in the paper that if this view is taken, it is impossible to reject legal moralism. The fact that paternalism is sometimes justifiable while moralism is not can be more firmly founded on a distinction made by C. L. Ten (1971). Ten's point is that in matters which concern only the individuals themselves, their actions cannot be legitimately restricted by appeals to the consequences of their action alone. Paternalistic control can be justified only if the decision-making abilities of the controlled individual are temporarily diminished. (shrink)

The Limits of Medical Paternalism defines and morally assesses paternalistic interventions, especially in the context of modern medicine and health care, particular emphasis is given to the analysis of the conceptual background of the paternalism issue. In this book an anti-paternalistic view is presented and defended.

Abstract.The legitimate impact of common morality on legal restrictions has been continuously discussed within the Western philosophy of law since Lord Patrick Devlin in the late 1950s presented his moralistic arguments against some liberal conclusions drawn by the English Committee on Homosexual Offences and Prostitution in their public report. Devlin's arguments were subsequently identified and refuted by Richard Wollheim, H. L. A. Hart and Ronald Dworkin, but in a way that later provoked further argument. In particular the attack against anti‐moralistic (...) principles set forth by Simon Lee (1986) owes much to the rather naive liberalism represented by the opponents of Devlin. The battle over liberalism and moralism from the Hart‐Devlin debate to the present day is reviewed. In addition to the discussion of the philosophers mentioned above, a potential flaw in the argumentation of Joel Feinberg (1986) is considered. (shrink)

Recent developments in biology have made it possible to acquire more and more precise information concerning our genetic makeup. There are four groups of people who may want to know about our genes. First, we ourselves can have an interest in being aware of own health status. Second, there are people who are genetically linked with us, and who can have an interest in the knowledge. Third, individuals with whom we have contracts and economic arrangements may have an interest in (...) knowing about our genetic makeup. Fourth, society as a whole can have an interest in the composition of our genes. As regards the question of motivation, the term 'should' can be interpreted in three ways. Prudentially speaking, to say that individuals should act in a certain manner is to say that the actions in question promote the long-term self-interest of these individuals. From the viewpoint of morality, we should do what is right and avoid doing what is wrong. When it comes to legal thinking, it is held in most liberal societies that grave other-regarding harm should be the primary justification for the use of coercion and constraint. In the paper, all these aspects are examined in more detail. (shrink)

In his book The Principles of Art Robin George Collingwood presents a theory of art as the expression of emotion. The connection between his view and the theories of the Italian neo-idealists Benedetto Croce and Giovanni Gentile is both well known and well documented. What seems to be less known, however, is the intellectual link R. G. Collingwood’s father, William Gershom Collingwood, formed between his son and John Ruskin, the great Victorian essayist, critic and reformer. There are some references in (...) the literature to the fact that W. G. Collingwood was Ruskin’s friend, pupil, assistant and private secretary, later on his intellectual interpreter and biographer. It has also been argued that since R. G. Collingwood was until the age of thirteen exclusively educated by his father, there must have been an educational link between Ruskin and the younger Collingwood. But when it has come to pointing out theoretical similarities between the aesthetic theories of Ruskin and Collingwood, philosophers of art have, by and large, kept a remarkably low profile. (shrink)

In his book The Principles of Art Robin George Collingwood presents a theory of art as the expression of emotion. The connection between his view and the theories of the Italian neo-idealists Benedetto Croce and Giovanni Gentile is both well known and well documented. What seems to be less known, however, is the intellectual link R. G. Collingwood’s father, William Gershom Collingwood, formed between his son and John Ruskin, the great Victorian essayist, critic and reformer. There are some references in (...) the literature to the fact that W. G. Collingwood was Ruskin’s friend, pupil, assistant and private secretary, later on his intellectual interpreter and biographer. It has also been argued that since R. G. Collingwood was until the age of thirteen exclusively educated by his father, there must have been an educational link between Ruskin and the younger Collingwood. But when it has come to pointing out theoretical similarities between the aesthetic theories of Ruskin and Collingwood, philosophers of art have, by and large, kept a remarkably low profile. (shrink)

The rapid spread of the Acquired Immune Deficiency Syndrome (AIDS) and its causative agent, the Human Immunodeficiency Virus (HIV), has posed people with difficult ethical questions. Philosophically, one of the most interesting problems is whether or not there is a right to remain in ignorance about one's own HIV infection.Being informed about a positive HIV test result has caused many people anguish and led some to suicidal thoughts. On these grounds a prima facte right not to know could be constructed. (...) Paternalistic arguments have been put forward to refute the alleged right, but these arguments are invalid, as is shown in the paper.However, by a utilitarian argument it can be shown that the prima facie right to remain in ignorance is overridden by other people's rights not to be infected. With certain qualifications, even a non-voluntary testing programme for HIV is justifiable. (shrink)

Recent developments in biology have made it possible to acquire more and more precise information concerning our genetic makeup. There are four groups of people who may want to know about our genes. First, we ourselves can have an interest in being aware of own health status. Second, there are people who are genetically linked with us, and who can have an interest in the knowledge. Third, individuals with whom we have contracts and economic arrangements may have an interest in (...) knowing about our genetic makeup. Fourth, society as a whole can have an interest in the composition of our genes. As regards the question of motivation, the term ‘should’ can be interpreted in three ways. Prudentially speaking, to say that individuals should act in a certain manner is to say that the actions in question promote the longterm self-interest of these individuals. From the viewpoint of morality, we should do what is right and avoid doing what is wrong. When it comes to legal thinking, it is held in most liberal societies that grave other-regarding harm should be the primary justification for the use of coercion and constraint. In the paper, all these aspects are examined in more detail. (shrink)

Where is philosophy going? Are we entering a post-philosophy millennium? The Future of Philosophy presents the notion of what the future of philosophy is as a crucial concept, since it allows us to speculate not only on the future, but also on the past. The insightful essays consider a variety of issues, from ethics to mind, language to feminist thought, postmodernism to religion. Contributors: Peter Edwards, Lenn Goodman, Sean Hand, Heta Hayry, Matti Hayry, Gill Howie, Oliver Leaman, Harry Lesser, (...) Gerard Livingstone, William Lyons and Catherine Wilson. (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)

The Nordic countries aim to have a unique place within the European and global health data economy. They have extensive nationally maintained and centralized health data records, as well as numerous biobanks where data from individuals can be connected based on personal identification numbers. Much of this phenomenon can be attributed to the emergence and development of the Nordic welfare state, where Nordic countries sought to systematically collect large amounts of population data to guide decision making and improve the health (...) and living conditions of the population. Recently, however, the so-called Nordic gold mine of data is being re-imagined in a wholly other context, where data and its ever-increasing logic of accumulation is seen as a driver for economic growth and private business development. This article explores the development of policies and strategies for health data economy in Denmark and Finland. We ask how nation states try to adjust and benefit from new pressures and opportunities to utilize their data resources in data markets. This raises questions of social sustainability in terms of states being producers, providers, and consumers of data. The data imaginaries related to emerging health data markets also provide insight into how a broad range of different data sources, ranging from hospital records and pharmacy prescriptions to biobank sample data, are brought together to enable “full-scale utilization” of health and welfare data. (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.

The article examines Barthes’s A Lover’s Discourse (1977) in conjunction with du Maurier’s Trilby (1894) in order to present an argument about the similarities they share with the male masochistic fantasy as theorised by Deleuze in his Coldness and Cruelty (1989). Barthes’s insistence on the connection between art and love directs my approach. Trilby deals with love and aesthetics in the contexts of art, music, and narrative. The discourses of Trilby’s competing lovers over the same woman serve as a point (...) of comparison against which I read Barthes’s dramatisation of a lover’s discourse. I argue that Barthes’s lover shares a number of central discursive figures with the Deleuzian masochistic lover. I examine Barthes’s suggestion about the tension between the non-narrative discourse of love and the metalanguage of conventional love stories. I focus on those figures in a lover’s discourse that Barthes identifies as keeping this discourse from turning into a love story. My argument is that many of these figures are among the hallmarks of the masochistic fantasy. In particular the formula of disavowal safeguards the lover’s discourse, hindering it from turning into a conventional narrative about love. (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)

_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)

According to surveys and opinion polls, citizens in Nordic welfare societies have positive, supportive attitudes towards medical research and biobanking. In Finland, it was expected that this would result in the active biobank participation of patients and citizens. Indeed, public support has been rhetorically utilised as a unique societal factor and advantage in the promotion of Finnish biobanks, underlining the potential Finland offers for the international biomedical enterprise. In this paper, we critically analyse the use of notions such as ‘willing (...) population’ and ‘engaged people’ in the promotion and legitimation of biobanking. First, there is a seeming contradiction between positive attitudes and actual participation rates, as biobanks have faced unexpected challenges in participant recruitment during the first years of their operations. As a result, the concept of a willing population was redirected to problematise the necessity of informed consent. Second, we question whether it is even meaningful to assume the existence of an informed and engaged population with regard to biobanking. Therefore, we suggest that it is problematic to talk about a willing population at the same time as the relevance of the informed consent system is being questioned by biobank actors and policy makers. We analyse this tension in relation to existing data on Finnish people’s attitudes, pointing out that positive, supportive views do not directly transform into high participation rates; nor do they justify the claims of policy makers and biobank proponents that people are willing to participate, when in fact surveys report that people know very little about biobanks. (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)

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 bookThe Future of Human Nature.

One of the core issues in medical ethics has been and still is autonomy, people's right to make their own self-regarding choices in situations where more than one option is available. Depending on the case, these choices may be influenced by personal life history, one's ethical and other values, and one's future expectancies. A professional soccer player may risk an operation, which for a less athletic individual would represent an unnecessary risk that might jeopardize her ability to even walk. Saying (...) no to painkillers may sound irrational to those who do not see anything ennobling in avoidable suffering, and preferring homeopathic medicine to more evidence-based medicine may lead others to seriously doubt the logic of one's thinking. But although these situations may be difficult,1 they seldom lead to an impasse. Even if serious value conflicts emerge in these patient–medical personnel encounters, they can be overcome by the fact that, in Western countries, honoring patients' autonomy has been widely accepted as part of medical professionalism. (shrink)

The idea of cloning adult human beings often gives rise to objections involving mad dictators producing copies of themselves, or deranged billionaires who want to live forever. But what about situations where we can more readily understand and accept the reasons for creating a clone? Consider, for instance, the case of parents who have simultaneously lost their newly born child and found out that they cannot have any more children of their own by other known methods. Would it be wrong (...) of them to want a new child, a genetic copy of the lost infant, if the child were healthy and could only be produced by cloning the infant who no longer lives? And would it be wrong of genetic engineers to assist them? (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.

In contemporary discussions on practical ethics, the concepts of autonomy and dignity have frequently been opposed. This tendency has been particularly visible in controversies regarding cloning, abortion, organ sales, and euthanasia. Freedom of research and freedom of choice, as instances of professional and personal autonomy, have been cited in arguments favouring these practices, while the dignity and sanctity of human life have been evoked in arguments against them. In the moral theory of Immanuel Kant, however, the concepts of autonomy and (...) dignity seem to coexist in mutual harmony. Respect for the freely chosen moral law and respect for the absolute value of humanity coincide, and give rise to a unified understanding of our duties toward ourselves and others. My question in this paper is, was Kant on to something here? Can autonomy and dignity, in the sense in which they are used in current debates, be brought together, and can the arguments be settled in a way that would satisfy both (or all) disagreeing parties? My answer to the question is, yes and no. Kant was definitely on to something in that he recognized two competing views in modern moral philosophy, and tried to consolidate them in an attempt to create a universal model of ethics. But in the end, he failed to fuse the two views together on equal terms. Instead, he sacrificed the modern idea of the self-governance of individuals on the altar of the premodern notion of the absolute inner worth of humanity. (shrink)

Finland is internationally known as one of the leading centers of twentieth century analytic philosophy. This volume offers for the first time an overall survey of the Finnish analytic school. The rise of this trend is illustrated by original articles of Edward Westermarck, Eino Kaila, Georg Henrik von Wright, and Jaakko Hintikka. Contributions of Finnish philosophers are then systematically discussed in the fields of logic, philosophy of language, philosophy of science, history of philosophy, ethics and social philosophy. Metaphilosophical reflections on (...) the nature of philosophy are highlighted by the Finnish dialogue between analytic philosophy, phenomenology, pragmatism, and critical theory. (shrink)