Bioethics

An Anthology

Udo Schüklenk, Peter Singer, Udo Schüklenk, Peter Singer

• Publisher: Wiley-Blackwell
• Year: 2021
• ISBN:
  9781119635154
• Edition: 4
• Topic: Medicine
• Subtopic: Ethics in Medicine

The new edition of the classiccollectionofkeyreadings in bioethics, fullyupdated to reflect the latest developmentsandmain issues inthe field

For more than two decades, Bioethics: An Anthology has been widely regarded as the definitive single-volume compendium of seminal readings on both traditional and cutting-edge ethical issues in biology and medicine. Acclaimed for its scope and depth of coverage, this landmark work brings together compelling writings by internationally-renowned bioethicist to help readers develop a thorough understanding of the central ideas, critical issues, and current debate in the field.

Now fully revised and updated, thefourth editioncontains a wealth of newcontentonethical questionsand controversies related tothe COVID-19 pandemic, advances inCRISPRgene editing technology, physician-assisted death, public health and vaccinations, transgender children, medical aid in dying, the morality of ending the lives of newborns, and much more.Throughout the new edition, carefully selected essays explore awide range of topicsandofferdiverse perspectivesthatunderscoretheinterdisciplinary nature of bioethical study.Edited bytwoof thefield'smost respectedscholars, Bioethics: An Anthology:

• Covers an unparalleled range ofthematically-organizedtopics in a single volume
• Discussesrecent high-profile cases, debates, and ethical issues
• Features three brand-new sections: Conscientious Objection, Academic Freedom and Research, andDisability
• Contains new essays on topics such asbrain death, life and death decisions forthecritically ill, experiments on humans and animals, neuroethics, and the use of drugs to ease the pain of unrequited love
• Includes a detailed index that allows the reader to easily find terms and topics of interest

Bioethics: An Anthology, Fourth Edition remainsamust-haveresource forallstudents, lecturers, and researchers studying the ethical implications of the health-related life sciences, and an invaluable reference fordoctors, nurses, and other professionalsworking in health care and the biomedical sciences.

Part I
Abortion

Introduction

The view that human life has special value is deeply rooted in most people’s thinking and no serious ethical theory allows a person to be killed without strong moral justification. Abortions terminate the lives of fetuses. Given that these fetuses are human, and of course innocent of any wrongdoing, it is easy to see why some people consider abortion to be unjustifiable homicide. In some respects fetuses are like persons; but in other respects they are very different. Therefore we need to ask whether they have the same moral status as those human beings we think of as persons.

In the first article in this Part, Michael Tooley provides a challenge to the view that fetuses are persons. In his 1972 landmark article “Abortion and Infanticide,” he seeks to articulate and defend an ethically significant criterion that confers personhood and a right to life. To have a right to life, Tooley argues, an entity needs to possess a concept of self, that is, be “capable of desiring to continue existing as a subject of experiences and other mental states.” An entity that has this capability is a person, whereas one that lacks it is not. This view has implications that enable us to defend abortion, but also challenge the moral views of most people who accept abortion; for on this view neither fetuses nor newborn infants are persons, whereas some nonhuman animals, such as chimpanzees and elephants, do seem to be persons.

Tooley thus holds that the potential to become a person is not sufficient to give fetuses a right to life. Here it is important to take a closer look at the notions of potentiality and capacity. Sleeping persons – unable to exercise the capacity to desire their own continued existence while asleep – are, according to Tooley, still persons because they possess the relevant capacity in a sense in which fetuses do not. A person who is asleep was self‐conscious before she went to sleep and will be the same self‐conscious person when she wakes up; a fetus, on the other hand, has never been awake and self‐conscious.

Tooley takes the issue of personhood to be central. Judith Jarvis Thomson, in “A Defense of Abortion” takes a very different approach. For the purposes of her argument, Thomson accepts that the fetus is a person, but argues that even if one grants this premise, the conclusion that every person has a right to life – in the sense that would make abortion wrong – does not follow. She then uses an ingenious analogy to support her view that one person’s right to life does not always outweigh another person’s rights to something less than life. This general view applies, Thomson holds, in the case of pregnancy and abortion. A woman has a right to control her body, and a fetus only has the right to use a woman’s body if she has implicitly given it that right. This would be the case if the woman is responsible, in some sense of the term, for its presence in her body. In many cases – certainly in the case of a pregnancy resulting from rape, and arguably, if more doubtfully, when contraception has failed – the woman bears little or no responsibility for the presence of the fetus in her body and would thus, according to Thomson, be justified in having an abortion. She would not be killing the fetus unjustly.

Thomson reminds us that any complete assessment of the ethics of abortion must focus not only on the purported rights or interests of fetuses, but also on the rights of women. But her argument has been criticized as incomplete. One of the strongest objections focuses on her narrow understanding of the right to life. It has, for example, been argued that a right to life, properly understood, also entails the provision of positive aid. If this is correct, then Thomson’s argument on abortion is inconclusive.

In “The Wrong of Abortion” Patrick Lee and Robert P. George argue that the choice to have an abortion is immoral, in an objective sense. They begin by noting three features of human embryos: their distinctiveness from sperm and egg, their humanness, and their completeness or wholeness. In their view, it follows from this that during an abortion a human being is killed. This human being is at an earlier stage of development than you or I, but is a member of our species nonetheless.

Lee and George reject Tooley’s personhood argument. In their view we are not consciousnesses that inhabit human bodies, rather we are continuing living bodily entities, some of which may take years to develop the capacity to reason. Contra Tooley, they think that the right to life belongs to any being with a rational nature, by which they mean, not that the being is actually capable of reasoning, but that it is a being with “the internal resources and active disposition” to develop the higher mental functions that are typically developed by human beings. This implies, of course, that whole human beings have that right, from the moment of conception. They reject Thomson’s argument by suggesting that while an unwanted pregnancy may lead to significant inconvenience, this inconvenience pales into insignificance considering that abortion leads to the preventable death of a human being.

In the final article of Part I, Don Marquis adopts yet another approach to explain, as the title of his article indicates, “Why Abortion is Immoral.” Like Tooley, and Lee and George, he assumes that the morality of abortion depends on whether or not the fetus is the kind of being whose life it is seriously wrong to end. According to Marquis, abortion is immoral for the same reason that it is wrong to kill you or me – not because the fetus is a person or a potential person, but rather because killing the fetus deprives it of its future. The loss of one’s life is one of the greatest losses one can suffer; it deprives the victim of all the projects, experiences, enjoyments and so on that would otherwise have constituted that individual’s future. This, Marquis holds, is what makes killing, other things being equal, wrong – regardless of whether one is a fetus, child, or adult.

Marquis argues that his position must not be confused with a sanctity of human life view. It does not, for example, rule out euthanasia. Killing a person who wants to die when she is seriously ill and faces a life of pain and suffering does not deprive that person of a valuable future. Nor is his theory, he claims, speciesist. The view that killing is wrong because it is the loss to the victim of the victim’s future is, Marquis points out, straightforwardly incompatible with the view that it is wrong to kill only beings that are biologically human. It would be equally wrong to kill nonhuman animals and species from other planets, if these beings have futures relevantly like ours. Similarly, it would not be wrong to kill a human fetus with a genetic abnormality that precludes any possibility of a life that is worth living.

These features of his theory, Marquis claims, avoid some of the problems faced both by proponents of the sanctity of all human life, and by adherents of a personhood view. Those who deny that fetuses are persons find themselves in the embarrassing position of having to accept that their theory will, in principle, not only allow the killing of fetuses, but also the killing of infants. Opponents of abortion, on the other hand, often rely on what Marquis calls the “invalid inference” that it is wrong to kill fetuses because they are potential persons. But is Marquis’ own account really so different from the argument from potential? Does it, like that argument, face the further criticism that such accounts make abortion and contraception equally wrong: if it is wrong to kill a one‐cell zygote because doing so deprives the zygote of a valuable future, why is it not equally wrong to deprive an egg and a sperm, still separate but considered jointly, of a valuable future?

1
Abortion and Infanticide

Michael Tooley¹

This essay deals with the question of the morality of abortion and infanticide. The fundamental ethical objection traditionally advanced against these practices rests on the contention that human fetuses and infants have a right to life. It is this claim which will be the focus of attention here. The basic issue to be discussed, then, is what properties a thing must possess in order to have a serious right to life. My approach will be to set out and defend a basic moral principle specifying a condition an organism must satisfy if it is to have a serious right to life. It will be seen that this condition is not satisfied by human fetuses and infants, and thus that they do not have a right to life. So unless there are other substantial objections to abortion and infanticide, one is forced to conclude that these practices are morally acceptable ones. In contrast, it may turn out that our treatment of adult members of other species – cats, dogs, polar bears – is morally indefensible. For it is quite possible that such animals do possess properties that endow them with a right to life.

I Abortion and Infanticide

One reason the question of the morality of infanticide is worth examining is that it seems very difficult to formulate a completely satisfactory liberal position on abortion without coming to grips with the infanticide issue. The problem the liberal encounters is essentially that of specifying a cutoff point which is not arbitrary: at what stage in the development of a human being does it cease to be morally permissible to destroy it? It is important to be clear about the difficulty here. The conservative’s objection is not that since there is a continuous line of development from a zygote to a newborn baby, one must conclude that if it is seriously wrong to destroy a newborn baby it is also seriously wrong to destroy a zygote or any intermediate stage in the development of a human being. His point is rather that if one says it is wrong to destroy a newborn baby but not a zygote or some intermediate stage in the development of a human being, one should be prepared to point to a morally relevant difference between a newborn baby and the earlier stage in the development of a human being.

Precisely the same difficulty can, of course, be raised for a person who holds that infanticide is morally permissible. The conservative will ask what morally relevant differences there are between an adult human being and a newborn baby. What makes it morally permissible to destroy a baby, but wrong to kill an adult? So the challenge remains. But I will argue that in this case there is an extremely plausible answer.

Reflecting on the morality of infanticide forces one to face up to this challenge. In the case of abortion a number of events – quickening or viability, for instance – might be taken as cutoff points, and it is easy to overlook the fact that none of these events involves any morally significant change in the developing human. In contrast, if one is going to defend infanticide, one has to get very clear about what makes something a person, what gives something a right to life.

One of the interesting ways in which the abortion issue differs from most other moral issues is that the plausible positions on abortion appear to be extreme positions. For if a human fetus is a person, one is inclined to say that, in general, one would be justified in killing it only to save the life of the mother.² Such is the extreme conservative position.³ On the other hand, if the fetus is n...