Richard Dees

The experience of newborn screening for Krabbe disease in New York State demonstrates the ethical problems that arise when screening programs are expanded in the absence of true understanding of the diseases involved. In its 5 years of testing and millions of dollars in costs, there have been very few benefits, and the testing has uncovered potential cases of late-onset disease that raise difficult ethical questions in their own right. For these reasons, we argue that Krabbe screening should only be continued as a research project that includes the informed consent of parents to the testing

Burke suggests that we should view society as a partnership between the past, the present, and the future. I defend this idea by outlining how we can understand the interests of the past and future people and the obligations that they have towards each other. I argue that we have forward-looking obligations to leave the world a decent place, and backward-looking obligations to respect the legacy of the past. The latter obligation requires an understanding of the role that traditions and meta-traditions should (and should not) play in tying together societies—especially national societies—over time.

Public health is concerned with increasing the health of the community at whole. Insofar as health is a ‘good’ and the community constitutes a ‘public’, public health by definition promotes a ‘public good’. But ‘public good’ has a particular and much more narrow meaning in the economics literature, and some commentators have tried to limit the scope of public health to this more narrow meaning of a ‘public good’. While such a move makes the content of public health less controversial, it also strips important goals from the realm of public health, goals that traditionally have been, and morally should be, a part of it. Instead, I will argue, while public health should be defined by public goods, it should be defined by a broader conception of public goods that I shall call ‘normative public goods’, goods that ought to be treated as if they were public goods in the more narrow sense.

From Rousseau and Marx to Alasdair MacIntyre and Michael Sandel, communitarians have argued that liberalism fails to understand and respect the values that arise from the practices of particular communities. But liberalism need not fall prey to this objection, once we understand the role that practices should play in a political theory. In the largely-unread historical and political works of David Hume, I argue, we can find the resources for a political theory that stresses the importance of the material and social conditions of a society that shape its practices and that can answer these and other critics of liberalism. ;The practices of a society, Hume suggests, are the best--and perhaps the only--means by which we can judge the legitimacy of its political structure. No abstract rules for revolution or absolute values for justification can ever do the task that is required. Only by constructing an interpretation of our own practices that is sensitive to the values that can be found within them can we, as political critics, determine when a revolution is justified. And only by seeing political justification itself as a social practice will we understand the dynamics of this process and the limits of its scope. ;Thus, liberal practices were justified in Britain after the Glorious Revolution of 1688, I argue, because they cohered best with the practices that had developed in Britain during the seventeenth century, and it is justified in the West today precisely because, despite the polemics of the communitarians, it is still the best system given our practices and our community.

After a long search, Jonathan has finally found someone willing to donate a kidney to him and thereby free him from dialysis. Meredith is Jonathan's second cousin, and she considers herself a generous person, so although she barely knows Jonathan, she is willing to help. However, as Meredith learns more about the donation process, she begins to ask questions about Jonathan: “Is he HIV positive? I heard he got it using drugs. Has he been in jail? He's already had one live donor, so what happened to the first kidney? Did he forget to take his drugs or something?” The transplant center must, then, decide if Meredith is, in fact, entitled to answers to these kinds of questions. According to the Consensus Statement on the Live Organ Donor, “It is incumbent on the transplant center to provide full and accurate disclosure to potential donors of all pertinent information regarding risk and benefit to the donor and recipient.” But whether answers to the Meredith's questions count as “pertinent information regarding the risk and benefit” is the issue at hand.

In the world according to Hume, people are complicated creatures, with convoluted, often contradictory characters. Consider, for example, Hume's controversial assessment of Charles I: "The character of this prince, as that of most men, if not of all men, was mixed .... To consider him in the most favourable light, it may be affirmed, that his dignity was free from pride, his humanity from weakness, his bravery from rashness, his temperance from austerity, his frugality from avarice .... To speak the most harshly of him, we may affirm, that many of his good qualities were attended with some latent frailty, which, though seemingly inconsiderable, was able, when seconded by the extreme malevolence of his fortune, to disappoint them of all their influence: His beneficent disposition was clouded by a manner not very gracious; his virtue was tinctured with superstition; his good sense was disfigured by a deference to persons of a capacity inferior to his own; and his moderate temper exempted him not from hasty and precipitate resolutions." This sketch shows Charles in all his complexities, with his virtues, near virtues, and contradicting virtues. I have quoted it at length because it is hard to summarize without losing the subtleties that lie within it. Hume's moral theory is based fundamentally on judgments of character, 2 so those subtleties are important to his view. The character sketches that pervade the..

The limits of toleration are at the limits of trust. Without a minimal level of trust between different groups, any accommodation will quickly break down (Dees 1999). In many ways, the point here is obvious: people have to trust one another enough to make toleration possible. In other words, they have to feel that their fundamental moral interests are not threatened if they accept toleration. If that trust breaks down, then civil war—in either the hot or the cold variety—will break out. A society built on toleration, then, requires a delicate balance between the practices within it that sustain toleration and those that build the trust between disparate groups. I explore these issues by looking at two groups--the non-Trinitarian Socinians in the 17th century and homosexuals in the 21st--to understand where those boundaries should be.

David Hume is an ardent supporter of the practice of religions toleration. For Hume, toleration forms part of the background that makes progress in philosophy possible, and it accounts for the superiority of philosophical thought in England in the eighteenth century. As he puts it in the introduction to the Treatise: “the improvements in reason and philosophy can only be owing to a land of toleration and of liberty” (T Intro.7; SBN xvii).1 Similarly, the narrator of part 11 of the First Enquiry comments: Our conversation began with my admiring the singular good fortune of philosophy, which, as it requires entire liberty above all other privileges, and chiefly flourishes from the free opposition of sentiments and argu­ mentation, received its first birth in an age and country of freedom and toleration. (EHU 11.2; SBN 132) The toleration to which Hume refers is broader than religious toleration, but in the context of the eighteenth century, religious toleration is clearly the paradigm case. Indeed, religious toleration represents one of the key accomplishments of the culminating event of Hume’s History of England: the Glorious Revolution of 1688. Yet even though religious toleration forms the background of philosophy in general—or perhaps just because it does so—Hume offers precious few arguments for it, and they are, for the most part, given implicitly rather than as formal argu­ ments. Nevertheless, we can distinguish three different, though interrelated, lines of support for toleration in Hume’s thought: (i) an argument based on a general skepticism; (ii) an argument based on a contempt for organized religion; and (iii) a pragmatic argument based on the need for peace and orderly government. From our point of view, what is striking about all of these argument is how un-Lockean they are: Hume does not rely on the idea of a fundamental conceptual separation of church and state, nor on a natural right to freedom of conscience that character­izes writers working in the Lockean tradition. However, of the arguments he gives, only the last, I will argue, has any hope to provide a useful case for toleration.