Should we make people healthier, smarter, and longer-lived if genetic and medical advances enable us to do so? Matti Häyry asks this question in the context of genetic testing and selection, cloning and stem cell research, gene therapies and enhancements. The ethical questions explored include parental responsibility, the use of people as means, the role of hope and fear in risk assessment, and the dignity and meaning of life. Taking as a starting point the arguments presented by Jonathan Glover, John (...) Harris, Ronald M. Green, Jürgen Habermas, Michael J. Sandel, and Leon R. Kass, who defend a particular normative view as the only rational or moral answer, Matti Häyry argues that many coherent rationalities and moralities exist in the field, and that to claim otherwise is mistaken"--Provided by publisher. (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)

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)

:Justice can be approached from many angles in ethical and political debates, including those involving healthcare, biomedical research, and well-being. The main doctrines of justice are liberal egalitarianism, libertarianism, luck egalitarianism, socialism, utilitarianism, capability approach, communitarianism, and care ethics. These can be further elaborated in the light of traditional moral and social theories, values, ideals, and interests, and there are distinct dimensions of justice that are captured better by some tactics than by others. In this article, questions surrounding these matters (...) are approached with the hermeneutic idea of a distinction between “American” and “European” ways of thinking. (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)

Blumenthal-Barby et al. (2022) present a nuanced and convincing case for the continued presence of moral and political philosophers in bioethics. We agree with the authors that philosophers should have a role in bioethical inquiry. However, we partly disagree on what that role should be. We assess the case taking our clues from a concern the authors mention – and another one that they do not directly address.

Governmental reactions to crises like the COVID-19 pandemic can be seen as ethics communication. Governments can contain the disease and thereby mitigate the detrimental public health impact; allow the virus to spread to reach herd immunity; test, track, isolate, and treat; and suppress the disease regionally. An observation of Sweden and Finland showed a difference in feasible ways to communicate the chosen policy to the citizenry. Sweden assumed the herd immunity strategy and backed it up with health utilitarian arguments. This (...) was easy to communicate to the Swedish people, who appreciated the voluntary restrictions approach and trusted their decision makers. Finland chose the contain and mitigate strategy and was towards the end of the observation period apparently hesitating between suppression and the test, track, isolate, and treat approach. Both are difficult to communicate to the general public accurately, truthfully, and acceptably. Apart from health utilitarian argumentation, something like the republican political philosophy or selective truth telling are needed. The application of republicanism to the issue, however, is problematic, and hiding the truth seems to go against the basic tenets of liberal democracy. (shrink)

Is there such a thing as corona solidarity? Does voluntary mutual aid solve the problems caused by COVID-19? I argue that the answer to the first question is “yes” and to the second “no.” Not that the answer to the second question could not, in an ideal world, be “yes,” too. It is just that in this world of global capitalism and everybody looking out for themselves, the kind of communal warmth celebrated by the media either does not actually exist (...) or is too weak to rule out the uglier manifestations of group togetherness, driven partly by the pandemic. I make my point by offering two approaches to understanding what solidarity is. According to the first, it is essentially partiality: “us” against “them.” According to the second, it can be many things, including the impartial promotion of the good of others. I show that the second reading would make it possible for mutual aid to solve the problems caused by COVID-19 and other crises. This would happen at the expense of conceptual clarity, but that is a minor concern. The major concern is that the more natural manifestations of group togetherness are incited by negative feelings. This is par for the course within the narrower reading of solidarity, but it means that the potentially positive ideas of identity, care, communal values, and special relations are displayed in violent confrontation instead of a calm recognition of the threats that most of us face together. (shrink)

The role of bioethicists amidst crises like the COVID-19 pandemic is not well defined. As professionals in the field, they should respond, but how? The observation of the early days of pandemic confinement in Finland showed that moral philosophers with limited experience in bioethics tended to apply their favorite theories to public decisions, with varying results. Medical ethicists were more likely to lend support to the public authorities by soothing or descriptive accounts of the solutions assumed. These are approaches that (...) Tuija Takala has called the firefighting and window dressing models of bioethics. Human rights lawyers drew attention to the flaws of the government’s regulative thinking. Critical bioethicists offered analyses of the arguments presented and the moral and political theories that could be used as the basis of good and acceptable decisions. (shrink)

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)

When humanity has either suppressed coronavirus disease 2019 or learned to come to terms with its continued existence, governments and corporations probably return to their prepandemic stances. Solutions to the world’s problems are sought from technology and business innovations, not from considerations of equality and well-being for all. This is in stark contrast with the pandemic-time situation. Many governments, at least initially, listened to the recommendations of expert advisers, most notably public health authorities, who proceeded from considerations of equality and (...) common good. I suggest that we should continue on this path when the immediate threat of the disease is over. Other crises are already ongoing—poverty, conflicts, climate change, financial bubbles, and so on—and it would be good to use expert knowledge rather than interests and ideologies in dealing with them. To assist in this, I outline the characteristics of a new kind of counsellor, impartial adviser, who is normatively motivated by a sense of copathy and who takes into account all views, nice and not-so-nice alike. I illustrate the nature and ideological orientation of copathic impartial advisers by placing them on a map of justice and examining their relationships with the main political moralities of our time. (shrink)

In a contribution to The Journal of Medicine and Philosophy , Professor Rosamond Rhodes argues that individuals sometimes have an obligation to know about their genetic disorders, because this is required by their status as autonomous persons. Her analysis, which is based on Kant's concept of autonomy and Aristotle's notion of friendship, is extended here to consequentialist concerns. These are of paramount importance if, as we believe and Professor Rhodes herself implies, the Kantian and Aristotelian doctrines can be helpful only (...) in the sphere of private morality, not in the public realm. Better tools for assessing the right to genetic ignorance as an issue of public policy can, we contend, be found in Mill's ideas concerning liberty and the prevention of harm. Our own conclusion, based on the Millian way of thinking, is that individuals probably do have the right to remain in ignorance in the cases Professor Rhodes presents as examples of a duty to know. (shrink)

Sustainability, properly understood, is an existential moral ideal. The United Nations, however, defines it in terms of 17 indivisible sustainable development goals. This definition changes the core idea of the concept. It turns sustainability from a moral ideal into a set of economy-based political aspirations. The European Union’s bioeconomy strategy demonstrates the shift aptly and reveals its main problem. When economy is prioritized, social and ecological concerns become secondary. This has been the United Nations line since the Brundtland Commission’s report, (...) Our Common Future in 1987. Considerations of justice illustrate the inadequacy of the approach. Equality and justice require that all those affected by decisions are heard in making them. Under the current operationalization, decisions related to the natural environment and climate change are currently being made without hearing voices that advocate deeper social and ecological equality. After an explication of the problem and the state of the art as outlined above, a new notion of justainability is introduced and it is argued that assuming it would be a step in the right direction in taking also noneconomic values properly into account in international decision making. (shrink)

I present a qualified new defense of antinatalism. It is intended to empower potential parents who worry about their possible children’s life quality in a world threatened by environmental degradation, climate change, and the like. The main elements of the defense are an understanding of antinatalism’s historical nature and contemporary varieties, a positional theory of value based on Epicurean hedonism and Schopenhauerian pessimism, and a sensitive guide for reproductive decision-making in the light of different views on life’s value and risk-taking. (...) My conclusion, main message, to the concerned would-be parents is threefold. If they believe that life’s ordinary frustrations can make it not worth living, they should not have children. If they believe that a noticeably low life quality makes it not worth living and that such life quality can be reasonably expected, they should not have children, either. If they believe that a noticeably low life quality is not reasonably to be expected or that the risk is worth taking, they can, in the light of their own values and beliefs, have children. The conclusion is supported by a combination of the extant arguments for reproductive abstinence, namely the arguments from consent, moral asymmetry, life quality, and risk. (shrink)

Rights, autonomy, privacy, and confidentialityare concepts commonly used in discussionsconcerning genetic information. When theseconcepts are thought of as denoting absolutenorms and values which cannot be overriden byother considerations, conflicts among themnaturally occur.In this paper, these and related notions areexamined in terms of the duties and obligationsmedical professionals and their clients canhave regarding genetic knowledge. It issuggested that while the prevailing idea ofautonomy is unhelpful in the analysis of theseduties, and the ensuing rights, an alternativereading of personal self-determination canprovide a firmer (...) basis for ethical guidelinesand policies in this field. (shrink)

Abstract:This paper explores how Finnish research ethics deals with matters of justice on the levels of practical regulation, political morality, and theoretical studies. The bioethical sets of principles introduced by Tom Beauchamp and James Childress in the United States and Jacob Dahl Rendtorff and Peter Kemp in Europe provide the conceptual background, together with a recently introduced conceptual map of theories of justice and their dimensions. The most striking finding is that the internationally recognized requirement of informed consent for research (...) on humans can be ideologically tricky in a Scandinavian welfare state setting. (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.

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.

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)

Academic freedom can be defined as immunity against adverse reactions from the general public, designed to keep scholars unintimidated and productive even after they have published controversial ideas. Francesca Minerva claims that this notion of strict instrumental academic freedom is supported by Ronald Dworkin, and that anonymity would effectively defend the sphere of immunity implied by it. Against this, I argue that the idea defended by Minerva finds no support in the work by Dworkin referred to; that anonymity would not (...) in most cases effectively protect the kind of immunity sought after; and that in some cases it would not even be desirable to protect scholars from public reactions to their controversial claims. (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)

The article examines five controversial views, expressed in Jonathan Swift’s _A Modest Proposal_, Helga Kuhse and Peter Singer’s _Should the Baby Live? The Problem of Handicapped Infants_, Alberto Giubilini and Francesca Minerva’s “After-birth abortion: why should the baby live?”, Julian Savulescu’s “Procreative beneficence: why we should select the best children”, and the author’s “A rational cure for prereproductive stress syndrome”. These views have similarities and differences on five levels: the grievances they raise, the proposals they make, the justifications they explicitly (...) use, the justifications they implicitly rely on, and the criticisms that they have encountered. A comparison of these similarities and differences produces two findings. First, some controversial views based on utilitarian considerations would probably fare better flipped upside down and presented as Juvenalian satires. Secondly, a modicum of humor or modesty could help presenters of controversial views to stir polite critical discussion on the themes that they put forward. (shrink)

This paper shows how most modern theories of justice could require or at least condone international aid aimed at alleviating the ill effects of disability. Seen from the general viewpoint of liberal egalitarianism, this is moderately encouraging, since according to the creed people in bad positions should be aided, and disability tends to put people in such positions. The actual responses of many theories, including John Rawls's famous view of justice, remain, however, unclear. Communitarian, liberal egalitarian, and luck egalitarian thinkers (...) alike have to consider their attitude towards cosmopolitan ideals before they can extend their theories across national borders. The only view of justice that automatically rejects the obligation of international aid based on disability is libertarianism. This is significant for two reasons. Libertarianism is arguably the economic doctrine of globalisation; and its moral appeal to voluntary charity draws attention to the foundations of voluntary corporate social res.. (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)

The COVID-19 pandemic has created or revealed scarcities in many domains: medical, civic, economic, and ideological. Responses to these are analyzed in the framework of a map of justice and an imperative of openness. The main argument is that whatever the view of justice chosen by public health authorities, they should be able and willing to disclose it to the citizens. Objections are considered and qualifications added, but the general conclusion is that in liberal democracies, truth-telling by those in power, (...) although politically hazardous, would be ethically advisable. (shrink)

In her thorough and thoughtful contribution to the Cambridge Quarterly of Healthcare Ethics titled “Medical Ethics: Common or Uncommon Morality” Rosamond Rhodes argues that contrary to American mainstream bioethics, medical ethics is not, and should not be, based on common morality, but rather, that the medical profession requires its own distinctive morality.1 She goes on to list sixteen duties that, according to her, form the core of medical ethics proper.

The reversal of Roe v. Wade by the U.S. Supreme Court allowed the states to regulate terminations of pregnancy more autonomously than during 1973–2022. Those who think that women should be legally entitled to abortions at their own request are suggesting that annulling the reversal could be an option. This would mean continued reliance on the interpretation of privacy that Roe v. Wade stood on. The interpretation does not have the moral support that its supporters think. This can be shown (...) by recalling the shortcomings of Judith Jarvis Thomson’s famous violinist example and its application to abortion laws. Philosophically better reasons for not restricting access to abortion can be found in a simple principle of fairness and in sensible theories on the value of human life. Whether or not philosophy has any use in the debate is another matter. Legal decisions to regulate terminations are probably based on pronatalist state interests, shared by the apparently disagreeing parties and immune to rational argumentation. (shrink)

In Passive Obedience Berkeley argues that we must always observe the prohibitions decreed by our sovereign rulers. He defends this thesis both by providing critiques against opposing views and, more interestingly, by presenting a moral theory that supports it. The theory contains elements of divine - command, natural - law, moral - sense, rule - based, and outcome - oriented ethics. Ultimately, however, it seems to rest on a notion of spiritual reason — a specific God - given faculty that (...) all rational human beings have. Berkeley’s work on immaterialism, for which he is better known, could thus perhaps best be seen as an attempt to find a scientific justification for his moral doctrine. (shrink)

This book explores the many connections that bioethical thinking has with social reality. Bioethics, if it is to be effective, must engage with and address the actualities of modern life: policies, regulations, markets, opinions, and technological advances. In these original contributions fifteen notable scholars working in the North West of England take on this challenge. The series Values in Bioethics makes available original philosophical books in all areas of bioethics, including medical and nursing ethics, health care ethics, research ethics, environmental (...) ethics, and global bioethics. (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.

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.

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)

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)

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)

Neuroethics addresses moral, legal, and social questions created or highlighted by theoretical and practical developments in neuroscience. Practices in need of scrutiny currently include at least brain imaging with new techniques, chemical attempts to shift exceptional brain function toward normality, chemical attempts to enhance ordinary brain function beyond normality, and brain manipulation by other methods.Matti H ja paha.

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.