This article addresses two questions: First, how does the value of human dignity distinctively bear on a state’s responsibilities in relation to migrants; and, secondly, how serious a wrong is it when a state fails to respect the dignity of migrants? In response to these questions, a view is presented about the distinction between wrongs that violate cosmopolitan standards and wrongs that violate the standards that are distinctive to a particular community; about when and how the contested concept of human (...) dignity might be engaged; and, elaborating a three-tiered and lexically ordered scheme of state responsibilities, about how we should assess the seriousness of a state’s failure to respect the dignity of migrants. (shrink)

This article, prompted by Heidi Crowter’s campaign to eliminate the discriminatory aspects of current abortion law, outlines the challenges to good governance in a context of bioethical plurality. First, the nature of the plurality is sketched. Secondly, some reflections are presented on how those who have governance responsibilities might ease the tensions engendered by the plurality; and, at the same time, how the discontented governed might reasonably press their views. Thirdly, a model of good governance (demanding integrity by those who (...) govern and respect for the global commons) is introduced. The conclusion is that good faith governance merits our respect, but it does not guarantee particular outcomes or positions that will meet with the approval of all bioethical constituencies or individuals. Accordingly, we have to learn not only to live with rocks and hard places but also to find civilized ways of debating our differences. (shrink)

This paper argues that, in a community of rights, the prima facie responsibilities of researchers to attend to the ancillary-care needs of their participants would be determined by a four-stage test . This test, it is suggested, sets a standard for common law courts that are invited to recognize the ancillary-care responsibilities of researchers, whether as a matter of contract or tort law.

Nuffield Council on Bioethics, London * Corresponding author: Nuffield Council on Bioethics, 28 Bedford Square, London WC1B 3JS, UK. Email: hschmidt{at}nuffieldbioethics.org ' + u + '@' + d + ' '//--> Abstract In November 2007, the Nuffield Council on Bioethics published the report Public Health: Ethical Issues . While the report has been welcomed by a wide range of stakeholders, there has also been some criticism. First, it has been suggested that it is not clear why, in developing its ‘stewardship (...) model’, the Council felt the need to go beyond the liberal position developed by John Stuart Mill—what is it that the stewardship model adds? Second, it is suggested that the Report is confused about the concept of paternalism. Third, it is argued that the discussion of the concept of stewardship is lacking in detail and substance. We clarify the Working Party's thinking regarding these three areas, which demonstrates the robustness of the framework set out in the report. CiteULike Connotea Del.icio.us What's this? (shrink)

This article sketches how liberal principles can be coherently set alongside the stewardship responsibilities of regulators. It indicates how this bears on the legitimacy of public health interventions in general and interventions of the kind associated with New York City’s public health programme in particular. The key idea is that stewardship responsibilities relate to the essential infrastructural conditions for human well-being; these conditions need to be protected because they are the staging for all human activity. Liberal principles, by contrast, presuppose (...) that the basic conditions for human well-being are in place; and, given this presupposition, they present a view about how humans should live, about how they should interact and transact and about how they should flourish. Where regulators are guided by a liberal ethic, they act illegitimately if they try to dictate how individuals should lead their lives; but, acting under their stewardship jurisdiction, regulators may legitimately intervene if they are trying to protect the conditions that are essential for any kind of human life. The article concludes by suggesting that while it is a good thing that New York City’s policies provoke debate about the legitimacy of public health interventions, it is the infrastructural conditions, and not the superstructural activities, that are the regulatory priority. (shrink)

It is axiomatic that the first responsibility of researchers, whether they are working in the developed or the developing world, is to do no harm to those who participate in their studies or trials. However, on neither side of the Atlantic is there any such settled view with regard to the responsibility of researchers to attend to the ancillary-care needs of their participants – that is, a responsibility to advise or assist participants who have medical condition X in circumstances where (...) the research concerns medical condition Y, and the research did not contribute to the presence of condition X in participants, nor did the having of condition X contribute to the research. Consider, for example, the following hypothetical posed by Leah Belsky and Henry Richardson:Researchers testing a new treatment for tuberculosis in a developing country discover some patients have HIV infection. Do they have a responsibility to provide antiretroviral drugs? (shrink)

This paper, guided by the UNESCO Universal Declaration on Bioethics and Human Rights, assumes that regulators should aim to support the development of nanomedicine while, at the same time, putting in place whatever limits or safeguards are indicated by ethical considerations. Relative to this regulatory objective, it is argued that, notwithstanding the importance of precaution (characteristically, concerning health, safety, and the environment), ethical reflection needs to go both broader and deeper. It is suggested that, by attending to the basic matrix (...) of ethical debate and the “bioethical triangle” through which the matrix is currently articulated, the breadth, depth, and conflictual plurality of ethical concerns about nanomedicine will be clarified. In this light, the conventional thinking about precaution is revisited and concerns about human dignity and informed consent (under conditions of extreme uncertainty) are analysed. The paper concludes that, once the range of ethical pluralism is grasped, the extent of the challenge facing regulators will be more clearly appreciated. (shrink)

This paper challenges the view, commonly held inbiolaw and bioethics, that there can be no proprietaryrights in our own bodies or body parts. Whether thestarting point is the post-intervention informedconsent regime of Article 22 of the Convention ofHuman Rights and Biomedicine or the traditional(exclusionary) understanding of private property it isargued that property in our own bodies or body partsis presupposed. Although these arguments do notdemonstrate that there is property of this kind (forthat, a full-scale justification of the institution ofprivate property (...) would be required), they suggestnevertheless that the commonly held view has animmanent property logic that has not yet been drawnout or appreciated. (shrink)

In the original publication the title reads “The Right to Know and the Right Not to Know Revisited: Part One”. The paper consisted of both Part One and Part Two hence the title has to be corrected.

This special issue of the Modern Law Review addresses a range of key issues - conceptual, ethical, political and practical - arising from the regulatory ...

Approximately 6000 men die every year from ruptured abdominal aortic aneurysm in England and Wales. Randomised clinical trials and a large pilot study have shown that ultrasound screening of men aged 65 years can prevent about half of these deaths. However, there is a significant perioperative morbidity and mortality from interventions to repair the detected aneurysm. This paper explores the ethical issues of screening men for abdominal aortic aneurysm. It is concluded that a population screening programme for abdominal aortic aneurysm (...) offers a clear balance of good over harm. It is therefore ethically justified, as long as men are given adequate information at every stage of the process. Each man has the right to be properly informed, regardless of whether he accepts the invitation to be screened and, if an aneurysm is detected, whether or not he accepts treatment. (shrink)