Timothy F. Murphy

The Human Genome Project is an expensive, ambitious, and controversial attempt to locate and map every one of the approximately 100,000 genes in the human body. If it works, and we are able, for instance, to identify markers for genetic diseases long before they develop, who will have the right to obtain such information? What will be the consequences for health care, health insurance, employability, and research priorities? And, more broadly, how will attitudes toward human differences be affected, morally and socially, by the setting of a genetic “standard”? The compatibility of individual rights and genetic fairness is challenged by the technological possibilities of the future, making it difficult to create an agenda for a “just genetics.” Beginning with an account of the utopian dreams and authoritarian tendencies of historical eugenics movements, this book’s nine essays probe the potential social uses and abuses of detailed genetic information. Lucid and wide-ranging, these contributions will interest bioethicists, legal scholars, and policy makers. Essays: “The Genome Project and the Meaning of Difference,” Timothy F. Murphy “Eugenics and the Human Genome Project: Is the Past Prologue?,” Daniel J. Kevles “Handle with Care: Race, Class, and Genetics,” Arthur L. Caplan “Public Choices and Private Choices: Legal Regulation of Genetic Testing,” Lori B. Andrews “Rules for Gene Banks: Protecting Privacy in the Genetics Age,” George J. Annas “Use of Genetic Information by Private Insurers,” Robert J. Pokorski “The Genome Project, Individual Differences, and Just Health Care,” Norman Daniels “Just Genetics: A Problem Agenda,” Leonard M. Fleck “Justice and the Limitations of Genetic Knowledge,” Marc A. Lappé

This dissertation shows that Nietzsche considered himself a philosopher, not because he specifically engaged in metaphysics or epistemology, but because he attempted educating humanity about various patterns of living. Consequently, he is to be taken seriously as a philosopher because he instructed in the art of human living. Towards a demonstration of these claims, various commentators are investigated for the reasons they elevate Nietzsche to the level of philosopher. Nietzsche's remarks on university education are examined, his insistence on the contest as the chief element of educational method is considered in light of the teacher's right to lie and to mask himself. Further, the nature of Nietzsche's political concerns is considered. An implicit and explicit unit emerges from these considerations: Nietzsche is urging his readers, indeed all of civilization to follow an ethic of amor fati: one must become what one is. Despite the militaristic and even incendiary tone of Nietzsche's writings, finally, one sees that Nietzsche proposes the dance as the symbol of successful education because the dance integrates man back into nature, nature bounded by the dance of the eternal return. In the end, the answer to the question 'What must one teach?' must be: the dance

Developments in uterus transplant put assisted gestation within meaningful range of clinical success for women with uterine infertility who want to gestate children. Should this kind of transplantation prove routine and effective for those women, would there be any morally significant reason why men or transgender women should not be eligible for the same opportunity for gestation? Getting to the point of safe and effective uterus transplantation for those parties would require a focused line of research, over and above the study of uterus transplantation for non-transgender women. Some commentators object to the idea that the state has any duty to sponsor research of this kind. They would limit all publicly-funded fertility research to sex-typical ways of having children, which they construe as the basis of reproductive rights. This objection has no force against privately-funded research, of course, and in any case not all social expenditures are responses to ‘rights’ properly speaking. Another possible objection raised against gestation by transgender women is that it could alter the social meaning of sexed bodies. This line of argument fails, however, to substantiate a meaningful objection to gestation by transgender women because social meanings of sexed bodies do not remain constant and because the change in this case would not elicit social effects significant enough to justify closing off gestation to transgender women as a class

Most advocates of biogenetic modification hope to amplify existing human traits in humans in order to increase the value of such traits as intelligence and resistance to disease. These advocates defend such enhancements as beneficial for the affected parties. By contrast, some commentators recommend certain biogenetic modifications to serve social goals. As Ingmar Persson and Julian Savulescu see things, human moral psychology is deficient relative to the most important risks facing humanity as a whole, including the prospect of Ultimate Harm, the point at which worthwhile life is forever impossible on the planet. These risks can be mitigated, they say, by enhancing moral psychology in novel ways. Persson and Savulescu argue that some parents should modify the underlying biogenetics of their children's moral psychology, if such measures were safe and effective, but they admit these interventions may not decouple humanity from Ultimate Harm. Neither are these modifications the only options, they concede, for addressing risks to humanity. Even with these concessions, saving humanity from itself is a fairly poor reason to modify the moral psychology of children. In most ways, adults would be better candidates, morally speaking, for modifications of psychology. Even then, there is no direct link between morally enhanced human beings and the hoped-for effect of better protection from Ultimate Harm. Asserting a general duty of all to contribute to the avoidance of Ultimate Harm is a better moral strategy than intervening in the moral psychology of some, even though meeting that duty may involve substantial interference with the free exercise of one's interests

Gay Ethics is an anthology that addresses ethical questions involving key moral issues of today--sexual morality, outing, gay and lesbian marriages, military service, anti-discrimination laws, affirmative action policies, the moral significance of sexual orientation research, and the legacy of homophobia in health care. It focuses on these issues within the social context of the lives of gay men and lesbians and makes evident the ways in which ethics can and should be reclaimed to pursue the moral good for gay men and lesbians. Gay Ethics is a timely book that illustrates the inadequacies of various moral arguments used in regard to homosexuality. This book reaches a new awareness for the standing and treatment of gay men and lesbians in society by moving beyond conventional philosophical analyses that focus exclusively on the morality of specific kinds of sexual acts, the nature of perversion, or the cogency of scientific accounts of the origins of homoeroticism. It raises pertinent questions about the meaning of sexuality for private and public life, civics, and science.Some of the issues covered: Sexual Morality Outing Same-Sex Marriage Military Service Anti-Discrimination Laws Affirmative Action Policy The Scientific Study of Sexual Orientation Bias in Psychoanalysis Homophobia in Health Care Gay Ethics presents a wide range of perspectives but remains united in the common purpose of illuminating moral arguments and social policies as they involve homosexuality. The chapters challenge social oppression in the military, civil rights, and the social conventions observed among gay men and lesbians themselves. This book is applicable to a broad range of academics working in gay and lesbian studies and because of its current content, is of interest to an educated lay public. It will be a standard reference point for future discussion of the matters it addresses.

Some commentators indirectly challenge the ethics of using synthetic gametes as a way for same-sex couples to have children with shared genetics. These commentators typically impose a moral burden of proof on same-sex couples they do not impose on opposite-sex couples in terms of their eligibility to have children. Other commentators directly raise objections to parenthood by same-sex couples on the grounds that it compromises the rights and/or welfare of children. Ironically, the prospect of synthetic gametes neutralises certain of these objections, insofar as they would ensure that children have parents whom they can know as their genetic parents, which outcome is not always possible when same-sex couples involve third parties as the source of gametes or embryos. Not all commentators in bioethics throw the use of synthetic gametes into doubt as far as same-sex couples are concerned, but even these commentators put parenting by gay men and lesbians at the conclusion of an argument rather than presupposing parental legitimacy from the outset. Synthetic gametes do raise questions of ethics in regard to parenthood for gay men and lesbians, but these are largely questions of access and equity, not questions of parental fitness and/or child welfare

Certain interventions now permit the derivation of mammalian gametes from stem cells cultivated from either somatic cells or embryos. These gametes can be used in an indefinite cycle of conception in vitro, gamete derivation, conception in vitro, and so on, producing genetic generations that live only in vitro. One commentator has described this prospect for human beings as eugenics, insofar as it would allow for the selection and development of certain traits in human beings. This commentary not only offers this topic for discussion, it also wades into the ethical fray over the practice. Several possible lines of objection can be raised against this practice, but these accounts are by and large insufficient as an ethical analysis of this possible, future way of conceiving human children

Bioconservative commentators argue that parents should not take steps to modify the genetics of their children even in the name of enhancement because of the damage they predict for values, identities and relationships. Some commentators have even said that adults should not modify themselves through genetic interventions. One commentator worries that genetic modifications chosen by adults for themselves will undermine moral agency, lead to less valuable experiences and fracture people's sense of self. These worries are not justified, however, since the effects of modification will not undo moral agency as such. Adults can still have valuable experiences, even if some prior choices no longer seem meaningful. Changes at the genetic level will not always, either, alienate people from their own sense of self. On the contrary, genetic modifications can help amplify choice, enrich lives and consolidate identities. Ultimately, there is no moral requirement that people value their contingent genetic endowment to the exclusion of changes important to them in their future genetic identities. Through weighing risks and benefits, adults also have the power to consent to—and assume the risks of—genetic modifications for themselves in a way not possible in prenatal genetic interventions.

This essay argues that informed consent remains desirable for both moral and practical reasons in regard to HIV testing by physicians. At the very least, respect for consent preserves patient control over treatment and affords the opportunity for education about the nature of HIV-related disorders. Nevertheless, there do appear to be circumstances under which involuntary testing may occur especially when health care workers may have become occupationally exposed to risk of HIV infection. To eliminate conflicts between health workers and their patients, however, it is desirable to work to eliminate the stigmatizing and discriminatory effects of HIV infection that can induce persons to resist testing

Some commentators have criticized bioethics as failing to engage religion both as a matter of theory and practice. Bioethics should work toward understanding the influence of religion as it represents people's beliefs and practices, but bioethics should nevertheless observe limits in regard to religion as it does its normative work. Irreligious skepticism toward religious views about health, healthcare practices and institutions, and responses to biomedical innovations can yield important benefits to the field. Irreligious skepticism makes it possible to raise questions that otherwise go unasked and to protect against the overreach of religion. In this sense, bioethics needs a vigorous irreligious outlook every bit as much as it needs descriptive understandings of religion

Jürgen Habermas has argued against prenatal genetic interventions used to influence traits on the grounds that only biogenetic contingency in the conception of children preserves the conditions that make the presumption of moral equality possible. This argument fails for a number of reasons. The contingency that Habermas points to as the condition of moral equality is an artifact of evolutionary contingency and not inviolable in itself. Moreover, as a precedent for genetic interventions, parents and society already affect children's traits, which is to say there is moral precedent for influencing the traits of descendants. A veil-of-ignorance methodology can also be used to justify prenatal interventions through its method of advance consent and its preservation of the contingency of human identities in a moral sense. In any case, the selection of children's traits does not undermine the prospects of authoring a life since their future remains just as contingent morally as if no trait had been selected. Ironically, the prospect of preserving human beings as they are – to counteract genetic drift – might even require interventions to preserve the ability to author a life in a moral sense. In light of these analyses, Habermas' concerns about prenatal genetic interventions cannot succeed as objections to their practice as a matter of principle; the merits of these interventions must be evaluated individually

Some commentators argue that conception signals the onset of human personhood and that moral responsibilities toward zygotic or embryonic persons begin at this point, not the least of which is to protect them from exposure to death. Critics of the conception threshold of personhood ask how it can be morally consistent to object to the embryo loss that occurs in fertility medicine and research but not object to the significant embryo loss that occurs through conception in vivo. Using that apparent inconsistency as a starting point, they argue that if that embryo loss is tolerable as a way of conceiving children, it should be tolerable in fertility medicine and human embryonic research. Double-effect reasoning shows, by contrast, that conception in vivo is justified even if it involves the death of persons because the motives for wanting children are not inherently objectionable, because the embryo loss that occurs in unassisted conception is not the means by which successful conception occurs, and because the effect of having children is proportionate to the loss involved. A similar outcome holds true for in vitro fertilisation in fertility medicine but not for in vitro fertilisation for research involving human embryos

Sex selection of children by pre-conception and post-conception techniques remains morally controversial and even illegal in some jurisdictions. Among other things, some critics fear that sex selection will distort the sex ratio, making opposite-sex relationships more difficult to secure, while other critics worry that sex selection will tilt some nations toward military aggression. The human sex ratio varies depending on how one estimates it; there is certainly no one-to-one correspondence between males and females either at birth or across the human lifespan. Complications about who qualifies as ‘male’ and ‘female’ complicate judgments about the ratio even further. Even a judiciously estimated sex ratio does not have, however, the kind of normative status that requires society to refrain from antenatal sex selection. Some societies exhibit lopsided sex ratios as a consequence of social policies and practices, and pragmatic estimates of social needs are a better guide to what the sex ratio should be, as against looking to ‘nature’. The natural sex ratio cannot be a sound moral basis for prohibiting parents from selecting the sex of their children, since it ultimately lacks any normative meaning for social choices