In the research ethics literature, there is strong disagreement about the ethical acceptability of placebo-controlled trials, particularly when a tested therapy aims to alleviate a condition for which standard treatment exists. Recently, this disagreement has given rise to debate over the moral appropriateness of the principle of clinical equipoise for medical research. Underlying these debates are two fundamentally different visions of the moral obligations that investigators owe their subjects.Some commentators and ethics documents claim that physicians, whether acting as care givers (...) or researchers, have the same duty of beneficence towards their patients and subjects: namely, that they must provide optimal medical care. In discussing placebo surgery in research on refractory Parkinson's disease, Peter Clark succinctly states this view: “The researcher has an ethical responsibility to act in the best interest of subjects.”. (shrink)

In the research ethics literature, there is strong disagreement about the ethical acceptability of placebo-controlled trials, particularly when a tested therapy aims to alleviate a condition for which standard treatment exists. Recently, this disagreement has given rise to debate over the moral appropriateness of the principle of clinical equipoise for medical research. Underlying these debates are two fundamentally different visions of the moral obligations that investigators owe their subjects.Some commentators and ethics documents claim that physicians, whether acting as care givers (...) or researchers, have the same duty of beneficence towards their patients and subjects: namely, that they must provide optimal medical care. In discussing placebo surgery in research on refractory Parkinson's disease, Peter Clark succinctly states this view: “The researcher has an ethical responsibility to act in the best interest of subjects.”. (shrink)

Over the past several years, the most widely publicized issue in capital litigation has been the constitutional status of states’ lethal injection protocols. Death row inmates have not challenged the constitutionality of lethal injection itself, but rather execution protocols and their potential for maladministration. The inmates’ concern is due to the three-drug protocol used in the vast majority of capital jurisdictions: if the anesthetic, which is administered first, is ineffectively delivered, then the second and third drugs — the paralytic and (...) heartbeat-ceasing agents — will cause torturous pain and suffering in violation of the Eight Amendment. Inmates have argued that the participation of anesthesiologists or other highly trained medical professionals is constitutionally required to minimize the risk of unnecessary suffering. This litigation, in conjunction with evidence that some executed inmates suffered torturous pain, has reinvigorated the ethical debate about physician participation in executions. Even though the United States Supreme Court has signaled that physician participation is not constitutionally required, lawmakers in death penalty states must consider the ethics of physician involvement. (shrink)

Moral judgments about a situation are profoundly shaped by the perception of individuals in that situation as either moral agents or moral patients (Gray & Wegner, 2009; Gray, Young, & Waytz, 2012), Specifically, the more we see someone as a moral agent, the less we see them as a moral patient, and vice versa. As a result, casting the perpetrator of a transgression as a victim tends to have the effect of making them seem less blameworthy (Gray & Wegner, 2011). (...) Based on this theoretical framework, we predicted that criminal offenders with a mental disorder that predisposes them to antisocial behavior would be judged more negatively when the disorder is described as having a genetic origin than when it is described as environmentally caused, as in the case of childhood abuse or accident. Further, we predicted that some environmental explanations would mitigate attributions of blame more than others, namely, that offenders whose disorder was caused by childhood abuse (intentional harm) would be seen as less blameworthy than offenders whose disorder is caused by an unfortunate accident (unintentional harm). Results from two vignette-based studies designed to test these predictions, conducted with participants recruited from Amazon Mechanical Turk (N = 244 and N = 387, respectively), confirmed the first prediction but not the second. Implications of this research for three areas — the psychology of moral judgment, philosophical debates about moral responsibility and determinism, and the practice of the law — are discussed in the sequel. (shrink)

*The opinions expressed are the views of the author and do not necessarily reflect the policy of the National Institutes of Health, the Public Health Service, or the U.S. Department of Health and Human Services.

Federal efforts beginning in the 1990's have successfully increased pediatric research to improve medical care for all children. Since 1997, the FDA has requested 800 pediatric studies involving 45,000 children. Much of this research is "non-beneficial"; that is, it exposes pediatric subjects to risk even though these children will not benefit from participating in the research. Non-beneficial pediatric research (NBPR) seems, by definition, contrary to the best interests of pediatric subjects, which is why one state supreme court has essentially prohibited (...) it. It also appears that the only plausible rationale for this research is utilitarian, as it risks some children for the good of all. But that rationale is troubling. This Article answers two related questions: (1) What is the appropriate legal relationship between NBPR and the "best interests of the child" standard? (2) What is the ethical justification for this research? I argue that courts should hold that the "best interests" standard governs pediatric research. But, contrary to existing case law, courts must consider the benefits to each child, including pediatric subjects, from a policy that permits NBPR, and not simply consider that a non-beneficial protocol presents more risk than potential benefit to a child. Moreover, I argue that the justification for the practice need not be utilitarian. There is no need to appeal to the greater good to justify the research because each child has reason to endorse a policy permitting NBPR where there is a very low ceiling on acceptable risk, and each child has reason to participate in a practice from which she benefits. More controversially, I argue that each child, like other persons, has reason to help others when she can do so at little to no cost to herself. The Article then highlights practical implications of the offered justifications. (shrink)

Responsibility theorists frequently discuss psychopathy because it challenges various accounts of the capacities required for appropriate ascriptions of moral and legal responsibility. As often described, the psychopath has the capacity to reason practically but lacks the capacity to grasp and control himself in light of moral considerations. As portrayed, then, the psychopath resides in the area of disagreement between two philosophical camps: (i) theorists who put forth the general capacity for practical reasoning or rational self-governance as sufficient for an agent (...) to be appropriately held morally responsible for his conduct; and (ii) theorists who view that general capacity as necessary but not sufficient for moral responsibility, additionally requiring the capacity to grasp and respond to distinctly moral reasons. On the former view, we may appropriately hold psychopaths responsible for their wrongful actions, but not on the latter. This article does not aim to describe the opposing views and argue for one over the other. Rather, I propose to deflate the debate as far as possible, attempting to reduce the area of disagreement. Meaningful disagreement exists only if there are, or could be, agents who have an undiminished capacity for practical reasoning or rational self-governance, yet truly are incapable of moral reasoning. However, I suggest that the capacity for rational self-governance entails the capacity to comprehend and act on moral considerations; thus, to the extent that an individual truly is incapable of grasping moral reasons, we should expect to find deeper, more general deficiencies in that individual's rational capacities. I appeal to the work of leading researchers who study individuals with psychopathy to determine whether psychopaths do represent rational self-governors without the capacity to grasp moral considerations. I argue that this work strongly suggests that the psychopath's incapacity for moral reasoning is, indeed, evidence of more general deficits in the rational capacities required for fully accountable agency. The Article closes with relevant considerations for thinking about any implications for criminal law. (shrink)

The nanotechnology hype, engendering both fanatical optimism and apocalyptic fears, has produced calls from different commentators for "a radical change in the way we address ethical issues" and a "novel [ethical] approach to the future" that must be divorced from existing moral theories. However, a unique ethical framework devised specifically for nanotechnology is both impossible and unnecessary. The ethical issues predicted to accompany nanomedicine and nanotechnology are raised by medicine, biotechnology, genetics, and other technologies, and will call for balancing familiar (...) values: autonomy, beneficence, fairness, etc. At present, ethical attention should concentrate on safety and environmental studies and preparing for unforeseeable consequences, while the scientific community should prepare for a public dialogue. (shrink)

Psychopathy presents a difficult challenge to moral and criminal responsibility theorists. Persons with the disorder have an impaired capacity for empathy and other moral emotions, and fail to feel the force of moral considerations. They have some rational impairments, but they reason adequately to manipulate, con, and exploit their victims, and otherwise to engage successfully in antisocial behavior. Is it appropriate to hold them morally responsible for their wrongdoing? Should the law hold psychopaths criminally responsible? This essay discusses philosophical debates (...) involved in addressing these questions. (shrink)

The American Journal of Bioethics, Volume 12, Issue 1, Page 44-46, January 2012.

Are judgments of praise for moral behavior modulated by knowledge of an agent's past suffering at the hands of others, and if so, in what direction? Drawing on multiple lines of research in experimental social psychology, we identify three hypotheses about the psychology of praise — typecasting, handicapping, and non-historicism — each of which supports a different answer to the question above. Typecasting predicts that information about past suffering will augment perceived patiency and thereby diminish perceived agency, making altruistic actions (...) seem less praiseworthy; handicapping predicts that this information will make altruistic actions seem more effortful, and hence more praiseworthy; and non-historicism predicts that judgments of praise will be insensitive to information about an agent's experiential history. We report the results of two studies suggesting that altruistic behavior tends to attract more praise when the experiential history of the agent involves coping with adversity in childhood rather than enjoying prosperity (Study 1, N = 348, p = .03, d = 0.45; Study 2, N = 400, p = .02, d = 0.39), as well as the results of a third study suggesting that altruistic behavior tends to be evaluated more favorably when the experiential history of the agent includes coping with adversity than in the absence of information about the agent's past experience (N = 226, p = .002). This pattern of results, we argue, is more consistent with handicapping than typecasting or non-historicism. (shrink)

To answer whether moral responsibility is compatible with determinism, two different methods for justifying compatibilist conditions of responsibility have emerged in recent literature. First-person approaches, such as Hilary Bok's, appeal to the first-person experience of human agency to justify our practices of holding agents responsible. In contrast, T. M. Scanlon and Jay Wallace, following P. F. Strawson, begin with an account of the interpersonal significance of holding each other responsible in order to discern the conditions under which it is appropriate (...) to assign that significance to an agent's actions. In this dissertation, I evaluate these different methodologies, and I examine the details of each view in order to find a proper understanding of the conditions of responsibility and of the significance of responsibility judgments within our interpersonal lives. ;I argue that the backward-looking significance we attach to responsibility judgments, including those of blame and praise, can be captured only by an interpersonal approach. Specifically, I argue that the significance of responsibility is not found in the negative consequences or emotions that we associate with holding agents responsible. Rather, ascribing to an agent the status of being responsible is a form a deep respect, which has practical implications. I argue that our intuitions concerning victims of severely deprived childhoods are best accounted for if we recognize that ascription as a form of respect and we separate the question of whether an agent is responsible from considerations of appropriate punishments. ;With regard to the conditions of responsibility, I argue that practical reasoners should be considered responsible not only for their choices, but also for negligent omissions, moral beliefs, and certain emotional reactions, even if such phenomena are not based on their choices. In addition, I argue that compatibilists do not need to add the capacity to grasp distinctly moral reasons to the requirements of responsible agency because that capacity is entailed by the basic capacity to reason practically. I examine the psychological literature on psychopaths---agents who supposedly are practical reasoners without moral understanding---to counter an objection to my view. (shrink)

The American Journal of Bioethics, Volume 11, Issue 8, Page 19-20, August 2011.