Thomas Douglas

Clinicians and researchers can often rescue patients or research participants from serious harms. Indeed, they often have a duty to do so—a duty to rescue. Duties to rescue are frequently discussed in the medical ethics literature, but according to Tina Rulli and Joseph Millum they are under-theorised and more problematic than is normally acknowledged. Rulli and Millum outline two widely discussed conceptions of rescue duties: a so-called duty of easy rescue, applying to all moral agents (including healthcare professionals), and the rule of rescue, applying specifically to institutions. They raise concerns about both.

In this chapter, I examine three deontological objections to adblocking: the objection from property (according to which adblocking involves accessing another’s property without satisfying the conditions placed on such access by the owner), the objection from complicity (according to which, by blocking ads, consumers become complicit in wrongdoing of adblocking software providers), and the objection from freeriding (according to which adblocking consumers free-ride on other consumers who allow ads to be served). I argue that, though these objections plausibly establish the moral impermissibility of some instances of adblocking, they do not, even collectively, establish a blanket moral prohibition on adblocking, as it is currently done.

In 2016, this Journal published an article by Rob Lawlor1 on what we might call the acceptance-refusal asymmetry in competence requirements. This is the view that there can be cases in which a patient is sufficiently competent to accept a treatment, but not sufficiently competent to refuse it. Though the main purpose of Lawlor’s paper was to distinguish this asymmetry from various other asymmetries with which it has sometimes been confused,1 Lawlor also presented a brief case in favour of it. Developing an earlier argument of Ian Wilks’,2 3 Lawlor argued that, when the risks associated with refusing a treatment are graver than those associated with accepting it, a higher level of competence may be required to refuse a treatment than to accept it. This claim could have important implications for the law, since determinations of competence often play a central role in determining the lawfulness of refusing or imposing a treatment. Indeed, the acceptance-refusal asymmetry in competence requirements, or something close to it, has played an important role in court judgments.2 However, Lawlor himself suggests that his conclusion will have practical implications only in a narrow range of cases.3 In this issue, Pickering, Giles Newton-Howes and Simon Walker respond to Lawlor’s piece.4 They deny that competence requirements should depend on the level of risk associated with a decision, and thus that there is any basis for the acceptance-refusal asymmetry in competence requirements. Part of the authors’ argument involves contesting the way in which Lawlor uses cases to support his view. In one case cited by Lawlor—and drawn from Wilks—we are invited to consider a whether …

We are grateful to the commentators for their close reading of our article 1 and for their challenging and interesting responses to it. We do not have space to respond to all of the objections that they raise, so in this reply, we address only a selection of them. Some commentaries question the usefulness of developing an account of the sort we provide, 2 or of revising the Standard Account (SA) in doing so. 3–5 Our schema is intended to provide a framework for developing a full account of invasiveness that captures existing uses of the term. On the assumption that the term is used somewhat reliably and consistently–and we are inclined to agree with some of our commentators 3 4 that people are not terribly confused or mistaken in how they employ the term–an account that captures these...

Several authors have recently claimed that we each possess a right against interference with our minds. However, it remains unclear how this claim is to be justified. I offer a novel argument in defence of it. The argument is intuitive—appealing centrally to intuitions regarding cases—and abductive—taking the form of an inference to the best explanation; I offer a series of cases involving intuitively wrongful interventions, argue that five somewhat promising attempts to account for the wrongfulness of these interventions leave some of this wrongfulness unexplained, and show that my proposed alternative explanation, which invokes a right against mental interference, can account for this residual wrongfulness.

Christine Clavien and Samia Hurst1 (henceforth C-H) make at least three valuable contributions to the literature on responsibility and healthcare. They offer an admirably clear and workable set of criteria for determining a patient's degree of responsibility for her health condition; they deploy those criteria to cast doubt on the view that patients with lifestyle-related conditions are typically significantly responsible for their conditions; and they outline several practical difficulties that would be raised by any attempt to introduce responsibility-sensitive healthcare funding. I am sympathetic to the general thrust of their argument, share—at least tentatively—their policy conclusions, and was persuaded by much of the detail of their argument. However, I do have three critical comments.

This chapter explores some implications of the view that the woman in the rubella case has a reason to defer conception. It considers its implications for the ethics of genetic selection. Genetic selection involves choosing to bring one child into existence rather than another, based in part on the genetic characteristics of the alternative possible children. The chapter argues that potential parents have reason to pursue genetic selection to avoid having a child with a disposition to a wellbeing-reducing disease or disability, a disposition to other wellbeing-reducing traits, and dispositions that tend to reduce the wellbeing of others. It considers several objections that might be raised against genetic selection. Some people would advance these objections only against the more controversial forms of genetic selection mentioned earlier: selection against non-medical traits, and selection for the benefit of third parties. Others would advance these objections even against the least controversial kind of genetic selection: selection to avoid disease or disability.

This edited book provides an in-depth examination of the implications of neuroscience for the criminal justice system. It draws together experts from across law, neuroscience, medicine, psychology, criminology, and ethics, and offers an important contribution to current debates at the intersection of these fields. It examines how neuroscience might contribute to fair and more effective criminal justice systems, and how neuroscientific insights and information can be integrated into criminal law in a way that respects fundamental rights and moral values. The book’s first part approaches these questions from a legal perspective, followed by ethical accounts in part two. Its authors address a wide range of topics and approaches: some more theoretical, like those regarding the foundations of punishment; others are more practical, like those concerning the use of brain scans in the courtroom. Together, they illustrate the thoroughly interdisciplinary nature of the debate, in which science, law and ethics are closely intertwined. It will appeal in particular to students and scholars of law, neuroscience, criminology, socio-legal studies and philosophy.