Taking care of one's own: justice and family caregiving

This paper asks whether adult children have aduty of justice to act as caregivers for theirfrail, elderly parents. I begin (Sections I.and II.) by locating the historical reasons whyrelationships within families were not thoughtto raise issues of justice. I argue that thesereasons are misguided. The paper next presentsspecific examples showing the relevance ofjustice to family relationships. I point outthat in the United States today, the burden ofcaregiving for dependent parents fallsdisproportionately on women (Sections III. andIV.). The paper goes on to use Rawls'theoretical tool of the veil of ignorance toargue that caring for parents should not belinked to a person's sex and more generally,that there is no duty of justice to assume therole of caregiver for dependent parents(Sections V.). Although justice does notprovide the moral foundations for parent care,I show that it nonetheless places importantlimits on the instinct to care. I concludethat the voice of justice should be audible,and is intrinsically present, withinfamilies.     

The Professional Status of Bioethics Consultation

Theoretical Medicine and Bioethics - Is bioethics consultation a profession? Withfew exceptions, the arguments andcounterarguments about whether healthcareethics consultation is a profession...     

A Synthetic Approach to Bioethical Inquiry

This paper attempts to sort out some of the current tensions and ambiguities inherent in the field of bioethics as it continues to mature. In particular it focuses on the question of the methodological relevance of theory or ethical principles to the domain of clinical ethics. I offer an approach to reasoning about moral conflict that combines the insights of contemporary moral theorists, the philosophy of American pragmatism, and the skills of rhetorical deliberation. This synthetic approach locates a proper role for moral theory in the practice of clinical ethics, thus linking abstract philosophical ideas about morality, humanity, suffering, and health to specific deeds, actions, and decisions in the concrete lives of particular individuals. The aim of this synthetic approach of bioethical inquiry is a rapprochement between theoretical knowledge in moral philosophy and the contextualized, relational, and practical understanding of what morality demands of us in our daily lives. I argue for a conception of bioethical inquiry that takes morality to be a study of certain practical, socially embedded concerns about matters of right and wrong, good and evil, as well as a study of the moral theories by which these actual concerns can be explored and critically evaluated.     

Gene therapy: ethical issues

To discern the ethical issues involved incurrent gene therapy research, to explore theproblems inherent in possible future genetherapies, and to encourage debate within thescientific community about ethical questionsrelevant to both, we surveyed American Societyof Human Genetics scientists who engage inhuman genetics research. This study of theopinions of U.S. scientific experts about theethical issues discussed in the literature ongene therapy contributes systematic data on theattitudes of those working in the field as wellas elaborative comments. Our survey finds thatrespondents are highly supportive of thepotential use of somatic cell gene therapy tocure serious diseases in adults and children aswell as prospective offspring. A clearmajority, however, believe that using suchgenetic techniques for enhancement purposes isunacceptable. Delineating the line betweendisease/disorder and improvement/enhancementposes a problem not easily resolved and oneconducive to the growth of slippery-slopeapprehensions. The majority of respondents alsoadvocate germ-line therapy, in theory at least,and under similar restrictions, but theyrecognize the roadblock that the existence ofunanticipated negative consequences currentlypresents. Another complex matter involvestrying to determine appropriate reasons forchoosing target diseases for research, forwhich the dichotomy between rare single-geneand common multifactorial diseases reveals anongoing dilemma.     

ISLAMIC MODERNITY AND THE CHALLENGES FOR SECULAR LIBERALISM

In his recent book Islam Evolving: Radicalism, Reformation, and the Uneasy Relationship with the Secular West, Taner Edis discusses Islamic responses to the modern world and how the West deals and should deal with them. He argues convincingly that the biggest threat to secular liberalism is not fundamentalism but an Islamic form of modernity. He attributes some of the latter's success to Western neoliberalism and to the failure of secular liberals to come up with persuasive arguments. He thus puts part of the blame on the West. However, although self‐criticism is an essential aspect of a well‐functioning democracy, we should not take it too far. Instead, there exist convincing reasons why a secular liberal society is strongly preferable to a religious conservative one.     

Access to excess: media as religion and the new cargo cults

Recent studies of religion and the media generally assume the secular nature of the latter impacting on the former. Religious relevance is set against a media culture of screens and networks that purportedly shape and reshape the symbols of sacredness. Yet the media itself may also be regarded as constituting a form of sacredness in its generation of excess. Within an expanding digital universe, the media creates and channels an abundance of information to overwhelm the attention of billions of people. The power to access excess places the sacred in the resources and practices of interconnectedness made possible by the use of digital devices that readies populations to anticipate limitless flows of data. Parallels can be drawn with the cargo cults of Melanesia where natives in contact with their colonisers came to anticipate the arrival of unlimited wealth and goods. This comparison may be used to illustrate the dual face of the media as secular in its operating system and religious in its production of excess. It also raises the question of whether the secular in digital culture could be treated as if it were wholly autonomous of the religious.     

Four Roles of Ethical Theory in Clinical Ethics Consultation

When clinical ethics committee members discuss a complex ethical dilemma, what use do they have for normative ethical theories? Members without training in ethical theory may still contribute to a pointed and nuanced analysis. Nonetheless, the knowledge and use of ethical theories can play four important roles: aiding in the initial awareness and identification of the moral challenges, assisting in the analysis and argumentation, contributing to a sound process and dialogue, and inspiring an attitude of reflexivity. These four roles of ethical theory in clinical ethics consultation are described and their significance highlighted, while an example case is used as an illustration throughout.     

INTRODUCTION: RETHINKING PHILOSOPHICAL PRESUMPTIONS IN LIGHT OF COGNITIVE DISABILITY

Abstract: This Introduction to the collection of essays surveys the philosophical literature to date with respect to five central questions: justice, care, agency, metaphilosophical issues regarding the language and representation of cognitive disability, and personhood. These themes are discussed in relation to three specific conditions: intellectual and developmental disabilities, Alzheimer's disease, and autism, though the issues raised are relevant to a broad range of cognitive disabilities. The Introduction offers a brief historical overview of the treatment cognitive disability has received from philosophers, and explains the specific challenges that cognitive disability poses to philosophy. In briefly summarizing the essays in the collection, it highlights the distinctive contributions the collection makes to ethics, political philosophy, bioethics, and the philosophy of disability. We hope that the richness of the topics explored by these essays will be a spur to further investigation.     

Feminist Bioethics: Where We've Been, Where We's Going

The primary contribution of feminism to bioethics is to note how imbalances of power in the sex-gender system play themselves out in medical practice and in the theory surrounding that practice. I trace the ten-year history of feminist approaches to bioethics, arguing that while feminists have usefully critiqued medicine's biases in favor of men, they have unmasked sexism primarily in the arena of women's reproductive health, leaving other areas of health care sorely in need of feminist scrutiny. I note as well that feminist bioethicists have contributed very little to bioethical theory. In the second part of the paper I suggest two future directions for feminist bioethics. The first is to expand its critique of gender bias beyond reproductive medicine, devoting attention to the same issues raised by advances in biomedical technology as are taken up by mainstream bioethicists. The second is to develop bioethical theory that is more responsive than are mainstream moral theories to the social practices that subordinate women and minority groups.     

On Hope and Hard Choices

In Handle with Care (2009), novelist Jodi Picoult presents a heartbreaking case involving the question of wrongful birth. This essay examines Ronald M. Green's writings in the field of bioethics to see what wisdom they might bring to this case. I argue that Green's contributions to bioethics exemplify some of the best of ethical argumentation: attention to facts, discernment of morally relevant differences, enunciation and justification of principles, originality, and compassion. I then draw from his work three foci that illuminate aspects of the dilemma presented by Picoult: the importance of parental love, the possibility that the dilemma might be reframed away from wrongful birth, and the need to shift our focus to questions of justice. While appreciating Green's contributions to bioethics, I also indicate several places of nuanced disagreement.