by Brian D. Earp / (@briandavidearp)
On behalf of the Journal of Medical Ethics, I am excited to announce the publication of a special “Editor’s Choice” issue, now online at the journal website. In a rare turn for the journal, the entire issue made up of “Editor’s Choice” papers, with invited (peer-reviewed) papers from both up-and-coming and established scholars.
Editor-in-Chief Professor Julian Savulescu explains the significance of the issue: “Our self-imposed brief was to concentrate on excellent but less well-known scholars from a variety of perspectives, especially those who are young and up and coming, alongside some more established contributors.”
Although no particular topic assignment was given, Professor Savulescu remarks that “it is interesting that [the] contributions aggregate naturally around four perennial clusters: the concept of the good life, end of life, public health and new technologies (enhancement/selection).”
Here are some highlights from each contribution to the issue:
In “Prenatal screening and prenatal diagnosis: contemporary practices in light of the past,” Ana S. Iltis discusses genetic selection in the context of modern eugenics. As Savulescu notes: “She gives five reasons to believe this is not significantly different from old style, discredited eugenics of the late nineteenth and early twentieth century. Indeed, she argues convincingly that social goals, ‘public health’ and cost-effectiveness remain important drivers of genetic screening and testing programmes.”
Then, in “The ethics of sexual reorientation: what should clinicians and researchers do?” Sean Aas and Candice Delmas take on an argument that Savulescu, along with Dr. Anders Sandberg of the University of Oxford as well as myself (Brian Earp), have advanced with respect to the ethics of sexual orientation “conversion” therapy. They argue that such therapy might indeed benefit individuals considered narrowly, but only at the expense of stigmatizing LGBT communities. As a consequence, they oppose any applied research into sexual orientation.
In his contribution, “Ageing, justice and resource allocation,” Tom Walker takes a provocative position: he argues that, as a matter of justice, we should attempt to combat the decline in capacities that comes along with “natural” aging using human enhancement technologies. As he states, at least in some cases: “allocating interventions using age as a criterion is both wholly consistent with showing equal consideration to older people, and morally required.”
The next contribution is by the top German scholar Reinhard Merkel: “Killing or letting die? Proposal of a (somewhat) new answer to a perennial question.” In this piece, Merkel, who published another major paper in the Journal of Medical Ethics back in 2013, takes on the long-standing distinction often discussed in philosophy between killing and letting die. His aim is to clarify the moral status of “actively withdrawing life-prolonging medical treatment,” an important issue in end-of-life ethics.
“Can facilitated aid in dying be permitted by ‘double effect’?” That is the question posed by Colin Gavaghan and Mike King in their article subtitled, “Some reflections from a recent New Zealand case.” Mobilizing this case (a legal decision), they offer an innovative interpretation of the Doctrine of Double Effect, another perennial issue in philosophy. If their argument succeeds, they write, “this may have significant implications for the aid in dying debate, and potentially for the legality of certain forms of aid in dying, not only in New Zealand, but more widely.”
The next contribution is “The right to public health” by James Wilson. Wilson argues for a right to public health understood as risk reduction, suggesting that this right should be considered analogous to the right to security. Savulescu states that, while he agrees with much of Wilson’s argument, he is “not sure that it helps to say we have a right to public health. Rather we have a strong (pro tanto) moral obligation to support public health measures because there is a moral reason.” Click here to read the article and decide what you think.
In a personal account, former Journal of Medical Ethics editor Raanan Gillon explains “Why I wrote my advance decision to refuse life-prolonging treatment: and why the law on sanctity of life remains problematic.” Gillon argues that “If the logical implications of [certain] legal requirements were thoroughly implemented, medical practice would be substantially and undesirably skewed towards provision of treatments to prolong life that are unwanted, non-beneficial and wasteful of health care resources.”
This is followed by two papers on autism and well-being: “Conceptualising well-being for autistic persons” by Ingrid Robeyns and “Autism and the good life: a new approach to the study of well-being” by Raffaele Rodogno, Katrine Krause-Jensen, and Richard E. Ashcroft. Savulescu highlights some of the similarities and differences between these two papers: “Both Rodogno et al. and Robeyns call for more person-specific accounts of well-being. Both draw attention to the different kinds of relationships children with autism have and can derive pleasure and value from. Rodogno et al. call for ‘experiments in living’ in order to find what is good for a particular child with autism while Robeyns argues for a broad capabilities approach referring to [Martha] Nussbaum’s account.”
In “Means, ends and the ethics of fear-based public health campaign,” Ronald Bayer and Amy L. Fairchild argue that if fear-based public health campaigns are to be used, transparency in justifying these campaigns must be paramount. Moreover, “transparency … requires creating processes of consultation that meaningfully engage and elicit the perspectives of communities to whom fear campaigns will be addressed or might touch.”
And rounding out the issue is “Parental enhancement and symmetry of power in the parent–child relationship” by Anca Gheaus. Gheaus argues that (1) children have the same moral status as adults, (2) parents ought to seek childrearing arrangements that embody egalitarian relationships, and (3) parental enhancement decisions can (therefore) be justified only if they are “necessary for the child to reach the level of advantage she is owed by justice” or if they are aimed at “morally required features.” For whatever it is worth, I have a paper coming out on the issue of parental enhancement decisions as well, which you can read online ahead of print here.