New reproductive technologies allow parents some choice over their children. Various moral principles have been suggested to regulate such choices. This article starts from a discussion of Julian Savulescu's Principle of Procreative Beneficence, according to which parents ought to choose the child expected to have the best quality of life, before combining two previously separate lines of attack against this principle. First, it is suggested that the appropriate moral principles of guiding reproductive choices ought to focus on general wellbeing (...) rather than prioritizing that of the child and, second, that they ought to be non-maximizing. Though neither of these suggestions is entirely novel, combining them results in a new, and arguably more plausible, principle to regulate procreative choices, which I call the Principle of Generalized Procreative Non-Maleficence. According to this principle, the primary obligation on parents is not to cause harm to other people through their reproductive choices. (shrink)

Cancer screening programmes cause harm to individuals via overdiagnosis and overtreatment, even where they confer population-level benefit. Screening thus appears to violate the principle of non-maleficence, since it entails medically unnecessary harm to individuals. Can consent to screening programmes negate the moral significance of this harm? In therapeutic medical contexts, consent is used as a means of rendering medical harm morally permissible. However, in this paper, I argue that it is unclear that the model of consent used within therapeutic (...) medicine can be applied unproblematically to preventive medicine. Invitation to screening changes the pragmatic norms and expectations of the patient–doctor encounter such that two key principles of consent may be violated. First, the pragmatics of a medical invitation are such that patients may fail to be adequately informed, since patients appear to assume medical invitations are made with their best interests in mind, even where information to the contrary is outlined. Second, screening invitations may place pressure on patients; in the context of a medical encounter, to make an invitation to screening may constitute an inducement to accept. In order to be sure that a patient’s consent to a screening invitation is valid, we must make clear to patients that their decision to accept screening may be shaped not only by how information about screening is presented, but by the pragmatic form of the invitation itself. (shrink)

The principle of non-maleficence, primum non nocere, has deep roots in the history of moral philosophy, being endorsed by John Stuart Mill, W. D. Ross, H. L. A. Hart, Karl Popper and Bernard Gert. And yet, this principle is virtually absent from current debates on social justice. This article suggests that non-maleficence is more than a moral principle; it is also a principle of social justice. Part I looks at the origins of non-maleficence as a principle of (...) ethics, and medical ethics in particular. Part II introduces the idea of non-maleficence as a principle of social justice. Parts III and IV define the principle of justice as non-maleficence in terms of its scope and coherence, while Part V argues that the motivation of not doing harm makes this principle an alternative to two well-established paradigms in the literature on social justice: justice as mutual advantage (David Gauthier) and justice as impartiality (Brian Barry). (shrink)

An abundance of data unequivocally shows that exercise can be an effective tool in the fight against obesity and its associated co-morbidities. Indeed, physical activity can be more effective than widely-used pharmaceutical interventions. Whilst metformin reduces the incidence of diabetes by 31% (as compared with a placebo) in both men and women across different racial and ethnic groups, lifestyle intervention (including exercise) reduces the incidence by 58%. In this context, it is notable that a group of prominent medics and exercise (...) scientists recently sent a well-publicised letter to the General Medical Council and Medical Schools Council calling for the introduction of evidence-based lifestyle education into all medical curricula. The letter warns that there is a lack of understanding of the impact that exercise and nutrition can have on physical health amongst doctors. In the absence of an educational overhaul, the signatories warn that the government is likely to fail to reach its goal of preventing tens of thousands of premature deaths from heart disease and cancer by 2020. Whilst we agree with the need to address this apparent lack of understanding, we argue that the ethical justification of doing so is not limited to this broadly beneficence-based justification. There is also a justification grounded in the duty of non-maleficence, that is, the duty to avoid unreasonably harming patients. This duty requires that doctors refrain from (i) preventing patients from undergoing beneficial treatment without good reason, (ii) exposing patients to unreasonable risks and (iii) reducing the therapeutic effect of an effective medical intervention. This requires an understanding of the physical impact of exercise. (shrink)

Expanded universal carrier screening (EUCS) entails a population‐wide screening offer for multiple disease‐causing mutations simultaneously. Although there is much debate about the conditions under which EUCS can responsibly be introduced, there seems to be little discussion about its aim: providing carrier couples with options for autonomous reproductive choice. While this links in with current accounts of the aim of foetal anomaly screening, it is different from how the aim of ancestry‐based carrier screening has traditionally been understood: reducing the disease burden (...) in the population. The reasons why the aim of EUCS is presented in terms of ‘autonomy’ rather than ‘prevention’ have not been spelled out in the literature. This paper seeks to fill this gap by considering the morally relevant similarities and dissimilarities between foetal anomaly screening, ancestry‐based carrier screening and EUCS. When carrier screening is performed in the prenatal period, enhancing autonomy appears the most appropriate aim of EUCS, as the alternative of ‘prevention through selective abortion’ would urge women to terminate wanted pregnancies. However, when screening is conducted in the preconception period, carrier couples can avoid the birth of affected children by other means than selective abortion, for instance preimplantation genetic diagnosis. To the extent that this increased control over passing on a genetic disorder raises questions of parental responsibility, it seems necessary that the account of the aims of EUCS is wider than only in terms of enhancing reproductive autonomy. (shrink)

Expanded universal carrier screening (EUCS) entails a population‐wide screening offer for multiple disease‐causing mutations simultaneously. Although there is much debate about the conditions under which EUCS can responsibly be introduced, there seems to be little discussion about its aim: providing carrier couples with options for autonomous reproductive choice. While this links in with current accounts of the aim of foetal anomaly screening, it is different from how the aim of ancestry‐based carrier screening has traditionally been understood: reducing the disease burden (...) in the population. The reasons why the aim of EUCS is presented in terms of ‘autonomy’ rather than ‘prevention’ have not been spelled out in the literature. This paper seeks to fill this gap by considering the morally relevant similarities and dissimilarities between foetal anomaly screening, ancestry‐based carrier screening and EUCS. When carrier screening is performed in the prenatal period, enhancing autonomy appears the most appropriate aim of EUCS, as the alternative of ‘prevention through selective abortion’ would urge women to terminate wanted pregnancies. However, when screening is conducted in the preconception period, carrier couples can avoid the birth of affected children by other means than selective abortion, for instance preimplantation genetic diagnosis. To the extent that this increased control over passing on a genetic disorder raises questions of parental responsibility, it seems necessary that the account of the aims of EUCS is wider than only in terms of enhancing reproductive autonomy. (shrink)

In “IRBs and The Protection Inclusion Dilemma: Finding a Balance,” Friesen et al. (2023) argue that IRBs ought to attend more, and better, to the need for the inclusion of under-researched populati...

Higher education institutions are increasingly relying on learning analytics to collect voluminous amounts of data ostensibly to inform student learning interventions. The use of learning analytics, however, can result in a tension between the Council for the Advancement of Standards in Higher Education (CAS) principles of autonomy and non-malfeasance on the one hand, and the principle of beneficence on the other. Given the complications around student privacy, informed consent, and data justice in addition to the potential to do harm, many (...) current practices around learning analytics within higher education can be considered to be in violation of CAS standards. This paper aims to explore this tension in greater detail and argues that the student voice offers a promising way to ensure that students’ autonomy is respected, harm is reduced, and that higher education institutions can still fulfil the principle of beneficence. (shrink)

The question I address in this paper is whether and under what conditions it is morally right to bring a person into existence. I defend the commonsensical thesis that, other things being equal, it is morally wrong to create a person who will be below some threshold of quality of life, even if the life of this potential person, once created, will nevertheless be worth living. However commonsensical this view might seem, it has shown to be problematic because of the (...) so-called 'Non-Identity Problem'. Both utilitarian and rights-based approaches have been unable to provide a solution to this problem. I rest my thesis on two premises: that causing a disability or impairment in a future person is prima facie wrong, so long as we can avoid causing such a disability to that very person; and that reproduction, under normal conditions, is prima facie morally indifferent. From these two premises, I conclude that it is prima facie wrong to bring into existence a person with a non-trivial disability or impairment (which might be, nonetheless, compatible with a worthwhile life), even if the only available alternative is to remain childless. (shrink)

There has been much argument over whether procreative selection is obligatory or wrong. Rebecca Bennett has recently challenged the assumption that procreative choices are properly moral choices, arguing that these views express mere preferences. This article challenges Bennett's view on two fronts. First, I argue that the Non-Identity Problem does not show that there cannot be harmless wrongs – though this would require us to abandon the intuitively attractive ‘person-affecting principle’, that may be a lesser cost than abandoning (...) some more firmly-held intuition. But, even if we accept Bennett's claim that these choices are not moral, that does not show them to be mere personal preferences. I argue that there is a class of non-moral ‘categorical preferences’ that have much the same implications as moral preferences. If a moral preference for able-bodied children is problematic, then so is a non-moral categorical preference. Thus, showing that these preferences are not moral does not show that they are not problematic, since they may still be categorical. (shrink)

This essay presents a challenge to the parental obligation objection. This objection is usually made by abortion opponents who argue that because child support laws hold men postnatally responsible for children they helped bring into existence, women too have prenatal parental responsibilities that should prevent them from ending pregnancies through abortions. My essay draws on recent publications in bioethics that distinguish procreative from parental responsibilities. This distinction was originally developed to clarify the duties of third-party participants in assisted reproduction. (...) However, the distinction inadvertently poses a problem for the parental obligation objection, for it raises questions about whether women who do not wish to carry a child to term have parental rather than procreative responsibilities. It does not necessarily follow that the objection must be wrong. But rather, that there is an explanatory gap in it. If abortion violates procreative responsibilities, then drastic changes must be made to fertility medicine. Conversely, there does not appear to be non-question-begging criteria that would explain why pregnant women must have parental responsibilities, in addition to procreative ones, whereas third-party participants in assisted reproduction, such as fertility doctors, embryologists, gamete donors, and surrogates, have only procreative responsibilities. (shrink)

The article considers the changing position of women and the family from the Second World War until today using the UK as its example. It offers a theoretical perspective by setting out to examine the possibility that the rise of second-wave feminism both reflected and spearheaded an aspect of demographic transition to non-replacement populations. It considers the tension between the formation of ‘sexual difference’ to enable reproduction and what it calls the ‘engendering of gender’ in lateral relations which are indifferent (...) to procreation. With the achievements of feminism as a political vanguard and the demographic transition as its socioeconomic base, women were no longer defined by the family; their definition ceased to depend on procreation. The article proposes that the new use of the term ‘gender’ entered the political arena to become a key concept of feminism to indicate non-procreative sexuality and sexual relations that need not be heterosexual or biologically procreative. Judith Butler’s well-known suggestion that ‘gender’ troubles the status quo in a revolutionary manner cannot be sustained. Rather than disturbing the universe, the advent of ‘gender’ reflects the transition to a new demographic order. (shrink)

The Principle of Procreative Beneficence claims that we have a moral obligation, where choice is possible, to choose to create the best child we can. The existence of this moral obligation has been proposed by John Harris and Julian Savulescu and has proved controversial on many levels, not least that it is eugenics, asking us to produce the best children we can, not for the sake of that child's welfare, but in order to make a better society. These are (...) strong claims that require robust justification that can be open to scrutiny and debate. This article argues that robust justifications are currently lacking in the work of Savulescu and Harris. The justifications provided for their conclusions about this obligation to have the best child possible rely heavily on Derek Parfit's Non-Identity Problem and the intuitive response this provokes in many of us. Unfortunately Harris and Savulescu do not embrace the entirety of the Non-Identity Problem and the puzzle that it presents. The Non-Identity Problem actually provides a refutation of PPB. In order to establish PPB as a credible and defendable principle, Harris and Savulescu need to find what has eluded Parfit and many others: a solution to the Non-Identity Problem and thus an overturning of the refutation it provides for PPB. While Harris and Savulescu do hint at possible but highly problematic solutions to the Non-Identity Problem, these are not developed or defended. As a result their controversial is left supported by little more than intuition. (shrink)

My dissertation investigates the requirements of procreative justice. The procreative justice problem is that parents' interest in procreation conflicts with children's interest in optimal birth conditions. Intergenerational reciprocity is the principle that adjudicates this conflict: reciprocity dictates that children demand no more of their parents' procreative practices than they themselves are willing to abide by as adults and dig parents only procreate in accordance with principles dig they would have wanted their own parents to have followed. I (...) develop a Rawlsian Contractualist theory, grounded in the view of justice as the principles that would result from self-interested rational choice under fair bargaining conditions, i.e. unbiased rational prudence over the course of a lifetime by agents who know that they will be born children and grow into adults who may want to procreate. ;This deliberation yields three principles: The Obvious Principle bans procreation that undermines the interests of both prospective parents and prospective children or involves risking/sustaining a major burden for the sake of a minor benefit. The Balance Principle permits procreation only when it would not be irrational for the prospective parent to accept for herself the very same risk her procreation imposes on her prospective child, in exchange for permission to procreate under these circumstances. The Motivation Restriction requires that procreation be at least partially, yet still prominently, motivated by a desire to raise, nurture, love, and care for one's future child once it is born. These principles are defended against rival principles and applied to a wide variety of cases. ;Stymied by metaphysical paradoxes and confusion about persons and existence, contemporary ethicists have struggled to formulate a sound theory of procreative justice that provides more than bare-bones consideration of children's interests. I argue that these efforts have failed. Whereas procreative liberty principles, including Feinberg's Birth Rights and Parfit's Non-Identity Problem principles, neglect children's interests, strictly paternalistic principles, e.g. Benatar's Asymmetry principle, neglect parental interests. My theory of procreative justice provides a much needed middle-ground position which promotes and protects the interests of prospective parents and children. (shrink)

The Asymmetry in procreative ethics consists of two claims. The first is that it is morally wrong to bring into existence a child who will have an abjectly miserable life; the second is that it is permissible not to bring into existence a child who will enjoy a very happy life. In this paper, I distinguish between two variations of the Asymmetry. The first is the Abstract Asymmetry, the idealized variation of the Asymmetry that many philosophers have been trying (...) to solve. The second is the Real-World Asymmetry, a non-idealized variation that applies explicitly to cases of ordinary human reproduction. I argue that the Real-World Asymmetry can be defended by properly acknowledging the general wrongness of causing someone else to suffer, the limits of what morality can reasonably demand of us, and the significance of respecting women’s autonomy. I then argue that the Abstract Asymmetry is indefensible. (shrink)

If Savulescu's controversial principle of Procreative Beneficence is correct, then an important implication is that couples should employ genetic tests for non-disease traits in selecting which child to bring into existence. Both defenders as well as some critics of this normative entailment of PB have typically accepted the comparatively less controversial claim about non-disease traits: that there are non-disease traits such that testing and selecting for them would in fact contribute to bringing about the child who is expected to (...) have the best life. We challenge this less controversial claim, not by arguing deductively for its falsity, but by showing that Savulescu's central argument for this presumably less controversial claim fails. Savulescu offers intelligence as the paradigm example of a testable non-disease trait such that testing and selecting for it would increase the likelihood that the child selected would be the one who is expected to have the best life. We provide a series of arguments aimed at demonstrating that Savulescu's argument from intelligence fails. If our arguments are successful, the upshot is not that PB is false, but more modestly, that the burden of proof remains squarely with Savulescu. (shrink)

If Savulescu's (2001, 2009) controversial principle of Procreative Beneficence (PB) is correct, then an important implication is that couples should employ genetic tests for non‐disease traits in selecting which child to bring into existence. Both defenders as well as some critics of this normative entailment of PB have typically accepted the comparatively less controversial claim about non‐disease traits: that there are non‐disease traits such that testing and selecting for them would in fact contribute to bringing about the child who (...) is expected to have the best life. We challenge this less controversial claim, not by arguing deductively for its falsity, but by showing that Savulescu's central argument for this presumably less controversial claim fails. Savulescu offers intelligence as the paradigm example of a testable non‐disease trait such that testing and selecting for it would increase the likelihood that the child selected would be the one who is expected to have the best life (or at least as good a life as the others). We provide a series of arguments aimed at demonstrating that Savulescu's argument from intelligence fails. If our arguments are successful, the upshot is not that PB is false, but more modestly, that the burden of proof remains squarely with Savulescu. (shrink)

Si, depuis quelques dizaines d'années, la médecine de la reproduction s'est considérablement développée pour venir en aide aux couples confrontés à l'impossibilité de concevoir naturellement un enfant, c'est généralement avec l'objectif initial de favoriser une conception avec les gamètes du couple. Le développement successif de l' " Insémination Artificielle " et de la " Fécondation in Vitro " a néanmoins permis dans le même temps de faire émerger différentes possibilités alternatives de conception, en transgressant notamment le principe de la filiation (...) biologique. Un couple peut aujourd'hui concevoir un enfant avec d'autres gamètes que les siens et même envisager l'accueil d'un embryon conçu par un autre couple. Dans ces situations, la question de la conciliation des intérêts des différents acteurs se pose. En optant pour la règle de l'anonymat des dons qui prive l'enfant de toute information sur le donneur, certaines législations semblent considérer que ce principe allie au mieux ces intérêts. Pourtant non seulement la demande croissante de levée de l'anonymat formulée par les enfants issus de l'assistance médicale à la procréation fragilise ce choix de société mais certains pays ont devancé ce voeu en choisissant la transparence génétique. Cet ouvrage est le fruit de riches débats et réflexions échangés entre juristes, médecins, psychanalystes et sociologues, lors du premier Workshop du Réseau Universitaire International de Bioéthique. Adoptant une approche comparative, les articles rassemblés examinent la manière dont sont organisées, dans seize pays de cultures différentes, les pratiques et les conséquences d'un anonymat absolu, relatif, voire inexistant. En dépit d'une diversité de systèmes, un constat unanime ressort : la question de la levée de l'anonymat se pose partout avec acuité. La réponse, elle, réunit ou divise. Mais peut-il en être autrement sur un sujet qui touche aux perceptions sociales de l'identité de la personne, de la filiation ou de la " parentalité "? Créé en 2007, le Réseau Universitaire International de Bioéthique a pour objectif de promouvoir la recherche universitaire en rapprochant des chercheurs, de pays et, de cultures différents, spécialistes des questions liées aux pratiques biomédicales. Partant d'une approche croisée des différents systèmes juridiques, les travaux de ce réseau analysent les choix sociaux en matière biomédicale à travers les prismes de l'éthique, de l'anthropologie, la philosophie ou la sociologie. Ils veulent ainsi contribuer à la réflexion internationale sur la régulation des pratiques biomédicales et, incidemment, sur la conciliation entre les diversités culturelles et un certain universalisme, terreau d'une harmonisation du droit. Cette nouvelle collection sera donc un outil indispensable pour toute personne en quête d'une compréhension des enjeux sociaux de la bioéthique. (shrink)

Although surprising to some proponents of sex selection for non-medical reasons (Dahl 2005), a considerable amount of critical debate has been raised by this practice (Blyth, Frith, and Crawshaw 2008; Dawson and Trounson 1996; Dickens 2002; Harris 2005; Heyd 2003; Holm 2004; Macklin 2010; Malpani 2002; McDougall 2005; Purdy 2007; Seavilleklein and Sherwin 2007; Steinbock 2002; Strange and Chadwick 2010; Wilkinson 2008). While abortion or infanticide has long been used as means of sex selection, a new technology—preimplantation genetic diagnosis (PGD)—has (...) become a highly efficient, and arguably less controversial, way of ensuring the birth of a child of a particular sex. PGD, used in combination with in vitro .. (shrink)

Although most people believe that it is morally wrong to intentionally create children who have an impairment, it is widely held that we cannot criticize such procreative choices unless we find a solution to Parfit’s non-identity problem. I argue that we can. Jonathan Glover has recently argued that, in certain circumstances, such choices would be self-defeating even if morally permissible. I argue that although the scope of Glover’s argument is too limited, it nevertheless directs attention to a moral defect (...) in the attitudes that could motivate such procreative choices, attitudes that, properly characterized, turn out to be person-affecting in character. I conclude by arguing that prospective parents who want to create a child with an impairment face a dilemma. If they want to avoid the charge that their aim is morally defective, they must deny that the desired impairment is harmful. But this would commit them to endorsing the controversial claim that it is morally permissible or even required to turn normal children into impaired ones. (shrink)

The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including “non-medical” traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative (...) impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as “non-medical”; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework. (shrink)

The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including “non-medical” traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative (...) impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as “non-medical”; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework. (shrink)

Rebecca Bennett, in a recent paper dismissing Julian Savulescu's principle of procreative beneficence, advances both a negative and a positive thesis. The negative thesis holds that the principle's theoretical foundation – the notion of impersonal harm or non-person-affecting wrong – is indefensible. Therefore, there can be no obligations of the sort that the principle asserts. The positive thesis, on the other hand, attempts to plug an explanatory gap that arises once the principle has been rejected. That is, it holds (...) that the intuitions of those who adhere to the principle are not genuine moral intuitions, but instead simply give voice to mere (non-moral) preferences. This paper, while agreeing that Savulescu's principle does not express a genuine moral obligation, takes issue with both of Bennett's theses. It is suggested that the argument for the negative thesis is either weak or question-begging, while there is insufficient reason to suppose the positive thesis true. (shrink)

The principle of procreative beneficence, first suggested by Julian Savulescu, argues that: If couples have decided to have a child, and selection is possible, then they have a significant moral reason to select the child, of the possible children they could have, whose life is expected, in light of the relevant available information, to go best or at least not worse than any of the others. While the validity of this moral principle has been widely contested, in this paper (...) we move away from these issues and grant, for the sake of argument, that PB is a valid moral principle, and that the justification for PB provided by Savulescu and co-authors is sound. We do this in order to explore the implications and consequences of accepting PB and show that even if we put aside questions about the validity and theoretical foundations of this principle, PB has many interesting, astonishing and highly problematic implications that have not been made explicit in the writing of Savulescu and others who support the notion of an obligation to bring to birth the best child possible :204, 2002). We suggest that these implications should be taken into account when considering both the soundness and strength of PB. (shrink)

Rebecca Bennett, in a recent paper dismissing Julian Savulescu's principle of procreative beneficence, advances both a negative and a positive thesis. The negative thesis holds that the principle's theoretical foundation – the notion of impersonal harm or non‐person‐affecting wrong – is indefensible. Therefore, there can be no obligations of the sort that the principle asserts. The positive thesis, on the other hand, attempts to plug an explanatory gap that arises once the principle has been rejected. That is, it holds (...) that the intuitions of those who adhere to the principle are not genuine moral intuitions, but instead simply give voice to mere (non‐moral) preferences.This paper, while agreeing that Savulescu's principle does not express a genuine moral obligation, takes issue with both of Bennett's theses. It is suggested that the argument for the negative thesis is either weak or question‐begging, while there is insufficient reason to suppose the positive thesis true. (shrink)

Augustine’s legacy, particularly his view of marriage as being primarily procreative and the sin of mutually desired non-procreative sex, has had a lasting impact on sexual theology and ethics in the Catholic Church. Yet indulging in the Augustinian legacy without reflection and regarding children as the end goal of marriage has led to the unchallenged assumption that children are needed in every marriage. I will examine the problematic concept of matrimony as a necessary producer of children through a (...) variety of ethical lenses – the environmental, the feminist, and the bioethical – and provide an alternative to the procreative norm of sexual expression. By focusing on the unitive aspect of marital love instead of the procreative, partners are liberated to realize their union as fully mature, regardless of biological generation thus addressing ethical concerns and providing a theological alternative to the procreative marriage. (shrink)

© The Author 2017. Published by Oxford University Press on behalf of The Analysis Trust. All rights reserved. For Permissions, please email: [email protected] Boonin’s The Non-Identity Problem and the Ethics of Future People and Rivka Weinberg’s The Risk of a Lifetime: How, When and Why Procreation May Be Permissible are both important books for those interested in procreative ethics. Each argues for surprising and controversial conclusions: Boonin argues that we should solve the non-identity problem by accepting its apparently unacceptable (...) conclusion that actions cannot be wrong due to their effects on future people whose lives are worth living and who would not exist were the actions not performed; Weinberg argues that there is no non-identity problem, that future children have no interest in existing, but significant interest in avoiding harm and that procreation is, therefore, a much more morally risky business than we tend to think. Even if... (shrink)

Philosophers concerned with procreative ethics have long been puzzled by Parfit’s Non-Identity Problem (NIP). Various solutions have been proposed, but I argue that we have not solved the problem on its own narrow person-affecting terms, i.e., in terms of the identified individuals affected by procreative decisions and acts, especially future children. Thus, the core problem remains unsolved. This is a nagging concern for all who hold the common intuition that actions that harm no one are permissible. I argue (...) against Harmon’s and Woodward’s direct, narrow person-affecting solutions, and in favor of a new solution to the NIP. My solution, or, rather, dissolution, is based on the argument that merely possible people, i.e., hypothetical people who could possibly, but will not actually, exist, are morally irrelevant. I show that the NIP only arises when we concern ourselves with merely possible people. Once we are careful to restrict our concerns to only those that do or will exist, the NIP is dissolved. (shrink)

Genetic engineering has been a topic of discussion for over 50 years, but it is only recently that gene editing has become a reality. CRISPR biotechnologies have made gene editing much safer, precise and feasible. We have witnessed the first cases of human germline genetic modification resulting in live births, conducted by He Jiankui. In this paper, we will analyse He Jiankui’s case in relation to one of the most difficult problems in procreative ethics (or the ethics of future (...) generations): the non‐identity problem. We believe that this analysis will help us to understand the ethics involved in gene editing and hopefully allow for a better, more philosophically grounded legislation on CRISPR and other gene‐editing technologies. (shrink)

Drawing on the views of donors and recipients about anonymity in a country that is experiencing a transition towards non-anonymous gamete donation mandated by the Constitutional Court, we explore how the intersection between rights-based approaches and an empirical framework enhances recommendations for ethical policy and healthcare. Between July 2017 and April 2018, 69 donors and 147 recipients, recruited at the Portuguese Public Bank of Gametes, participated in this cross-sectional study. Position towards anonymity was assessed through an open-ended question in a (...) self-report questionnaire, which was subject to content analysis. Preference for an anonymous donation regime was mentioned by 82.6% of donors and 89.8% of recipients; and all those with children. Instead of the rights-based reasoning used by the Constitutional Court, donors highlighted concerns over future relationships and recipients focused on socioethical values linked with the safeguard of safety, privacy and confidentiality. The remaining participants advocated the choice between anonymity or non-anonymity, invoking respect for their autonomy. The complex, diverse ethical views and reasoning of donors and recipients expand a traditionally dichotomous discussion. Their perspectives challenge the transition towards non-anonymity and international guidelines, raising awareness to the need for their involvement in the design of policies to enable choice according to their values and preferences, and of psychosocial counselling responsive to their socioethical concerns and sensitive to their parental status. Empirical frameworks complement rights-based approaches to uphold justice, fairness and equal respect, and to incorporate utility, beneficence and non-maleficence in policymaking and healthcare in the transition towards non-anonymity. (shrink)

Although shared decision-making is a standard in medical care, unilateral decisions through process-based conflict resolution policies have been defended in certain cases. In patients who do not stand to receive proportional clinical benefits, the harms involved in interventions such as cardiopulmonary resuscitation seem to run contrary to the principle of non-maleficence, and provision of such interventions may cause clinicians significant moral distress. However, because the application of these policies involves taking choices out of the domain of shared decision-making, they (...) face important ethical and legal problems, including a recent challenge to their constitutionality. In light of these concerns, we suggest a re-conceptualization of informed non-dissent as an alternative approach in cases where the application of process-based policies is being considered. This clinician-directed communication model still preserves what is valuable in such policies and salvages professional integrity, while minimising ethical and legal challenges. (shrink)

Doctors hold coexisting ethical duties to avoid causing deliberate harm to their patients (non-maleficence), to act in patients’ best interests (beneficence), to respect patients’ right to self-determination (autonomy) and to ensure that costs and benefits are fairly distributed among patients (justice). In the context of non-directed altruistic kidney donations (NDAKD), doctors’ duties of autonomy and justice are in tension with those of non-maleficence and beneficence. This article examines these competing duties across three scenarios in which general practitioners (GPs) (...) could promote NDAKD to healthy adults. In the first—when a healthy adult patient prompts the GP to discuss NDAKD—the GP is ethically obligated to counsel the patient about NDAKD to respect their autonomy, yet this does not constitute any form of promotion of NDAKD. In the remaining scenarios, healthy adult patients are unaware of the possibility of NDAKD. In the second, it is ethically permissible for GPs to indirectly raise awareness of NDAKD among healthy adults by displaying recruitment campaign material to non-specified groups of patients in their waiting rooms. In the third, it is ethically impermissible for GPs to directly promote NDAKD to individual healthy adults by raising the possibility of NDAKD with such individuals. The major counterarguments raised against this position are problems with kinds of counselling that fail to reach expected professional standards, rather than problems with the ethical claims made in this article. (shrink)

In his recent work, Parfit returns to the examination of the non-identity problem, but this time not in the context of a theory of value but as part of a Scanlonian theory of reasons for action. His project is to find a middle ground between pure impersonalism and the narrow person-affecting view so as to do justice to some of our fundamental intuitions regarding procreative choices. The aim of this article is to show that despite the sophisticated and challenging (...) thought experiments and conceptual suggestions , Parfit’s project fails and that we are left with the stark choice between personalism and impersonalism. (shrink)

In formulating procreative principles, it makes sense to begin by thinking about whose interests ought to matter to us. Obviously, we care about those who exist. Less obviously, but still uncontroversially, we care about those who will exist. Ought we to care about those who might possibly, but will not actually, exist? Recently, unusual positions have been taken regarding merely possible people and the non-identity problem. David Velleman argues that what might have happened to you – an existent person (...) – often doesn't merit moral consideration since the alternative person one would have been had what might have happened actually happened is a merely possible person about whom one has no reason to care. He argues that his way of thinking can eliminate the non-identity problem. Caspar Hare argues that merely possible people have interests and are morally relevant. He argues that we can solve the non-identity problem by rejecting the view that merely possible people are morally irrelevant. Both Hare and Velleman argue that focusing on one's de dicto rather than on one's de re children can help us avoid the non-identity problem. I analyze the role that merely possible, nonexistent hypothetical entities ought to play in our moral reasoning, especially with regard to procreation. I refute both Velleman's and Hare's views and demonstrate the difficulties we encounter when we try to apply their views to common non-identity cases. I conclude with the common-sense view regarding who matters, morally: only those who do, did, or will exist. (shrink)

Background Non-therapeutic trials in which terminally ill cancer patients are asked to undergo procedures such as biopsies or venipunctures for research purposes, have become increasingly important to learn more about how cancer cells work and to realize the full potential of clinical research. Considering that implementing non-therapeutic studies is not likely to result in direct benefits for the patient, some authors are concerned that involving patients in such research may be exploitive of vulnerable patients and should not occur at all, (...) or should be greatly restricted, while some proponents doubt whether such restrictions are appropriate. Our objective was to explore clinician-researcher attitudes and concerns when recruiting patients who are in advanced stages of cancer into non-therapeutic research. Methods We conducted a qualitative exploratory study by carrying out open-ended interviews with health professionals, including physicians, research nurses, and study coordinators. Interviews were audio-recorded and transcribed. Analysis was carried out using grounded theory. Results The analysis of the interviews unveiled three prominent themes: 1) ethical considerations; 2) patient-centered issues; 3) health professional issues. Respondents identified ethical issues surrounding autonomy, respect for persons, beneficence, non-maleficence, discrimination, and confidentiality; bringing to light that patients contribute to science because of a sense of altruism and that they want reassurance before consenting. Several patient-centered and health professional issues are having an impact on the recruitment of patients for non-therapeutic research. Facilitators were most commonly associated with patient-centered issues enhancing communication, whereas barriers in non-therapeutic research were most often professionally based, including the doctor-patient relationship, time constraints, and a lack of education and training in research. Conclusions This paper aims to contribute to debates on the overall challenges of recruiting patients to non-therapeutic research. This exploratory study identified general awareness of key ethical issues, as well as key facilitators and barriers to the recruitment of patients to non-therapeutic studies. Due to the important role played by clinicians and clinician-researchers in the recruitment of patients, it is essential to facilitate a greater understanding of the challenges faced; to promote effective communication; and to encourage educational research training programs. (shrink)

A study of the constitution and development of the human being from the metaphysical point of view, with special reference to Vedantic doctrine.

Artificial Intelligence (AI) is already having a major impact on society. As a result, many organizations have launched a wide range of initiatives to establish ethical principles for the adoption of socially beneficial AI. Unfortunately, the sheer volume of proposed principles threatens to overwhelm and confuse. How might this problem of ‘principle proliferation’ be solved? In this paper, we report the results of a fine-grained analysis of several of the highest-profile sets of ethical principles for AI. We assess whether these (...) principles converge upon a set of agreed-upon principles, or diverge, with significant disagreement over what constitutes ‘ethical AI.’ Our analysis finds a high degree of overlap among the sets of principles we analyze. We then identify an overarching framework consisting of five core principles for ethical AI. Four of them are core principles commonly used in bioethics: beneficence, non-maleficence, autonomy, and justice. On the basis of our comparative analysis, we argue that a new principle is needed in addition: explicability, understood as incorporating both the epistemological sense of intelligibility (as an answer to the question ‘how does it work?’) and in the ethical sense of accountability (as an answer to the question: ‘who is responsible for the way it works?’). In the ensuing discussion, we note the limitations and assess the implications of this ethical framework for future efforts to create laws, rules, technical standards, and best practices for ethical AI in a wide range of contexts. (shrink)

The Reign of Quantity gives a concise but comprehensive view of the present state of affairs in the world, as it appears from the point of view of the 'ancient wisdom', formerly common both to the East and to the West, but now almost entirely lost sight of. The author indicates with his fabled clarity and directness the precise nature of the modern deviation, and devotes special attention to the development of modern philosophy and science, and to the part played (...) by them, with their accompanying notions of progress and evolution, in the formation of the industrial and democratic society which we now regard as 'normal'. Guénon sees history as a descent from Form (or Quality) toward Matter (or Quantity); but after the Reign of Quantity-modern materialism and the 'rise of the masses'-Guénon predicts a reign of 'inverted quality' just before the end of the age: the triumph of the 'counter-initiation', the kingdom of Antichrist. This text is considered the magnum opus among Guénon's texts of civilizational criticism, as is Symbols of Sacred Science among his studies on symbols and cosmology, and Man and His Becoming according to the Vedanta among his more purely metaphysical works. (shrink)

Description: Contents: Preface 1. General Remarks on the Vedanta 2. Fundamental Distinction Between The Self and the Ego 3. The Vital Centre of the Human Being, Seat of Brahma 4. Purusha and Prakriti 5. Purusha Unaffected by Individual Modifications 6. The Degrees of Individual Manifestation 7. Buddhi or the Higher Intellect 8. Manas or the Inward Sense : The Ten External Faculties of Sensation and Action 9. The Envelopes of the Self ; The Five Vayus or Vital Functions 10. The (...) Essential Unity and Identity of the Self in all the States of the Being 11. The Different Conditions of Atma in the Human Being 12. The Waking State or the Condition of Vaishwanara 13. The Dream State or the Condition of Taijasa 14. The State of Deep Sleep or the Condition of Prajna 15. The Unconditioned State of Atma 16. The Symbolical Representation of Atma and its Conditions by the Sacred Monosyllable Om 17. The Posthumous Evolution of the Human Being 18. The Reabsorption of the Individual Faculties 19. Differences in the Posthumous Conditions According to the Degrees of Knowledge 20. The Coronal Artery and the Solar Ray 21. The Divine Journey of the Being on the Path of Liberation 22. Final Deliverance 23. Videha-mukti and Jivana-mukti 24. The Spiritual State of the Yogi : The Supreme Identity. (shrink)

Background: Ethical frameworks for organ donation following circulatory death (DCD) were established >20 years ago. However, considerable variation exists among these, indicating consensus has not been reached on all issues. Additionally, advances such as cardiac DCD transplants and normothermic regional perfusion (NRP) may have reignited old debates.Methods: We reviewed the English-language literature addressing ethical issues in DCD from 1993 to 2022, examining changes in frequency with which ethical principles and their sub-themes identified within each, were addressed.Results: Non-maleficence was the (...) most frequently addressed principle (192 of 199 articles), as well as the most varied, with 9 subthemes (versus 2-4 within each of the other bioethical principles).Conclusions: There were several changes in the terminology used to refer to DCD over time, and substantial interest in cardiac DCD and NRP in recent publications, arising in 11 and 19 of the 30 publications from 2018 to 2022. (shrink)

The principles of biomedical ethics – autonomy, non-maleficence, beneficence, and justice – are of paradigmatic importance for framing ethical problems in medicine and for teaching ethics to medical students and professionals. In order to underline this significance, Tom L. Beauchamp and James F. Childress base the principles in the common morality, i.e. they claim that the principles represent basic moral values shared by all persons committed to morality and are thus grounded in human moral psychology. We empirically investigated the (...) relationship of the principles to other moral and non-moral values that provide orientations in medicine. By way of comparison, we performed a similar analysis for the business & finance domain. (shrink)

In this paper, I respond to the (infamous) causal impotence objection to the standard arguments for ethical vegetarianism. The paper defends a non-consequentialist response to this objection, one that draws on an account of the principle of non-maleficence inspired by Ross.

Purpose: To survey the attitudes of the general public in Sweden to biobank research and to discuss the findings in the light of some well-known ethical principles.Methods: A questionnaire was used to survey the opinions of the general public in Sweden, and an ethical analysis (using the principles of autonomy, non-maleficence, beneficence and justice) was performed to discuss the possible conditions of such research.Findings: Between 3 and 9% answered that they did not want their samples to be collected and (...) stored in a biobank. Many respondents required information about the purpose of the research and wanted to be able to consent or refuse. About one third of the respondents said they would have answered differently if financial gain was involved and those who commented indicated a more negative attitude. The principle of autonomy maintains that the right to self-determination should be respected, and the principles of non-maleficence and beneficence that the probable harms and benefits resulting from a particular project by using samples from a biobank should be balanced. The general public disagree about how these principles are to be balanced. Interpretation: In the light of the findings different interpretations of the situation as well as possible alternatives are discussed in this paper. (shrink)

QUALITY AND QUANTITY are fairly generally regarded as complementary terms, although the profound reason for their comple- mentarism is often far from being understood, this reason lying in the 'polar' correspondence referred to toward ...

The concluding chapter lays down the essential conditions for any genuine understanding between East and West, which can only come through the work of those who have attained, at least in some degree, to the realization of 'wisdom uncreate' ...