Klemens Kappel

CRISPR is currently viewed as the central tool for future gene therapy. Yet, many prominent scientists and bioethicists have expressed ethical concerns around CRISPR gene therapy. This paper provides a critical review of concerns about CRISPR gene therapy as expressed in the mainstream academic literature, paired with replies also generally found in that literature. The expressed concerns can be categorised into three types depending on whether they stress risk/benefit ratio, autonomy and informed consent, or concerns related to various aspects of justice. In the reviewed literature, we found no intrinsic objections to CRISPR gene therapy, even though many such objections were present in discussions of gene editing in the 1990s. The paper then proposes a brief outline for a practically applicable moral framework for public decision-making about CRISPR gene therapy and suggests how such a framework might be supported. We also suggest that this framework should govern public engagement about CRISPR gene therapy in order to reduce the risk that we make decisions about CRISPR gene therapy based on misperceptions, inflated views of risk, or unreasonable moral or religious views.

If we tried, all the time, to do the acts which, according to consequentialism, are right, this would be worse, on consequentialist terms, than if we were less ambitious. In this way consequentialism is indirectly self‐defeating, as Parfit says in Reasons and Persons. But, as Parfit also says, this is not an objection to consequentialism. In a recent contribution, Dancy argues that this is a mistake, however. There is, Dancy suggests, a sense in which consequentialism both recommends that we do certain acts, and that the same time says that we should not do them, and no ethical theory can do so. I discuss Dancy's objection, and argue that there is no way to understand it such that it presents a challenge to consequentialism.

The aim of this article is to explore the impact of commercial marketing on personal autonomy. Several philosophers argue that marketing conflicts with ideals of autonomy or, at best, is neutral to these ideals. After qualifying our concept of marketing and introducing the distinctions between (i) divergent and convergent marketing and (ii) being autonomous and acting autonomously, we demonstrate the heretofore unnoticed positive impact of marketing on autonomy. Specifically, we argue that (i) convergent marketing has a significant potential to reinforce autonomous action and (ii) divergent marketing has a significant potential to reinforce the state of being autonomous.

In this survey we have investigated the experiences and attitudes of Danish physicians regarding end-of-life decisions. Most respondents have made decisions that involve hastening the death of a patient, and almost all find it acceptable to do so. Such decisions are made more often, and considered ethically more acceptable, with the informed consent of the patient than without. But both non-resuscitation decisions, and decisions to provide pain relief in doses that will shorten the patient's life, have been made and found acceptable by at least 50% of the respondents, even when there is no informed consent. Furthermore, 12% have doubled morphine dosages with fixed intervals, thus providing doses substantially higher than that necessary to control pain, without the informed consent of the patient. Two per cent have helped in assisted suicide, and 5% have administered a lethal injection at the patient's request. Respectively 37% and 34% find these last two practices ethically acceptable. Amongst those that do not find them acceptable, the most important reasons to be opposed are, the doctrine of double effect, the doctrine of doing and allowing, and the view that human life is sacred. Amongst supporters, the most important reasons mentioned are, that the patient's right to self-determination should be respected, the view that a patient should not be forced to suffer, and the view that the patient has a right to be helped to a dignified death

ABSTRACT For a distribution of health care resources to be fair, it should consider the consequences for the whole lives of the affected persons and not just how badly off they are at the present moment. Since, other things being equal, a person is worse off if he dies young than if he dies old, it is fair to give scarce vital health care resources to young rather than to old persons. In the paper this ageist view is restated and defended against a number of objections raised by John Harris. According to Harris' so‐called anti‐ageist argument the only relevant consideration in the distribution of vital health care resources is people's desire to go on living. On reflection, this is highly counterintuitive. Instead, it is argued that both present desires to go on living and possible future happiness should weigh together with considerations of fairness. Both fairness and possible future happiness will in most cases speak in favour of saving the young before the old. A number of other problems for the ageist view are discussed, and solutions are suggested.

ABSTRACT In this survey we have investigated the experiences and attitudes of Danish physicians regarding end‐of life decisions. Most respondents have made decisions that involve hastening the death of a patient, and almost all find it acceptable to do so. Such decisions are made more often, and considered ethically more acceptable, with the informed consent of the patient than without. But both non‐resuscitation decisions, and decisions to provide pain relief in doses that will shorten the patient's life, have been made and found acceptable by at least 50% of the respondents, even when there is no informed consent. Furthermore, 12% have doubled morphine dosages with fixed intervals, thus providing doses substantially higher than that necessary to control pain, without the informed consent of the patient. Two per cent have helped in assisted suicide, and 5% have administered a lethal injection at the patient's request. Respectively 37% and 34% find these last two practices ethically acceptable. Amongst those that do not find them acceptable, the most important reasons to be opposed are, the doctrine of double effect, the doctrine of doing and allowing, and the view that human life is sacred. Amongst supporters, the most important reasons mentioned are, that the patient's right to self‐determination should be respected, the view that a patient should not be forced to suffer, and the view that the patient has a right to be helped to a dignified death.

We sometimes disagree not only about facts, but also about how best to acquire evidence or justified beliefs within the domain of facts that we disagree about. And sometimes we have no dispute-independent ways of settling what the best ways of acquiring evidence in these domains are. Following Michael Lynch, I call this phenomenon deep disagreement. In the paper, I outline various forms of deep disagreement, following but also in certain respects revising and expanding Lynch’s exposition in (2010, 2012). As is well known, for the externalist about knowledge and epistemic justification deep disagreements may be nothing more than an unfortunate failure of communication. Yet, though he grants this, Lynch argues that deep disagreement points to a sort of practical problem. I agree. In my paper I propose a revised account of the sort of practical problem that deep disagreement may pose. In short, my claim is that deep disagreement may be a problem due to the role that shared factual beliefs may have in common decision-making. I discuss and assess various reactions to the problem of deep disagreement, including the one proposed by Lynch. I argue that none of the solutions discussed in the paper are satisfactory.

The aim of this chapter is to examine how diversity benefits deliberation, information exchange and other socio‐epistemic practices associated with free speech. We separate five distinct dimensions of diversity, and discuss a variety of distinct mechanisms by which various forms of diversity may be thought to have epistemically valuable outcomes. We relate these results to the moral justification of free speech. Finally, we characterise a collective action problem concerning the compliance with truth‐conducive norms of deliberation, and suggest what may solve this problem.