Torbjörn Tännsjö

Conservatism has an essence, or so I argue. Typical of the conservative attitude is to take what is an established fact or order to be worthy of preservation, precisely because it is well established. The question what fact is established must be answered in a context, and people of different political bent answer it differently. This is why we have left‐wing as well as right‐wing conservatism, sharing a common rationale. In my Conservatism for Our Time I discuss various different aspects of this rationale, and my answer to certain strictures raised by Robert Grant concerns several of them. The most important concerns a conservative or traditionalist criticism of rationalism. This criticism has been developed by ‐ among others ‐Michael Oakeshott. In my book, and in my answer to Grant, I defend and elaborate on this criticism.

According to estimates more than 400 biobanks currently operate across Europe. The term ‘biobank’ indicates a specific field of genetic study that has quietly developed without any significant critical reflection across European societies. Although scientists now routinely use this phrase, the wider public is still confused when the word ‘bank’ is being connected with the collection of their biological samples. There is a striking lack of knowledge of this field. In the recent Eurobarometer survey it was demonstrated that even in 2010 two-thirds of the respondents had never even heard about biobanks. The term gives the impression that a systematic collection of biological samples can constitute a ‘bank’ of considerable financial worth, where the biological samples, which are insignificant in isolation but are valuable as a collection, can be preserved, analysed and put to ‘profitable use’. By studying the practices of the numerous already existing biobanks, the authors address the following questions: to what extent does the term ‘biobank’ reflect the normative concept of using biological samples for the purposes of biomedical research? Furthermore, is it in harmony with the so far agreed legal–ethical consensus in Europe or does it deliberately pull science to the territory of a new, ambiguous commercial field? In other words, do biobanks constitute a medico-legal fiction or are they substantively different from other biomedical research protocols on human tissues?

In the Fall of 1997 the leading Swedish newspaper, Dagens Nyheter, created a media hype over the Swedish policy of compulsory sterilisation that had been in operation between 1935 and 1975. In the discussion that followed the moral condemnation of our medical past was unanimous. However, the reasons for rejecting what had gone on were varied and mutually inconsistent. Three strands of criticism were common: the argument from autonomy, the argument from caution, and the argument from biological scepticism. In the paper it is argued that what point of departure you choose in your criticism of the past should be of consequence also for your ideas about present and future medical practice. In particular, if you rely on the argument from autonomy, you should be prepared to accept a liberal (present and future) use of reproductive techniques.

The paper is a record of a debate which took place between a group of clinicians and the author concerning a clinical trial of a drug supposed to postpone the time when HIV-patients develop AIDS. A problem with the trial was that on available (inconclusive) evidence it appeared that one patient out of 500 was killed by the drug. The question raised was whether, in view of this evidence, it was morally defensible to go on with the trial. The discussion came to involve general topics such as the appropriate role of the ideal of autonomy as well as more particular topics of quantitative and qualitative risk assessments. The main thrust of the argument is that different conceptions of rationality may provide rationales of conflicting clinical decisions. Philosophy matters to medicine. Keywords: autonomy, equipoise, hazards, the Helsinki Declaration, maximizing expected utility, potential benefits, rationality, risk assessment CiteULike Connotea Del.icio.us What's this?

In principle, there seem to be three main ways in which society can react when people commit crimes under influence of mental illness. (1) The standard model. We excuse them. If they are dangerous they are detained in the interest of safety of the rest of the citizens. (2) The Swedish model. We hold them responsible for their criminal offence, we convict them, but we do not sentence them to jail. Instead, we sentence them to psychiatric treatment. (3) My model. We sentence them to jail, but offer them (voluntary) psychiatric treatment. The advantages of my model are obvious. We get a clear delineation of roles. We allow the psychiatrist to be just a doctor, not a warden. We liberate psychiatry of the objective of deciding whether people who were mentally ill when they committed criminal offences ‘could have acted otherwise’— a hopeless task. We allow that psychiatrists live up to their professional ethical code (the Hawaii Declaration). We treat psychically ill persons as ‘normal’, we allow them to repent their crimes, which renders easier their recovery. However, two objections to my model come to mind. First of all, is it not unfair to sentence people to jail who could not help doing what they did? And, secondly, the question of fairness set to one side, is it not inhumane to sentence mentally ill persons to jail? Is it not inhumane to the mentally ill persons themselves, and does it not mean that they will be a burden to other prisoners? In my paper I show that, if our system of criminal punishment takes a civilised form, neither of these objections carries any weight.

We cannot easily condemn in principle a policy where people are non-voluntarily sterilized with their informed consent (where they accept sterilization, if they do, in order to avoid punishment). There are conceivable circumstances where such a policy would be morally acceptable. One such conceivable circumstance is the one (incorrectly, as it were) believed by most decent advocates of eugenics in the late nineteenth and early twentieth century to exist: to wit, a situation where the human race as such is facing a threat. Perhaps today's Chinese experience with a threat of overpopulation is a more realistic example? Finally, there is some room for a kind of non-voluntary (and coercive) sterilization without informed consent. I think of people who are severely mentally retarded, and who cannot understand how sexual intercourse relates to conception. If some of these persons are fertile and sexually active, it may very well be the morally right thing to do to sterilize these persons, in their own best interest, but without their consent - if necessary even through coercive means.

Quine is an important philosopher. The point of departure of his philosophical enterprise is sound: his down to earth naturalism, his scientism and behaviourism. However, he tends to get carried away by it, when he goes to extremes – and ends up in nihilism. It is certainly true that we can never quite rule out the possibility that we have misunderstood another person. And what he or she means is a consequence mainly of two things. It is a consequence of his actual intention with the utterance and also, to some extent, of the way the world actually is. This is not to say, however, that there is no fact of the matter. While there is underdetermination by actual evidence of interpretation there is no such thing as indeterminacy of translation . While there may well exist conflicting empirically adequate theories, there is no room for ontological relativity. Some of these theories may be the right one and the others wrong, even if this is something we cannot even in principle decide on empirical grounds

Particularism is in vogue in ethics today. Particularism is sometimes described as the idea that what is a sufficient moral reason in one situation need not be a sufficient moral reason in another situation. Indeed, it has been held, on particularism, what is a reason for an action in one situation might be a reason against the same type of action, or might not be a reason at all, in another situation. However, this description is insufficient. Even a generalist, such as a utilitarian, may admit that, what is in one situation a sufficient reason for the rightness of an action may, in another situation, be a sufficient reason for its wrongness. For example, the fact that if I shoot at a certain person, I kill him, may, in one situation, be a sufficient reason not to shoot at him. It is sufficient for the wrongness of shooting at him if, in the situation, shooting at him suffices to guarantee that welfare does not get maximized. He is killed, say, and deprived of future pleasure, with no positive ‘side-effects’ whatever.

Should we change the human genome? The most general arguments against changing the human genome are here in focus. Distinctions are made between positive and negative gene therapy, between germ-line and somatic therapy, and between therapy where the intention is to benefit a particular individual (a future child) and where the intention is to benefit the human gene-pool.Some standard arguments against gene-therapy are dismissed. Negative somatic therapy is not controversial. Even negative, germ-line therapy is endorsed, if the intention is to cure a certain individual (a future child). In rare cases, positive therapy on somatic cells may be warranted. Germ-line therapy may become a valuable method of preventing harm, through genetic vaccination. If safe methods evolve, it is harmless (though vain), to try to achieve more ambitious goals. Prospective parents should not be prevented from exercising this harmless kind of parental authority.

I conclude that the explanatory view of consequences is a fruitful one.This view accounts for our common sense view that actions are, in some sense, ‘sufficient’ for their consequences. It shows in a concrete and illuminating manner that we are or may be responsible for a vast number of events no matter how ‘innocently’ our actions may be described. It allows for the fact that individuals lack responsibility for consequences of collective actions, thereby explaining a generally felt ‘double effect’ built into our social morality. It brings into light and explains the fact that some degree of determinism seems to be presupposed if people are ever morally responsible for any events whatsoever. Finally, the explanatory view of consequences yields precise and attractive interpretations of the open and the closed views of responsibility

Derek Parfit has famously pointed out that ‘total’ utilitarian views, such as classical hedonistic utilitarianism, lead to the conclusion that, to each population of quite happy persons there corresponds a more extensive population with people living lives just worth living, which is better. In particular, for any possible population of at least ten billion people, all with a very high quality of life, there must be some much larger imaginable population whose existence, if other things are equal, would be better, even though its members have lives that are barely worth living. This world is better if the sum total of well-being is great enough, and it is great enough if only enough sentient beings inhabit it. This conclusion has been considered by Parfit and others to be ‘repugnant’.

The repugnant conclusion is acceptable from the point of view of total utilitarianism. Total utilitarians do not seem to be bothered with it. They feel that it is in no way repugnant. To me, a hard-nosed total utilitarian, this settles the case. However, if, sometimes, I doubt that total utilitarianism has the final say in ethics, and tend to think that there may be something to some objection to it or another, it is the objection to it brought forward from egalitarian thought that first comes to mind. But if my argument in this article is correct, then it is clear that the repugnant conclusion should be equally acceptable to egalitarians of various different bents as it is to total utilitarians