Impairment Arguments, Interests, and Circularity.

A common justification for abortion rights is that the death of the fetus does not violate any of the fetus's time-relative interests. The time-relative interest account (TRIA) of harm and wrongdoing tells us that a necessary condition for harming someone is that his or her time-relative interests are frustrated. Regarding the justification for abortion, this account falls prey to impairment arguments. Impairment arguments entertain cases of prenatal injury, such as the mother using illicit drugs that disable the child. The intuition is that the child who is born with such disabilities is harmed by the mother's drug use. But it is unclear what time-relative interest is violated in cases of prenatal harm. Typical responses to impairment arguments point out that the abortion case is different because the child does not exist to experience such harms; but in prenatal injury + survival cases, the child does live to experience those harms. Thus, the TRIA justification for abortion is not impugned by impairment counter-examples. This article argues that this response to impairment arguments is viciously circular. The response must say that so long as you kill the child, no harm is done. But this assumes that killing itself is morally inconsequential and is not itself a case of harm. The response to impairment arguments, then, assumes the permissibility of abortion.

Identifying organisms.

Defenders of human, embryonic, destructive stem-cell research and early abortion typically argue for their position by showing that you and I do not come into existence at conception but rather at some point after. Eugene Mills has provided an ingenious argument that you and I could not have come into existence at conception. I argue against Mills's argument on two counts: first, his argument depends upon a cursory limning of human conception, and when fuller details are considered, a premise in his argument is undercut. Second, Mills's argument invites us to ask questions about how to identify individual organisms. Given a fuller description of human conception and some plausible metaphysical principles, I argue that Mills should hold instead that you and I do in fact come into being at conception. SUMMARY: One way to argue that early abortions are permissible is to argue against the view that you and I come into existence at conception. Most abortion rights defenders argue for this conclusion by noting that in order for you and I to exist, there must be developed psychological capacities. Eugene Mills takes a different route and argues that you and I could not come into existence at conception because that would mean being identical to an egg - which he rightly notes we cannot be. I argue against Mills in this article.

Perception of Value and the Minimally Conscious State.

The "disability paradox" is the idea that for those who become severely disabled, their own quality of life (QoL) assessment remains at or slightly below the QoL assessments of normal controls. This is a source of skepticism regarding third-person QoL judgments of the disabled. I argue here that this skepticism applies as well to those who are in the minimally conscious state (MCS). For rather simple means of sustaining an MCS patient's life (for example, tube feeding), the cost of being wrong that the patient would not want further support is high. Pair this cost with the reason to be skeptical of third-person judgments, and my argument suggests not withholding food and water from MCS patients.

When should we not respect a patient's wish?

Patients who face making a high-stakes decision-whether or not to accept a lifesaving intervention-may make a decision that their careproviders believe is deeply and dangerously mistaken. How can careproviders best help patients in such situations? If a determination of competency exam seems to be in the patients' best interests, how can careproviders refer their patients without betraying their patients' trust, given that the trust between patients and careproviders is one of the most powerful tools careproviders have in working with patients? Ethically, is it possible for careproviders to participate in determinations of competency for their own patients? I will present approaches that careproviders can adopt to help patients who "won't budge" when making what appear to be dangerously erroneous choices regarding lifesaving interventions.

Challenging research on human subjects: justice and uncompensated harms.

Ethical challenges to certain aspects of research on human subjects are not uncommon; examples include challenges to first-in-human trials (Chapman in J Clin Res Bioethics 2(4):1-8, 2011), certain placebo controlled trials (Anderson in J Med Philos 31:65-81, 2006; Anderson and Kimmelman in Kennedy Inst Ethics J 20(1):75-98, 2010) and "sham" surgery (Macklin in N Engl J Med 341:992-996, 1999). To date, however, there are few challenges to research when the subjects are competent and the research is more than minimal risk with no promise of direct benefit. The principal reason given for allowing research that is more than minimal risk without benefit is that we should respect the autonomy of competent subjects. I argue that though the moral intuitions informing respect for autonomy are sound, there is another set of intuitions regarding what we take to be just treatment of another when one agent knowingly causes or allows suffering on another agent. I argue that concerns generated by commutative justice serve as limitations on permissible research. I highlight our intuitions informing this notion of justice by appealing to work done on theodicy; what counts as a morally sufficient reason for God to allow suffering in humans is applicable also to the researcher-subject relationship. I conclude that all human subjects who are exposed to more than minimal risk research should enjoy the same actual protections (e.g., subpart D) as those given subjects who cannot consent.

Persons and evidence for death: A reply to Bulzacchelli.

This article is a reply to Bulzacchelli's argument via two routes. First, I argue that Bulzacchelli has not clarified what he means by the two key terms in his argument: person and reduction. Second, and more importantly, I argue that Bulzacchelli's argument involves a contradiction. He seems to think that determining death on the basis of physiological evidence (i.e. the cessation of organismic functioning) is reductionistic. But he also endorses arguments against whole brain death (WBD) and those arguments maintain that because organ systems function (with external support) in the setting of WBD, the person still exists. But to say that the person still exists simply in virtue of organ systems still functioning is the very reduction Bulzacchelli intimates is a problem.

The Missing Premise in the HIV-Condom Debate.

In a recent article in this journal, "Condoms and HIV: The State of the Debate," William Newton argues that there are basically two issues around which parties dispute. The first is whether the use of a condom by a discordant couple amounts to performing a contraceptive act. At issue here is whether a couple's use of a condom to prevent disease transmission renders the act a contraceptive act. The second issue pertains to whether the use of a condom, apart from whatever the intentions of the agents are, is itself a failure to consummate a marital act. It is the second issue that I wish to address in this paper. I aim to argue that the Canon-Law argument, as I will call it, wishes to argue that because condomistic sex fails to consummate a marriage, the sexual act performed is immoral. I argue against this inference on two grounds: the first is that the conclusion succumbs to counterexamples, and second, the inference must rely on a premise that I show is false.

A regulatory argument against human embryonic stem cell research.

This article explores the plausibility of an argument against embryonic stem cell research based on what the regulations already say about research on pregnant women and fetuses. The center of the argument is the notion of vulnerability and whether such a concept is applicable to human embryos. It is argued that such an argument can be made plausible. The article concludes by responding to several important objections.