James Taylor

In a recent article (“The current state of the platelet supply in the US and proposed options to decrease the risk of critical shortages”) published in _Transfusion,_ Stubbs et al. have argued that platelet donors should be paid. Dodd et al. have argued against this proposal, supporting their response with survey data that shows that blood donors (and by extension platelet donors) and potential platelet donors are uninterested in receiving incentives to encourage them to donate. Instead, argue Dodd et al., prospective platelet donors are motivated more by the ease of donation than the prospect of payment. This article defends Stubbs et al. from the criticisms of Dodd et al. It first argues that the preferences that persons state they have in response to survey questions might not reflect the preferences that their actions would reveal they have in actual rather than hypothetical situations. This hypothetical bias is especially likely when persons respond to surveys that ask them about the performance of morally commendable actions (such as platelet donation). This article then argues that the survey that Dodd et al. rely on exhibits serious selection bias with respect to the set of persons it considers to be potential platelet donors.

Schweda and Schicktanz argue that the debate over the ethics of using financial incentives to procure human transplant organs rests on socioempirical premises that need to be critically assessed. They contend that once this is achieved a completely new perspective on the debate should be adopted, with organ donation being viewed primarily as a reciprocal social interaction between donor and recipient. This paper challenges this conclusion, arguing that rather than supporting a new perspective on the debate over the commercial procurement of organs, the observations of Schweda and Schicktanz support the view that human organs should be commercialized

Teck Chuan Voo and Soren Holm argue that “organs should be inheritable if they were to be socially and legally recognised as tradable property.”1 To support this view they first observe that “…legal recognition of objects as property… opens up the possibility of the legal recognition of the survival of the property rights and their inheritability after the death of the source/owner, even if those rights are intimately bound with the person.”1 They also note that if organs are tradable property then they could be sold by their current owners for removal by the buyer after the original owner dies. Having established that a person's property rights in her organs should be respected in this way if organs are tradable property, Voo and Holm hold that “[p]rima facie, organs should be disposable by testation”.1 They believe that this claim is supported by the same consequentialist reasons that support organs being recognised as tradable property: that this increases persons’ freedom and control over their organs, and increases transfers of transplantable organs to persons who need them. But while these reasons support recognising organs as tradable property, they do not support their being …

Many still oppose legalizing markets in human organs on the grounds that they are morally repugnant. I will argue in this paper that the repugnance felt by some persons towards sales of human organs is insufficient to justify their prohibition. Yet this rejection of the view that markets in human organs should be prohibited because some persons find them to be morally repugnant does not imply that persons’ feelings of distress at the possibility of organ sales are irrational. Eduardo Rivera-Lopez argues that such instinctive distress is an appropriate response to the perception that certain kinds of arguments that are offered in favor of legalizing organ sales are “in an important sense, illegitimate.” Having argued that repugnance should not ground the prohibition of markets in human organs, I will also argue that the moral distress that some feel towards certain arguments that favor such markets is not rationally defensible, either

Markets have long had a whiff of sulphur about them. Plato condemned innkeepers, whose pursuit of profit he believed led them to take advantage of their customers, Aristotle believed that the pursuit of profit was indicative of moral debasement, and Cicero held that retailers are typically dishonest as this was the only path to gain. And even those who are more favorably disposed towards markets in general are frequently inclined to be suspicious of markets in medical goods and services. For example, Margaret Thatcher supported the legal prohibition of markets in kidneys despite being arguably the most pro-market Prime Minister the United Kingdom saw in the 20th century.

A standard objection to a market in political votes is that it will enable the rich politically to dominate the poor. If a market in votes was allowed then the poor would be the most likely sellers and the rich the most likely buyers. The rich would thus accumulate the votes of the poor, and so the candidates elected and the policies passed would represent only their interests and not those of the electorate as a whole. To ensure that the poor do not become de facto disenfranchised, then, markets in votes should be disallowed. This objection seems so straightforward and compelling that it has received almost no critical scrutiny. This is unfortunate, for close examination reveals that this argument is not as straightforward as it initially appears. Indeed, there are four different ways of understanding this objection. It could be understood as expressing: the concern that markets in votes would enable candidates to win elections who would otherwise lose them; the concern that they would enable the election of candidates opposed by the majority of the electorate; the concern that they would lead to the poor having disproportionately low political influence; and the concern that they would lead to the rich having disproportionately high political influence. I will argue in this paper that only and could plausibly ground objections to markets in votes. Moreover, these will only plausibly ground objections to unrestricted markets in votes; they will not ground objections to markets in votes per se. Thus, if we are to continue to object to markets in political votes we will have to do this on grounds other than that were they to be allowed the rich will politically dominate the poor.

Christopher Freiman, Jason Brennan, and Peter M. Jaworski have recently defended markets in votes. While their views differ in several respects they all believe that the primary justificatory burden lies not with those who defend markets in votes but with those who oppose them. Yet while the burden of proof should typically rest with those who wish to prohibit markets in certain goods this does not hold for the debate over markets in votes. Votes are crucially different from other goods in that for a market in them to exist, it is not enough that it be legalized; it must also be provided with institutional support so that the buyer of a vote would know that it has been cast as she wished. Defenders of markets in votes must thus provide positive arguments for the view that markets in votes should be institutionally facilitated—they cannot simply try to shift the burden of proof onto those who oppose them. This is bad news for those who defend the legalization of vote-buying, for none of the positive arguments that Freiman has offered in favor of the legalization of this type of vote-buying are sound.

In recent years a concern with the value of personal autonomy has come to dominate discussions in medical ethics. This emphasis on autonomy has naturally led to discussions of what criteria must be met for a person to be autonomous, or to be autonomous with respect to her decisions, her actions, or those of her desires that motivate her to make or to perform the decisions or the actions that she makes or does. It has also led to discussions of whether autonomy is valuable in itself, instrumentally valuable, or whether its value is a combination of the two: that a person’s autonomy is valuable to her not merely as a means to securing something else that she finds valuable, but is valuable as its possession is part of what makes her life go well.Questions that concern the value of autonomy are necessarily linked to the prior question of the precise nature of autonomy. There are two main approaches to answering this question within the Western philosophical tradition. The first is Kantian ..

In 1998, The Lancet published a research paper by Andrew Wakefield that provided support to the formerly-discredited theory that the Measles, Mumps, Rubella (MMR) vaccine could cause colitis and autism spectrum disorders (Wakefield et al. 1998). Although this paper was fully retracted in 2010 after being exposed as fraudulent, it served as a catalyst for concerns about the safety of vaccination, both the MMR vaccine in particular and vaccination in general. While the scientific consensus concerning both the MMR vaccine and others that are routinely provided to persons in developed Western countries is that the benefits of receiving them far outweigh the risks, there is still serious concern on the part of some parents about the safety of vaccinating their children. Moreover, in addition to concerns about the safety of vaccination some parents are concerned about the effects that receiving certain vaccinations will have upon their childrens’ volitional actions. For example, the possibil

The papers in this special thematic issue of HEC Forum critically and carefully explore key issues at the intersection of patient privacy and commodification. For example, should hospitals be required to secure a person’s consent to any possible uses to which his discarded body parts might be put after his treatment or should it only be concerned with securing his informed consent to his treatment? Should a hospital be required to raise the possibility of the commodification of such body parts, or should it only be required to address this issue if the patient asks about it? Should persons be paid to engage in medical research, or should they only be compensated for their time, on the grounds, perhaps, that such payment would be coercive or exploitative, for it might move some persons to agree to participate in research who otherwise would not have done? This number of HEC Forum illustrates the widespread implications of these issues upon which healthcare ethics committees are called to deliberate.

Some of the most difficult ethical issues that arise in clinical bioethics concern the practice of medicine upon children. Unlike adults, children are incapable of providing informed consent either to undergoing the procedures that might be performed upon them, or to taking the drugs that might benefit them. Since this is so, children—like impaired adults—often have decisions made for them by competent adults who can consent on their behalf. This leads to a series of well-known philosophical problems concerning the basis upon which such decisions should be made. While it might seem clear that such decisions should be made to secure the best interests of the child, difficulties arise when there is disagreement between parents and others as to what those best interests would be. This might occur in the context of parents’ decisions being guided by their religious beliefs: For example, should a child whose parents are devout Jehovah’s Witnesses have a life-saving blood transfusion withhel

It is widely accepted that a person can be harmed by events that occur after her death. The most influential account of how persons can suffer such posthumous harm has been provided by George Pitcher and Joel Feinberg. Yet, despite its influence (or perhaps because of it) the Feinberg-Pitcher account of posthumous harm has been subject to several well-known criticisms. Surprisingly, there has been no attempt to defend this account of posthumous harm against these criticisms, either by philosophers who work on the metaphysics of death or by those who draw upon this account of posthumous harm in their work in other philosophical fields. This paper will rectify this omission, by defending this view against the criticisms it has been subject to—a defense that will both be of intrinsic interest to those who work on the metaphysics of death and that will remedy the lacunae in the wide-ranging philosophical literature that draws upon this account of how posthumous harm is possible.

How much understanding should be required of a person with respect to her actions and their implications for her to be autonomous with respect to her decisions to perform them? I defend a thin approach to the question of how much understanding of her acts a person should possess for her possibly to be autonomous with respect to her decisions to perform them: That a person could be autonomous with respect to her decision to perform a certain action if she understood both the nature of the act and its expected implications under the intensional description under which she intentionally performed it. This paper is divided into three sections. First, I argue that a concern for the moral value of autonomy does not undergird the ethical requirement to secure a person’s informed consent to her medical treatment. Second, I respond to several objections that have been leveled against this argument that focus on its implicit premise that only a thin understanding of one’s actions is required for one to be autonomous with respect to one’s decisions to perform them. I conclude by indicating why this minimalist account of autonomy that I defend is preferable to its more robust competitors.

The UCLA Medical Center has initiated a “voucher program” under which a person who donated a kidney would receive a voucher that she could provide to someone of her choosing who could then use it to move to the top of the renal transplantation waiting list. If the use of such vouchers as incentives for donors is morally permissible, then cash payments for kidneys are also morally permissible. But, that argument faces five objections. First, there are some goods whose nature allows them to be exchanged for similar goods but renders them monetarily inalienable. Hence, kidneys might be exchanged for kidneys but not sold for cash. Second, voucher programs respect donor autonomy, whereas the offer of cash payments does not. Third, the burden of proof lies with the advocates of cash payments for kidneys to show that their benefits would outweigh the costs of their legalization. Fourth, allowing cash payments for kidneys would stifle medical innovation. Fifth, allowing cash payments for kidneys would result in these organs being used as collateral to secure loans—and that this would disadvantage potential borrowers who did not want to risk their kidneys in this way. This paper will rebut all these objections.

This paper comments on Cohen’s “Philosophy with Teeth” (also in this issue), and raises four questions surrounding the relationship between philosophy and psychology, most of which are requests for clarification from Cohen but two of which are more critical in character: Against Cohen’s claim that APPE disavows any intrinsic connection between philosophical counseling and psychology, it is suggested that this still leaves open the pos­sibility of an instrumental connection. And against Cohen’s claim that pure philosophy is “grist for the classroom” or for “stimulating discussions over coffee,” it is maintained that pure philosophy may have more “teeth” than what this suggests.

This is the first book to argue in favor of paying people for their blood plasma. It does not merely argue that offering compensation to plasma donors is morally permissible. It argues that prohibiting donor compensation is morally wrong--and that it is morally wrong for all of the reasons that are offered against allowing donor compensation. Opponents of donor compensation claim that it will reduce the amount and quality of plasma obtained, exploit and coerce donors, and undermine social cohesion. James Stacey Taylor argues that empirical evidence demonstrates that compensating plasma donors greatly increases the amount of plasma obtained with no adverse effects on the quality of the pharmaceutical products that are manufactured from it. Prohibiting compensation thus harms patients by reducing their access to the medicines they need. He also argues that it is the prohibition of compensation--not its offer--that exploits donors, fails to respect the moral need to secure a person's authoritative consent to her treatment, and prevents donors from giving their informed consent to donate. Prohibiting compensation thus not only harms patients--it wrongs donors. Bloody Bioethics will appeal to researchers, advanced students, and medical professionals interested in bioethics, moral philosophy, and the moral limits of markets.