Not a Defence of Organ Markets

Selgelid and Koplin’s article ‘Kidney Sales and the Burden of Proof’ (K&S 2019) presents a series of detailed and persuasive arguments, intended to demolish my own arguments against the prohibition of organ selling. And perhaps they might succeed, if the case described by the authors were anything like the one I actually make. However, notwithstanding the extensive quotations and the detailed explanations of the way I supposedly argue, this account of my position comprehensively mistakes both the conclusions I reach and the arguments I give for them. I know that there are around many misconceptions about my views on this subject, but I have always hoped they could not survive a reading of what I had actually written. I have just—after a gap of many years—looked again at the two most recent of the texts Koplin and Selgelid refer to, and it goes without saying that I can see various things I could now do better; but I do still find these misinterpretations hard to understand. And since anyone with nothing to go on but this article would reasonably conclude that the original texts were not worth reading, I am grateful to the editors for the opportunity to try to set the record straight. I presume not many readers would be interested in a detailed comparative commentary on the texts, showing where this account gets my intentions wrong. I shall try instead to explain how what I do mean—and what I think I say—diverges from what is said here, and then go on to a brief outline of what my arguments and conclusions really are. I hope this may also give some sense of why, for all the opposition I have encountered since I was first drawn into this debate, I persist in thinking that the work I have been doing is important not only for this topic but for analysis in practical ethics more generally

Metaphysics for the Marriage Debate

The debate concerning what marriage is and what marriage ought to be is confused by conflicting ideas of natural law. John Stuart Mill sees law as a means by which to improve a universe with no natural moral order, whereas James Fitzjames Stephen views law as a means to correct that which is morally against nature. This article focuses on understanding a morally neutral working of nature, which requires looking past something\u27s moral desirability, and devising what form social arrangements, like marriage, should take. Once the ideas of natural law, together with moral goodness, are abandoned, and ideas discussing the scientific differences between the sexes are explored, traditional marriage becomes less justifiable, thus leaving few reasons to exclude same-sex marriage and other alternative arrangements. The author concludes that considering new social arrangements is a large step involving a complex set of incentives and disincentives, such as childrearing, sexual justice, and demographics, which focus on achieving better cumulative effects for individuals

How Not to End Disability

When advances in genetic technology offer the chance of preventing or curing disease and disability, it is one thing to recommend caution on the grounds that these obvious benefits may be outweighed by associated harms. It is quite another to deny even that there are benefits to be outweighed, and that attempts to prevent disability by these means should be resisted outright. That, however, is a view that is increasingly widespread in the disability rights movement

Stimulus for Organ Donation: A Survey of the American Society of Transplant Surgeons Membership

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74730/1/j.1600-6143.2009.02741.x.pd

Why the fair innings argument is not persuasive

The fair innings argument (FIA) is frequently put forward as a justification for denying elderly patients treatment when they are in competition with younger patients and resources are scarce. In this paper I will examine some arguments that are used to support the FIA. My conclusion will be that they do not stand up to scrutiny and therefore, the FIA should not be used to justify the denial of treatment to elderly patients, or to support rationing of health care by age. There are six issues arising out of the FIA which are to be addressed. First, the implication that there is such a thing as a fair share of life. Second, whether it makes sense to talk of a fair share of resources in the context of health care and the FIA. Third, that 'fairness' is usually only mentioned with regard to the length of a person's life, and not to any other aspect of it. Fourth, if it is sensible to discuss the merits of the FIA without taking account of the 'all other things being equal' argument. Fifth, the difference between what is unfair and what is unfortunate. Finally, that it is tragic if a young person dies, but only unfortunate if an elderly person does

Elective Modernism and the Politics of (Bio) Ethical Expertise

In this essay I consider whether the political perspective of third wave science studies – ‘elective modernism’ – offers a suitable framework for understanding the policy-making contributions that (bio)ethical experts might make. The question arises as a consequence of the fact that I have taken inspiration from the third wave in order to develop an account of (bio)ethical expertise. I offer a précis of this work and a brief summary of elective modernism before considering their relation. The view I set out suggests that elective modernism is a political philosophy and that although its use in relation to the use of scientific expertise in political and policy-making process has implications for the role of (bio)ethical expertise it does not, in the final analysis, provide an account that is appropriate for this latter form of specialist expertise. Nevertheless, it is an informative perspective, and one that can help us make sense of the political uses of (bio)ethical expertise

Safety, fairness, and inclusion: transgender athletes and the essence of Rugby

In this paper, I link philosophical discussion of policies for trans inclusion or exclusion, to a method of policy making. I address the relationship between concerns about safety, fairness, and inclusion in policy making about the inclusion of transwomen athletes into women’s sport. I argue for an approach based on lexical priority rather than simple ‘balancing’, considering the different values in a specific order. I present justifying reasons for this approach and this lexical order, based on the special obligations of International Federations such as World Rugby. As a result, I provide a justificatory framework for the WR Guidelines that exclude transwomen from the women’s game in WR competitions. Finally, I give an account of a maximally safe, maximally fair and maximally inclusive form of sex categorisation in sport

“They All Said You Could Come and Speak to Us”:Patients’ Expectations and Experiences of Help on an Acute Psychiatric Inpatient Ward

Acute psychiatric inpatient care forms an integral part of mental health services. Few studies have focussed on the patient experience of acute care. Research into patient experience is increasingly important to policy and service development processes. Knowledge of patient experiences facilitates the development of nursing practice. The aim of the study was to gain insight into the experience of being a patient on an acute inpatient psychiatric ward. Thirteen participants were recruited from the acute ward. Unstructured interviews were used to gather narrative data of their experiences. Holistic analysis of the narratives was informed by Gee's socio-linguistic theories that meaning is linked to narrative structure. Reading of the holistic analyses yielded themes of help, safety and power running across the participants' experiences. The patient experience was characterized by dissonance between expectation and experience, the search for a nurse–patient relationship and the development of strategies to cope with being on the acute ward. This paper focuses on the theme of ‘Help’ where participants describe their expectation that they will receive help through the development of relationships with the nurses, and their experience of the barriers to this. In response, participants developed strategies to support each other