Animal ethics committees (AECs) appeal to utilitarian principles in their justification of animal experiments. Although AECs do not grant rights to animals, they do accept that animals have moral standing and should not be unnecessarily harmed. Although many appeal to utilitarian arguments in the justification of animal experiments, I argue that AECs routinely fall short of the requirements needed for such justification in a variety of ways. I argue that taking the moral status of animals seriously—even if this falls short of granting rights to animals—should lead to a thorough revision or complete elimination of many of the current practices in animal experimentation.
Global health and national borders: the ethics of foreign aid in a time of financial crisis.
BACKGROUND: The governments and citizens of the developed nations are increasingly called upon to contribute financially to health initiatives outside their borders. Although international development assistance for health has grown rapidly over the last two decades, austerity measures related to the 2008 and 2011 global financial crises may impact negatively on aid expenditures. The competition between national priorities and foreign aid commitments raises important ethical questions for donor nations. This paper aims to foster individual reflection and public debate on donor responsibilities for global health. METHODS: We undertook a critical review of contemporary accounts of justice. We selected theories that: (i) articulate important and widely held moral intuitions; (ii) have had extensive impact on debates about global justice; (iii) represent diverse approaches to moral reasoning; and (iv) present distinct stances on the normative importance of national borders. Due to space limitations we limit the discussion to four frameworks. RESULTS: Consequentialist, relational, human rights, and social contract approaches were considered. Responsibilities to provide international assistance were seen as significant by all four theories and place limits on the scope of acceptable national autonomy. Among the range of potential aid foci, interventions for health enjoyed consistent prominence. The four theories concur that there are important ethical responsibilities to support initiatives to improve the health of the worst off worldwide, but offer different rationales for intervention and suggest different implicit limits on responsibilities. CONCLUSIONS: Despite significant theoretical disagreements, four influential accounts of justice offer important reasons to support many current initiatives to promote global health. Ethical argumentation can complement pragmatic reasons to support global health interventions and provide an important foundation to strengthen collective action.
Disability, Enhancement and the Harm-Benefit Continuum
Suppose that you are soon to be a parent and you learn that there are some simple measures that you can take to make sure that your child will be healthy. In particular, suppose that by following the doctor’s advice, you can prevent your child from having a disability, you can make your child immune from a number of dangerous diseases and you can even enhance its future intelligence. All that is required for this to happen is that you (or your partner) comply with lifestyle and dietary requirements. Do you and your partner have any moral reasons (or moral obligations) to follow the doctor’s advice? Would it make a difference if, instead of following some simple dietary requirements, you consented to genetic engineering to make sure that your child was free from disabilities, healthy and with above average intelligence? In this paper we develop a framework for dealing with these questions and we suggest some directions the answers might take.
Involuntary experiments in former colonies: The case for a moratorium
Abstract: There is a rich literature on the use of medical trials as a model for designing and evaluating the outcomes of social policy interventions in former colonies. Yet social experimentalists have not engaged in a correspondingly vibrant discussion of medical ethics. A systematic review of social experiments shows that few studies explicitly discuss informed consent, or the serious constraints on securing informed consent from impoverished or child participants, particularly in the context of cluster randomization. The silence on informed consent, and in some cases active denial thereof, suggests that it is often considered less important than other elements of experimental design. This matters since involuntary experimentation on vulnerable people violates their personhood, increases the risk of unintended harm, and establishes continuities with colonial experimentation. There is a need to develop more effective mechanisms for regulating social experiments in former colonies. In the interim, scholars in the South have a responsibility to call for a moratorium on experiments.
The Moral Limits of Markets: The Case of Human Kidneys
Abstract: This paper examines the morality of kidney markets through the lens of choice, inequality, and weak agency looking at the case for limiting such markets under both non-ideal and ideal circumstances. Regulating markets can go some way to addressing the problems of inequality and weak agency. The choice issue is different and this paper shows that the choice for some to sell their kidneys can have external effects on those who do not want to do so, constraining the options that are now open to them. I believe that this is the strongest argument against such markets.
Markets and the needy: Organ sales or aid?
Abstract: As organ shortages have become more accute, support for a market in organs has steadily increased. Whilst many have argued for such a market, it is Gerald Dworkin who most persuasively defends its ethics. As Dworkin points out, there are two possibilities here – a futures market and a current market. I follow Dworkin in focusing on a current market in the sale of organs from living donors, as this is generally considered to be the most difficult to justify. One of the most pressing concerns here is that such a market will exploit the poor. I outline this concern and scrutinise Dworkin’s and others’ rejection of it. Briefly, I argue that the arguments Dworkin employs for allowing the poor to sell their organs fail, and in fact better support an argument for increasing aid to the needy.
A vote for no confidence
Abstract: This paper considers the justifications for adhering to a principle of confidentiality within medical practice. These are found to derive chiefly from respect for individual autonomy, the doctor/patient contract, and social utility. It is suggested that these will benefit more certainly if secrecy is rejected and the principle of confidentiality is removed from the area of health care
Bioethics: An African perspective
Abstract: In this paper I have attempted to open a window on an African approach to Bioethics – that of the Nso’ of the Bamenda Highlands of Kamerun – from the vantage position of someone who has familiarity with both African and Western cultures. Because of its scientific-cum-technological sophistication and its proselytising character, Western culture, as well as Western systems of thought and practice, have greatly affected and influenced other cultures, particularly African culture. But Western culture, systems of thought and practice, have been highly impervious and immune to influences from other cultures, philosophies, systems of thought and practice, even where these might have been salutary and enriching to Western culture and systems. What I have here termed Nso’ eco-bio-cummunitarianism clearly indicates a viable alternative world-view within which some of the bioethical perplexities and controversies of today might be more satisfactorily resolved than within a Western framework. I have further attempted to show, by way of example, how within such a world-view, abortion and suicide, for instance, would be disapproved of while euthanasia, in its etymological purity, is approved of
Elements of African Bioethics in a Western Frame
Abstract: For millennia, Africans have lived on the African continent, in close contact with the diversities of nature: floral, faunal and human; and in so doing they have developed cultures, values, attitudes and perspectives to the problems, ethical and otherwise, that have arisen from the existential pressures of their situation. The problem, however, is that such values and perspectives do not necessarily form coherent ethical theories. Theory-making is a second order activity requiring a certain amount of leisure and comfort which the existential conditions of life on the African continent have not easily permitted in the retrospect-able past. The elements of African bioethics are to be found in its cultural values, traditions, customs and practices. These are research-able, highlight-able and usable by those who would. The bioethical problems of our current global existential situation are such that all possible solutions, no matter their provenance, ought to be tried. Western culture has far too loud a voice combined with deaf ears in contemporary ethical discourse. But it should never be forgotten that other cultures have their own word to say and that alternative values, ways of thinking and practices exist, and attempt should always be made to bring these out and to highlight them, if they could possibly contribute to the satisfactory solution of a global problem. This book brings together various papers on bioethical issues and problems, written at different times, some previously published, each of which attempts to bring out some African elements, perspective or concern. The African narrative style predominates through these essays but their framing conforms, more or less, to the Western paradigm for presenting academic issues.
Truth-telling in health care
Abstract: This article is about the description of all the situations in which clinician find difficult to tell the truth to patients regarding their condition. Moral importance of telling the truth is recognized in both moral theory and in the practical reality of everyday living. However, empirical studies continue to show that health- care professional identify the question of truth-telling and disclosure as a source of moral and psychological discomfort in many situations. Other situation creating difficulties for clinicians are not related directly to the patient’s wants or needs regarding their illness but to wider issues such as disclosure of medical error and identifying poor performance in colleagues.