universal deduction". Matter is resolved into space, and thereby disappears. Hence the problem wi... more universal deduction". Matter is resolved into space, and thereby disappears. Hence the problem with electricity; physics is turned into a pure geometry (p. 84), and the theory of electricity is made superfluous whenever the simple structure of space is sufficient to account for the observed phenomena. Einstein largely realized Descartes' programme of reducing the physical to the spatial (p. 129). That includes time, and the nature of time is similarly "destroyed" by being spatialized, i.e. turned into something too like space. The theory of time is what most have found philosophically challenging in relativity theory, but it is not Meyerson's central interest, which is more in the general theory than the special theory, and more to do with space and matter than with time alone. The focus is on very broad issues, metaphysical rather than physical. It is understandable from that, that Einstein could evidently make little of their curious public encounter in Paris in 1922, when he replied in one brief defensive sentence to two questions from Meyerson which it takes four pages of the present excellent edition to put.
In this paper I discuss the application of the principles of medical ethics and of medical resear... more In this paper I discuss the application of the principles of medical ethics and of medical research to the case of children and others whose consent to treatment and to research is problematic. Public health depends substantially on the possibility of ongoing research into all conditions which affect the health of the people. Constraints on this research are therefore a public health issue. Moreover and more importantly the possibility of predictive testing and indeed of screening for health-relevant conditions is an important public health tool, and limitations on the use of this tool are of great significance to public health medicine. Having considered the particular problems created by research and predictive testing on children for late-onset conditions I go on to discuss research on those whose consent is problematic more generally. I conclude with radical recommendations for the reform of The Declaration of Helsinki and of the International Ethics Guidelines for Biomedical Re...
This short comment presents arguments in support of human enhancement. What is enhancement? Surel... more This short comment presents arguments in support of human enhancement. What is enhancement? Surely it is a procedure that improves our functioning: any intervention which increases our general capabilities for human flourishing. We exclude from consideration those procedures often termed "enhancements" that are of dubious overall benefit (for example breast or penis augmentation, or the taking of anabolic steroids to increase muscle mass). Equally we are not talking of "designer" modifications which are more akin to aesthetic or fashion preferences than to improvements: hair colour, eye colour, or physique. An enhancement (as we are using the term) is something of benefit to the individual.
This paper argues that a precautionary approach to scienti®c progress of the sort advocated by Wa... more This paper argues that a precautionary approach to scienti®c progress of the sort advocated by Walter Glannon with respect to life-extending therapies involves both incoherence and irresolvable paradox. This paper demonstrates the incoherence of the precautionary approach in many circumstances and argues that with respect to life-extending therapies we have at present no persuasive reasons for a moratorium on such research.
Although countries with different traditions, laws, and cultures may not agree on standards for s... more Although countries with different traditions, laws, and cultures may not agree on standards for stem cell research, a set of principles could clarify terms of collaboration.
is a research associate in the Centre for Social Ethics and Policy (School of Law) at the Univers... more is a research associate in the Centre for Social Ethics and Policy (School of Law) at the University of Manchester. Her research interests are in philosophy of mind, philosophy of science, philosophy of psychology and applied ethics. She has written on the notion of rationality, theories of interpretation, delusions and animal cognition. She works now at the EURECA project on delimiting the research concept and research activities. The project, funded by the European Commission, is coordinated by Professor John Harris and has eight project partners across the European Community.
When children are too young to make their ownautonomous decisions, decisions have to be madefor t... more When children are too young to make their ownautonomous decisions, decisions have to be madefor them. In certain contexts we allow parentsand others to make these decisions, and do notinterfere unless the decision clearly violatesthe best interest of the child. In othercontexts we put a priori limits on whatkind of decisions parents can make, and/or whatkinds of considerations they have
When things go wrong with assisted reproduction we should look at what's best for everyone in the... more When things go wrong with assisted reproduction we should look at what's best for everyone in the particular circumstances A RTBs, as we must now call them, are becoming more and more frequent. In the recent United Kingdom case (discussed in April JME 1-3) Mr and Mrs A, a "white" couple, gave birth to twins described as "black". The mix up apparently occurred because a Mr and Mrs B, a "black" couple, were being treated in the same clinic and Mrs A's eggs were fertilised with Mr B's sperm. Mr and Mrs A love the twins and wish to keep them and the facts seem to be that Mrs A is the genetic mother of the twins but her partner is not the genetic father. Under English law, in assisted reproduction, the woman who gives birth to the child is the legal mother and this is true also in cases of surrogacy. I think there is no doubt in this case that English law has taken the right path and that it would be unconscionable to contemplate taking a child away from the woman who had undergone the risks and pains of pregnancy and childbirth and the bonding process that goes along with that when she wishes to keep the child particularly when there is no substantial and pressing evidence that she would be an unsafe parent. I argued this in my book The Value of Life 4 and I think it is still true. So in this case justice, morality, and decency are served by confirming Mr and Mrs A as the parents of the children. Since in English law there is some ambiguity over paternity and how that is to be assigned and since Mr A is apparently not the genetic father, I think it is important that Mr B or whoever does turn out to be the sperm donor in this case is protected from the responsibilities of paternity (financial maintenance etc) and also is not permitted the right to access or contact which might otherwise be thought to go with genetic paternity.
Recent breakthroughs in stem cell differentiation and reprogramming suggest that functional human... more Recent breakthroughs in stem cell differentiation and reprogramming suggest that functional human gametes could soon be created in vitro. While the ethical debate on the uses of in vitro generated gametes (IVG) was originally constrained by the fact that they could be derived only from embryonic stem cell lines, the advent of somatic cell reprogramming, with the possibility to easily derive human induced pluripotent stem cells from any individual, affords now a major leap in the feasibility of IVG derivation and in the scope of their potential applications. In this paper we develop an ethical framework, rooted in recent scientific evidence, to support a robust experimental pipeline that could enable the first-inhuman use of IVG. We then apply this framework to the following objectives: (1) a clarification of the genetic parenting options afforded by IVG, along with their ethical underpinnings; (2) a defence of the use of IVG to remedy infertility, broadening their scope to same-sex couples; (3) an assessment of the most far-reaching implications of IVG for multiplex parenting. These include, first, the liberation of parenting roles from the constraints of biological generations in vivo, allowing multiple individuals to engage in genetic parenting together, thus blurring the distinction between biological and social generations. Second, we discuss the conflation of IVG with sequencing technology and its implications for the possibility that prospective parents may choose among a hitherto unprecedented number of potential children. In view of these perspectives, we argue that, contrary to the exhausted paradigm according to which society lags behind science, IVG may represent instead a salient and most visible instance where biotechnological ingenuity could be used in pursuit of social experimentation.
Moral enhancement is a topic that has sparked much current interest in the world of bioethics. Th... more Moral enhancement is a topic that has sparked much current interest in the world of bioethics. The possibility of making people 'better,' not just in the conventional enhancement sense of improving health and other desirable (and desired) qualities and capacities, but by making them somehow more moral, more decent, altogether better people, has attracted attention from both advocates1 2 and sceptics3 alike. The concept of moral enhancement, however, is fraught with difficult questions, theoretical and practical. What does it actually mean to be 'more moral'? How would moral enhancement be defined and would it necessarily, as some have claimed, make the world a better or safer place? How would or could such enhancement be achieved safely and without undue constraint on personal liberty and autonomy?
Principles ofjustice and equality demand that H I V seropositive individuals and those with A I D... more Principles ofjustice and equality demand that H I V seropositive individuals and those with A I D S should not be discriminated against in any area of social provision. I f social policy on A I D S is constructed in terms of reciprocal obligations, that is if obligations to the H I V seropositive individual and obligations of the H I V seropositive individual are given equal weight, the civil rights of H I V seropositive individuals may be secured and this may create a climate in which H I V seropositive individuals will more readily notifi. partners, and others at risk of infection, of their H I V status. It is conceivable that such a climate could facilitategreater control of the spread of HIVIAIDS.
People have a powerful interest in geneticprivacy and its associated claim to ignorance,and some ... more People have a powerful interest in geneticprivacy and its associated claim to ignorance,and some equally powerful desires to beshielded from disturbing information are oftenvoiced. We argue, however, that there is nosuch thing as a right to remain in ignorance,where a right is understood as an entitlementthat trumps competing claims. This doesnot of course mean that information must alwaysbe forced upon
Sex is not the answer to everything, though young men think it is, but it may be the answer to th... more Sex is not the answer to everything, though young men think it is, but it may be the answer to the intractable debate over the ethics of human embryonic stem cell research. In this paper, I advance one ethical principle that, as yet, has not received the attention its platitudinous character would seem to merit. If found acceptable, this principle would permit the beneficial use of any embryonic or fetal tissue that would, by default, be lost or destroyed. More important, I make two appeals to consistency, or to parity of reasoning, that I believe show that no one who either has used or intends to use sexual reproduction as their means of procreation, nor indeed anyone who has unprotected heterosexual intercourse, nor anyone who finds in vitro fertilization (IVF) acceptable, nor anyone who believes that abortion is ever permissible can consistently object on principle to human embryo research nor to the use of embryonic stem cells for research or therapy.
Matti Häyry’s new book is deliberately challenging; it tells six contemporary bioethicists, and a... more Matti Häyry’s new book is deliberately challenging; it tells six contemporary bioethicists, and all who share their methodologies or even their general approach, that they have got it badly wrong. From the striking photograph of Häyry himself on the front cover to the very last line, the genetic challenge is issued and elaborated. Häyry has divided his protagonists into three pairs, of which I find myself a member, and this makes responding a duty as well as a pleasure. Although I cannot speak for my partner in crime, Jonathan Glover, I am at least in the very best of all possible company.
Opponents of destructive embryo research, such as embryo rightists, as well as proponents accept ... more Opponents of destructive embryo research, such as embryo rightists, as well as proponents accept that natural reproduction is permissible. There is an alternative to natural reproduction-to remain childless. John Harris began this series of articles by asking, what does a commitment to the permissibility of natural reproduction entail? Harris has argued that a commitment to the permissibility of natural reproduction entails a commitment to the permissibility of destructive embryo research. Julian Savulescu has denied this. However, there are significant areas in which our views have converged. What are some of the potentially relevant moral features of natural reproduction? 1. Natural reproduction involves a very high rate of embryo loss. We have assumed that four out of five embryos perish during attempts at natural reproduction.
Pertaining or adapted to the production of fine offspring. B. sh. in pl. The science which treats... more Pertaining or adapted to the production of fine offspring. B. sh. in pl. The science which treats of this. (The Shorter Oxford English Dictional-y Third Edition 1965).
This paper restates some o f t h principal arguments agaimt an automatic prtference for the young... more This paper restates some o f t h principal arguments agaimt an automatic prtference for the young as advocated by Kappel and Sandoe, arguments many of which have been extant for over a decade but which Kappel and Sandoe largely ignore. It then goes on to demonstrate that Kappel and Sand0e's "indference test "fails to do the work required of it because it can be met by unacceptable conceptions ofjustice. The paper develops a number o f new arguments against what I have called "ageist" preferences for the young or for those with long lqe expectancy. Finally I show that Kappel and Sand0e must believe that murdering older people is less morally wrong than murdering the young and that people relying on arguments such as theirs will have to accept the moral respectability of killing the innocent in order to maximise units of lifetime. "Other things being equal we ought, when distributing resources essential for survival, favour the young." So say Klemens Kappel and Peter Sandae in their 'QALYs, Age and Fairness' (Bioethics 6:4, October 1992). They wish to establish that QALYs are not ageist enough, that fairness requires that we distribute health care resources "so that the fundamental interests of [people] are fulfilled to the same degree"' and that, since staying alive is a fundamental interest, this means that, other things being equal,2 different lives should be of equal duration as well as equally fulfilled in other ways. Kappel and Sandee arrive at this conclusion partly as a result of isolating and criticising five assumptions upon which they believe my claim that QALYs are unjust is d e~e n d e n t .~ Klernens Kappel and Peter Sandee 'QALYs, Age and Fairness' Bioethics Vol. Things to which we will come in due course. Kappel and Sandee have constructed assumptions tailored to beg the question as to whether or not survival and certain other fundamental interests are divisible and distributable. I do not in fact make nor rely upon the assumptions they list. Moreover they have quoted from perhaps the shortest of the many things I have @ Basil Blackwell Ltd.
This paper discusses the role of consent in decision making generally and its role in end of life... more This paper discusses the role of consent in decision making generally and its role in end of life decisions in particular. It outlines a conception of autonomy which explains and justifies the role of consent in decision making and criticises some misapplications of the idea of consent, particular the role of fictitious or "proxy" consents. Where the inevitable outcome of a decision must be that a human individual will die and where that individual is a person who can consent, then that decision is ethical if and only if the individual consents. In very rare and extreme cases such a decision will be ethical in the absence of consent where it would be massively cruel not to end life in order to prevent suffering which is in no other way preventable. Where, however, the human individual is not a person, as is the case with abortion, the death of infants like Mary (one of the conjoined twins in a case discussed in the paper), or in the very rare and extreme cases of those who have ceased to be persons like Tony Bland, such decisions are governed by the ethics of ending the lives of non-persons.
universal deduction". Matter is resolved into space, and thereby disappears. Hence the problem wi... more universal deduction". Matter is resolved into space, and thereby disappears. Hence the problem with electricity; physics is turned into a pure geometry (p. 84), and the theory of electricity is made superfluous whenever the simple structure of space is sufficient to account for the observed phenomena. Einstein largely realized Descartes' programme of reducing the physical to the spatial (p. 129). That includes time, and the nature of time is similarly "destroyed" by being spatialized, i.e. turned into something too like space. The theory of time is what most have found philosophically challenging in relativity theory, but it is not Meyerson's central interest, which is more in the general theory than the special theory, and more to do with space and matter than with time alone. The focus is on very broad issues, metaphysical rather than physical. It is understandable from that, that Einstein could evidently make little of their curious public encounter in Paris in 1922, when he replied in one brief defensive sentence to two questions from Meyerson which it takes four pages of the present excellent edition to put.
In this paper I discuss the application of the principles of medical ethics and of medical resear... more In this paper I discuss the application of the principles of medical ethics and of medical research to the case of children and others whose consent to treatment and to research is problematic. Public health depends substantially on the possibility of ongoing research into all conditions which affect the health of the people. Constraints on this research are therefore a public health issue. Moreover and more importantly the possibility of predictive testing and indeed of screening for health-relevant conditions is an important public health tool, and limitations on the use of this tool are of great significance to public health medicine. Having considered the particular problems created by research and predictive testing on children for late-onset conditions I go on to discuss research on those whose consent is problematic more generally. I conclude with radical recommendations for the reform of The Declaration of Helsinki and of the International Ethics Guidelines for Biomedical Re...
This short comment presents arguments in support of human enhancement. What is enhancement? Surel... more This short comment presents arguments in support of human enhancement. What is enhancement? Surely it is a procedure that improves our functioning: any intervention which increases our general capabilities for human flourishing. We exclude from consideration those procedures often termed "enhancements" that are of dubious overall benefit (for example breast or penis augmentation, or the taking of anabolic steroids to increase muscle mass). Equally we are not talking of "designer" modifications which are more akin to aesthetic or fashion preferences than to improvements: hair colour, eye colour, or physique. An enhancement (as we are using the term) is something of benefit to the individual.
This paper argues that a precautionary approach to scienti®c progress of the sort advocated by Wa... more This paper argues that a precautionary approach to scienti®c progress of the sort advocated by Walter Glannon with respect to life-extending therapies involves both incoherence and irresolvable paradox. This paper demonstrates the incoherence of the precautionary approach in many circumstances and argues that with respect to life-extending therapies we have at present no persuasive reasons for a moratorium on such research.
Although countries with different traditions, laws, and cultures may not agree on standards for s... more Although countries with different traditions, laws, and cultures may not agree on standards for stem cell research, a set of principles could clarify terms of collaboration.
is a research associate in the Centre for Social Ethics and Policy (School of Law) at the Univers... more is a research associate in the Centre for Social Ethics and Policy (School of Law) at the University of Manchester. Her research interests are in philosophy of mind, philosophy of science, philosophy of psychology and applied ethics. She has written on the notion of rationality, theories of interpretation, delusions and animal cognition. She works now at the EURECA project on delimiting the research concept and research activities. The project, funded by the European Commission, is coordinated by Professor John Harris and has eight project partners across the European Community.
When children are too young to make their ownautonomous decisions, decisions have to be madefor t... more When children are too young to make their ownautonomous decisions, decisions have to be madefor them. In certain contexts we allow parentsand others to make these decisions, and do notinterfere unless the decision clearly violatesthe best interest of the child. In othercontexts we put a priori limits on whatkind of decisions parents can make, and/or whatkinds of considerations they have
When things go wrong with assisted reproduction we should look at what's best for everyone in the... more When things go wrong with assisted reproduction we should look at what's best for everyone in the particular circumstances A RTBs, as we must now call them, are becoming more and more frequent. In the recent United Kingdom case (discussed in April JME 1-3) Mr and Mrs A, a "white" couple, gave birth to twins described as "black". The mix up apparently occurred because a Mr and Mrs B, a "black" couple, were being treated in the same clinic and Mrs A's eggs were fertilised with Mr B's sperm. Mr and Mrs A love the twins and wish to keep them and the facts seem to be that Mrs A is the genetic mother of the twins but her partner is not the genetic father. Under English law, in assisted reproduction, the woman who gives birth to the child is the legal mother and this is true also in cases of surrogacy. I think there is no doubt in this case that English law has taken the right path and that it would be unconscionable to contemplate taking a child away from the woman who had undergone the risks and pains of pregnancy and childbirth and the bonding process that goes along with that when she wishes to keep the child particularly when there is no substantial and pressing evidence that she would be an unsafe parent. I argued this in my book The Value of Life 4 and I think it is still true. So in this case justice, morality, and decency are served by confirming Mr and Mrs A as the parents of the children. Since in English law there is some ambiguity over paternity and how that is to be assigned and since Mr A is apparently not the genetic father, I think it is important that Mr B or whoever does turn out to be the sperm donor in this case is protected from the responsibilities of paternity (financial maintenance etc) and also is not permitted the right to access or contact which might otherwise be thought to go with genetic paternity.
Recent breakthroughs in stem cell differentiation and reprogramming suggest that functional human... more Recent breakthroughs in stem cell differentiation and reprogramming suggest that functional human gametes could soon be created in vitro. While the ethical debate on the uses of in vitro generated gametes (IVG) was originally constrained by the fact that they could be derived only from embryonic stem cell lines, the advent of somatic cell reprogramming, with the possibility to easily derive human induced pluripotent stem cells from any individual, affords now a major leap in the feasibility of IVG derivation and in the scope of their potential applications. In this paper we develop an ethical framework, rooted in recent scientific evidence, to support a robust experimental pipeline that could enable the first-inhuman use of IVG. We then apply this framework to the following objectives: (1) a clarification of the genetic parenting options afforded by IVG, along with their ethical underpinnings; (2) a defence of the use of IVG to remedy infertility, broadening their scope to same-sex couples; (3) an assessment of the most far-reaching implications of IVG for multiplex parenting. These include, first, the liberation of parenting roles from the constraints of biological generations in vivo, allowing multiple individuals to engage in genetic parenting together, thus blurring the distinction between biological and social generations. Second, we discuss the conflation of IVG with sequencing technology and its implications for the possibility that prospective parents may choose among a hitherto unprecedented number of potential children. In view of these perspectives, we argue that, contrary to the exhausted paradigm according to which society lags behind science, IVG may represent instead a salient and most visible instance where biotechnological ingenuity could be used in pursuit of social experimentation.
Moral enhancement is a topic that has sparked much current interest in the world of bioethics. Th... more Moral enhancement is a topic that has sparked much current interest in the world of bioethics. The possibility of making people 'better,' not just in the conventional enhancement sense of improving health and other desirable (and desired) qualities and capacities, but by making them somehow more moral, more decent, altogether better people, has attracted attention from both advocates1 2 and sceptics3 alike. The concept of moral enhancement, however, is fraught with difficult questions, theoretical and practical. What does it actually mean to be 'more moral'? How would moral enhancement be defined and would it necessarily, as some have claimed, make the world a better or safer place? How would or could such enhancement be achieved safely and without undue constraint on personal liberty and autonomy?
Principles ofjustice and equality demand that H I V seropositive individuals and those with A I D... more Principles ofjustice and equality demand that H I V seropositive individuals and those with A I D S should not be discriminated against in any area of social provision. I f social policy on A I D S is constructed in terms of reciprocal obligations, that is if obligations to the H I V seropositive individual and obligations of the H I V seropositive individual are given equal weight, the civil rights of H I V seropositive individuals may be secured and this may create a climate in which H I V seropositive individuals will more readily notifi. partners, and others at risk of infection, of their H I V status. It is conceivable that such a climate could facilitategreater control of the spread of HIVIAIDS.
People have a powerful interest in geneticprivacy and its associated claim to ignorance,and some ... more People have a powerful interest in geneticprivacy and its associated claim to ignorance,and some equally powerful desires to beshielded from disturbing information are oftenvoiced. We argue, however, that there is nosuch thing as a right to remain in ignorance,where a right is understood as an entitlementthat trumps competing claims. This doesnot of course mean that information must alwaysbe forced upon
Sex is not the answer to everything, though young men think it is, but it may be the answer to th... more Sex is not the answer to everything, though young men think it is, but it may be the answer to the intractable debate over the ethics of human embryonic stem cell research. In this paper, I advance one ethical principle that, as yet, has not received the attention its platitudinous character would seem to merit. If found acceptable, this principle would permit the beneficial use of any embryonic or fetal tissue that would, by default, be lost or destroyed. More important, I make two appeals to consistency, or to parity of reasoning, that I believe show that no one who either has used or intends to use sexual reproduction as their means of procreation, nor indeed anyone who has unprotected heterosexual intercourse, nor anyone who finds in vitro fertilization (IVF) acceptable, nor anyone who believes that abortion is ever permissible can consistently object on principle to human embryo research nor to the use of embryonic stem cells for research or therapy.
Matti Häyry’s new book is deliberately challenging; it tells six contemporary bioethicists, and a... more Matti Häyry’s new book is deliberately challenging; it tells six contemporary bioethicists, and all who share their methodologies or even their general approach, that they have got it badly wrong. From the striking photograph of Häyry himself on the front cover to the very last line, the genetic challenge is issued and elaborated. Häyry has divided his protagonists into three pairs, of which I find myself a member, and this makes responding a duty as well as a pleasure. Although I cannot speak for my partner in crime, Jonathan Glover, I am at least in the very best of all possible company.
Opponents of destructive embryo research, such as embryo rightists, as well as proponents accept ... more Opponents of destructive embryo research, such as embryo rightists, as well as proponents accept that natural reproduction is permissible. There is an alternative to natural reproduction-to remain childless. John Harris began this series of articles by asking, what does a commitment to the permissibility of natural reproduction entail? Harris has argued that a commitment to the permissibility of natural reproduction entails a commitment to the permissibility of destructive embryo research. Julian Savulescu has denied this. However, there are significant areas in which our views have converged. What are some of the potentially relevant moral features of natural reproduction? 1. Natural reproduction involves a very high rate of embryo loss. We have assumed that four out of five embryos perish during attempts at natural reproduction.
Pertaining or adapted to the production of fine offspring. B. sh. in pl. The science which treats... more Pertaining or adapted to the production of fine offspring. B. sh. in pl. The science which treats of this. (The Shorter Oxford English Dictional-y Third Edition 1965).
This paper restates some o f t h principal arguments agaimt an automatic prtference for the young... more This paper restates some o f t h principal arguments agaimt an automatic prtference for the young as advocated by Kappel and Sandoe, arguments many of which have been extant for over a decade but which Kappel and Sandoe largely ignore. It then goes on to demonstrate that Kappel and Sand0e's "indference test "fails to do the work required of it because it can be met by unacceptable conceptions ofjustice. The paper develops a number o f new arguments against what I have called "ageist" preferences for the young or for those with long lqe expectancy. Finally I show that Kappel and Sand0e must believe that murdering older people is less morally wrong than murdering the young and that people relying on arguments such as theirs will have to accept the moral respectability of killing the innocent in order to maximise units of lifetime. "Other things being equal we ought, when distributing resources essential for survival, favour the young." So say Klemens Kappel and Peter Sandae in their 'QALYs, Age and Fairness' (Bioethics 6:4, October 1992). They wish to establish that QALYs are not ageist enough, that fairness requires that we distribute health care resources "so that the fundamental interests of [people] are fulfilled to the same degree"' and that, since staying alive is a fundamental interest, this means that, other things being equal,2 different lives should be of equal duration as well as equally fulfilled in other ways. Kappel and Sandee arrive at this conclusion partly as a result of isolating and criticising five assumptions upon which they believe my claim that QALYs are unjust is d e~e n d e n t .~ Klernens Kappel and Peter Sandee 'QALYs, Age and Fairness' Bioethics Vol. Things to which we will come in due course. Kappel and Sandee have constructed assumptions tailored to beg the question as to whether or not survival and certain other fundamental interests are divisible and distributable. I do not in fact make nor rely upon the assumptions they list. Moreover they have quoted from perhaps the shortest of the many things I have @ Basil Blackwell Ltd.
This paper discusses the role of consent in decision making generally and its role in end of life... more This paper discusses the role of consent in decision making generally and its role in end of life decisions in particular. It outlines a conception of autonomy which explains and justifies the role of consent in decision making and criticises some misapplications of the idea of consent, particular the role of fictitious or "proxy" consents. Where the inevitable outcome of a decision must be that a human individual will die and where that individual is a person who can consent, then that decision is ethical if and only if the individual consents. In very rare and extreme cases such a decision will be ethical in the absence of consent where it would be massively cruel not to end life in order to prevent suffering which is in no other way preventable. Where, however, the human individual is not a person, as is the case with abortion, the death of infants like Mary (one of the conjoined twins in a case discussed in the paper), or in the very rare and extreme cases of those who have ceased to be persons like Tony Bland, such decisions are governed by the ethics of ending the lives of non-persons.
Uploads
Papers by john harris