Fertilisation and moral status: a scientific perspective.

The debate about the moral status of the embryo has gained new impetus because of the advances in reproductive technology that have made early human embryo experimentation a possibility, and because of the public concern that this arouses. Several philosophical arguments claiming that fertilisation is the event that accords moral status to the embryo were initially formulated in the context of the abortion debate. Were they formulated with sufficient precision to account for the scientific facts as we now understand them? Or do these arguments need modification? Aspects of three arguments for moral status being acquired at fertilisation are examined in relation to current scientific knowledge, highlighting the reasons why such arguments, at present, seem to provide an inadequate basis for the determination of moral status.     

Ethics for embryos

This paper responds to DW Brock's technically strong case for the use of human embryonic stem cells in medical research. His main issue in this context is the question of whether it is moral to destroy viable human embryos. He offers a number of reasons to support his view that it is moral to destroy them, but his use of conceptual arguments is not adequate to secure his position. The purpose and scope of this paper is wholly concerned with his arguments rather than with the conclusion that it is justifiable to destroy human embryos. The author proceeds through his variety of arguments and offers reasons for rejecting them. The author concludes that Brock has not shown that it is moral to destroy viable human embryos.     

Moral theories may have some role in teaching applied ethics

In a recent paper, Rob Lawlor argues that moral theories should not be taught in courses on applied ethics. The author contends that Dr Lawlor's arguments overlook at least two important roles that some attention to ethical theories may play in practical ethics courses. The conclusion is not that moral theory must be taught, but rather that there is more to be said for it than Dr Lawlor's arguments reveal.     

"It's all too subjective": scepticism about the possibility or use of philosophical medical ethics

In one of a series of articles on philosophical medical ethics, Gillon rebuts the argument that moral claims are essentially different from scientific claims because scientific claims are objective and confirmable or refutable, while moral claims are subjective, unconfirmable, irrefutable, and their differences incapable of resolution. He contends that there is widespread agreement about many moral principles, that moral disagreement may arise from the use of ambiguous terminology, and that progress toward resolution may be accomplished by analysis of the logical validity and consistency of the arguments.     

Paying organ donors.

Following an earlier paper in the journal in which Evans argued that it was commercial exploitation, not mere payment, that was morally objectionable about certain sorts of organ donation, this paper looks at the moral issues when commercial exploitation is eliminated from systems of paid organ donation. It argues that there are no conclusive moral arguments against such schemes for non-exploitative paid kidney donation.     

Persons, post-persons and thresholds

DeGrazia argues that post-persons have as much justification in believing that they have higher moral status than persons as persons have in believing that they have higher moral status than animals. DeGrazia's claim presupposes that what Buchanan calls the "moral equality assumption" is false. This article argues that DeGrazia has given us no reason to disbelieve the moral equality assumption. Further, even if DeGrazia's arguments about moral status were sound, it is unclear that his first-order normative claims about how we should weigh human against animal interests would follow.     

Telling the truth and medical ethics

Gillon discusses the conflicting moral implications of the principles of respect for autonomy and of beneficence and non-maleficence when telling patients the truth about their illnesses and treatments. The case for nondisclosure is usually based on three major arguments: that doctors' Hippocratic obligations to benefit and not harm their patients take precedence over not deceiving them; that the range of possible conditions and prognoses makes it difficult for physicians to know the full truth or for patients to comprehend it; and that patients do not wish to be told dire news. Gillon rejects each of these arguments, contending that avoiding deceit is a basic moral norm that can be defended from utilitarian as well as deontological points of view. With regard to the argument concerning patient attitudes, he recommends that pilot studies be done, asking patients what their preferences are at the time they register with a doctor or hospital.     

Biological processes and moral events.

It is often argued that the continuity of the processes of embryo development precludes the establishment of morally significant boundaries, once development is under way. These arguments typically claim that marking out any moral boundaries requires identifying particular significant events, and that in such circumstances this is either impossible or arbitrary. In this paper it is argued that arguments of this kind are not cogent. The paper concludes by indicating where the real problems lie.     

Reproductive cloning in humans and therapeutic cloning in primates: is the ethical debate catching up with the recent scientific advances?

After years of failure, in November 2007 primate embryonic stem cells were derived by somatic cellular nuclear transfer, also known as therapeutic cloning. The first embryo transfer for human reproductive cloning purposes was also attempted in 2006, albeit with negative results. These two events force us to think carefully about the possibility of human cloning which is now much closer to becoming a reality. In this paper we tackle this issue from two sides, first summarising what scientists have achieved so far, then discussing some of the ethical arguments in favour and against human cloning which are debated in the context of policy making and public consultation. Therapeutic cloning as a means to improve and save lives has uncontroversial moral value. As to human reproductive cloning, we consider and assess some common objections and failing to see them as conclusive. We do recognise, though, that there will be problems at the level of policy and regulation that might either impair the implementation of human reproductive cloning or make its accessibility restricted in a way that could become difficult to justify on moral grounds. We suggest using the time still available before human reproductive cloning is attempted successfully to create policies and institutions that can offer clear directives on its legitimate applications on the basis of solid arguments, coherent moral principles, and extensive public consultation.     

Can arguments address concerns?

People have concerns, and ethicists often respond to them with philosophical arguments. But can conceptual constructions properly address fears and anxieties? It is argued in this paper that while it is possible to voice, clarify, create and-to a certain extent-tackle concerns by arguments, more concrete practices, choices, and actions are normally needed to produce proper responses to people's worries. While logical inconsistencies and empirical errors can legitimately be exposed by arguments, the situation is considerably less clear when it comes to moral, cultural, and emotional norms, values, and expectations.     

Double effect: a useful rule that alone cannot justify hastening death

The rule of double effect is regularly invoked in ethical discussions about palliative sedation, terminal extubation and other clinical acts that may be viewed as hastening death for imminently dying patients. Unfortunately, the literature tends to employ this useful principle in a fashion suggesting that it offers the final word on the moral acceptability of such medical procedures. In fact, the rule cannot be applied appropriately without invoking moral theories that are not explicit in the rule itself. Four tenets of the rule each require their own ethical justification. A variety of moral theories are relevant to making judgements in a pluralistic society. Much of the rich moral conversation germane to the rule has been reflected in arguments about physician-assisted suicide and voluntary active euthanasia, but the rule itself has limited relevance to these debates, and requires its own moral justifications when applied to other practices that might hasten death.     

Medicine, lies and deceptions

This article offers a qualified defence of the view that there is a moral difference between telling lies to one's patients, and deceiving them without lying. However, I take issue with certain arguments offered by Jennifer Jackson in support of the same conclusion. In particular, I challenge her claim that to deny that there is such a moral difference makes sense only within a utilitarian framework, and I cast doubt on the aptness of some of her examples of non-lying deception. But I argue that lies have a greater tendency to damage trust than does non-lying deception, and suggest that since many doctors do believe there is a moral boundary between the two types of deception, encouraging them to violate that boundary may have adverse general effects on their moral sensibilities.     

Critical notice--defending life: a moral and legal case against abortion choice by Francis J Beckwith

Francis Beckwith's Defending life: a moral and legal case against abortion choice defends the pro-life position on moral, legal and political grounds. In this critical notice I consider three key issues and argue that Beckwith's treatment of each of them is unpersuasive. The issues are: (1) whether abortion is politically justified by the principle that we should err on the side of liberty in the face of reasonable disagreement over the moral status of the fetus; (2) whether the fetus's natural capacity or genetic propensity to develop rationality and communication is sufficient to give it a moral right to life; and (3) whether abortion is morally justified on the basis of bodily rights. I also show that Beckwith's book fails to consider several important issues and arguments.     

Current knowledge in moral cognition can improve medical ethics

Physicians frequently face ethical dilemmas when caring for patients. To help them to cope with these, biomedical ethics aims to implement moral norms for particular problems and contexts. As a means of studying the cognitive and neurobiological features underlying the respect for these norms, moral cognitive neuroscience could help us to understand and improve ethical questioning. The article reviews recent developments in the field and presents neurobiological arguments to highlight why some moral rules are universally shared and why some ethical responses are very dependent on context.     

Potential and the early human.

Some form of potential or "capacity" is often seen as evidence of human moral status. Opinions differ as to whether the potential of the embryo should be regarded as such evidence. In this paper, I discuss some common arguments against regarding the embryo's potential as a sign of human status, together with some less common arguments in favour of regarding the embryo's potential in this way.     

Research on human embryos--a justification.

The philosophical debate surrounding the moral status of the embryo has reached the public arena. The author of this paper examines some of the common arguments against embryo experimentation, including an influential article by Professor Ian Kennedy. He concludes that these arguments do not succeed in demonstrating that the intentional creation of embryos for research purposes is wrong, unless they also succeed in demonstrating that contemporary liberal abortion laws are also wrong. The author also criticises the conclusions of the Warnock Report, and suggests that the reasons for permitting embryo research must be given a wider public audience.     

The ethics of killing and letting die: active and passive euthanasia

In their account of passive euthanasia, Garrard and Wilkinson present arguments that might lead one to overlook significant moral differences between killing and letting die. To kill is not the same as to let die. Similarly, there are significant differences between active and passive euthanasia. Our moral duties differ with regard to them. We are, in general, obliged to refrain from killing each and everyone. We do not have a similar obligation to try (or to continue to try) to prevent each and everyone from dying. In any case, to be morally obliged to persist in trying to prevent their deaths would be different from being morally obliged to refrain from killing all other people even if we had both obligations.     

Participation in biomedical research is an imperfect moral duty: a response to John Harris

In his paper "Scientific research is a moral duty", John Harris argues that individuals have a moral duty to participate in biomedical research by volunteering as research subjects. He supports his claim with reference to what he calls the principle of beneficence as embodied in the "rule of rescue" (the moral obligation to prevent serious harm), and the principle of fairness embodied in the prohibition on "free riding" (we are obliged to share the sacrifices that make possible social practices from which we benefit). His view that biomedical research is an important social good is agreed upon, but it is argued that Harris succeeds only in showing that such participation and support is a moral good, among many other moral goods, while failing to show that there is a moral duty to participate in biomedical research in particular. The flaws in Harris's arguments are detailed here, and it is shown that the principles of beneficence and fairness yield only a weaker discretionary or imperfect obligation to help others in need and to reciprocate for sacrifices that others have made for the public good. This obligation is discretionary in the sense that the individuals are free to choose when, where, and how to help others in need and reciprocate for earlier sacrifices. That Harris has not succeeded in claiming a special status for biomedical research among all other social goods is shown here.     

Paternalism and medical ethics

In one of a series of articles on philosophical medical ethics, Gillon considers various moral arguments in support of medical paternalism. He maintains that the utilitarian principle of maximizing happiness by improving health, minimizing suffering, and prolonging life is not promoted by granting physicians the authority to deceive patients or to make decisions for them in areas of moral and subjective choice. If one wants to do good for a patient, one generally needs to find out what the patient wants one to do. Gillon concludes that many utilitarians agree with deontologists that respect for autonomy is required if human welfare really is to be maximized.     

An introduction to philosophical medical ethics: the Arthur case

The application of moral theory to decisions involving medical ethics is illustrated by the 1981 case in which a British pediatrician, Dr. Leonard Arthur, was acquitted of attempted murder for prescribing dihydrocodeine and "nursing care only" for a Down's syndrome newborn after the child had been rejected by his mother. Gillon outlines the moral arguments of the "prosecution" and the "defense," and then categorizes their various premises in accordance with concepts of normative ethical theory.