Leveraging a Sturdy Norm: How Ethicists Really Argue?

Rarely do everyday discussions of ethical issues invoke ethical theories. Even ethicists deploy ethical theories less frequently than one might expect. In my experience, the most powerful ethical arguments rarely appeal to an ethical theory. How is this possible? I contend that ethical argumentation can proceed successfully without invoking any ethical theory because the structure of good ethical argumentation involves leveraging a sturdy norm, where the norm is usually far more specific than a complete ethical theory. To illustrate this idea, I present the argumentative structure of five powerful articles in the ethics literature. I further argue that the present model of ethical argumentation is consistent with the coherence model of ethical justification, but the former need not--and usually should not--invoke the latter explicitly for various practical reasons.

Elephants, Personhood, and Moral Status.

This essay uses the lens of moral status to explore the question of whether elephants ought to count as persons under the law. After distinguishing descriptive, moral, and legal concepts of personhood, the author argues that elephants are (descriptively) at least "borderline persons," justifying an attribution of full moral status and, thereby, a solid basis for legal personhood. A final section examines broad implications of elephant personhood.

Robots with Moral Status?

Assuming robots of the future will be far more advanced than their present-day forebears, it is not premature to ask what they will have to be like in order to have moral status. This article first examines criteria for moral status, criticizing several models before briefly defending an interest-based account. It next investigates the epistemological challenge of applying criteria for moral status to robots, before eliciting implications with attention to basic moral status, rights, and respect for autonomy. The article concludes with reflections on species-based prejudice and an acute practical dilemma that will confront robotics.

On Ethicists and Their Diets.

Factory farming is one of the most destructive institutions in human history. In the United States alone, it raises and kills ten billion animals every year. Conditions in which animals live and the way they are treated in transit are exceptionally cruel. Factory farming is also an environmental disaster. Do ethicists have a greater obligation than the average person to maintain an ethical diet? Various psychological and cultural factors explain why most people in our society regularly consume meat, eggs, and dairy products from factory farms even though there is an overwhelmingly strong case that doing so is wrong. But ethicists are supposed to be good at examining important ethical questions. So, while they have the same obligation as everyone else, ethicists have no excuses for failing to understand dietary ethics and living accordingly.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Challenge Experiments in Nonhuman Primates: An Ethical Perspective.

The coronavirus disease 2019 (COVID-19) pandemic has stimulated massive investment in biomedical research with the aims of understanding the disease and developing effective vaccine and therapeutic interventions. What role should animal research play in this scientific endeavor? Both the urgency to evaluate candidate interventions for human use and growing societal concern about ethical treatment of (nonhuman) animals put into question the justifiability of animal research as a precursor to clinical trials. Yet forgoing animal research in the rush to undertake human testing might expose human research participants to unacceptable risks. In this article, we apply a recently developed framework of principles for animal research ethics in exploring ethical questions raised by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection challenge experiment involving rhesus macaques, which evaluated the protective efficacy of the mRNA-1273 vaccine that was recently approved for emergency use. Our aim is to illuminate the ethical issues while introducing, and illustrating the use of, the framework.

Should biomedical research with great apes be restricted? A systematic review of reasons.

BACKGROUND: The use of great apes (GA) in invasive biomedical research is one of the most debated topics in animal ethics. GA are, thus far, the only animal group that has frequently been banned from invasive research; yet some believe that these bans could inaugurate a broader trend towards greater restrictions on the use of primates and other animals in research. Despite ongoing academic and policy debate on this issue, there is no comprehensive overview of the reasons advanced for or against restricting invasive research with GA. To address this gap, we conducted a systematic review of the reasons reported in the academic literature on this topic. METHODS: Seven databases were searched for articles published in English. Two authors screened the titles, abstracts, and full texts of all articles. Two journals specialized in animal ethics, and the reference lists of included articles were subsequently also reviewed. RESULTS: We included 60 articles, most of which were published between 2006 and 2016. Twenty-five articles argued for a total ban of GA research, 21 articles defended partial restrictions, and 14 articles argued against restrictions. Overall, we identified 110 reason types, 74 for, and 36 against, restricting GA research. Reasons were grouped into nine domains: moral standing, science, welfare, public and expert attitudes, retirement and conservation, respect and rights, financial costs, law and legal status, and longer-term consequences. CONCLUSION: Our review generated five main findings. First, there is a trend in the academic debate in favor of restricting GA research that parallels worldwide policy changes in the same direction. Second, in several domains (e.g., moral standing, and respect and rights), the reasons were rather one-sided in favor of restrictions. Third, some prominent domains (e.g., science and welfare) featured considerable engagement between opposing positions. Fourth, there is low diversity and independence among authors, including frequent potential conflicts of interests in articles defending a strong position (i.e., favoring a total ban or arguing against restrictions). Fifth, scholarly discussion was not the norm, as reflected in a high proportion of non-peer-reviewed articles and authors affiliated to non-academic institutions.

Beyond the 3 Rs to a More Comprehensive Framework of Principles for Animal Research Ethics.

We have produced a framework of general moral principles for animal research ethics in a book, Principles of Animal Research Ethics, which is forthcoming with Oxford University Press in fall 2019. This book includes a detailed statement and defense of our framework along with critical commentaries on our work from seven eminent scholars: Larry Carbone, Frans de Waal, Rebecca Dresser, Joseph Garner, Brian Hare, Margaret Landi, and Julian Savulescu. In the present paper, we explain the motivation for our project and present our framework of principles. The first section explains why a new framework is both needed and timely, on the basis of six important developments in recent decades. The second section challenges assertions of an unbridgeable gulf dividing the animal-research and animal-protection communities on the issue of animal research. It does so, first, by indicating common ground in the core values of social benefit and animal welfare and, then, by presenting and briefly defending our framework: three principles of social benefit and three principles of animal welfare. These six principles, we argue, constitute a more suitable framework than any other that is currently available, including the canonical 3 Rs advanced in 1959 by William M. S. Russell and Rex L. Burch.

Regulating international clinical research: an ethical framework for policy-makers.

The global distribution of clinical trials is shifting to low-income and middle-income countries (LMICs), and adequate regulations are essential for protecting the rights and interests of research participants in these countries. However, policy-makers in LMICs can face an ethical trade-off: stringent regulatory protections for participants can lead researchers or sponsors to conduct their research elsewhere, potentially depriving the local population of the opportunity to benefit from international clinical research. In this paper, we propose a three-step ethical framework that helps policy-makers to navigate this trade-off. We use a recent set of regulatory protections in Chile to illustrate the practical value of our proposed framework, providing original ethical analysis and previously unpublished data from Chile obtained through freedom of information requests.

Can Knowledge Itself Justify Harmful Research?

In our paper, we argue for three necessary conditions for morally permissible animal research: (1) an assertion (or expectation) of sufficient net benefit, (2) a worthwhile-life condition, and (3) a no-unnecessary-harm/qualified-basic-needs condition.1 We argue that these conditions are necessary, without taking a position on whether they are jointly sufficient. In their excellent commentary on our paper, Matthias Eggel, Carolyn Neuhaus, and Herwig Grimm (hereafter, the authors) argue for a friendly amendment to one of our three conditions.2 In particular, they argue for replacing the first condition-expectation of sufficient net benefit (ESNB)-with an expectation of knowledge production (EKP).3 In this reply, we will explain why we are open to this proposed amendment, but not yet convinced.

Human-Animal Chimeras, "Human" Cognitive Capacities, and Moral Status.

In "Human-Animal Chimeras: The Moral Insignificance of Uniquely Human Capacities," Julian Koplin explores a promising way of thinking about moral status. Without attempting to develop a model in any detail, Koplin picks up Joshua Shepherd's interesting proposal that we think about moral status in terms of the value of different kinds of conscious experience. For example, a being with the most basic sort of consciousness and sentience would have interests that matter morally, while a being whose consciousness featured the riches of loving affection, say, might have greater moral status and therefore deserve some sort of priority if the interests of the two beings conflicted. This approach represents an improvement over the more common, transparently anthropocentric habits of thinking about moral status, whether in connection with evaluating human-animal chimera research, deciding what one can ethically eat, or pursuing some other moral inquiry.

Ethics of patient activation: exploring its relation to personal responsibility, autonomy and health disparities.

Discussions of patient-centred care and patient autonomy in bioethics have tended to focus on the decision-making context and the process of obtaining informed consent, leaving open the question of how patients ought to be counselled in the daily maintenance of their health and management of chronic disease. Patient activation is an increasingly prominent counselling approach and measurement tool that aims to improve patients' confidence and skills in managing their own health conditions. The strategy, which has received little conceptual or ethical analysis, raises important questions about how clinicians ought to foster confidence and a sense of control in their patients without exposing them to blame, stigma and other harms. In this paper, we describe patient activation, discuss its relationship to personal responsibility, autonomy and health disparities, and make recommendations regarding its use and measurement.

Defining the Boundaries of a Right to Adequate Protection: A New Lens on Pediatric Research Ethics.

We argue that the current ethical and regulatory framework for permissible risk levels in pediatric research can be helpfully understood in terms of children's moral right to adequate protection from harm. Our analysis provides a rationale for what we propose as the highest level of permissible risk in pediatric research without the prospect of direct benefit: what we call "relatively minor" risk. We clarify the justification behind the usual standards of "minimal risk" and "a minor increase over minimal risk" and explain why it is permissible to impose any risks at all on child participants who do not stand to benefit directly from enrollment in research. Finally, we illuminate some aspects of the concept of "best interests."

Nonhuman Primates, Human Need, and Ethical Constraints.

"The Ethics of Infection Challenges in Primates," by Anne Barnhill, Steven Joffe, and Franklin Miller, is an exceptionally timely contribution to the literature on animal research ethics. Animal research has long been both a source of high hopes and a cause for moral concern. When it comes to infection challenge studies with nonhuman primates, neither the hope-to save thousands of human lives from such diseases as Ebola and Marburg-nor the concern-the conviction that primates deserve especially strong protections-could be much higher. Coming just a few years after the National Institutes of Health adopted the Institute of Medicine's recommendations regarding chimpanzees, Barnhill and colleagues attempt to nudge the clarification and specification-one might say the evolution-of NHP research ethics and regulation. They assert that NHP challenge studies "are not justified by marginal gains in human safety or by efficacy gains that are unlikely to translate directly into saving human lives or preventing morbidity." How, in turn, is their standard-which, although stringent, does permit causing NHPs to suffer and die for human benefit-to be justified?

Relieving pain using dose-extending placebos: a scoping review.

Placebos are often used by clinicians, usually deceptively and with little rationale or evidence of benefit, making their use ethically problematic. In contrast with their typical current use, a provocative line of research suggests that placebos can be intentionally exploited to extend analgesic therapeutic effects. Is it possible to extend the effects of drug treatments by interspersing placebos? We reviewed a database of placebo studies, searching for studies that indicate that placebos given after repeated administration of active treatments acquire medication-like effects. We found a total of 22 studies in both animals and humans hinting of evidence that placebos may work as a sort of dose extender of active painkillers. Wherever effective in relieving clinical pain, such placebo use would offer several advantages. First, extending the effects of a painkiller through the use of placebos may reduce total drug intake and side effects. Second, dose-extending placebos may decrease patient dependence. Third, using placebos along with active medication, for part of the course of treatment, should limit dose escalation and lower costs. Provided that nondisclosure is preauthorized in the informed consent process and that robust evidence indicates therapeutic benefit comparable to that of standard full-dose therapeutic regimens, introducing dose-extending placebos into the clinical arsenal should be considered. This novel prospect of placebo use has the potential to change our general thinking about painkiller treatments, the typical regimens of painkiller applications, and the ways in which treatments are evaluated.