David Archard

Using the example of an unconsented mouth swab I criticise the view that an action of this kind taken in itself is wrongful in respect of its being a violation of autonomy. This is so much inasmuch as autonomy merits respect only with regard to ‘critical life choices’. I consider the view that such an action is nevertheless harmful or risks serious harm. I also respond to two possible suggestions: that the action is of a kind that violates autonomy; and, that the class of such actions violates autonomy. I suggest that the action is wrongful in as much as it is a bodily trespass. I consider, and criticise, two ways of understanding how morally I stand to my own body: as owner and as sovereign. In respect of the latter I consider Arthur Ripstein's recent defence of a sovereignty principle. Finally I criticise an attempt by Joel Feinberg to explain bodily trespass in terms of personal autonomy.

Children are young human beings. Some children are very young human beings. As human beings children evidently have a certain moral status. There are things that should not be done to them for the simple reason that they are human. At the same time children are different from adult human beings and it seems reasonable to think that there are things children may not do that adults are permitted to do. In the majority of jurisdictions, for instance, children are not allowed to vote, to marry, to buy alcohol, to have sex, or to engage in paid employment. What makes children a special case for philosophical consideration is this combination of their humanity and their youth, or, more exactly, what is thought to be associated with their youth. One very obvious way in which the question of what children are entitled to do or to be or to have is raised is by asking, Do children have rights? If so, do they have all the rights that adults have and do they have rights that adults do not have? If they do not have rights how do we ensure that they are treated in the morally right way? Most jurisdictions accord children legal rights. Most countries—though not the United States of America—have ratified the United Nations Convention on the Rights of the Child which was first adopted in 1989. The Convention accords to children a wide range of rights including, most centrally, the right to have their ‘best interests’ be ‘a primary consideration’ in all actions concerning them, the ‘inherent right to life’, and the right of a child “who is capable of forming his or her own views … to express these views freely in all matters affecting the child”. However it is normal to distinguish between ‘positive’ rights, those that are recognised in law, and ‘moral’ rights, those that are recognised by some moral.

In the face of differences about how sex should be taught to young persons, and consistent with a liberal principle of neutrality, educationalists can adopt one of two strategies. The ‘retreat to basics’ consists in teaching only a basic agreed code of sexual conduct, or a set of agreed principles of sexual morality. The ‘conjunctive–disjunctive’ strategy consists in teaching the facts of sexual activity together with the various possible evaluations of these facts. Both strategies are beset with significant and insuperable difficulties. Perhaps one should presume only to teach sex in a way that maximises the foundational liberal ideal of autonomy.

According to Stephen Macedo, ‘[liberal], democratic politics is not only about individual rights and limited government, it is also about justification … political justification … understood politically.’ ‘Political justification,’ he asserts, ‘is a core liberal goal.’ Gerald Gaus, similarly, writes that the ‘idea of public justification is at the heart of a contractual liberalism.’ Very many other contemporary political philosophers believe that the politics of a liberal polity must be justifiable to its citizens. In what follows I shall seek to understand the basis for such a belief and, in particular, to expose two possible sources in the views of Locke and Kant. Neither source, I shall argue, provides any warrant for the demand in question. First the bald claim—that the politics of a polity needs justifying—must be unpacked. By way of initial clarification I shall say something about, respectively, ‘justification’ and ‘politics.’

If rape is evaluated as a serious wrong, can it also be defined as non-consensual sex (NCS)? Many do not see all instances of NCS as seriously wrongful. I argue that rape is both properly defined as NCS and properly evaluated as a serious wrong. First, I distinguish the hurtfulness of rape from its wrongfulness; secondly, I classify its harms and characterize its essential wrongfulness; thirdly, I criticize a view of rape as merely ‘sex minus consent’; fourthly, I criticize mistaken attempts to discount the wrongfulness of rape for those who do not value sex; fifthly, I contrast two models for weighing interests, according to one of which rape is not seriously wrongful; finally, I sketch a defence of the view that our sexual integrity ought to be a central interest of ours.

Prolonging neonatal lifeThe paradox that medicine’s success breeds medicine’s problems is well known to readers of the Journal of Medical Ethics. Advances in neonatal medicine have worked wonders. Not long ago, extremely premature birth babies, or those born with very serious health problems, would inevitably have died. Today, neonatologists can resuscitate babies born at ever-earlier stages of gestation. And very ill babies also benefit from advances in neonatal intensive care. Infant lives can be prolonged. Unfortunately, several such babies will not survive for long whatever is done for them. Others will live to leave hospital, but face severe health problems. Doctors have gained the ability to prolong neonatal life. But should they always do so? This question is central to the recent report of the Nuffield Council on Bioethics, Critical care decisions in fetal and neonatal medicine.1 In many quarters, the report received a very positive response, commended in The Lancet as “thoughtful, sensitive and sensible” and welcomed by the premature baby charity BLISS. Critics attacked on both flanks. The report goes too far—ushering in a culture of “throw away babies”. Or it does not go far enough—failing to endorse the Dutch precedent to sanction active neonatal euthanasia.TOO FAR?One of the key recommendations of the report is that guidelines be developed in relation to the institution of intensive neonatal care. It is these guidelines, which have been savaged by some parts of the media. The BMA called them “blanket rules” smothering clinical discretion. The guidelines on resuscitation at birth apply to babies born at the borderline of viability, that is, at or before a gestational age of 25 weeks 6 days. The earlier the baby is born, the lower are the chances that he/she will survive to leave hospital. Before 21 weeks 6 days, none of …

Consider the following examples of behavior by Smith: 1. Smith, seated at her restaurant table, gives an order to the waiter; 2. Smith gets into a cab and names a destination; 3. Smith agrees to Jones's suggestion that they go back to Jones's apartment for a few drinks; 4. Smith casts her vote in some election. In each of these instances what can Smith be understood as consenting to? Is she consenting to pay the bill for whatever meal she orders; pay the fare for the journey to her named destination; sexual intimacy with Jones; and accept the authority of whatever individual or political part is elected? The fact that Smith does not actually express her consent to each of these states of affairs or outcomes need not mean that she is not giving her consent to them. The idea that individuals can give their consent in ways other than by means of a formal verbal expression of agreement is a familiar, if controversial, one