Aeddan Shaw

Environmental ethics has long been the poor relation to its more glamourous counterparts in bioethics, namely medical and animal ethics. However, as this article will argue, a number of issues in medical bioethics require a broader environmental context in order to fully understand them. The different dominant perspectives in bioethics, from utilitarianism to virtue ethics, offer compelling accounts and arguments for and against issues from stem cell research to human augmentation but they are frequently deadlocked as they encounter competing accounts which also claim to have similar weight. Attfield’s practice-consequentialism, however, adds two crucial aspects to be considered when making any deontic decisions: the impact upon the environment and upon future generations, with both united by the key concept of flourishing. This ecocentric perspective, this paper argues, will not only hold its own against other traditional accounts but it will also shed light on the often unconsidered consequences of their adoption.

The validity of the double effect doctrine is examined in euthanasia and abortion. In these two situations killing is a method of treatment. It is argued that the doctrine cannot apply to the care of the dying. Firstly, doctors are obliged to harm patients in order to do good to them. Secondly, patients should make their own value judgments about being mutilated or killed. Thirdly, there is little intuitive moral difference between direct and indirect killing. Nor can the doctrine apply to abortion. Doctors kill fetuses as a means of treating the mother. They also kill them as an inevitable side effect of other treatment. Drawing a moral distinction between the direct and the indirect killing gives counterintuitive results. It is suggested that pragmatic rules, not ethics, govern practices around euthanasia and cause it to be more restricted than abortion.