Jeffrey Blustein

The meaning of valid proxy consent for children has recently been the subject of an important debate between Richard McCormick and Paul Ramsey on the ethics of experimenting with children. Ramsey is willing to agree with McCormick that parental consent for a child to undergo some medical procedure is valid only if parents consider what the child would consent to if he could. But beyond this, Ramsey has a fundamentally different conception of the child from McCormick, and therefore gives a very different interpretation to this standard for valid proxy consent. In Ramsey's view, McCormick's basic mistake is to think of the child as a small adult, thereby overlooking the child's peculiar vulnerabilities and needs. In particular, McCormick fails to attend to the child's needs for "preservation in life and healthful growth". In this paper, the author pursues Ramsey's suggestion that a correct analysis of valid proxy consent for children would replace the "language of consent" with the "language of need". He does this by sketching a theory of parenthood that rests on two central notions: that of primary goods, as found in the writing of John Rawls, and that of autonomy

Philosophically, the most interesting objection to the reliance on advance directives to guide treatment decisions for formerly competent patients is the argument from the loss of personal identity. Starting with a psychological continuity theory of personal identity, the argument concludes that the very conditions that bring an advance directive into play may destroy the conditions necessary for personal identity, and so undercut the authority of the directive. In this article, I concede that if the purpose of a theory of personal identity is to provide an answer to the question What is it for a person to persist over time?, then reflection on personal identity poses a potentially serious threat to the moral authority of advance directives. However, as Marya Schechtman observes, questions about how a single person persists through change are not what most of us are interested in when we think about who a person is. Rather, we are interested in what it means to say that a particular set of actions, experiences, and characteristics is that of a given person rather than someone else.

RÉSUMÉ: J'examine ici trois façons de défendre l'idée que les personnes ont individuellement une valeur. Je pars de la thèse selon laquelle la valeur des individus tient à la valeur de leurs qualités particulières. Je m'arrête alors sur l'objection que pour comprendre ce qui fait la valeur individuelle des personnes, il nous faut accorder une place distinctive à leurs conceptions d'elles-mêmes. L'approche par la conception de soi qui résulte de ces considérations se révèle problématique à l'examen, mais elle nous oriente vers une façon «kantienne», plus satisfaisante, de rendre compte de la valeur des individus. L'explication en question développe la doctrine des «deux points de vue» avancée par Christine Korsgaard et fait reposer ma valeur en tant qu'individu sur la dignité qui est la mienne en tant que maître d'œuvre de ma propre vie, un titre que personne d'autre ne peut avoir.

Urban bioethics seeks to broaden the traditional focus of bioethics to encompass questions about the interplay of individuals with family, group, community, and society. Urban bioethics will need to deal with cultural diversity, issues of equity, and the conflict between individual rights and the public good. Encouraging a multicultural ethical discernment, fostering an appreciation of the political, economic, sociological, and psychological issues that inform the question of urban moral choice, urban bioethics is essentially a multi-disciplinary, synthesizing enterprise. Several theoretical models including social contract, rule utilitarian, communitarian, and feminist paradigms offer complementary conceptual frameworks. This paper is offered as a proposal, a road map for future study to place current bioethical analysis into a broader context.

The recent child custody case Weisberger v Weisberger raises a number of ethical issues concerning the rights and responsibilities of parents. Chavie Weisberger, thirty‐five, and her husband, both members of an ultraorthodox Hasidic community, appeared before a religious court in 2008 to obtain a divorce. There are two sharply contrasting legal rulings in this case. Setting aside the legally significant fact that Chavie had signed the divorce agreement with the clause requiring her to raise her children Hasidic, which decision is ethically more defensible and why? Were Chavie's parental rights violated when the court removed her children from her care? Should her ex‐husband have been awarded full custody on the ground that this was in the children's best interest, and is this the right standard to use in making custody decisions? What parental responsibilities did Chavie and her ex‐husband have, and were they satisfactorily discharging them? A theory of the moral foundations of parenthood should provide answers to these questions among others. Joseph Millum, in his excellent new book The Moral Foundations of Parenthood, does this and more. His theory encompasses accounts of the foundation and content of parental rights and responsibilities, the acquisition of parental responsibilities, and the standards governing parental decision‐making.

This paper is a response to particularist critics of the normative force of moral principles. The particularist critique, as I understand it, is a rejection not only of principle‐based accounts of moral deliberation and justification, but also of accounts of character in which principles play a central role. I focus on the latter challenge and counter it with a view I call character‐principlism. I begin by discussing in a general way what motivates the particularity objection to principles and then contrast two views – both of which insist on the importance of attentiveness to particularity – about the relative normative status of principles and particular cases. I present some reasons for believing that we need a more normatively robust conception of the role of moral principles than the particularists provide. In the main portion of the paper, I discuss how character‐principlism sees principles functioning in our lives and the lives we lead with others. I contrast this with some other accounts of desirable character that particularists can embrace, and argue that these are seriously flawed because, unlike character‐principlism, they cannot satisfactorily explain how a person could possess the constancy of character that moral integrity requires.