Bernard Baertschi

Lorsqu'il est question de distribuer les soins de santé de manière juste, le critère qui est le plus souvent spontanément proposé est le besoin. Il faut soigner chacun selon ses besoins. Dans cette étude, nous examinons la signification de ce critère et ses limites. Il apparaît en effet, dès qu'on entre dans les détails, qu'on rencontre de graves difficultés lorsqu'on veut l'appliquer. Ces difficultés sont conceptuelles (le besoin a plusieurs significations) et substantielles (le besoin est insuffisant comme critère). Nous concluons que la justice demande qu'on abandonne au moins partiellement l'approche de haut en bas (l'application d'un critère aux cas particuliers) au profit d'une approche de bas en haut, laissant plus de place au patient comme autorité de décision. When we consider just distribution of health care, the criterion we usually encounter is need. We must treat patients proportionally to their needs. In this paper, we examine the meaning and limits of this criterion. As soon as we go into the details, we encounter serious difficulties in its application. Those difficulties are conceptual (need has various meanings) and substantial (need is not enough as a criterion).We conclude that justice requires a partial renunciation to a top-down approach (application of a criterion to particular cases) on behalf of a bottom-up one, giving more weight to the patient, as an authority of choice.

Moral status is a vexing topic. Linked for so long to the unending debates about ensoulment and the morality of abortion, it has recently resurfaced in the embryonic stem cell controversy. In this new context, it should benefit from new insights originating in recent scientific advances. We believe that the recently observed capability of somatic cells to return to a pluripotential state (a capability we propose to name 'reversed potency') in a controlled manner requires us to modify the traditional concept of moral status and to consider it as referring not only to intrinsic properties (like 'to possess reason' or 'to be a person'), but also to extrinsic or relational ones.

In the contemporary ethical discourse, we constantly take recourse to human rights and dignity, and frequently rights are said to be founded on dignity. However, when we examine this concept, we begin to doubt that this recourse is adequate, because dignity manifests two features that are difficult to reconcile with liberal values on which our societies are established. First, and the appearances notwithstanding, dignity is not a universalist concept; and second, it possesses a perfectionist side. A rapid historical survey will help to understand the point, showing that the concept of dignity refers to a nature that is at the same time a task to perform.

As elsewhere, the ethical debate on embryonic stem cell research in Central Europe, especially Germany and Switzerland, involves controversy over the status of the human embryo. There is a distinctive Kantian flavor to the standard arguments however, and we show how they often embody a set of misunderstandings and argumentative shortcuts we term "embryological Kantianism." We also undertake a broader analysis of three arguments typically presented in this debate, especially in official position papers, namely the identity, continuity, and potentiality arguments. It turns out that these arguments do not support the strong, quasi-personal status accorded to the embryos in these official opinions.

This article analyses neuronal determinism and mentions that at first sight it appears to be a type of qualified determinism. Neurodeterminism is better conceived as determinism tout court when it is applied to human beings. It differs importantly from genetic determinism, together the two views that are often regarded as similar in form if not in content. Moreover, the article examines the question of genetic determinism, because it is a paradigm of qualified determinism. It then explains the meaning of determinism tout court, its relation with the notions of “free will” and “responsibility,” and the debate about their alleged incompatibility. It provides an understanding of what neurodeterminism consists of, shows that it should be conceived as determinism tout court when it is applied to human beings, imparting an empirical turn to a very old metaphysical conundrum.