Bruce P. Blackshaw

Pascal’s wager uses decision theory to argue that it is rational to attempt to nurture belief in God, based on the expected utility of believing (infinite happiness) compared to not believing (at best, only finite happiness). A belief in an eternal conscious torment in hell (infinite suffering) for non-believers makes the differences in expected utility even more apparent, strengthening the argument. Similar reasoning can also be used to calculate the expected moral value of actions, including procreation. Under theism, if possible future children might suffer eternal conscious torment, the expected moral value of procreation is extremely negative. This implies that theists have a moral obligation not to procreate, which for most theists, entails a moral obligation to be celibate or to undergo sterilisation surgery.

According to a recent survey, a significant majority of professional philosophers support the permissibility of induced abortion in the first trimester of pregnancy. This thesis aims to defend the minority ‘pro-life’ view that abortion is immoral throughout pregnancy. To achieve this goal, the metaphysical and moral account of human beings known as the substance view of persons will be critically examined. This account maintains that all human beings deserve equal consideration in their treatment. That is, they have equal moral value; they are moral persons. Accordingly, prenatal human beings, like adults, enjoy the same ‘right to life’, and therefore, the substance view implies that abortion is prima facie impermissible. In the course of my investigation of the substance view, I argue that it can be defended against many of the objections of critics. Yet, I nonetheless find that the substance view has important shortcomings. Therefore, I recommend an alternative account I have developed as a replacement, the rational animal account. During this investigation, I also develop some critiques of important pro-choice arguments and evaluate other pro-life arguments that try to avoid the issue of moral personhood.

The permissibility of conscientious objection (CO) in healthcare presents a complex balance of benefits and harms, and philosophers disagree on whether it should be permitted at all. For example, consequentialists such as Udo Schuklenk argue that healthcare professionals should never be allowed to object, a position known as the ‘incompatibility thesis’.1 Steve Clarke, however, believes that there is a positive consequentialist case for permitting CO in healthcare.2 The most important benefits he notes are that permitting CO prevents moral injury, and it means objectors do not have to leave their profession. Potential harms include denial of healthcare services, which can result in impairment, even death, and patient distress or humiliation when a request is refused, particularly in time-sensitive contexts. In Clarke’s view, a good consequentialist solution is to try to acquire the benefits of CO while avoiding its harms. One approach is Dan Brock’s ‘conventional compromise’, whereby healthcare professionals with a strong moral objection to providing a legal service can abstain from doing so, provided they inform the patient of the service and refer the patient to another healthcare professional willing to provide it.3 Clarke sees Brock’s proposal as an improvement on the incompatibility thesis from a consequentialist perspective, but identifies two important issues that could cause harm. First, the act of referral still makes …

Alexandre Erler’s commentary challenges our argument against creating human ‘bodyoids’. While he considers our concerns speculative, we briefly defend speculative bioethics as vital for anticipating ethical risks before technologies emerge. We maintain that historical practices such as organ procurement and embryo experimentation illustrate how instrumental uses of human bodies can erode moral boundaries. Erler’s confidence in safeguards like the dead donor rule is, we suggest, misplaced. Ethical reflection at this formative stage is essential to prevent the normalization of technologies that risk profound dehumanization.

Alexandre Erler’s commentary challenges our argument against creating human ‘bodyoids’. While he considers our concerns speculative, we briefly defend speculative bioethics as vital for anticipating ethical risks before technologies emerge. We maintain that historical practices such as organ procurement and embryo experimentation illustrate how instrumental uses of human bodies can erode moral boundaries. Erler’s confidence in safeguards like the dead donor rule is, we suggest, misplaced. Ethical reflection at this formative stage is essential to prevent the normalization of technologies that risk profound dehumanization.

The impairment argument aims to establish the immorality of abortion without relying on the fetus’s moral status. Instead, it appeals to logical consistency in moral reasoning: if it is immoral to impair a fetus by causing injury, then it must be even more immoral to impair it by causing death. For this reasoning to succeed, all the morally relevant details between these impairments must be held constant, which the author of the argument, Perry Hendricks, refers to as the _ceteris paribus_ requirement. This requirement has proven difficult to define, and in his latest work, Hendricks suggests a more precise explanation of the _ceteris paribus_ clause based on the valuable goods that obtain from impairments. He also outlines a test to determine if the _ceteris paribus_ clause is broken, thereby causing the impairment argument to fail. In this paper, I argue that this new formulation is too narrow, resulting in fatal counterexamples. Accordingly, I show that in addition to valuable goods, the harms of impairment must be considered, as well as the reasons why impairing a fetus is considered immoral. I demonstrate that these reasons ultimately rest on one’s view of the fetus’ moral status, rendering the impairment argument superfluous.

The persistent shortage of organs, cadavers, and research participants in medicine has prompted proposals such as human 'bodyoids'—engineered human bodies lacking neural components necessary for consciousness and pain. Here, we critically assess the feasibility and ethics of creating bodyoids, highlighting significant technological challenges that render their development highly speculative and economically impractical. We further argue that even if feasible, engineering bodies devoid of consciousness raises profound ethical issues, including moral ambiguity, potential dehumanization, and legal concerns akin to those surrounding patients with severe brain injuries. Our analysis suggests that pursuing bodyoids raises concerns about respect for human life and dignity. We conclude that resources should instead focus on more viable and ethically sound alternatives to address urgent clinical needs in transplantation and research.

Joshua Shaw argues that one common belief among abortion opponents—that embryos possess full moral status—is inconsistent with their support for ‘parent-friendly’ in vitro fertilisation (IVF) policies, that allow the production of surplus embryos (which are then stored indefinitely or destroyed). These abortion opponents, Shaw argues, should conclude that it is morally objectionable to destroy, discard, or freeze embryos indefinitely. Thus, they should reject current IVF practices and should consider the millions of frozen embryos that currently exist to be an urgent moral crisis. Yet, Shaw notes, many abortion opponents support ‘parent-friendly’ IVF. This raises doubts over their commitment to the claim that embryos possess full moral status. Shaw continues that, contrary to some scholars’ suggestions, artificial-gestation technologies—which could, theoretically, be used to “rescue” surplus embryos—are unlikely to resolve this tension. In fact, they seem likely to increase the number of surplus embryos, worsening existing problems. We agree with Shaw that if embryos possess full moral status, then current ‘parent-friendly’ IVF practices are morally objectionable. We also agree that artificial womb technology cannot change this fact. What those technologies could do, however, is (eventually) rescue frozen embryos that currently exist. Thus, we argue abortion opponents should do two things. First, advocate to alter current ‘parent-friendly’ IVF practices in more ‘embryo-friendly’ ways. Second, advocate to keep existing surplus embryos frozen until they may be rescued.

Rob Lovering has developed an interesting new critique of views that regard embryos as equally valuable as other human beings: the moral argument for frozen human embryo adoption. The argument is aimed at those who believe that the death of a frozen embryo is a very bad thing, and Lovering concludes that some who hold this view ought to prevent one of these deaths by adopting and gestating a frozen embryo. Contra Lovering, we show that there are far more effective strategies for preserving the lives of frozen embryos than adoption. Moreover, we point out that those who regard the deaths of frozen embryos as a very bad thing will generally regard the deaths of all embryos as a very bad thing, whether they are discarded embryos, aborted embryos or embryos that spontaneously abort. This entails that these other embryos must be taken into account when considering moral obligations, as well as other human lives at risk from preventable causes.

To determine when the life of a human organism begins, Mark T. Brown has developed the somatic integration definition of life. Derived from diagnostic criteria for human death, Brown’s account requires the presence of a life‐regulation internal control system for an entity to be considered a living organism. According to Brown, the earliest point at which a developing human could satisfy this requirement is at the beginning of the fetal stage, and so the embryo is not regarded as a living human organism. This, Brown claims, has significant bioethical implications for both abortion and embryo experimentation. Here, we dispute the cogency of Brown’s derivation. Diagnostic criteria for death are used to determine when an organism irreversibly ceases functioning as an integrated whole, and may vary significantly depending on how developed the organism is. Brown’s definition is derived from a specific definition of death applicable to postnatal human beings, which is insufficient for generating a general definition for human organismal life. We have also examined the bioethical implications of Brown’s view, and have concluded that they are not as significant as he believes. Whether the embryo is classified as a human organism is of peripheral interest—a far more morally relevant question is whether the embryo is a biological individual with an identity that is capable of persisting during development.

Aim To examine the challenges and opportunities presented by generative artificial intelligence in healthcare education and explore how it can be used ethically to enhance rather than compromise future healthcare workforce competence. Background Generative artificial intelligence is fundamentally changing healthcare education, yet many universities and healthcare educators have failed to keep pace with its rapid development. Design A discussion paper. Methods Discussion and analysis of the challenges and opportunities presented by students' increasing use of generative artificial intelligence in healthcare education, with particular focus on assessment approaches, critical thinking development and artificial intelligence literacy. Results Students' widespread use of generative artificial intelligence threatens assessment integrity and may inhibit critical thinking, problem-solving skills and knowledge acquisition. Without adequate artificial intelligence literacy there is a risk of eroding future healthcare workforce competence and compromising patient safety and professional integrity. Conclusion While generative artificial intelligence presents significant challenges to healthcare education, it offers great promise if used carefully with awareness of its limitations. The development of artificial intelligence literacy is crucial for maintaining professional standards and ensuring patient safety and mitigating its potentially negative impact on the formation of critical thinking skills.

Arguments that claim opponents of abortion are inconsistent in some manner are becoming increasingly prevalent both in academic and public discourse. For example, it is common to claim that they spend considerable time and resources to oppose induced abortion, but show little concern regarding the far greater numbers of naturally occurring intrauterine deaths (miscarriages). Critics argue that if abortion opponents took their beliefs about the value of embryos and fetuses seriously, they would invest more time and resources combating these naturally occurring deaths than those caused by induced abortion. The implication is that abortion opponents do not take their beliefs about embryos and fetuses seriously—and so why should anyone else? These “inconsistency arguments”, as we have called them, have considerable intuitive appeal: showing that someone is living inconsistently or holding beliefs that seem prima facie inconsistent seems to many to undermine those beliefs. However, upon closer examination, these arguments become less convincing. In short, we show that the inconsistency arguments we are aware of are severely flawed, and so, if critics wish to continue their criticism, they should abandon inconsistency arguments in favor of other styles of argument. We will proceed in four stages. First, we describe the basic form of inconsistency arguments against abortion opponents. Second, we outline specific instances of the inconsistency argument that have been advanced. Third, we outline specific responses to these arguments, noting ways in which responses also conform to set patterns. Finally, we assess the debate and suggest how it might progress in productive ways.

Pascal’s wager uses decision theory to argue that it is rational to attempt to nurture belief in God, based on the expected utility of believing (infinite happiness) compared to not believing (at best, only finite happiness). A belief in an eternal conscious torment in hell (infinite suffering) for non-believers makes the differences in expected utility even more apparent, strengthening the argument. Similar reasoning can also be used to calculate the expected moral value of actions, including procreation. Under theism, if possible future children might suffer eternal conscious torment, the expected moral value of procreation is extremely negative. This implies that theists have a moral obligation not to procreate, which for most theists, entails a moral obligation to be celibate or to undergo sterilisation surgery.

The impairment argument claims that abortion is immoral, because it results in a greater impairment to a fetus than other actions that are clearly immoral, such as inflicting fetal alcohol syndrome. Alex Gillham argues that the argument requires clarification of the meaning of greater impairment. He proposes two definitions, and points out the difficulties with each. In response, I argue that while the impairment argument’s definition of greater impairment is narrow in scope, it is sufficient for its intended purpose. Broadening its scope to more controversial comparisons of impairment is likely to undermine the intuitive appeal of the impairment principle that the argument is based upon.

Kyle van Oosterum and Emma Curran have recently argued that the impairment argument against abortion is weak and accomplishes little. They also claim that impairment fails to explain what makes giving a child fetal alcohol syndrome (FAS) immoral, which is an important premise of the argument. Here, I explain that the impairment argument is not as weak as they believe. Further, I argue that impairment offers a superior explanation for what makes giving a child FAS immoral than their proposal based on creative beneficence.

One of the most influential philosophical arguments in favour of the permissibility of abortion is Judith Jarvis Thomson’s violinist analogy, presented in ‘A Defense of Abortion’. Its appeal for pro-choice advocates lies in Thomson’s granting that the fetus is a person with equivalent moral status to any other human being, and yet demonstrating—to those who accept her reasoning—that abortion is still permissible. In her argument, Thomson draws heavily on the parable of the Good Samaritan, arguing that gestating a fetus in some circumstances is what she calls a Good Samaritan act, and claiming that we are not morally required to be Good Samaritans. Here, I argue that Thomson has subverted the parable to justify an action that is the antithesis of its meaning. I contend that Christians are required to be Good Samaritans, and explain that for Christians, this entails abortion is impermissible in all circumstances. Further, I argue that the parable shows the fetus is our neighbour in need of our mercy and assistance, and consequently Christians should be actively involved in helping to ensure the unborn are protected, whether they are fetuses in danger of induced abortion or miscarriage, or surplus frozen embryos.

Don Marquis’ future-like-ours account argues that abortion is seriously immoral because itdeprives the embryo or fetus of a valuable future much like our own. Marquis was mindful ofcontraception being reductio ad absurdum of his reasoning, and argued that prior tofertilisation, there is not an identifiable subject of harm. Contra Marquis, Tomer Chaffercontends that the ovum is a plausible subject of harm, and therefore contraception deprives theovum of a future-like-ours. In response, I argue that being an identifiable subject of harm is notsufficient for Marquis’ argument to succeed. In addition, we must also share our identity withan ovum. I show that on the account of personal identity utilised by Marquis’ defenders, weare not identical with an ovum. As a result, Chaffer’s reductio fails.

Hersey et al have outlined a proposed ethical framework for assessing abortion policies that locates the effect of government legislation between the provider and the patient, emphasising its influence on interactions between them. They claim that their framework offers an alternative to the personal moral claims that lie behind legislation restricting abortion access. However, they fail to observe that their own understanding of reproductive justice and the principles of medical ethics are similarly predicated on their individual moral beliefs. Consequently, the conclusions obtained from their framework are also derived from their individual beliefs, and have no claim to being objective.

According to the psychological account of personal identity, our identity is based on the continuity of psychological connections, and so we do not begin to exist until these are possible, some months after conception. This entails the psychological account faces a challenge from the non-identity problem—our intuition that someone cannot be harmed by actions that are responsible for their existence, even if these actions seem clearly to cause them harm. It is usually discussed with regard to preconception harms, but in the context of the psychological account, it is also applicable to prenatal harms. Inflicting prenatal injury is widely thought to be morally impermissible, but if the injury is identity-determining on the psychological account, then no-one seems to be harmed—rather, the injury is responsible for bringing them into existence. Here, I argue that identity-determining injuries can routinely occur on the psychological account, and that this undermines the account. I assess Nicola Williams’ proposal to salvage the account based on a trans-world account of personal identity, and show that it is unsuccessful. I then show that Jeff McMahan’s embodied mind account of personal identity is also susceptible. I conclude that identity-determining prenatal injuries pose a significant challenge for the psychological account and its variants, and provide a reason for supporting alternative accounts that fix personal identity at conception.

William Simkulet has recently criticised Colgrove et al ’s defence against what they have called inconsistency arguments—arguments that claim opponents of abortion act in ways inconsistent with their underlying beliefs about human fetuses. Colgrove et al presented three objections to inconsistency arguments, which Simkulet argues are unconvincing. Further, he maintains that OAs who hold that the fetus is a person at conception fail to act on important issues such as the plight of frozen embryos, poverty and spontaneous abortion. Thus, they are morally negligent. In response, we argue that Simkulet has targeted a very narrow group of OAs, and so his criticisms are inapplicable to most OAs. We then explain why his responses to each of Colgrove et al’s objections do not succeed, even for this restricted group. Finally, we note that Simkulet fails to provide evidence for his claims regarding OAs’ supposed failures to act, and we show that OAs veritably do invest resources into these important issues. We conclude that Colgrove et al ’s reasons for rejecting inconsistency arguments remain intact.