Several fascinating new bioethics articles in January 2012 journals
December 15, 2011
Mark D. White
The January 2012 issues of Bioethics (26/1) and Cambridge Quarterly of Healthcare Ethics (21/1) recently came out, with some particularly interesting articles (some of which I actually had a chance to read during my finals!). Here's a sampling:
Whoopie Pies, Supersize Fries: "Just" Snacking? "Just" Des(s)erts?, Leonard M. Fleck
Liberals generally deny that any one ordering of values should govern all individual lives. Some individuals might make maximizing their health their highest value, but that obligates no one else. Still, if some individuals daily indulge in rich desserts, this will have consequences for others in the form of high health costs for diabetes or heart disease. What should a just, liberal, egalitarian society do by way of tolerating, discouraging, regulating, forbidding, or punishing personal health choices that impose costs on others? This is our central question. A related question is whether a just, liberal, egalitarian society should use judgments of personal responsibility for ill health to impose those costs on individuals in order to control escalating healthcare costs for society.
"Please Don't Tell Me": The Right Not to Know, Jonathan Herring and Charles Foster
Knowledge is generally a good thing. People who know lots of bits of information are generally admired. Some of them win prizes in TV competitions. If you were offered the gift of having an entire encyclopedia wired into your brain, you would probably accept, without thinking. But we should be wary of assuming that all knowledge is good. Too much knowledge can inhibit rather than enable thought.
One of the requirements in the Dutch regulation for euthanasia and assisted suicide is that the doctor must be satisfied ‘that the patient's suffering is unbearable, and that there is no prospect of improvement.’ In the notorious Chabot case, a psychiatrist assisted a 50 year old woman in suicide, although she did not suffer from any somatic disease, nor strictly speaking from any psychiatric condition. In Seduced by Death, Herbert Hendin concluded that apparently the Dutch regulation now allows physicians to assist anyone in suicide simply because he or she is unhappy.
In this paper, I reject Hendin's conclusion and in particular his description of Mrs Boomsma as someone who was ‘simply unhappy.’ After a detailed narration of her lifestory, I turn to the American philosopher Harry Frankfurt's account of volitional incapacity and love for a more accurate characterization of her suffering. Having been through what she had, she could only go on living as another person than the one she had been when she was a happy mother. That would have violated her integrity, and that she could not bring herself to do.
Risk and Mid-Level Moral Principles, Nicolas Espinoza and Martin Peterson
We discuss ethical aspects of risk-taking with special focus on principlism and mid-level moral principles. A new distinction between the strength of an obligation and the degree to which it is valid is proposed. We then use this distinction for arguing that, in cases where mid-level moral principles come into conflict, the moral status of the act under consideration may be indeterminate, in a sense rendered precise in the paper. We apply this thought to issues related to pandemic influenza vaccines. The main conclusion of the paper is that on a principlist approach some acts may be neither right nor wrong (or neither permissible nor impermissible), and we claim that this has important implications for how we ought to make decisions under risk.