Simon Rippon

Principles of procreative beneficence (PPBs) hold that parents have good reasons to select the child with the best life prospects. Sparrow (2010) claims that PPBs imply that we should select only female children, unlesswe attach normative significance to “normal” human capacities. We argue that this claim fails on both empirical and logical grounds. Empirically, Sparrow’s argument for greater female wellbeing rests on a selective reading of the evidence and the incorrect assumption that an advantage for females would persist even when a serious gender imbalance is obtained. Logically, PPBs cite only pro tanto reasons and allow that the good of an individual child could be outweighed by other morally relevant considerations, such as those which take collectively suboptimal outcomes into account. There is thus no need to attach value to the “normal.”

I make the observation that English sentences such as “You have reason to take the bus or to take the train” do not have the logical form that they superficially appear to have. I find in these sentences a conjunctive use of “or,” as found in sentences like “You can have milk or lemon in your tea,” which gives you a permission to have milk, and a permission to have lemon, though no permission to have both. I argue that a confusion of genuine disjunctions with sentences of the above form has motivated the mistaken acceptance by some philosophers of principles like the one I call “Liberal Transmission.” This is the principle that if you have a reason to do something, then you have a reason to do it in each of the possible ways in which it can be done (though not more than one of them). I argue that Liberal Transmission and its close relatives are false. Wide-scope reasons are defined as reasons that have a conditional or other logical connective within the scope of the reason operator. For example, a wide-scope instrumental reason might be: reason(if you have an end, take the means). By refuting Liberal Transmission, I show that you could have wide-scope instrumental reasons like this while nevertheless lacking any narrow-scope reason to take the means, or narrow-scope reason to not have the end. This enables me to respond to two major objections to the wide-scope approach to the instrumental principle that have been developed by Joseph Raz and by Niko Kolodny.

There is a libertarian argument for live donor organ markets, according to which live donor organ markets would be permitted if we simply refrained from imposing any substantive and controversial moral assumptions on people who reasonably disagree about morality and justice. I argue that, to the contrary, this endorsement of live donor organ markets depends upon the libertarians’ adoption of a substantive and deeply controversial conception of strong, extensive property rights. This is shown by the fact that these rights would prevent states intervening in cases of preventable and intuitively impermissible wronging of others that can arise when free individuals engage in voluntary offers and exchanges. I outline two forms of such wronging: discrimination and disrespectful demands. I argue that although these types of acts are morally impermissible, the policy question of whether and how they should be regulated by states is non-trivial. I then argue that there is good reason to think that organ markets would rely on disrespectful demands. This may help explain the widespread moral repugnance people feel toward organ trading. It also provides a prima facie, though not decisive, case for states to prohibit such markets.

This chapter describes a philosophical approach to theorizing justice, mapping out some main strands of the tradition leading up to contemporary political philosophy. We first briefly discuss what distinguishes a philosophical approach to justice from other possible approaches to justice, by explaining the normative focus of philosophical theories of justice – that is, a focus on questions not about how things actually are, but about how things ought to be. Next, we explain what sorts of methods philosophers use to justify theories of justice. Following this, in the longest section, we highlight major questions about justice that have drawn the attention of philosophers, and indicate how competing conceptions of justice have arisen from differing answers to these questions. The goal here is not to answer but to elucidate some of the larger questions about justice, as well as to establish a framework for understanding and distinguishing different kinds of claims about justice and some of the relations between them.

This chapter describes how philosophical theorizing about justice can be connected with empirical research in the social sciences. We begin by drawing on some received distinctions between ideal and non-ideal approaches to theorizing justice along several different dimensions, showing how non-ideal approaches are needed to address normative aspects of real-world problems and to provide practical guidance. We argue that there are advantages to a transitional approach to justice focusing on manifest injustices, including the fact that it enables us to set aside some reasonable disagreements about justice. The ‘bottom-up’ approach we advocate, for which we borrow Wolff’s term ‘real-world political philosophy’, is an empirically-informed normative analysis that attends to specific, identifiable injustices, and thus is partial, though not isolationist. We illustrate our approach by considering how different models of the nature of disability suggest different kinds of remedy for injustices faced by persons living with disabilities. We reflect on the nature and significance of vulnerabilities, and we assess the role of public opinion in normative theorizing, suggesting a particular significance for the opinions and experiences of marginalized groups. We finally reflect on the relevance of European legal and institutional frameworks for theorizing justice in Europe.

A prominent defence of a market in organs from living donors says that if we truly care about people in poverty, we should allow them to sell their organs. The argument is that if poor vendors would have voluntarily decided to sell their organs in a free market, then prohibiting them from selling makes them even worse off, at least from their own perspective, and that it would be unconscionably paternalistic to substitute our judgements for individuals' own judgements about what would be best for them. The author shows that this ‘Laissez-Choisir Argument’ for organ selling rests on a mistake. This is because the claim that it would be better for people in poverty to sell their organs if given the option is consistent with the claim that it would be even better for them to not have the option at all. The upshot is that objections to an organ market need not be at all paternalistic, since we need not accept that the absence of a market makes those in poverty any worse off, even from their own point of view. The author goes on to argue that there are strong theoretical and empirical reasons for believing that people in poverty would in fact be harmed by the introduction of a market for live donor organs and that the harm constitutes sufficient grounds for prohibiting a market.

Intuitively, it seems that certain basic desires, or urges, are rationally impotent, i.e., that they provide no reasons for action (a famous example is Warren Quinn's story of a man who has a brute urge to turn on every radio he sees). This intuition seems to conflict with the internalist, or Humean subjectivist, claim that our desires give us reasons. But Harry Frankfurt's well-known subjectivist account, with its distinction between first- order and higher-order desires and its concepts of identification and commitment, may be able to accommodate this intuition. Regan Lance Reitsma has argued that to do so, it needs to be supplemented with a concept of "personal ideals", which demand that we give no normative weight to certain inclinations. I argue that Reitsma's account depends on the unexplained assumption that some kinds of desire have special standing, and thus cannot improve on the explanation of the rational impotence of urges already available to Frankfurt.

I defend the claim that Kant held a wide-scope view of hypothetical imperatives, against objections raised by Mark Schroeder [2005]. There is an important objection, now commonly known as the ‘bootstrapping’ problem, to the alternative, narrow-scope, view which Schroeder attributes to Kant. Schroeder argues that Kant has sufficient resources to reply to the bootstrapping problem, and claims that this leaves us with no good reason to attribute to Kant the wide-scope view. I show that Schroeder's Kantian reply to the bootstrapping problem cannot fully answer it. Schroeder also offers three main textual arguments for attributing to Kant the narrow-scope view: from Kant's claim that the moral imperative is unique in virtue of its categoricity, from Kant's distinction between ‘problematic’ and ‘assertoric’ hypothetical imperatives, and from Kant's conception of analyticity together with his claim that hypothetical imperatives are analytic. I argue that each of these views can be understood as cohering with the..

In my recent article in the Journal of Medical Ethics, I attacked the Laissez Choisir Argument in defence of letting individuals choose whether to sell kidneys or other organs as living donors, and I argued that such transactions should generally remain prohibited.1 The LC Argument arises as a response to a prohibitionist claim that I endorse: organ sales should be banned to protect potential poverty-stricken vendors, even if a free market could provide great benefits to potential organ recipients. The LC Argument says that this is misplaced paternalism, since banning the market only takes away from willing vendors what they must regard as their best option, thereby leaving them even worse off, at least as they see things. My refutation of the LC Argument pointed out, on the contrary, that giving some people the option to sell their organs may harm them in ways they would reasonably prefer not to be harmed—even though they would reasonably prefer to take the option once it is presented. The upshot is that many potentially willing organ vendors might themselves reasonably prefer prohibition. I argued that the harms of a live donor organ market to this group would in fact be significant and unavoidable, and that it would be morally impermissible to impose these harms. And I suggested that this argument for prohibition best explicates an inchoate but widely shared moral concern about the exploitative nature of live donor organ trading.I thank Gerald Dworkin, Janet Radcliffe Richards and Adrian Walsh for their engaging and often insightful commentaries.2–4 I agree with a lot, but I will …

Thousands of lives are lost each year because of a lack of organs available for transplant, but currently, in the UK and many other countries, organs cannot be taken from a deceased donor without explicit consent from the donor or his or her relatives. Switching to an ‘opt‐out’ system for organ donation could substantially increase the supply of organs, and save many lives. However, it has been argued in some quarters that there are serious ethical objections to an opt‐out policy, and that it would be better to adopt a different policy known as the ‘presumptive approach’, that requires explicit consent while also attempting to sway the choices of potential donors and family in the direction of donating, using various persuasive techniques. This article shows how reflection on the impact of a well‐known cognitive bias known as ‘status quo bias’ can explain why moving from the status quo to an opt‐out policy might be effective in increasing organ availability, even without impinging on anyone's autonomous choices, why we might have overestimated the strength of the objections to an opt‐out policy, and why the presumptive approach is morally objectionable, while an opt‐out policy is not