Benjamin Sachs

This paper investigates whether moral status talk gets us anywhere in our search for answers to questions in the ethics of marginal cases. I consider the usefulness of moral status talk first on the assumption that an individual's possession of moral status is not a further fact about that individual, and then on the assumption that it is. Finally, I offer an expressivistic interpretation of moral status talk. In each case, I argue that such talk conveys nothing that cannot be conveyed more clearly in other words. My conclusion is that we should stop using moral status and its cognates

Here I inquire into the status of the rules promulgated in the canonical pronouncements on human subjects research, such as the Declaration of Helsinki and the Belmont Report. The question is whether they are ethical rules or rules of policy. An ethical rule is supposed to accurately reflect the ethical fact, whereas rules of policy are implemented to achieve a goal. We should be skeptical, I argue, that the actions prescribed by the rules are ethically obligatory, and consequently we should focus our attention on how to craft the rules so as to promote the legitimate goals of human subjects research. Unfortunately, this cannot be done without evidence about the likely effects of various candidate policies—evidence we currently lack. Therefore, we should take the rules as mere starting points, subject to revision as the evidence comes in.

In November 2008 Professor Mike Richards issued his much awaited review of the British Department of Health's policy on out-of-pocket payments for drugs not approved as cost effective by the National Institute for Health and Clinical Excellence. The policy stated, or had been construed as stating, that those who top up thereby became ineligible for further National Health Service treatment for the condition targeted by the drug. For instance, if a lung cancer sufferer bought Avastin, which is not NICE approved, she could no longer receive free treatment for her cancer on the NHS's tab. Richards, the National Cancer Director, recommended that the policy be repealed. From an ethical point of view, this change should be enthusiastically welcomed