{"title":"Confessions of an Antinatalist Philosopher.","authors":"Matti Häyry","doi":"10.1017/S0963180123000634","DOIUrl":"https://doi.org/10.1017/S0963180123000634","url":null,"abstract":"<p><p>Antinatalism assigns reproduction a negative value. There should be fewer or no births. Those who say that there should be fewer births have been called conditional antinatalists. A better name for their view would be selective pronatalism. Those who say that there should be no births face two challenges. They must define the scope of their no-birth policy. Does it apply only to human or sentient beings or can it also be extended to all organic life, perhaps even to machine consciousness? And whatever the scope, they have to justify the eventual extinction of humankind or other life forms, an inevitable consequence of unconditional antinatalism. Different axiologies and moral theories produce different responses to these challenges. It is argued that a two-value conflict-sensitive negative utilitarianism would produce a kind and reasonable justification for ending at least human and factory-animal reproduction. The conclusion is purely moral and supports only voluntary extinction for humankind.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-19"},"PeriodicalIF":1.8,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Naming and Describing Disability in Law and Medicine.","authors":"Heloise Robinson, Jonathan Herring","doi":"10.1017/S0963180123000609","DOIUrl":"https://doi.org/10.1017/S0963180123000609","url":null,"abstract":"<p><p>This article explores the effects of naming and describing disability in law and medicine. Instead of focusing on substantive issues like medical treatment or legal rights, it will address questions which arise in relation to the use of language itself. When a label which is attached to a disability is associated with a negative meaning, this can have a profound effect on the individual concerned and can create stigma. Overly negative descriptions of disabilities can be misleading, not only for the individual, but also more broadly in society, if there are inaccurate perceptions about disability in the social context. This article will examine some relevant examples of terminology, where these issues arise. It will also suggest that the role of medicine and the law in naming and describing disability is particularly important because in these areas there is, perhaps more than anywhere else, a recognized source of authority for the choice of terminology. Labels and descriptions used in the medical and legal contexts can not only perpetuate existing stigmatization of disabled people, but can also contribute to creating stigma at its source, given that the words used in these contexts can constitute an exercise of power.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sam's Story: Reflections on Suicide and the Doctor/Patient Relationship.","authors":"William Andereck","doi":"10.1017/S0963180123000610","DOIUrl":"https://doi.org/10.1017/S0963180123000610","url":null,"abstract":"","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-3"},"PeriodicalIF":1.8,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Social Support: From Exclusion Criteria to Medical Service.","authors":"Jacob M Appel","doi":"10.1017/S0963180123000014","DOIUrl":"10.1017/S0963180123000014","url":null,"abstract":"<p><p>One of the criteria used by many transplant centers in assessing psychosocial eligibility for solid organ transplantation is social support. Yet, social support is a highly controversial requirement that has generated ongoing debate between ethicists and clinicians who favor its consideration (i.e., utility maximizers) and those who object to its use on equity grounds (i.e., equity maximizers). The assumption underlying both of these approaches is that social support is not a commodity that can be purchased in the marketplace. This essay argues for the reconceptualization of social support as a product that can-and should-be purchased for transplant candidates to render them eligible for transplant.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"17-22"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10720601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Discrimination Based on Personal Responsibility: Luck Egalitarianism and Healthcare Priority Setting.","authors":"Andreas Albertsen","doi":"10.1017/S0963180123000415","DOIUrl":"10.1017/S0963180123000415","url":null,"abstract":"<p><p>Luck egalitarianism is a responsibility-sensitive theory of distributive justice. Its application to health and healthcare is controversial. This article addresses a novel critique of luck egalitarianism, namely, that it wrongfully discriminates against those responsible for their health disadvantage when allocating scarce healthcare resources. The philosophical literature about discrimination offers two primary reasons for what makes discrimination wrong (when it is): harm and disrespect. These two approaches are employed to analyze whether luck egalitarian healthcare prioritization should be considered wrongful discrimination. Regarding harm, it is very plausible to consider the policies harmful but much less reasonable to consider those responsible for their health disadvantages a socially salient group. Drawing on the disrespect literature, where social salience is typically not required for something to be discrimination, the policies are a form of discrimination. They are, however, not disrespectful. The upshot of this first assessment of the discrimination objection to luck egalitarianism in health is, thus, that it fails.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"23-34"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10113762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Precision Medicine and Rough Justice: Wicked Problems.","authors":"Leonard M Fleck","doi":"10.1017/S0963180123000312","DOIUrl":"10.1017/S0963180123000312","url":null,"abstract":"<p><p>What exactly is a \"wicked problem\"? It is a social or economic problem that is so complex and so interconnected with other issues that it is extraordinarily difficult or impossible to resolve. This is because all proposed resolutions generate equally complex, equally wicked problems. In this essay, I argue that precision medicine, especially in the context of the U.S. healthcare system, generates numerous wicked problems related to distributive justice. Further, I argue that there are no easy solutions to these wicked problems. The need for trade-offs is inescapable. Rough justice is the best outcome we can hope for, and that outcome requires a commitment to processes of public reason that are fair and inclusive.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-4"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9631289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Synthesizing Methuselah: The Question of Artificial Agelessness.","authors":"Richard B Gibson","doi":"10.1017/S0963180123000488","DOIUrl":"10.1017/S0963180123000488","url":null,"abstract":"<p><p>As biological organisms, we age and, eventually, die. However, age's deteriorating effects may not be universal. Some theoretical entities, due to their synthetic composition, could exist independently from aging-artificial general intelligence (AGI). With adequate resource access, an AGI could theoretically be ageless and would be, in some sense, immortal. Yet, this need not be inevitable. Designers could imbue AGIs with artificial mortality via an internal shut-off point. The question, though, is, should they? Should researchers curtail an AGI's potentially endless lifespan by deliberately making it mortal? It is this question that this article explores. First, it considers what type of AGI is under discussion before outlining how such beings could be ageless. Then, after clarifying the type of immortality under discussion and arguing that imbuing an AGI with synthetic aging would be person-affecting, the article explores four core conundrums: (i) deliberately causing a morally significant being's death; (ii) immortality's associated harms; (iii) concerns about immortality's unequal assignment; and (iv) the danger of immortal AGI overlords. The article concludes that while prudence requires we create an aging AGI, in the face of the material harm such an action would constitute, this is an insufficient reason to justify doing so.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"60-75"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41140388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Federalism for Bioethics?","authors":"Leslie Francis, John Francis","doi":"10.1017/S0963180123000476","DOIUrl":"10.1017/S0963180123000476","url":null,"abstract":"<p><p>In the wake of the <i>Dobbs</i> decision withdrawing federal constitutional protection for reproductive rights, the United States is in the throes of federalist conflicts. Some states are enacting draconian prohibitions of abortion or gender-affirming care, whereas other states are attempting to shield providers and their patients seeking care. This article explores standard arguments supporting federalism, including that it allows for cultural differences to remain along with a structure that provides for the advantages of common security and commerce, that it provides a laboratory for confined experiments, that it is government closer to the people and thus more informed about local needs and preferences, and that it creates layers of government that can constrain one another and thus doubly protect rights. We contend that these arguments do not justify significant differences among states with respect to the recognition of important aspects of well-being; significant injustices among subnational units cannot be justified by federalism. However, as nonideal theorists, we also observe that federalism presents the possibility of some states protecting rights that others do not. Assuming that movement among subnational units is protected, those who are fortunate enough to be able to travel will be able to access rights they cannot access at home. Nonetheless, movement may not be readily available to minors, people without documentation, people with disabilities, people who lack economic resources, or people who have responsibilities that preclude travel. Only rights protection at the federal level will suffice in such cases.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"112-120"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41174588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"When Is Something an Alternative? A General Account Applied to Animal-Free Alternatives to Animal Research.","authors":"Koen Kramer","doi":"10.1017/S0963180123000300","DOIUrl":"10.1017/S0963180123000300","url":null,"abstract":"<p><p>The first \"R\" from animal research ethics prescribes the replacement of animal experiments with animal-free alternatives. However, the question of when an animal-free method qualifies as an alternative to animal experiments remains unresolved.Drawing lessons from another debate in which the word \"alternative\" is central, the ethical debate on alternatives to germline genome editing, this paper develops a general account of when something qualifies as an alternative to something. It proposes three ethically significant conditions that technique, method, or approach X must meet to qualify as an alternative to Y: (1) X must address the same problem as Y, under an appropriate description of that problem; (2) X must have a reasonable chance of success, compared to Y, in solving the problem; and (3) X must not be ethically unacceptable as a solution. If X meets all these conditions, its relative advantages and disadvantages determine whether it is preferable, indifferent, or dispreferable as an alternative to Y.This account is then applied to the question of whether animal-free research methods qualify as alternatives to animal research. Doing so breaks down the debate around this question into more focused (ethical and other) issues and illustrates the potential of the account.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"89-101"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9948250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}