Abortion for life-limiting foetal anomaly is often an intensely painful choice for the parents; though widely offered and supported, it is surprisingly difficult to defend in ethical terms. Abortion on this ground is sometimes defended as foetal euthanasia but has features which sharply differentiate it from standard non-voluntary euthanasia, not least the fact that any suffering otherwise anticipated for the child may be neither severe nor prolonged. Such abortions may be said to reduce suffering for the family (...) including siblings – a consideration rarely stated so explicitly in defences of postnatal euthanasia – or for the woman who must in any case face the eventual loss of her baby, and for whom the abortion is seen as therapeutic in minimising pain. Finally, the abortion may be said to constitute the cessation of morally optional life support on the part of the woman, and/or to be a ‘social’ choice she is entitled to make, whether or not this in fact promotes her interests or those of her child. These defences need honest exploration: the intense parental suffering caused by the choice to end an often much-wanted pregnancy should not preclude but rather encourage the question whether this choice can indeed be ethically proposed to couples, especially compared with the neonatal palliative care (‘perinatal hospice’) approach so well received by parents who experience it. (shrink)

Deborah is a thirty-three-year-old who presented to labor and delivery at thirty-seven weeks gestation with complaints of contractions. Upon arrival, she explained that her fetus, Nathan, had been diagnosed with a “lethal” condition by her primary obstetrician. At twenty-two weeks gestation, an amniocentesis confirmed trisomy 13, a chromosomal abnormality leading to miscarriage or stillbirth in nearly one-half of affected pregnancies. During the admission process, Deborah voices the worry that due to Nathan's brain and heart structure, vaginal delivery could be (...) traumatic and cause him to suffer. Deborah wishes for him to have as painless and as dignified a death as possible; cesarean section, she feels, will achieve this. Yet with her history of three prior vaginal deliveries, normally progressing labor, and poor fetal prognosis that is unlikely to improve with cesarean delivery, there is no maternal or fetal indication for a cesarean section. Should the obstetrician proceed with a cesarean delivery despite knowing that it would expose the mother to surgical risks with little or no corresponding fetal or neonatal benefit? (shrink)

Approximately one-fourth of all the inhabitants on earth are Muslims. Due to unprecedented migration, physicians are often confronted with cultures other than their own that adhere to different paradigms.

Although many of the congenital syndromes that used to be lethal no longer are, they are still routinely referred to as “lethal anomalies.” But the label is not only inaccurate, it is also dangerous: by portraying as a medical determination what is in fact a judgment about the child's quality of life, it wrests from the parents a decision that only the parents can make.

The case of Vo v. France represents the latest phase of the European Court of Human Rights’ thinking on the scope of Article 2 of the European Convention on Human Rights (the right to life) in relation to foetal life where a foetus had been lost owing to a medical accident. The Court by a majority decided that, “even assuming” Article 2 applied to the instant case (albeit to the life of the pregnant woman rather than that of the (...) foetus), it had not been violated. While the facts in Vo were extreme and exceptional, the Court will shortly hear the case of D v. Ireland concerning access to abortion for foetal anomaly, an application made under Articles 3, 8, 10 and 14 of the European Convention. If the case of D were declared admissible, the Court would then have to consider whether a denial of access to abortion for foetal anomaly constitutes inhuman and degrading treatment contrary to Article 3, or an interference with a pregnant woman’s right to respect for private life under Article 8 (and if so, how the doctrine of the margin of appreciation applies). The Grand Chamber precedent of Vo displays ambivalence about whether Article 2 should apply to foetal life, and its resort to the “even assuming” formula spared Member States the difficulty of having to justify their various abortion regimes, by reference to this Article. It remains to be seen whether in a case like D that is directly concerned with abortion, the Court will take a more definite stance on the correct balance to be struck between the State’s interest in protecting foetal life and the Convention rights of pregnant women. (shrink)

Objective Standards of care regarding obstetric management of life-threatening anomalies are not defined. It is hypothesised that physicians' management of these pregnancies is variable and influenced by demographic factors. Design A questionnaire was mailed to members of the Society of Maternal–Fetal Medicine with valid US addresses assessing obstetric management of both ‘uniformly lethal’ (eg, anencephaly, renal agenesis) and ‘uniformly severe, commonly lethal’ (eg, trisomy 13 and 18) anomalies. Respondents were asked to answer as if not limited by state/institutional (...) restrictions. Fisher's exact or χ2 tests were used as appropriate and correction made for multiple comparisons in analyses that were not prespecified. Results The response rate was 36% (732/2038). Nearly 100% of respondents discuss termination for both uniformly and commonly lethal anomalies. In continuing pregnancies, with patient request for obstetric non-intervention 99% of providers would comply for either uniformly or commonly lethal anomalies. The majority ‘encourage’ such management, but some were non-directive or discouraged this management. In continuing pregnancies, with patient request for full obstetric intervention the majority of respondents was willing to comply for both uniformly (71%) and commonly (82%) lethal anomalies. While most practitioners ‘discouraged’ full intervention, some were non-directive or encouraged this management. Demographics and severity of anomaly influenced counselling. Conclusion Discrepancies exist regarding the management of life-threatening fetal anomalies. Patients may be offered different options based on practitioner demographics. The majority of physicians comply with patient wishes. Differences were noted when comparing the management of lethal with that of severe commonly lethal anomalies, suggesting that practitioners make a distinction when counselling patients. (shrink)

Factory farming continues to grow around the world as a low-cost way of producing animal products for human consumption. However, many of the practices associated with intensive animal farming have been criticized by public health professionals and animal welfare advocates. The aim of this essay is to raise three independent moral concerns with factory farming, and to explain why the practices associated with factory farming flourish despite the cruelty inflicted on animals and the public health risks imposed on people. I (...) conclude that the costs of factory farming as it is currently practiced far outweigh the benefits, and offer a few suggestions for how to improve the situation for animals and people. (shrink)

It is widely agreed that one of the core functions of government is to supply public goods that markets either fail to provide or cannot provide efficiently. I will suggest that arguments for government provision of public goods require fundamental moral judgments in addition to the usual economic considerations about the relative efficacy of markets and governments in supplying them. While philosophers and policymakers owe a debt of gratitude to economists for developing the theory of public goods, the link between (...) public goods and public policy cannot be forged without moral reflection on the proper function and scope of government power. (shrink)

Many people greet evidence of biologically based race and sex differences with extreme skepticism, even hostility. We argue that some of the vehemence with which many intellectuals in the West resist claims about group differences is rooted in the tacit assumption that accepting evidence for group differences in socially valued traits would undermine our reasons to treat people with respect. We call this theegalitarian fallacy. We first explain the fallacy and then give evidence that self-described liberals in the United States (...) are especially likely to commit it when they reason about topics like race and sex. We then argue that people should not be as worried as they often are about research that finds psychological differences between men and women, or between people of different racial or ethnic groups. We conclude that if moral equality is believed to rest on biological identity, ethnically diverse societies are in trouble. (shrink)

Abstract:Trust is important for a variety of social relationships. Trust facilitates trade, which increases prosperity and induces us to interact with people of different backgrounds on terms that benefit all parties. Trade promotes trustworthiness, which enables us to form meaningful as well as mutually beneficial relationships. In what follows, I argue that when we erect institutions that enhance trust and reward people who are worthy of trust, we create the conditions for a certain kind of moral progress.

For most of human history children have been a byproduct of sex rather than a conscious choice by parents to create people with traits that they care about. As our understanding of genetics advances along with our ability to control reproduction and manipulate genes, prospective parents have stronger moral reasons to consider how their choices are likely to affect their children, and how their children are likely to affect other people. With the advent of cheap and effective contraception, and the (...) emergence of new technologies for in vitro fertilization, embryo selection, and genetic engineering, it is becoming increasingly difficult to justify rolling the genetic dice by having children without thinking about the traits they will have. It is time to face up to the awesome responsibilities that accompany our reproductive choices. (shrink)

On most accounts, beliefs are supposed to fit the world rather than change it. But believing can have social consequences, since the beliefs we form underwrite our actions and impact our character. Because our beliefs affect how we live our lives and how we treat other people, it is surprising how little attention is usually given to the moral status of believing apart from its epistemic justification. In what follows, I develop a version of the harm principle that applies to (...) beliefs as well as actions. In doing so, I challenge the often exaggerated distinction between forming beliefs and acting on them.1 After developing this view, I consider what it might imply about controversial research the goal of which is to yield true beliefs but the outcome of which might include negative social consequences. In particular, I focus on the implications of research into biological differences between racial groups. (shrink)

Antibiotic resistance is one of the most pressing public health problems humanity faces. Research into new classes of antibiotics and new kinds of treatments – including risky experimental treatments such as phage therapy and vaccines – is an important part of improving our ability to treat infectious diseases. In order to aid this research, we will argue that we should permit researchers to pay people any amount of money to compensate for the risks of participating in clinical trials, including ‘challenge (...) studies’ that involve deliberately infecting patients. We think that standard worries about paying for participation in risky research are reducible to concerns that can be addressed with the right screening mechanisms. (shrink)

Synthetic meat made from animal cells will transform how we eat. It will reduce suffering by eliminating the need to raise and slaughter animals. But it will also have big public health benefits if it becomes widely consumed. In this paper, we discuss how “clean meat” can reduce the risks associated with intensive animal farming, including antibiotic resistance, environmental pollution, and zoonotic viral diseases like influenza and coronavirus. Since the most common objection to clean meat is that some people find (...) it “disgusting” or “unnatural,” we explore the psychology of disgust to find possible counter-measures. We argue that the public health benefits of clean meat give us strong moral reasons to promote its development and consumption in a way that the public is likely to support. We end by depicting the change from farmed animals to clean meat as a collective action problem and suggest that social norms rather than coercive laws should be employed to solve the problem. (shrink)

See "What's Wrong with Factory Farming?" (2015) for an updated treatment of these issues.

Procreation is the ultimate public goods problem. Each new child affects the welfare of many other people, and some (but not all) children produce uncompensated value that future people will enjoy. This essay addresses challenges that arise if we think of procreation and parenting as public goods. These include whether individual choices are likely to lead to a socially desirable outcome, and whether changes in laws, social norms, or access to genetic engineering and embryo selection might improve the aggregate outcome (...) of our reproductive choices. (shrink)

ABSTRACT: This essay examines and criticizes a set of Kantian objections to Parfit's attempt in Reasons and Persons to connect his theory of personal identity to practical rationality and moral philosophy. Several of Parfit's critics have tried to sever the link he forges between his metaphysical and practical conclusions by invoking the Kantian thought that even if we accept his metaphysical theory of personal identity, we still have good practical grounds for rejecting that theory when deliberating about what to do. (...) The argument between Parfit and his opponents illuminates broader questions about the relationship between our metaphysical beliefs and ourpractical reasons.RÉSUMÉ: Cet article examine et critique un ensemble d'objections kantiennes à la tentative de Parfit, dans Reasons and Persons, d'ajuster sa théorie de l'identité personnelle à la rationalité pratique et à la philosophie morale. Plusieurs des critiques de Parfit ont essayé de rompre le lien qu'il tisse entre ses conclusions métaphysiques et pratiques en évoquant l'idée kantienne selon -laquelle, même si nous acceptons sa théorie métaphysique de l'identité personnelle, il existe cependant de bonnes raisons pratiques de rejeter cette théorie lorsque nous délibérons à propos de ce que nous devons faire. Le débat entre Parfit et ses adversaires nous éclaire sur un questionnement plus large à propos du rapport entre croyance métaphysique et raison pratique. (shrink)

The article Public goods and procreation, written by Jonathan Anomaly, was originally published electronically on the publisher’s internet portal (currently SpringerLink) on 10 December 2014 without open access.

For over a century, scientists have run experiments using phage viruses to treat bacterial infections. Until recently, the results were inconclusive because the mechanisms viruses use to attack bacteria were poorly understood. With the development of molecular biology, scientists now have a better sense of how phage work, and how they can be used to target infections. As resistance to traditional antibiotics continues to spread around the world, there is a moral imperative to facilitate research into phage therapy as an (...) alternative treatment. This essay reviews ethical questions raised by phage therapy, and discusses regulatory challenges associated with phage research, and phage treatments. (shrink)

The only book on the market to include classical and contemporary readings from key authors in Philosophy, Politics, and Economics (PPE), this unique anthology provides a comprehensive overview of the central topics in this rapidly expanding field. Each chapter opens with an introduction that helps students understand the central arguments and key concepts in the readings. The selections encourage students to think about the extent to which the three disciplines offer complementary or contradictory ways of approaching the relevant issues. Philosophy, (...) Politics, and Economics: An Anthology is ideal for undergraduate PPE programs and courses in political philosophy and political economy. (shrink)

In this article I first clarify and then defend Bernard Williams' claim that all practical reasons are internal. I argue that since external reasons are incompatible with a plausible version of the ought-implies-can principle, they are all false. Although some defend internalism by asserting that external reasons fail to explain rational action, a better defense appeals to the fact that only internal reasons are consistent with the ought-implies-can principle.

Creating Future People offers readers a fast-paced primer on how advances in genetics will enable parents to influence the traits of their children, including their children's intelligence, moral capacities, physical appearance, and immune system. It explains the science of gene editing and embryo selection, and motivates the moral questions it raises by thinking about the strategic aspects of parental choice. Professor Anomaly takes seriously the diversity of preferences parents have, and the limits policymakers face in regulating what will soon (...) be a global market for reproductive technology. Anomaly argues that once embryo selection for complex traits happens it will change the moral landscape by altering the incentives each person faces. All of us will take an interest in the traits everyone else selects, and this will present coordination problems that previous writers on genetic enhancement have failed to consider. Anomaly ends by considering how genetic engineering will transform humanity. Key Updates to the Second Edition · Significant revisions to the Preface and three separate chapters to include more details about what will be scientifically possible in the coming years and the moral issues these developments will raise · New and substantial coverage of embryo selection (guided by polygenic scores) for minimizing the risk of genetic diseases · Engagement with all important, new publications on the science of genetic enhancement. (shrink)