Diversity Reading List

Publisher's Note: The Blackwell Guide to Medical Ethics is a guide to the complex literature written on the increasingly dense topic of ethics in relation to the new technologies of medicine. Examines the key ethical issues and debates which have resulted from the rapid advances in biomedical technology Brings together the leading scholars from a wide range of disciplines, including philosophy, medicine, theology and law, to discuss these issues Tackles such topics as ending life, patient choice, selling body parts, resourcing and confidentiality Organized with a coherent structure that differentiates between the decisions of individuals and those of social policy

Abstract: Is it morally permissible for me to have children? 1A decision to procreate is surely one of the most significant decisions a person can make. So it would seem that it ought not to be made without some moral soul-searching. There are many reasons why one might hesitate to bring children into this world if one is concerned about their welfare. Some are rather general, like the deteriorating environment or the prospect of poverty. Others have a narrower focus, like continuing civil war in Ireland, or the lack of essential social support for childrearing persons in the United States. Still others may be relevant only to individuals at risk of passing harmful diseases to their offspring. There are many causes of misery in this world, and most of them are unrelated to genetic disease. In the general scheme of things, human misery is most efficiently reduced by concentrating on noxious social and political arrangements. Nonetheless, we shouldn't ignore preventable harm just because it is confined to a relatively small corner of life. So the question arises: can it be wrong to have a child because of genetic risk factors?2Unsurprisingly, most of the debate about this issue has focused on prenatal screening and abortion: much useful information about a given fetus can be made available by recourse to prenatal testing. This fact has meant that moral questions about reproduction have become entwined with abortion politics, to the detriment of both. The abortion connection has made it especially difficult to think about whether it is wrong to Prevent a child from coming into being since doing so might involve what many people see as wrongful killing; yet there is no necessary link between the two. Clearly, the existence of genetically compromised children can be prevented not only by aborting already existing fetuses but also by preventing conception in the first place. Worse yet, many discussions simply assume a particular view of abortion, without any recognition of other possible positions and the difference they make in how people understand the issues. For example, those who object to aborting fetuses with genetic problems often argue that doing so would undermine our conviction that all humans are in some important senseequal.3 However, this position rests on the assumption that conception marks the point at which humans are endowed with a right to life. So aborting fetuses with genetic problems looks morally the same as killing "imperfect" people without their consent. This position raises two separate issues. One pertains to the legitimacy of different views on abortion. Despite the conviction of many abortion activists to the contrary, I believe that ethically respectable views can be found on different sides of the debate, including one that sees fetuses as developing humans without any serious moral claim on continued life. There is no space here to address the details, and doing so would be once again to fall into the trap of letting the abortion question swallow up all others. Fortunately, this issue need not be resolved here. However, opponents of abortion need to face the fact that many thoughtful individuals do not see fetuses as moral persons. It follows that their reasoning process and hence the implications of their decisions are radically different from those envisioned by opponents of prenatal screening and abortion. So where the latter see genetic abortion as murdering people who just don't mea-sure up, the former see it as a way to prevent the development of persons who are more likely to live miserable lives. This is consistent with a worldview that values persons equally and holds that each deserves high quality life. Some of those who object to genetic abortion appear to be oblivious to these psychological and logical facts. It follows that the nightmare scenarios they paint for us are beside the point: many people simply do not share the assumptions that make them plausible. How are these points relevant to my discussion? My primary concern here is to argue that conception can sometimes be morally wrong on grounds of genetic risk, although this judgment will not apply to those who accept the moral legitimacy of abortion and are willing to employ pre-natal screening and selective abortion. If my case is solid, then those who oppose abortion must be especially careful not to conceive in certain cases, as they are, of course, free to follow their conscrence about abortion. Those like myself who do not see abortion as murder have more ways to prevent birth.

Publisher's Note: Controversies about abortion and women's reproductive technologies often seem to reflect personal experience, religious commitment, or emotional response. Laura M. Purdy believes, however, that coherent ethical principles are implicit in these controversies and that feminist bioethics can help clarify the conflicts of interest which often figure in human reproduction. As she defines the underlying issues, Purdy emphasizes the importance of taking women's interests fully into account. Reproducing Persons first explores the rights and duties connected with conception and pregnancy. Purdy asks whether conceiving a child or taking a pregnancy to term can ever be morally wrong. She challenges the thinking of those who feel the prospect of disability or serious genetic disease should not constrain conception or justify abortion. The essays next look at abortion from a variety of angles. One contends that killing fetuses is not murder; others emphasize the moral importance of access to abortion. Purdy considers the conflicting interests of women and men regarding abortion, and argues against requiring a husband's consent. The book concludes with a consideration of new reproductive technologies and arrangements, including the controversial issue of surrogacy, or contract pregnancy. Throughout, Purdy combines traditional utilitarianism with some of the most powerful insights of contemporary feminist ethics. Her provocative essays create guidelines for approaching new topics and inspire fresh thinking about old ones.

Abstract: An integrity-based approach to ethics management combines a concern for the law with an emphasis on managerial responsibility for ethical behavior. Though integrity strategies may vary in design and scope, all strive to define companies' guiding values, aspirations, and patterns of thought and conduct. When integrated into the day-to-day operations of an organization, such strategies can help prevent damaging ethical lapses while tapping into powerful human impulses for moral thought and action. Then an ethical framework becomes no longer a burdensome constraint within which companies must operate, but the governing ethos of an organization.

Publisher's Note: This volume brings together Nussbaum's published papers on the relationship between literature and philosophy, especially moral philosophy. The papers, many of them previously inaccessible to non-specialist readers, explore such fundamental issues as the relationship between style and content in the exploration of ethical issues; the nature of ethical attention and ethical knowledge and their relationship to written forms and styles; and the role of the emotions in deliberation and self-knowledge. Nussbaum investigates and defends a conception of ethical understanding which involves emotional as well as intellectual activity, and which gives a certain type of priority to the perception of particular people and situations rather than to abstract rules. She argues that this ethical conception cannot be completely and appropriately stated without turning to forms of writing usually considered literary rather than philosophical. It is consequently necessary to broaden our conception of moral philosophy in order to include these forms. Featuring two new essays and revised versions of several previously published essays, this collection attempts to articulate the relationship, within such a broader ethical inquiry, between literary and more abstractly theoretical elements.

Abstract: In this paper, we examine the scientific, legal, and ethical foundations for inclusion of transgender women athletes in competitive sport, drawing on IOC principles and relevant Court of Arbitration for Sport decisions. We argue that the inclusion of transathletes in competition commensurate with their legal gender is the most consistent position with these principles of fair and equitable sport. Biological restrictions, such as endogenous testosterone limits, are not consistent with IOC and CAS principles. We explore the implications for recognizing that endogenous testosterone values are a natural physical trait and that excluding legally recognized women for high endogenous testosterone values constitutes discrimination on the basis of a natural physical trait. We suggest that the justificatory burden for such prima facie discrimination is unlikely to be met. Thus, in place of a limit on endogenous testosterone for women (whether cisgender, transgender, or intersex), we argue that legally recognized gender is most fully in line with IOC and CAS principles.

Abstract: It seemed like only minutes after a team of Scottish scientists announced, in late February 1997, that they had successfully cloned a sheep, that governmental officials and private citizens throughout the world called for a ban on cloning human beings. The rush to legislate or issue executive orders was so swift, it is reasonable to wonder why the news that a mammal had been cloned ignited such a stampede to prohibit, even criminalize, attempts to clone humans. These events raise a series of separate, yet related questions. Why does the prospect of cloning human beings incite such strong reactions? What reasons have been proposed for enacting national laws or international conventions to prohibit cloning? Can these prohibitions be justified by sound ethical arguments? Before attempting to answer these questions, let us look first at the responses that called for public policy measures to ban human cloning.

Publisher's Note: The Elimination of Morality poses a fundamental challenge to the dominant conception of medical ethics. In this controversial and timely study, Anne Maclean addresses the question of what kind of contribution philosophers can make to the discussion of medico-moral issues and the work of health care professionals. She establishes the futility of bioethics by challenging the conception of reason in ethics which is integral to the utilitarian tradition. She argues that a philosophical training confers no special authority to make pronouncements about moral issues, and proposes that pure utilitarianism eliminates the essential ingredients of moral thinking. Maclean also exposes the inadequacy of a utilitarian account of moral reasoning and moral life, dismissing the claim that reason demands the rejection of special obligations. She argues that the utilitarian drive to reduce rational moral judgment to a single form is ultimately destructive of moral judgment as such. This vital discussion of the nature of medical ethics and moral philosophy will be important reading for anyone interested in the fields of health care ethics and philosophy.

Abstract: More than half a century after the Universal Declaration of Human Rights defined what a human being is and is entitled to, Catharine MacKinnon asks: Are women human yet? If women were regarded as human, would they be sold into sexual slavery worldwide; veiled, silenced, and imprisoned in homes; bred, and worked as menials for little or no pay; stoned for sex outside marriage or burned within it; mutilated genitally, impoverished economically, and mired in illiteracy--all as a matter of course and without effective recourse?

Publisher's Note: This collection of original essays explores the social and relational dimensions of individual autonomy. Rejecting the feminist charge that autonomy is inherently masculinist, the contributors draw on feminist critiques of autonomy to challenge and enrich contemporary philosophical debates about agency, identity, and moral responsibility. The essays analyze the complex ways in which oppression can impair an agent's capacity for autonomy, and investigate connections, neglected by standard accounts, between autonomy and other aspects of the agent, including self-conception, self-worth, memory, and the imagination.