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)

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

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

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)

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.

_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.

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)

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)

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

Abstract.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)

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)

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)

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)

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

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

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

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

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

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

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

_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)

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

_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)

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.

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

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

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

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

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.

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