Jill B. Delston

Successful personalized precision medicine requires adherence to biomedical ethics. But what does ethics require in the domain of personalized precision medicine? In this chapter, I have considered precision health ethics from a research as well as a clinical perspective, arguing that certain ethical principles are necessary to mediate the innovation and implementation of precision medicine. Specifically, I argue that equity, informed consent, and privacy ought to serve as guideposts for scientists and clinicians as they pursue precision medicine.

In this paper, I argue that virtue ethics is unfortunately committed to a developmentally detrimental form of moral evaluation in its traditional iterations. That is, first, because both action guidance and moral development are central to virtue ethic and, second, because virtue ethics permits or requires character appraisal in moral education and child-rearing through praise and blame. However, studies from developmental and clinical psychology show that praise or blame involving character appraisal can be detrimental to children and, especially, to women and girls. While not all empirical studies point in this direction, the data are sufficiently murky to warrant an objection to virtue ethics along the lines of a situationism. Using a feminist and care-oriented critique, I argue this could pose a problem for virtue ethics. However, I argue that the criterion of moral evaluation can and must be distinguished from successful moral education of children to avoid this problem. By focusing on behavior instead of character, moral agents can avoid the harm virtue ethics may cause. Finally, I respond to an objection that doing so makes virtue ethics esoteric or self-effacing and argue that it fares no worse than other moral theories.

In this paper, I defend an account of the ethics of precision medicine that can explain both its possibilities and limits. Creating a new conceptual and normative model of the ethics of precision health can ensure that good medicine is also excellent and that excellent medicine is also good by providing a resource to scientists and clinicians. First, I propose a new conceptual analysis of precision health. I argue that precision health is defined primarily by targeted medical interventions and not by stratification, as others have asserted. Next, I argue that failure to be adequately responsive to this conceptual analysis explains common ethical abuses in the field. Third, I argue that this conceptual analysis can also pave the way for future research heretofore overlooked. Thus, we can limit abuses in precision health research and care while at the same time opening new avenues to help historically oppressed communities.

How should we respond to political ambivalence when conflicting avenues for political action arise? Some theories of justice, such as objective theories, tell us to follow whatever norms realize a set of independently determined objective goods. I argue such theories are incomplete because they specify political goods to aim at, but do not specify which norms to follow, and thus yield an ineliminable ambivalence. Through analysis of a series of significant obstacles, I show that the objective goods that theorists defend are multiply realizable and thus that different sets of mutually exclusive norms could successfully bring about such goods. I call this set of obstacles “ambivalence” in objective theories of political norms because we must choose between multiple conflicting would-be norms, each of which is compatible with the theory. Objective theories cannot provide direction on these choices and so international norms of justice raise a question about which ambivalence could be appropriate. How should we solve this ambivalence problem? I consider a range of competing alternatives that could complete objective accounts and show that consent through social contract theory presents the best available alternative. I conclude that avoiding political ambivalence on objective global political norms necessitates a consent-based constructivist element.

Politicians, employers, courts, and health insurance companies are often discussed as problematically preventing access to birth control. However, doctors have more direct control over women's health and quietly have been much more effective at preventing patients' access to contraception. Obstetrician/Gynecologists routinely deny their patients access to contraception ostensibly in the name of health by withholding birth control until patients undergo yearly pap smears. I argue that those in the medical field are motivated by similarly sexist concerns as those in other major institutions in the United States, but that they are often overlooked in discussions of biomedical ethics. After providing background, I argue that using birth control as a bargaining chip to control patients is morally impermissible, is paternalistic, and is contrary to consent. I next argue that sexism explains, though does not justify, this practice. I discuss the medical harms of routine pap smears and withholding birth control. These claims make medical malpractice likely. Withholding birth control to coerce individuals seeking medical care is medical malpractice, paternalistic, violates autonomy, and is contrary to consent.

What obligations do global actors have to prevent terrorism? Is consent required to create an international obligation, or does the correctness of its goals ground its legitimacy? In this paper, I consider these questions with respect to a subset of international law often overlooked: anti-money laundering and combating the financing of terrorism. AML/CFT comprises peaceful response to violence and terrorism, making it a significant component of international justice and diplomacy. First, I present the current legal framework for AML/CFT institutions and identify two conflicting sources of justification: objective value and consent. The fix for this problem, I argue, does not come from either component alone. Objective value cannot provide the sole source of justification because it cannot settle the choice between multiple competing norms that would achieve the same objective goods were we to follow them. Consent cannot provide the sole source of justification (‘the const..

This best-selling text continues to fill an existing gap in the literature taught in applied ethics courses. As a growing number of courses that include the perspectives of diverse cultures are being added to the university curriculum, texts are needed that represent more multicultural and diverse histories and backgrounds. This new edition enhances gender coverage, as nearly half of the pieces are now authored by women. The new edition also increases the percentage of pieces written by those who come from a non-Western background. It offers twelve up-to-date articles on human rights, environmental ethics, poverty, war and violence, gender, race, euthanasia, and abortion; all of these topics are addressed from Western and non-Western perspectives

The role of microaggressions has gained increasing philosophical attention in recent years. However, microaggressions only tell part of the story. An often-overlooked component of inequality is the uneven and unjust distribution of microaffirmations. In this paper, I give a new definition of microaffirmations as signals that a recipient belongs to some valued or high-status class. Microaffirmations can—but need not—lead individuals to gain a sense of confidence, belonging, and merit. I then explain the harms of microaffirmations, arguing that when microaffirmations are distributed inequitably, they can have larger ramifications for injustice, harming some vulnerable groups more than others. In addition, microaffirmations can lead individual actors to make choices based on who gives them microaffirmations and where they receive them, and thus can have outsized influence over the direction of an individual’s life because individuals tend to migrate to where they feel valued, appreciated, and included. I then turn to solutions to the problems I raise. I argue we should attend to and attempt to rectify inequalities in microaffirmations because doing so can help ensure not just the absence of negative attention, but also that the presence of positive attention is flowing in a just and equitable way.