Podcast: Justifications for Non-Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation
Dr Jonathan Pugh’s St Cross Special Ethics Seminar on 12 November 2015 is now available at http://media.philosophy.ox.ac.uk/uehiro/MT15_STX_Pugh.mp3
Speaker: Dr Jonathan Pugh
Although a central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to that intervention, there are some circumstances in which it seems that this moral requirement may be trumped. For instance, in some circumstances, it might be claimed that it is morally permissible to carry out certain sorts of non-consensual interventions on competent individuals for the purpose of infectious disease control (IDC). In this paper, I shall explain how one might defend this practice, and consider the extent to which similar considerations might be invoked in favour of carrying out non-consensual medical interventions for the purposes of facilitating rehabilitation amongst criminal offenders. Having considered examples of non-consensual interventions in IDC that seem to be morally permissible, I shall describe two different moral frameworks that a defender of this practice might invoke in order to justify such interventions. I shall then identify five desiderata that can be used to guide the assessments of the moral permissibility of non-consensual IDC interventions on either kind of fundamental justification. Following this analysis, I shall consider how the justification of non-consensual interventions for the purpose of IDC compares to the justification of non-consensual interventions for the purpose of facilitating criminal rehabilitation, according to these five desiderata. I shall argue that the analysis I provide suggests that a plausible case can be made in favour of carrying out certain sorts of non-consensual interventions for the purpose facilitating rehabilitation amongst criminal offenders.
Written by Professor Neil Levy
The recent discovery of what is claimed to be a distinct species of the genus Homo, our genus, raises to three the number of species that may have co-existed with Homo Sapiens. Homo naledi is yet to be dated, but it may be only tens of thousands of years old; if so, it coexisted with modern humans. Homo floresiensis, the so-called ‘hobbit’, seems to have been extant well after sapiens evolved, and there is strong evidence that the Neanderthals coexisted with, probably interbred with, and may have been killed by, our ancestors.
If any of these species had survived into contemporary times, we would be faced with an ethical question which is novel: negotiating our stance toward a species that is not quite human, but too close to be regarded as simply animal (using that word in its common meaning, to refer to non-human animals). More specifically, we would face the problem of how to respond to another deeply cultural being. Naledi seems to have had a culture – so the researchers conclude from the placement of the bones, which they think indicates burial. Perhaps it was language using (floresiensis seems a very good candidate for language using). Yet they might not have been intellectual equals of modern humans (perhaps they were – genetic difference certainly doesn’t entail inferiority – but for the purposes of this post I will assume they weren’t). If they were our contemporaries, would we be obliged to allow them to vote? To have affirmative action for them in universities and in jobs (assuming that some of them, perhaps rare geniuses, could function at a high enough level to take advantage of these opportunities)? Should we treat them as permanent children, appointing guardians for them?
Some philosophers would say that the answer to these questions is quite easy: we should give them equal consideration. Equality of consideration is the kind of equality which philosophers like Peter Singer argue should be extended to chickens and chimps, just as much as human beings. Treating chickens equally in that sense doesn’t entail affirmative action or voting rights for chickens, because chickens don’t have an interest in either. It just requires taking their interests equally into account.
While there are strong reasons for thinking we ought to extend equality of consideration to homo naledi, floresiensis and Neanderthals, that doesn’t tell us the answer to the concrete questions. Insofar as they are self-aware, these people (let’s call them that) have an interest in self-government, and therefore in voting. But (let’s assume) they have a limited capacity to understand the issues on which we vote. As self-aware beings, they might be harmed by being treated as inferior. But there may be good grounds for thinking that they are inferior.
We might offer them limited rights: rights to vote in elections for people who have the special role of looking after their interests. That would entail that they are not as self-governed as we are, since they would be living in a broader society (or in a world, at any rate) in which decisions are taken over which they have less say than we do.
I don’t think there are good answers to these questions. That is, while I am sure there are better and worse answers, I think this would be a true moral dilemma: the best possible response would have big moral costs. There seems to be no way to act that would involve some harms to a properly cultural being that couldn’t be fully autonomous: harms that would arise from its awareness that it was less autonomous and less able to govern its own life than others.
Julian Baggini sees in the discovery of naledi good news for humanity; it shows that in some sense we are not alone. Perhaps, but had they survived, we would face a tragic dilemma. To that extent, we are lucky that they didn’t. Genetic diversity among modern human beings is tiny, with genetic differences between groups swamped by those within them. That ensures that the questions we face about how to treat members of other groups are in one central way easier: they are in every important respect our equals. Our ethics would struggle to settle how to treat a deeply cultural group distinct from us which is in some respects not our equals.
Catia Faria, Pompeu Fabra University
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Throughout history, countless species have come into existence only to later become extinct. Whether extinction is caused by natural processes or human agency, environmental scientists and the general public seem to agree that extinction is a bad thing and that, therefore, conservation efforts should be made to counteract, and perhaps revert, the losses. Resources are often devoted to the reintroduction of endangered species into ecosystems in which they have long been absent. In other cases, states implement measures to protect autochthonous species (that is, species which are native to a certain natural environment, as opposed to introduced as a result of human activity) which are threatened by the presence of a foreign species by eradicating the members of the latter. There are entire organisations dedicated simply to the aim of preventing the extinction of species whose continued existence is at risk. However, these practices rely on rather controversial assumptions.
Written by Darlei Dall’Agnol
Stephen Hawking has recently made two very strong declarations:
- Philosophy is dead;
- Artificial intelligence could spell the end of the human race.
I wonder whether there is a close connection between the two. In fact, I believe that the second will be true only if the first is. But philosophy is not dead and it may undoubtedly help us to prevent the catastrophic consequences of misusing science and technology. Thus, I will argue that it is through the enhancement of our wisdom that we can hope to avoid artificial intelligence (AI) causing the end of mankind. Continue reading
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Luke Malone has published an extremely moving, disturbing, and distressing article in Medium, entitled ‘You’re 16. You’re a pedophile. You don’t want to hurt anyone. What do you do now?’ (warning: Malone’s article contains a graphic description of child abuse). The article focuses on ‘Adam’, a young man who, aged 16, was horrified to discover that he was sexually attracted to children. Disturbed by his sexual desires, and desperate to avoid acting on them, he suffered depression and initially used child pornography as an outlet for his feelings. (He subsequently stopped doing this.) Adam describes how he eventually went to see a therapist, who was unsympathetic, inexperienced in this area, and ultimately of little help. It turns out that, despite the fact that paedophilia is recognised as a mental disorder, there are major obstacles to helping people who, like Adam, are desperate to avoid harming children. Malone summarises some of the main problems: Continue reading
Last week, the Crown Prosecution Service announced that it would not pursue further action against Oxford Union president Ben Sullivan, due to insufficient evidence arising from an investigation into the two accusations of rape and attempted rape made against him. In early May, Sullivan was arrested and released on bail, prompting a chaotic six-week period for the Union as the Thames Valley Police investigated the claims made against him. After Sullivan refused to resign, a number of high-profile speakers, including the UK director of Human Rights Watch, the Interpol secretary-general, and a Nobel Peace prize winner, pulled out of their speaking commitments as part of a larger boycott of Union events.
In an open letter (which has since been taken down) calling for the boycott, students Sarah Pine, who is Oxford University Student Union’s Vice President for Women, and Helena Dollimor wrote, “Remaining in his presidency continues to offer prestige and power to someone who is being investigated for rape. This undermines the severe nature of allegations of sexual offences.” In contrast, Oxford professor A.C. Grayling penned a response to the letter refusing to cancel his scheduled talk at the Union, noting, “I simply cannot, in all conscience, allow myself to act only on the basis of allegations and suspicions, or of conviction by the kangaroo court of opinion, or trial by press…” In this post, I look at the spectrum of responses in the wake of Sullivan’s arrest, of which these two examples represent the poles. More broadly, I consider how we ought to respond – both as individuals and a society – when those in positions of power are accused of rape or other sexual offences. Continue reading
Complicity and Contraception: Rethinking Hobby Lobby’s Claim of ‘Substantial Burden on the Exercise of Religion’
Within the next month, the United States Supreme Court will decide whether for-profit corporations shall receive an exemption from providing certain types of contraceptives that are otherwise mandated for healthcare coverage by federal law to employees on the basis of the religious objections of the corporations’ owners. The two cases considered in tandem by the Supreme Court, Sebelius v Hobby Lobby Stores, Inc., and Conestoga Wood Specialties Corporation v Sebelius (Hobby Lobby from here on out), feature a Christian-owned arts and crafts chain and a Mennonite Christian-owned furniture manufacturer, the owners of which object to four specific forms of birth control that they claim cause abortions.
In making their argument for an exemption, the claimants rely mainly on the Religious Freedom Restoration Act (RFRA) passed by Congress in 1993. The RFRA states, “Government shall not substantially burden a person’s exercise of religion…” unless “that application of the burden to the person – 1) is furtherance of a compelling governmental interest; and 2) is the least restrictive means of furthering that compelling governmental interest.” This sets up three tests for judging the permissibility of a government act: the substantial burden test, the compelling interest test, and the least restrictive means test. For the claimants in Hobby Lobby to be successful under the RFRA, the Supreme Court would need to decide first that the government’s ‘contraception mandate’ is indeed a ‘substantial burden’ and second that the provision of contraception is both a compelling government interest and that employer based health insurance is the least restrictive method for securing that interest.
Scholars and journalists have taken various approaches in responding to the range of questions related to these three tests. However, I argue here that Hobby Lobby’s exemption claim can be denied without diving into this spectrum by showing that it fails to meet the first test: the government does not place a substantial burden on the exercise of religion by Hobby Lobby and Conestoga Wood in its ‘contraception mandate.’ Continue reading
Stop killer robots now, UN asks: the UN special rapporteur on extrajudicial, summary or arbitrary executions Christof Heyns has delivered a report about Lethal Autonomous Robots arguing that there should be a moratorium on the development of autonomous killing machines, at least until we can figure out the ethical and legal issues. He notes that LARs raise far-reaching concerns about the protection of life during war and peace, including whether they can comply with humanitarian and human rights law, how to device legal accountability, and “because robots should not have the power of life and death over human beings.”
Many of these issues have been discussed on this blog and elsewhere, but it is a nice comprehensive review of a number of issues brought up by the new technology. And while the machines do not yet have fully autonomous capabilities the distance to them is chillingly short: dismissing the issue as science fiction is myopic, especially given the slowness of actually reaching legal agreements. However, does it make sense to say that robots should not have the power of life and death over human beings?
The first two weeks of 2013 were marked by a flurry of news articles considering “the new science” of pedophilia. Alan Zarembo’s article for the Los Angeles Times focused on the increasing consensus among researchers that pedophilia is a biological predisposition similar to heterosexuality or homosexuality. Rachel Aviv’s piece for The New Yorker shed light upon the practice of ‘civil commitment’ in the US, a process by which inmates may be kept in jail past their release date if a panel decides that they are at risk of molesting a child (even if there is no evidence that they have in the past). The Guardian’s Jon Henley quoted sources suggesting that perhaps some pedophilic relationships aren’t all that harmful after all. And Rush Limbaugh chimed in comparing the ‘normalization’ of pedophilia to the historical increase in the acceptance of homosexuality, suggesting that recognizing pedophilia as a sexual orientation would be tantamount to condoning child molestation.
So what does it all mean? While most people I talked to in the wake of these stories (I include myself) were fascinated by the novel scientific evidence and the compelling profiles of self-described pedophiles presented in these articles, we all seemed to have a difficult time wrapping our minds around the ethical considerations at play. Why does it matter for our moral appraisal of pedophiles whether pedophilia is innate or acquired? Is it wrong to imprison someone for a terrible crime that they have not yet committed but are at a “high risk” of committing in the future? And if we say that we can’t “blame” pedophiles for their attraction to children because it is not their “fault” – they were “born this way” – is it problematic to condemn individuals for acting upon these (and other harmful) desires if it can be shown that poor impulse control is similarly genetically predisposed? While I don’t get around to fully answering most of these questions in the following post, my aim is to tease out the highly interrelated issues underlying these questions with the goal of working towards a framework by which the moral landscape of pedophilia can be understood. Continue reading