Lisa Forsberg

This chapter explores the relationship between classical utilitarianism and feminism in one period of utilitarianism's history. In Section 2.1, the main features of classical utilitarianism are identified and clarified. In Section 2.2, the main arguments of John Stuart Mill's _The Subjection of Women_ are analysed, making explicit their utilitarian basis. In Section 2.3, some criticisms of Mill's utilitarian feminism are examined and evaluated. This chapter's contention is that while utilitarianism provides solid support for feminism, Mill's feminism contains weaknesses.

Anti-libidinal interventions (ALIs) are a type of crime-preventing neurointervention (CPN) already in use in many jurisdictions. This chapter examines different types of legal regimes under which ALIs might be provided to sex offenders. The types of legal regimes examined are dedicated statutes that directly provide for ALI use, consensual ALI provision under general medical law principles, mental health legislation providing for ALI use (exemplified by the mental health regime in England and Wales), and European human rights law as it pertains to ALI provision. The chapter considers what we might learn from ALIs in respect of likely or possible arrangements for the provision of other CPNs, and draws attention to some ethical issues raised by each of these types of regime, worth keeping in mind when considering arrangements for CPN provision.

The purpose of the introduction to Consenting Children is to acquaint readers with the themes explored in the volume, to provide readers with a summary of the chapters comprising it, and to situate its contributions. Our ambition is for the volume’s contributions to lay the groundwork for future engagement in the legal and philosophical literature with the controversies raised by arguments about children’s autonomy, responsibility, and well-being, and the myriad interactions between them. We anticipate that the chapters in this volume will serve as an indispensable critical reference for scholars working in the broad range of disciplines dealing with the treatment of children. We hope, further, that the volume demonstrates the potential of the study of children to generate insights into thinking about consent, autonomy, responsibility, and well-being more broadly.

In "Treating Adolescents Differently", Anthony Skelton, Isra Black, and Lisa Forsberg develop a well-being-based justification of the asymmetrical treatment of adolescent consent and refusal in the context of health-care to justify the differential and paternalistic treatment of adolescents more generally. The core of Skelton, Black, and Forsberg’s view is a variabilist theory of what is fundamentally and non-instrumentally prudentially good for adolescents, which includes the prudential value of what they call shielding—or the value of being insulated from full responsibility for their choices. This theory of well-being, they argue, explains why adolescents may be treated differentially and paternalistically in numerous domains. It is good for them to be shielded because it allows for a variety of freedom from making certain kinds of decisions in the absence of a safety net provided by others in supportive and caring relationships. Skelton, Black, and Forsberg argue that their account of the justification of differential and paternalistic treatment of adolescents has attractive implications for a range of cases and holds up well in the face of philosophical criticism.

Children are treated differently compared to adults in many domains, including in health care, education, employment, and criminal justice. The differential treatment of children—to adults, and in the case of younger children and adolescents, to each other—makes it both practically and theoretically important to examine the justification of when and why this treatment is permissible. Because the justifications of children’s differential treatment typically appeal to foundational normative considerations—matters of autonomy, responsibility, and well-being—they provoke considerable controversy and disagreement in law and ethics, especially, though not exclusively in the contexts of health care, sexual relations, and criminal justice. Consenting Children brings together philosophers and academic lawyers to grapple with these matters and domains and to share disciplinary and interdisciplinary insights and understanding. The volume’s contributors engage in deep and fruitful discussions of children’s consent and responsibility, decision-making capacity and best interests, as well as the role, powers, and duties of parents and state institutions. The volume lays the groundwork for future engagement in the legal and philosophical literature with the controversies raised by children’s autonomy, responsibility, and well-being, and the myriad interactions between them concerning children’s consent.

Many medical procedures involve the causation of serious injury by doctors to their patients. Yet when accepted as ‘proper medical treatment’, doctors incur no criminal liability for their actions, per the ‘medical exception’ in criminal law. This exception is well established; its scope much less so. This article seeks to clarify the scope of the medical exception. First, it examines whether legal authority provides an explicit principle for determining the scope of the exception, arguing that no such explicit principle can be found. Second, it seeks to identify an implicit principle: a property shared by interventions that fall within the medical exception, which distinguishes them from interventions without. It considers three candidates, based on physiological, objective psychological, and broad welfare benefit, arguing that none fully succeeds in accounting for the medical exception's scope. The article then considers some implications, an objection, and some remaining problems for future research to consider.

It is standardly accepted that medical interventions can be permissibly administered to a patient who has decision-making capacity only when she has given her valid consent to the intervention. However, this requirement for valid medical consent is much less frequently discussed in relation to psychological interventions (‘PIs’) than it is in relation to bodily interventions (‘BIs’). Moreover, legal and professional consent requirements in respect of PIs are laxer than the analogous requirements in respect of BIs. One possible justification for these differences appeals to the Differential Importance View—the view that it is presumptively morally less important to obtain explicitly given valid consent for PIs than for BIs. In this article, we argue against the Differential Importance View by considering and rejecting three possible justifications for it. These invoke differences between PIs and BIs with respect to implicit consent, risk, and wrongfulness.

The possibility of neurotechnological interference with our brain and mind raises questions about the moral rights that would protect against the (mis)use of these technologies. One such moral right that has received recent attention is the right to mental integrity. Though the metaphysical boundaries of the mind are a matter of live debate, most defences of this moral right seem to assume an internalist (brain-based) view of the mind. In this article, we will examine what an extended account of the mind might imply for the right to mental integrity and the protection it provides against neurotechnologies. We argue that, on an extended account of the mind, the scope of the right to mental integrity would expand significantly, implying that neurotechnologies would no longer pose a uniquely serious threat to the right. In addition, some neurotechnologies may even be protected by the right to mental integrity, as the technologies would become part of the mind. We conclude that adopting an extended account of the mind has significant implications for the right to mental integrity in terms of its protective scope and capacity to protect against neurotechnologies, demonstrating that metaphysical assumptions about the mind play an important role in determining the moral protection provided by the right.

We are grateful to the commentators for their close reading of our article 1 and for their challenging and interesting responses to it. We do not have space to respond to all of the objections that they raise, so in this reply, we address only a selection of them. Some commentaries question the usefulness of developing an account of the sort we provide, 2 or of revising the Standard Account (SA) in doing so. 3–5 Our schema is intended to provide a framework for developing a full account of invasiveness that captures existing uses of the term. On the assumption that the term is used somewhat reliably and consistently–and we are inclined to agree with some of our commentators 3 4 that people are not terribly confused or mistaken in how they employ the term–an account that captures these...

There is growing interest in the use of neurointerventions to reduce the risk that criminal offenders will reoffend. Commentators have raised several ethical concerns regarding this practice. One prominent concern is that, when imposed without the offender’s valid consent, neurointerventions might infringe offenders’ right to bodily integrity. While it is commonly held that we possess a moral right to bodily integrity, the extent to which this right would protect against such neurointerventions is as-yet unclear. In this paper, we will assess whether, why, and how severely three forms of neurointervention might infringe the right to bodily integrity. We show that the severity of the infringement of the right to bodily integrity differs across different forms of neurointervention. Moreover, we argue that mental and behavioral effects of neurointerventions could in some cases be relevant to determining the severity of infringements of the right to bodily integrity.

The classification of medical interventions as either invasive or non-invasive is commonly regarded to be morally important. On the most commonly endorsed account of invasiveness, a medical intervention is invasive if and only if it involves either breaking the skin (‘incision’) or inserting an object into the body (‘insertion’). Building on recent discussions of the concept of invasiveness, we show that this standard account fails to capture three aspects of existing usage of the concept of invasiveness in relation to medical interventions—namely, (1) usage implying that invasiveness comes in degrees, (2) that the invasiveness of an intervention can depend on the characteristics of the salient alternative interventions, and (3) that medical interventions can be invasive in non-physical ways. We then offer the beginnings of a revised account that, we argue, is able to capture a wider range of existing usage. Central to our account is a distinction between two properties: basic invasiveness and threshold invasiveness. We end by assessing what the standard account gets right, and what more needs to be done to complete our schematic account.

In recent years, there has been increased academic interest in the human right to freedom of thought (RFoT). Scholars from various disciplines are currently debating the content and scope of this right. In his annual thematic report of 2021, the United Nations Special Rapporteur on Freedom of Religion or Belief paid explicit and comprehensive attention to the RFoT, encouraging further clarification of the content and scope of the right. This paper aims to contribute to this end, setting the stage for further research, by offering a multidisciplinary analysis of the RFoT’s scope, relation to other rights, practical significance and moral foundations.

This article is about the information relevant to decision-making capacity in refusal of life-prolonging medical treatment cases. We examine the degree to which the phenomenology of the options available to the agent—what the relevant states of affairs will feel like for them—forms part of the capacity-relevant information in the law of England and Wales, and how this informational basis varies across adolescent and adult medical treatment cases. We identify an important doctrinal phenomenon. In the leading authorities, the courts appear to count the first-personal phenomenology of the available options among the information that adolescents seeking to refuse life-prolonging treatment must understand and appreciate in order to possess capacity; adults are not held to this (higher) standard. We evaluate this differential treatment in light of philosophical work on transformative choice—decisions involving options whose sensory character, and effect on our values and preferences, are grasped only through experience itself.

Adolescents are routinely treated differently to adults, even when they possess similar capacities. In this article, we explore the justification for one case of differential treatment of adolescents. We attempt to make philosophical sense of the concurrent consents doctrine in law: adolescents found to have decision-making capacity have the power to consent to—and thereby, all else being equal, permit—their own medical treatment, but they lack the power always to refuse treatment and so render it impermissible. Other parties, that is, individuals who exercise parental responsibility or a court, retain the authority to consent on an adolescent’s behalf. We explore four defences of the doctrine. We reject two attempts to defend the asymmetry in the power to consent to and refuse medical treatment by reference to transitional paternalism. We then consider and reject a stage of life justification. Finally, we articulate a justification based on the distinctiveness of adolescent well-being.

It is often said that the institutions of criminal justice ought or—perhaps more often—ought not to rehabilitate criminal offenders. But the term ‘criminal rehabilitation’ is often used without being explicitly defined, and in ways that are consistent with widely divergent conceptions. In this paper, we present a taxonomy that distinguishes, and explains the relationships between, different conceptions of criminal rehabilitation. Our taxonomy distinguishes conceptions of criminal rehabilitation on the basis of the aims or ends of the putatively rehabilitative measure, and the means that may be used to achieve the intended end. We also explore some of the implications of each conception, some of the payoffs of a taxonomy of the kind we offer, and some areas for future work.

Many states recognize a legal right to bodily integrity, understood as a right against significant, nonconsensual interference with one’s body. Recently, some have called for the recognition of an analogous legal right to mental integrity: a right against significant, nonconsensual interference with one’s mind. In this chapter, we describe and distinguish three different rationales for recognizing such a right. The first appeals to case-based intuitions to establish a distinctive duty not to interfere with others’ minds; the second holds that, if we accept a legal right to bodily integrity, then we must, on pain of philosophical inconsistency, accept a case for an analogous right over the mind; and the third holds that recent technological developments create a need for a legal right to mental integrity.

Moral enhancements aim to morally improve a person, for example by increasing the frequency with which an individual does the right thing or acts from the right motives. Most of the applied ethics literature on moral enhancement focuses on moral bioenhancement – moral enhancement pursued through biomedical means – and considers examples such as the use of drugs to diminish aggression, suppress implicit racial biases, or amplify empathy. A number of authors have defended the voluntary pursuit of moral bioenhancement, or the development of technologies that would enable it. They have highlighted the need for humans to morally improve themselves in order to address moral failures such as the oppression of women, the mistreatment of animals, and anthropogenic climate change. They have also emphasised the moral similarities between moral bioenhancement and more familiar forms of moral enhancement, such as that achieved through childhood education, introspective reflection, and engagement with literature. Critics of moral enhancement have argued that it may undermine our freedom to ‘fall’ (i.e. be immoral), and therefore our moral agency, or exacerbate the domination of individuals by political authorities. They have also questioned the potential for biomedical interventions to produce the deepest and most valuable forms of moral improvement, and have highlighted the risks that technologies for moral bioenhancement might misfire or be intentionally misused, thereby producing moral deterioration. Underlying some of these worries is the observation that there is little agreement on which psychological transformations would constitute moral improvements, and in which contexts. Defenders of moral enhancement have made various proposals for resolving or side-stepping these disagreements, but it remains unclear how far these proposals can take us beyond establishing consensus on the worst types of moral failure.

Would compulsory treatment or vaccination for Covid-19 be justified? In England, there would be significant legal barriers to it. However, we offer a conditional ethical argument in favour of allowing compulsory treatment and vaccination, drawing on an ethical comparison with external constraints—such as quarantine, isolation and ‘lockdown’—that have already been authorised to control the pandemic. We argue that, if the permissive English approach to external constraints for Covid-19 has been justified, then there is a case for a similarly permissive approach to compulsory medical interventions.

Sex offenders are sometimes offered or required to undergo pharmacological interventions intended to diminish their sex drive (anti-libidinal interventions or ALIs). In this paper, we argue that much of the debate regarding the moral permissibility of ALIs has been founded on an inaccurate assumption regarding their intended purpose—namely, that ALIs are intended solely to realise medical purposes, not correctional goals. This assumption has made it plausible to assert that ALIs may only permissibly be administered to offenders with their valid consent, in line with the approach taken to most other interventions with a medical aim. However, we argue that, contrary to this assumption, the state's intention in relation to at least some ALIs is, at least in part, to achieve correctional objectives. We evaluate two legal regimes for ALI provision—section 645 of the California Penal Code and the mental health regime in England and Wales. In each case, we identify the state's implicit purpose in imposing ALIs and argue that the Californian and English regimes both serve as counterexamples to the view that ALIs are intended solely for medical purposes. While the moral implications of our argument are not straightforward, it raises the question whether consent is required for permissible imposition of ALIs, and more generally, whether the moral permissibility of crime-preventing interventions using medical means should be assessed against the standards of medical ethics or against those of criminal justice ethics.

It is often said that the institutions of criminal justice ought or—perhaps more often—ought not to rehabilitate criminal offenders. But the term ‘criminal rehabilitation’ is often used without being explicitly defined, and in ways that are consistent with widely divergent conceptions. In this paper, we present a taxonomy that distinguishes, and explains the relationships between, different conceptions of criminal rehabilitation. Our taxonomy distinguishes conceptions of criminal rehabilitation on the basis of (i) the aims or ends of the putatively rehabilitative measure, and (ii) the means that may be used to achieve the intended end. We also explore some of the implications of each conception, some of the payoffs of a taxonomy of the kind we offer, and some areas for future work.

We explore the ethics of using motivational interviewing, an evidence-based, client-centred and directional counselling method, in conversations with next of kin about deceased solid organ donation. After briefly introducing MI and providing some context around organ transplantation and next of kin consent, we describe how MI might be implemented in this setting, with the hypothesis that MI has the potential to bring about a modest yet significant increase in next of kin consent rates. We subsequently consider the objection that using MI in this context would be manipulative. Although we cannot guarantee that MI would never be used in a problematically manipulative fashion, we conclude that its use would, nevertheless, be permissible as a potential means to increase next of kin consent to deceased solid organ donation. We propose that MI be trialled in consent situations with next of kin in nations where there is widespread public support for organ donation.

We engage with the nature and the value of achievement through a critical examination of an argument according to which biomedical “enhancement” of our capacities is impermissible because enhancing ourselves in this way would threaten our achievements. We call this the argument against enhancement from achievement. We assess three versions of it, each admitting to a strong or a weak reading. We argue that strong readings fail, and that weak readings, while in some cases successful in showing that enhancement interferes with the nature or value of achievement, fail to establish that enhancement poses an unusual threat to achievement.