Stephen Napier

Ethical challenges to certain aspects of research on human subjects are not uncommon; examples include challenges to first-in-human trials (Chapman in J Clin Res Bioethics 2(4):1–8, 2011), certain placebo controlled trials (Anderson in J Med Philos 31:65–81, 2006; Anderson and Kimmelman in Kennedy Inst Ethics J 20(1):75–98, 2010) and “sham” surgery (Macklin in N Engl J Med 341:992–996, 1999). To date, however, there are few challenges to research when the subjects are competent and the research is more than minimal risk with no promise of direct benefit. The principal reason given for allowing research that is more than minimal risk without benefit is that we should respect the autonomy of competent subjects. I argue that though the moral intuitions informing respect for autonomy are sound, there is another set of intuitions regarding what we take to be just treatment of another when one agent knowingly causes or allows suffering on another agent. I argue that concerns generated by commutative justice serve as limitations on permissible research. I highlight our intuitions informing this notion of justice by appealing to work done on theodicy; what counts as a morally sufficient reason for God to allow suffering in humans is applicable also to the researcher-subject relationship. I conclude that all human subjects who are exposed to more than minimal risk research should enjoy the same actual protections (e.g., subpart D) as those given subjects who cannot consent

The “disability paradox” is the idea that for those who become severely disabled, their own quality of life assessment remains at or slightly below the QoL assessments of normal controls. This is a source of skepticism regarding third-person QoL judgments of the disabled. I argue here that this skepticism applies as well to those who are in the minimally conscious state. For rather simple means of sustaining an MCS patient’s life, the cost of being wrong that the patient would not want further support is high. Pair this cost with the reason to be skeptical of third-person judgments, and my argument suggests not withholding food and water from MCS patients

Recently, Verheijde and Potts (2011) have called into question the whole-brain death (WBD) criterion and, in particular, have taken issue with my admittedly limited defense of WBD. I would like to thank Verheijde and Potts for their comments and for identifying key points in the debate that need further clarification and defense. This article is an attempt to provide such clarification and to focus on Verheijde and Potts’s key argument against me and other proponents of WBD. The structure of this reply is first to clear away some misunderstandings and to articulate further some of my original arguments. These clarifications are necessary to acuminate attention to what is, I believe, the fundamental locus of disagreement between proponents of WBD and its detractors. Detractors assert that patients who satisfy WBD can still evince integrated functioning. On the assumption that persons are not dead yet if they can manifest integrated functioning, WBD is not a reliable indicator of death. In the second section, I address this fundamental point of disagreement, arguing that with no (known) exceptions, patients satisfying WBD require external support (e.g., ventilator) in order to maintain integrated functioning. This fact is important because on the account of the person I endorse, one which I think is plausible, the soul confers on the body certain vital potencies. When the body itself has lost such potencies, we have evidence of the soul not being present. Emphasizing the aspect of self-integration that is characteristic of living human beings avoids the challenge that WBD persons are still alive. In the third section, however, I address what I take to be Verheijde and Potts’s strongest objection against WBD criterion, namely the objection from spontaneous circulation. The responses to this objection point to the fundamental and limited role the WBD criterion is meant to play in organ donation decisions

The author reviews one of the more intriguing articles in the stem cell research issue of the journal Metaphilosophy (April 2007), “Killing Embryos for Stem Cell Research,” by Jeff McMahan. He begins by recapitulating McMahan’s argument against the proposition that we are essentially individual human organisms. He then turns to two main critiques of the argument. First, he shows that the term “essentially” is insufficiently defined by McMahan and, more important, if we take the typical explication of the concept by modal metaphysicians, then the claim “we are essentially human beings” is true—contrary to McMahan’s argument. Second, the author offers a counterexample to McMahan’s implicit acceptance of the principle that only beings who have developed the capacity for self-consciousness are the proper subjects of moral worth. The author presents a regenerative therapy example to show that McMahan’s commitment on this point is counterintuitive. National Catholic Bioethics Quarterly 8.2 (Summer 2008): 255–264.

It is common in bioethical discussion to present thought experiments or cases in order to construct an argument. Some thought experiments are quite illuminating, and ethical theorizing will often appeal at some point to one’s intuitions. But there are cases in which thought experiments are useless or do not contribute to the argument. This article considers cases presented in the context of stem cell research that are destructive of human embryos. I argue that certain popular cases that are meant to motivate the view that such research is permissible either are dialectically useless or do not contribute to the argument. By dialectically useless, I mean that the cases analyzed here yield intuitions in people who are already committed to the permissibility of such research. I end with some reflections that challenge the reliability of our intuitions on applied ethics issues by suggesting that thought experiments in this field are dubious from the start. My argument should not be read to support moral skepticism but to urge that our inquiries on applied issues requires certain intellectual virtues.

Contemporary philosophical discussion on human embryonic stem cell research has focused primarily on the metaphysical and meta-ethical issues suchresearch raises. Though these discussions are interesting, largely ignored are arguments rooted in the secular research ethics tradition already informing humansubject research. This tradition countenances the notion of vulnerability and that vulnerable human subjects (of which human embryos are likely members)ought to be protected from research-related harms. This is the basic idea behind the argument from vulnerability, and it enjoys prima facie plausibility. This articlepresents the vulnerability argument and then focuses critically on several lines of attack including: (1) twinning and totipotency arguments, (2) embryo-rescuearguments, and (3) natural loss arguments. The article concludes that there is no good defeater for the vulnerability argument, and, therefore, we have undefeated reasons for protecting human embryos from research related harms.

Contemporary philosophical discussion on human embryonic stem cell research has focused primarily on the metaphysical and meta-ethical issues suchresearch raises. Though these discussions are interesting, largely ignored are arguments rooted in the secular research ethics tradition already informing humansubject research. This tradition countenances the notion of vulnerability and that vulnerable human subjects (of which human embryos are likely members)ought to be protected from research-related harms. This is the basic idea behind the argument from vulnerability, and it enjoys prima facie plausibility. This articlepresents the vulnerability argument and then focuses critically on several lines of attack including: (1) twinning and totipotency arguments, (2) embryo-rescuearguments, and (3) natural loss arguments. The article concludes that there is no good defeater for the vulnerability argument, and, therefore, we have undefeated reasons for protecting human embryos from research related harms.

Debates on moral enhancement focus legitimate attention on the questions of whether it is possible and/or what could count as a moral enhancement given deep ethical disagreement. I argue here that moral enhancements might not even be rational to consider—from the perspective of the agent. At issue is the assessment of whether the enhancement is truly reliable. Since we assess reliable belief forming processes by their outputs, whether they are true, an agent who is entertaining a putative moral enhancement faces a trilemma. If she already believes the promised outputs of the enhancement, the enhancement is obsolete. If she does not believe the promised outputs, it would be irrational from her current perspective to undertake the “enhancement.” If she is uncertain, she has no reason for thinking that the enhancement truly augments her moral beliefs. On any option, the agent has no reason for taking a putative moral enhancement.

I argue in this paper two theses. First, I argue that the internal consistency of the argument from evil demands that it take into account some form of EST. Thus, there is no ground for the atheist to chide the theist when the theist appeals to an expanded version of theism. Second, I show that it isprima facie probable that RST does in fact ential EST. I show this by capitalizing on the distinction between what is contained in a concept and what is entailed by a concept. What a term or concept means is different from what it may entail. What a concept or term entails is conceptually more robust than what it simply means. I call this the “containment objection” and if is true, then the restricted conjunction rule cannot apply since a version of theism sufficient to deflate the evidential argument would not be logically independent from RST,pace Rowe

The respect for one’s conscience is rooted in a broader respect for the human person. The conscience represents a person’s ability to identify the values and goods that inform her moral identity. Ignoring or overriding a person’s conscience can lead to significant moral and emotional distress. Refusals to respect a person’s conscientious objection to cases of killing are a source of incisive distress, since judgments that it is impermissible to kill so-and-so are typically held very strongly and serve as central moral commitments in one’s moral identity. I think it is wrong for a college basketball coach to pay his players, but I think it is really wrong to kill people. This article argues that any and all arguments for not respecting a conscientious objection to abortion commit a deontic fallacy. Briefly, arguments for the permissibility of abortion are structurally such that abortion is at best permissible, not obligatory. Now, arguments to justify overriding or ignoring a person’s objection to performing action (α) must understand action (α) as being obligatory. Thus, arguments for ignoring conscientious objections to performing abortion are incongruent with the actual philosophical justifications for abortion. Such arguments, then, commit a deontic fallacy.

Most philosophers will grant that on some issues and in some circumstances, we can acquire knowledge from another. But when it comes to moral knowledge, the presumption is on the side of autonomy; we must not rely on others for our moral beliefs. I argue here for the surprising thesis that in some circumstances we must rely on others in order to acquire moral knowledge. I believe that this, or something trivially different, is a position that Leibniz would hold. When woven together, his comments on teaching, authority, errors of conscience, and testimony provide concrescent support for this surprising thesis.

Bioethics is a field of inquiry and as such is fundamentally an epistemic discipline. Knowing how we make moral judgments can bring into relief why certain arguments on various bioethical issues appear plausible to one side and obviously false to the other. Uncertain Bioethicsmakes a significant and distinctive contribution to the bioethics literature by culling the insights from contemporary moral psychology to highlight the epistemic pitfalls and distorting influences on our apprehension of value. Stephen Napier also incorporates research from epistemology addressing pragmatic encroachment and the significance of peer disagreement to justify what he refers to as epistemic diffidence when one is considering harming or killing human beings. Napier extends these developments to the traditional bioethical notion of dignity and argues that beliefs subject to epistemic diffidence should not be acted upon. He proceeds to apply this framework to traditional and developing issues in bioethics including abortion, stem cell research, euthanasia, decision-making for patients in a minimally conscious state, and risky research on competent human subjects. to traditional and developing issues in bioethics including abortion, stem cell research, euthanasia, decision-making for patients in a minimally conscious state, and risky research on competent human subjects.