David DeGrazia

Agnieszka Jaworska and Julie Tannenbaum address a central problem confronting efforts to understand moral status: the Problem of Nonparadigm Humans. The authors contend that human infants and cognitively disabled human beings whose capacities are comparable to those of dogs nevertheless have higher moral status. In this discussion, I will first reconstruct the authors’ assumptions and argumentative goals. In the article’s two major sections, I will examine the authors’ reasoning in pursuit of those goals and contend that the chain of argumentation contains several weak links. The discussion will close with brief reflections on how the problem might be addressed

In addressing the shape of appropriate gun policy, this essay assumes for the sake of discussion that there is a legal and moral right to private gun ownership. My thesis is that, against the background of this right, the most defensible policy approach in the United States would feature moderate gun control. The first section summarizes the American gun control status quo and characterizes what I call “moderate gun control.” The next section states and rebuts six leading arguments against this general approach to gun policy. The section that follows presents a positive case for moderate gun control that emphasizes safety in the home and society as well as rights whose enforcement entails some limits or qualifications on the right to bear arms. A final section shows how the recommended gun regulations address legitimate purposes, rather than imposing arbitrary restrictions on gun rights, and offers concluding reflections.

“The Ethics of Infection Challenges in Primates,” by Anne Barnhill, Steven Joffe, and Franklin Miller, is an exceptionally timely contribution to the literature on animal research ethics. Animal research has long been both a source of high hopes and a cause for moral concern. When it comes to infection challenge studies with nonhuman primates, neither the hope—to save thousands of human lives from such diseases as Ebola and Marburg—nor the concern—the conviction that primates deserve especially strong protections—could be much higher. Coming just a few years after the National Institutes of Health adopted the Institute of Medicine's recommendations regarding chimpanzees, Barnhill and colleagues attempt to nudge the clarification and specification—one might say the evolution—of NHP research ethics and regulation. They assert that NHP challenge studies “are not justified by marginal gains in human safety or by efficacy gains that are unlikely to translate directly into saving human lives or preventing morbidity.” How, in turn, is their standard—which, although stringent, does permit causing NHPs to suffer and die for human benefit—to be justified?

Advance directives permit competent adult patients to provide guidance regarding their care in the event that they lose the capacity to make medical decisions. One concern about the use of advance directives is the possibility that, in certain cases in which a patient undergoes massive psychological change, the individual who exists after such change is literally a (numerically) distinct individual from the person who completed the directive. If this is true, there is good reason to question the authority of the directive Ð which is supposed to apply to the individual who completed it, not to someone else. This is `the someone else problem'. After briefly introducing advance directives as a basis for medical decision-making, this paper elaborates `the someone else problem' in the context of severe dementia. The paper then reconstructs the reasoning that leads to this putative problem and exposes the important underlying assumption that we are essentially persons. An alternative view of what we are, one that regards personhood as inessential, is then considered, before several arguments are advanced in favor of that alternative view. The paper next explores implications for advance directives: `The someone else problem' is effectively dissolved, while it is noted that a related problem (one beyond the paper's scope) may persist. A few implications beyond advance directives are also identified.

Might it be morally wrong to procreate? David Benatar answers affirmatively in Better Never to Have Been , arguing that coming into existence is always a great harm. I counter this view in several ways. First, I argue against Benatar’s asserted asymmetry between harm and benefit—which would support the claim that any amount of harm in a human life would make it not worth starting—while questioning the significance of his distinction between a life worth starting and one worth continuing. I further contend that his understanding of hedonism and desire-fulfillment theories distorts their implications for the quality of human life; as for objective-list theories, I rebut his critique of their human-centered basis of evaluation. Notwithstanding this multi-tiered challenge to Benatar’s reasoning, I conclude with praise for his work and the intellectual virtues it embodies

The field of bioethics has deployed different models of justification for particular moral judgments. The best known models are those of deductivism, casuistry, and principlism (under one, rather limited interpretation). Each of these models, however, has significant difficulties that are explored in this essay. An alternative model, suggested by the work of Henry Richardson, is presented. It is argued that specified principlism is the most promising model of justification in bioethics. Keywords: casuistry, deductivism, ethical theories, intuition principlism, specified principlism, specification CiteULike Connotea Del.icio.us What's this?

When it comes to caring about and helping those in need, our imaginations tend to be weak and our motivation tends to be parochial. This is a major moral problem in view of how much unmet need there is in the world and how much material capacity there is to address that need. With this problem in mind, the present paper will focus on genetic means to the enhancement of a moral capacity—a disposition to altruism—and of a cognitive capacity that facilitates use of the moral capacity: the ability to grasp vividly the needs of individuals who are unknown and not present. I will address two questions, with more extensive attention to the first question. First, assuming we had excellent reason to believe that the enhancements were safe, effective, and available to all who desired them, would seeking these enhancements be inherently morally acceptable—that is, free of inherent wrongness? Second, would it be wise for a society to pursue these enhancements? I will defend an affirmative answer to the first question while leaving the second question open.

Implicit in our everyday attitudes and practices is the assumption that death ordinarily harms a person who dies. A far more contested matter is whether death harms sentient individuals who are not persons, a category that includes many animals and some human beings. On the basis of the deprivation account of the harm of death, I argue that death harms sentient nonpersons. I next consider possible bases for the commonsense judgment that death ordinarily harms persons more than it harms sentient nonpersons. Contrary to what some philosophers believe, it is doubtful that the familiar resources of prudential value theory can vindicate this judgment. I show that the approach that at first glance seems most promising for supporting this judgment – namely, invoking an objective account of well-being – faces substantial challenges, before arguing that McMahan's time-relative interest account supplies the needed theoretical basis. I then go on to extract a significant practical implication of the first thesis, that death ordinarily harms sentient nonpersons: We should find a way to discontinue the routine killing of animal subjects following their use in experiments.

This volume provides a general overview of the basic ethical and philosophical issues of animal rights. It asks questions such as: Do animals have moral rights? If so, what does this mean? What sorts of mental lives do animals have, and how should we understand welfare? By presenting models for understanding animals' moral status and rights, and examining their mental lives and welfare, David DeGrazia explores the implications for how we should treat animals in connection with our diet, zoos, and research. Animal Rights distinguishes itself by combining intellectual rigor with accessibility, offering a distinct moral voice with a non-polemical tone

Some people contend that fetuses have moral status but less than that of paradigm persons. Many people hold views implying that sentient animals have moral status but less than that of persons. These positions suggest that moral status admits of degrees. Does it? To address this question, we must first clarify what it means to speak of degrees of moral status. The paper begins by clarifying the more basic concept of moral status and presenting two models of degrees of moral status. It then sketches several significant considerations in favor of, and several against, the assertion of degrees of moral status. The paper concludes by drawing lessons from the discussion.

The creation of chimeras by introducing human stem cells into nonhu- man animals has provoked intense concerns. Addressing objections that appeal to human dignity, I focus in this essay on stem cell research intended to generate human neurons in Great Apes and rodents. After considering samples of dignity- based objections from the literature, I examine the underlying assumption that nonhuman animals have lower moral status than personsFwith particular attention to what it means to speak of higher and lower moral statusFbefore evaluating the chimera research in question. I argue that (1) such experiments involving Great Apes should be prohibited out of respect for the research subjects and (2) such experiments involving rodents may or may not be permissible, depending on how we answer unresolved questions regarding rodents’ moral status. In the end, concerns about human dignity prove insignificant.

In this paper, we present three necessary conditions for morally responsible animal research that we believe people on both sides of this debate can accept. Specifically, we argue that, even if human beings have higher moral status than nonhuman animals, animal research is morally permissible only if it satisfies (a) an expectation of sufficient net benefit, (b) a worthwhile-life condition, and (c) a no unnecessary-harm/qualified-basic-needs condition. We then claim that, whether or not these necessary conditions are jointly sufficient conditions of justified animal research, they are relatively demanding with the consequence that many animal experiments may fail to satisfy them.

As the President's Council on Bioethics emphasized in a recent report, rapid growth of biotechnologies creates increasingly many possibilities for enhancing human traits. This article addresses the claim that enhancement via biotechnology is inherently problematic for reasons pertaining to our identity. After clarifying the concept of enhancement, and providing a framework for understanding human identity, I examine the relationship between enhancement and identity. Then I investigate two identity-related challenges to biotechnological enhancements: (1) the charge of inauthenticity and (2) the charge of violating inviolable core characteristics. My thesis is that a lucid, plausible understanding of human identity largely neutralizes these charges, liberating our thinking from some seductive yet unsound objections to enhancement via biotechnology.

: The fifth edition of Beauchamp and Childress's Principles of Biomedical Ethics is distinguished by its emphatic embrace of common morality as the ultimate source of moral norms. This essay critically evaluates the fifth edition's discussion of common morality and, to a lesser extent, its treatment of coherence (both the model of ethical justification and the associated concept). It is argued that the book is overly accommodating of existing moral beliefs. The paper concludes with three suggestions for improving this leading text.

This paper defends a qualified version of moral vegetarianism. It defends a weak thesis and, more tentatively, a strong thesis, both from a very broad basis that assumes neither that animals have rights nor that they are entitled to equal consideration. The essay's only assumption about moral status, an assumption defended in the analysis of the wrongness of cruelty to animals, is that sentient animals have at least some moral status. One need not be a strong champion of animal protection, then, to embrace moral vegetarianism. One need only assume some reasonable view of animals' moral status

When philosophers address personal identity, they usually explore numerical identity: what are the criteria for a person's continuing existence? When non-philosophers address personal identity, they often have in mind narrative identity: Which characteristics of a particular person are salient to her self-conception? This book develops accounts of both senses of identity, arguing that both are normatively important, and is unique in its exploration of a range of issues in bioethics through the lens of identity. Defending a biological view of our numerical identity and a framework for understanding narrative identity, DeGrazia investigates various issues for which considerations of identity prove critical: the definition of death; the authority of advance directives in cases of severe dementia; the use of enhancement technologies; prenatal genetic interventions; and certain types of reproductive choices. He demonstrates the power of personal identity theory to illuminate issues in bioethics as they bring philosophical theory to life.

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.

Placebos are often used by clinicians, usually deceptively and with little rationale or evidence of benefit, making their use ethically problematic. In contrast with their typical current use, a provocative line of research suggests that placebos can be intentionally exploited to extend analgesic therapeutic effects. Is it possible to extend the effects of drug treatments by interspersing placebos? We reviewed a database of placebo studies, searching for studies that indicate that placebos given after repeated administration of active treatments acquire medication-like effects. We found a total of 22studies in both animals and humans hinting of evidence that placebos may work as a sort of dose extender of active painkillers. Wherever effective in relieving clinical pain, such placebo use would offer several advantages. First, extending the effects of a painkiller through the use of placebos may reduce total drug intake and side effects. Second, dose-extending placebos may decrease patient dependence. Third, using placebos along with active medication, for part of the course of treatment, should limit dose escalation and lower costs. Importantly, provided that nondisclosure is pre-authorized in the informed consent process and that robust evidence indicates therapeutic benefit comparable to that of standard full-dose therapeutic regimens, introducing dose-extending placebos into the clinical arsenal should be considered. This novel prospect of placebo use has the potential to change our general thinking about painkiller treatments, the typical regimens of painkiller applications, and the ways in which treatments are evaluated.