David DeGrazia

In “Human‐Animal Chimeras: The Moral Insignificance of Uniquely Human Capacities,” Julian Koplin explores a promising way of thinking about moral status. Without attempting to develop a model in any detail, Koplin picks up Joshua Shepherd's interesting proposal that we think about moral status in terms of the value of different kinds of conscious experience. For example, a being with the most basic sort of consciousness and sentience would have interests that matter morally, while a being whose consciousness featured the riches of loving affection, say, might have greater moral status and therefore deserve some sort of priority if the interests of the two beings conflicted. This approach represents an improvement over the more common, transparently anthropocentric habits of thinking about moral status, whether in connection with evaluating human‐animal chimera research, deciding what one can ethically eat, or pursuing some other moral inquiry.

This article examines basic interests that animals have in liberty—the absence of external constraints on movement. It takes liberty to be a benefit for sentient animals that permits them to pursue what they want and need. Obviously farms, zoos, pets in homes, animals for sale in stores, circuses, and laboratories all involve forms of confinement that restrict liberty. The discussion aims to know the conditions, if there are any, under which such liberty-limitation is morally justified. It first lays out the harms caused by confinement. It then examines and evaluates five possible standards for the justification of confinement: a basic-needs requirement; a comparable-life requirement; a no-unnecessary-harm standard; a worthwhile-life criterion; and an appeal to respect.

Opening with a vignette about Francis, who wants to use medications to achieve particular changes in his personality, the paper asks the following: whether his plan involves the use of a biomedical enhancement and, if so, whether this makes his plan morally problematic; whether his plan poses a threat to his identity in a problematic way; and whether his intentions are inauthentic. In response to, it is argued that Francis’ plan does involve biomedical enhancement on either of two plausible understandings of the latter concept, but that its status as involving enhancement is not problematic per se. In response to, the paper distinguishes numerical and narrative senses of identity and argues that avoiding conflation of these two senses largely neutralizes concerns about enhancement as identity-threatening. In response to, the concept of authenticity is analyzed in the service of vindicating the authenticity of Francis’ self-transformation project. The analysis also shows that some self-transformation projects can prove inauthentic due to an agent’s failure to demonstrate sufficient self-respect. Finally, the paper concludes by suggesting redirection of moral attention to certain issues that already confront us.

Discussions of patient-centred care and patient autonomy in bioethics have tended to focus on the decision-making context and the process of obtaining informed consent, leaving open the question of how patients ought to be counselled in the daily maintenance of their health and management of chronic disease. Patient activation is an increasingly prominent counselling approach and measurement tool that aims to improve patients’ confidence and skills in managing their own health conditions. The strategy, which has received little conceptual or ethical analysis, raises important questions about how clinicians ought to foster confidence and a sense of control in their patients without exposing them to blame, stigma and other harms. In this paper, we describe patient activation, discuss its relationship to personal responsibility, autonomy and health disparities, and make recommendations regarding its use and measurement.

Walter Sinnott-Armstrong and Frank Miller's article is an intelligent, interesting and important discussion.1 Its central thesis is that what makes killing wrong is not that killing causes death or loss of consciousness, but that killing causes an individual to be completely, irreversibly disabled. The first of two main implications is that it is not even pro tanto wrong to kill someone who is already in such a thoroughly disabled state. The second is that the dead donor rule in the context of vital organ transplantation should be abandoned.I embrace the second main implication. As the authors argue, the dead donor rule is routinely violated in contemporary vital organ procurement; but what should change are not the standard practices in which the rule is violated, but the rule itself. In general, I believe that the practical implications of the authors’ account of the wrongness of killing are more justified than the account itself. My judgment is possible because their account has mostly the same implications as what I take to be the best account—at least regarding the killing of human beings. I turn now to points of disagreement.First, the authors argue that the wrongness of killing is a function of harming and that, because ‘a loss of autonomy is a kind of harm, broadly construed…,’ …

Responding to several leading ideas from a paper by Allen Buchanan, the present essay explores the implications of genetic enhancement for moral status. Contrary to doubts expressed by Buchanan, I argue that genetic enhancement could lead to the existence of beings so superior to contemporary human beings that we might aptly describe them as post-persons. If such post-persons emerged, how should we understand their moral status in relation to ours? The answer depends in part on which of two general models of moral status—one based on respect and one based on interests—is more adequate. Buchanan tentatively argues that a respect-based model is preferable. I challenge Buchanan's view, along these lines: If we embrace a respect-based model of moral status featuring a threshold that divides persons, who are thought to have full and equal moral status, from sentient nonpersons, thought to have less moral status, then we should acknowledge a second threshold and a level of moral status higher than ours. A better option, I tentatively suggest, is to drop the idea of levels of moral status, accept that all sentient beings have moral status, and allow that some differences in interests and capacities justify some significant differences in how we should treat beings of different kinds.

I am grateful to the journal for commissioning commentaries by Allen Buchanan,1 Nicholas Agar,2 James Wilson and Thomas Douglas,3,4 and to those authors for their thoughtful remarks. In this brief reply, I respond to them in turn. Buchanan remains doubtful that there could be post-persons in the sense of beings who might plausibly be regarded as having higher moral status than (mere) persons. According to Buchanan, moral status is a threshold concept, and the property one needs in order to reach the threshold is accountability for reasons. He makes a decent case for his claim that dogs are not accountable for reasons at all and that persons are. Although I am sceptical that the most immature persons are significantly accountable for reasons and that there is a meaningful break between them and the most cognitively complex non-persons, here I set these doubts aside. Importantly, Buchanan claims that accountability for reasons is the only property that matters for the possession of moral status. (Note that on his view—and in his terminology, which differs from mine—dogs have moral standing in virtue of being sentient, but only persons have full and equal moral status in virtue of being accountable.) This claim strikes me as somewhat arbitrary and perhaps ad hoc as well. Consider alternative criteria that philosophers have suggested as the basis for full and equal moral status: temporal self-awareness, agency, the capacity for symbolic thought, and moral agency in a broader sense than simply accountability for reasons. These criteria seem no less plausible than Buchanan's for undergirding our moral status—assuming, for the moment, that the latter is closely connected with personhood and that sentience is insufficient—yet a wealth of empirical data suggest that the relevant characteristics come in various forms and different degrees, and that many animals …

A couple of decades after becoming a major area of both public and philosophical concern, animal ethics continues its inroads into main- stream consciousness. Increasingly, philosophers, ethicists, professionals who use animals, and the broader public confront specific ethical issues regarding human use of animals as well as more fundamental questions about animals’ moral status. A parallel, related development is the explo- sion of interest in animals’ mental lives, as seen in exciting new work in cognitive ethology and in the plethora of movies, television commercials, and popular books featuring apparently intelligent animals. As we approach the turn of the twenty-first century, philosophical animal ethics is an area of both increasing diversity and unrealized poten- tial – a thesis supported by this essay as a whole. Following up on an earlier philosophical review of animal ethics (but without that review’s focus on animal research), the present article provides an updated narrative – one that offers some perspective on where we have been, a more detailed account of where we are, and a projection of where we might go. Each of the three major sections offers material that one is unlikely to find in other reviews of animal ethics: the first by viewing familiar territory in a different light (advancing the thesis that the utility-versus-rights debate in animal ethics is much less important than is generally thought); the second by reviewing major recent works that are not very well-known (at least to nonspecialists); and the third by identifying important issues that have been largely neglected.

The idea of a patient's best interests raises issues in prudential value theory–the study of what makes up an individual's ultimate (nonmoral) good or well‐being. While this connection may strike a philosopher as obvious, the literature on the best interests standard reveals almost no engagement of recent work in value theory. There seems to be a growing sentiment among bioethicists that their work is independent of philosophical theorizing. Is this sentiment wrong in the present case? Does value theory make a significant difference in interpreting best interests? In pursuing this question, I begin with a quick sketch of broad kinds of value theories, identifying representatives that are plausible enough to count as contenders. I then explore what each account suggests in (1) neonatal treatment decisions, and (2) decisions for patients in persistent vegetative states. I conclude that while these accounts converge somewhat in their interpretations of best interests, they also have importantly different implications.

Animal research has long been a source of biomedical aspirations and moral concern. Examples of both hope and concern are abundant today. In recent months, as is common practice, monkeys have served as test subjects in promising preclinical trials for an Ebola vaccine or treatment 1, 2, 3 and in controversial maternal deprivation studies. 4 The unresolved tension between the noble aspirations of animal research and the ethical controversies it often generates motivates the present issue of the Cambridge Quarterly of Healthcare Ethics. As editors of this special section, we hope that these original and timely articles will push the professional discussion of animal research ethics in a positive direction that will benefi t research scientists and others interested in moral problems in animal research. We also look forward to a day when animal research will genuinely meet both appropriate scientifi c and appropriate ethical criteria—criteria that themselves can be improved by critical scrutiny. Animal research—that is, the use of live animals as experimental subjects in biomedical and behavioral fi elds of learning—has been deeply entrenched for well over half a century. One signal development was the enactment in the late 1930s of federal product safety legislation in the United States and other nations that required animal testing of food, drugs, and medical devices prior to use by human subjects or consumers. 5 Another development was the publication of codes of research ethics that called for animal research prior to human research. The Nuremberg Code, published by an American military tribunal in 1947–48 after scrutiny of Nazi medical atrocities, stated that experiments involving the use of human subjects should be " based on the results of animal experimentation. " 6 The Declaration of Helsinki, fi rst published in 1964, reaffi rmed this assumption and added, rather imprecisely, that " the welfare of animals used for research must be respected. " 7 Against the background of such statements, the institutionalization and widespread acceptance of animal research in the twentieth century rested on two basic assumptions, one factual and one moral. The factual assumption was that animal research is suffi ciently reliable as a basis for predicting the effects of drugs, products, and other materials on human beings that animal trials can be expected to yield signifi cant scientifi c conclusions and medical benefi ts to humanity.

Many critics of American gun culture and policy argue that the public health benefits of stricter regulations compensate for the associated loss of freedom: a bit less freedom is an acceptable cost for the expected gains in public safety. By contrast, gun advocates sometimes claim that freedom to own guns underlies all other important freedoms and therefore deserves priority over considerations of public health. In this volume, philosopher Firmin DeBrabander takes a distinct critical approach, denying any significant loss of freedom associated with gun control. Widespread gun ownership in the context of lax regulation makes Americans—and anyone else similarly situated—less free. In developing his...

In this essay I attempt to shed some light on the moral status of animals and provide a framework for further illumination. I attempt in chapter one to determine the necessary and sufficient conditions for having moral status, which I tie to having interests. My conclusion is that the key characteristic is conation. ;In chapter two I distinguish the concepts of equal moral status and equal consideration of identical interests--which have not been clearly distinguished, leading to confusion. Moral status is the degree of moral resistance to having one's interests thwarted. Crucially, the principle of equal consideration --which I defend--is consistent with the thesis that differences in moral status exist. ;In chapter three I defend a moral methodology that employs both an intuitive method and a principle of maximizing interests. In doing so I attempt to refute various misconceptions regarding intuition. I then examine categories of judgments I call 'fixed intuitions' and 'strong intuitions' and assess their epistemological strength. ;In chapter four I endeavor to identify the most important interests--experiential welfare, freedom, autonomy, and life--and the characteristics that underlie them. Then I make suggestions regarding which animals possess these interests. I also discuss various interests typically had by humans that substantially add to the value of their lives. I reach various normative conclusions by interest-maximization. While some are general in character, concerning, for example, the comparative values of different kinds of lives, others are more specific and concern the harmful use of animals in research. For example, I contend that research animals are usually provided inadequate living space. ;Finally, I test these conclusions in chapter five with the intuitive method, using fixed and strong intuitions, before concluding. I contend that differences in moral status show up mainly with respect to life-interests and freedom-interests, but that the principle of equal consideration evens out moral status to a greater degree than is generally acknowledged.

Most theories of parenthood assume, at least implicitly, that a child will grow up to be an independent, autonomous adult. However, some children with cognitive limitations or psychiatric illness are unable to do so. For this reason, these accounts do not accommodate the circumstances and responsibilities of parents of such adult children. Our article attempts to correct this deficiency. In particular, we describe some of the common characteristics and experiences of this population of parents and children, examine the unique aspects of their relationships, review several philosophical accounts of parental obligations, consider how these accounts might be extrapolated to semiautonomous adult children, and provide suggestions about parental obligations to promote autonomy and independence in adult children with cognitive limitations or psychiatric illness. In extending accounts of parental responsibilities to the case of semiautonomous adults, we find that the parental role includes the duty to continue to provide care—indefinitely if necessary—while cultivating autonomy and independence.

We argue that the current ethical and regulatory framework for permissible risk levels in pediatric research can be helpfully understood in terms of children’s moral right to adequate protection from harm. Our analysis provides a rationale for what we propose as the highest level of permissible risk in pediatric research without the prospect of direct benefit: what we call “relatively minor” risk. We clarify the justification behind the usual standards of “minimal risk” and “a minor increase over minimal risk” and explain why it is permissible to impose any risks at all on child participants who do not stand to benefit directly from enrollment in research. Finally, we illuminate some aspects of the concept of “best interests.”

Kagan argues that human beings who are neither persons nor even potential persons — if their impairment is independent of genetic constitution — are modal persons: individuals who might have been persons. Moreover, he proposes a view according to which both personhood and modal personhood are sufficient for counting more, morally, than nonhuman animals. In response to this proposal, I raise one relatively minor concern about Kagan's reasoning — that he judges too quickly that insentient beings can have interests — before engaging the appeal to modal personhood. I challenge the thesis that modal personhood is relevant to one's moral status, first, by way of analogy to a kicker who misses a field goal though he might have made it; second, by casting doubt on implications for two impaired infants ; and, finally, by examining implications for dogs who would count as modal persons when genetic enhancements are capable of transforming them into persons.

Transcending the overplayed debate between utilitarians and rights theorists, the book offers a fresh methodological approach with specific constructive conclusions about our treatment of animals. David DeGrazia provides the most thorough discussion yet of whether equal consideration should be extended to animals' interests, and examines the issues of animal minds and animal well-being with an unparalleled combination of philosophical rigor and empirical documentation. This book is an important contribution to the field of animal ethics.