Journal of Medicine and Philosophy, 39: 207–216, 2014 doi:10.1093/jmp/jhu019

Bioethics and Disagreement: Organ Markets, Abortion, Cognitive Enhancement, Double Effect, and Other Key Issues in Bioethics

*Address correspondence to: Victor Saenz, MA, Department of Philosophy, Rice University, 6100 S. Main Street, Houston, TX 77251, USA. E-mail: [email protected]

I.  Bioethics and Disagreement Bioethics was born in the 20th century out of an attempt to cope with rapidly and radically developing medical technologies, especially as they arose around the time of the Second World War. Albert R. Jonsen, one of the founders of bioethics, writes in reminiscence: New techniques, from antibiotics to transplanted and artificial organs, genetic discoveries, and reproductive manipulations, together with the research that engendered them, presented the public, scientists, doctors, and politicians with questions which had never before been asked. (Jonsen, 2000, 115; cf. Jonsen, 1998)

But more importantly, bioethics arose as well due to major cultural changes that marginalized previous approaches to moral issues in health care and that brought into question medical ethics as an enterprise grounded in the medical profession. Philosophers, theologians, social scientists, and lawyers joined scientists and physicians in confronting what appeared to be unprecedented challenges (Jonsen, 1998; Engelhardt, 2012). Things have changed since then, in that bioethics is now a well-established field. However, there is an increasing uncertainty as to the foundations and significance of bioethics itself (Beauchamp, 2004; Cherry, 2012). But perhaps just as tellingly, in the view of some, one thing seems to remain the same. Some might complain that about 40 years since its inception, bioethicists are still arguing—and arguing about the very same things, or at least the very same kinds of things. Disagreement seems stark: in many cases philosophers, theologians, social scientists, lawyers, scientists, and physicians are departing from differing first principles. Philosopher Alasdair MacIntyre recognizes this radical state of the disagreement (MacIntyre, 1984), while arguing for a positive proposal for how to move forward (MacIntyre, 1988, 1990, 2009).1 Yet, MacIntyre does © The Author 2014. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: [email protected]

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Victor Saenz* Rice University, Houston, Texas, USA

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seem to be importantly right about the extent of the disagreement. In important ways, the collection of essays in this issue of the Journal of Medicine and Philosophy, engaging in core issues in bioethics—among them organ transplants, reproductive technologies, and the application of the traditionally theologico-philosophical framework of double effect—reflect some of the very same concerns pointed to at the inception of bioethics, though of course, shaped by new factors. And it is an understatement that the essays reflect disagreement.

Thousands of people die each year awaiting an organ transplant. In fact, 3,381 died in the United States in 2013 awaiting the transplant of a kidney, the most commonly transplanted organ.2 Of 14,029 kidney transplants performed last year, a mere 4,715 came from living donors. With these harrowing statistics in mind, many ask might not a market of organs, where people are monetarily compensated for giving up their organs, provide a solution at once efficient and desirable? This proposal has historically been met with very strong opposition, so much so that even in 2005, Mark Cherry spoke of a “global consensus” against for-profit markets in human organs (Cherry, 2005, 4), which was importantly shaped by official statements by the Transplantation Society, the World Health Organization, the Nuffield Council on Bioethics, and the US Task Force on Organ Donation.3 Especially in recent years, however, some have forcefully argued in its favor (Savulescu, 2003; Taylor, 2005; Cherry, 2005, 2013). Yet, there remain strong opponents of organ markets. Many opponents appeal to considerations of human dignity, the threat of exploitation, or the dangers of instrumentalizing human beings (e.g., Hughes, 2009; Kerstein, 2009). Further, others argue that the commercialization of organs is a threat to a spirit of altruism and the virtue of generosity (Davis and Crowe, 2009). In the first article, Schweda and Schicktanz (2014)—replying to a special issue on organ markets in the Journal of Medicine and Philosophy (Hippen, 2009)—suggest that both sides of the debate are importantly one-sided and incomplete. Schweda and Schicktanz agree in part with the general approach taken in Hippen (2009): answers to questions of organ markets do indeed depend on answers to more general philosophical problems. However, in important contrast to that approach, the authors maintain that answers also depend “on certain socioempirical premises that need to be made explicit and reassessed critically” (2014, 218). Seeing the relevance of such empirical premises should help us to reframe the debate about organ markets in important ways, they claim. Against proponents of organ markets, Schweda and Schicktanz affirm that the focus on increasing organ supplies—paradigmatically, via financial compensation in an organ market—is the result of a one-sided focus on organ

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II. Organ Markets and Empirical Studies—An Ongoing Debate



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III. Conceding Key Premises: A Strategy to Advance the Abortion Conversation Despite a massive literature on the moral status of abortion that has emerged in the decades since the inception of the modern debate,5 prominent proponents on both sides of the debate continue to hope that the issue is one that can be settled rationally, on premises that both parties can reasonably

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recipients, as opposed to nonrecipients. They point to their own empirical studies (Schicktanz and Schweda, 2009) to show that potential organ recipients and nonrecipients—lay people more generally—tend to think of organ supplies differently from each other. Potential recipients tend to speak of a “shortage,” so that a main ethical consideration in organ supplies is to increase the supply of organs. In contrast, nonrecipients tend to think of organ supplies as steady, so that a main ethical question is not so much how to increase the supply, but rather to establish the criteria for fair allocation of these supplies. The authors, in ignoring such different perceptions, argue that recent debates have without justification focused merely on the perspective of the organ recipient, while ignoring the perspective of lay people. The result is a misguided focus on questions of how to increase supplies to the detriment of questions of how to decrease organ demand or how equitably to distribute already available resources. Schweda and Schicktanz also argue that there is a problematic incompleteness both in a particular and influential argument against organ markets— the argument that the commercialization of organs militates against altruism and generosity (Davis and Crowe, 2009)—and in the framing of the academic debate about organ markets more generally. The debate, they affirm, has been framed in terms of a “strict dichotomy between the idea of purely altruistic donation and market-oriented models” (Schweda and Schicktanz, 2014, 220).4 They once more point to their empirical studies (Schweda and Schicktanz, 2009) to argue that organ recipients seem to present a constant desire and—more importantly—a constant inability to reciprocate with their donors. This state of affairs opens up new vistas in the debate that move the focus from whether this issue is a matter of altruism versus organ markets to whether and how organ recipients are able appropriately to reciprocate. To these claims, one of the major scholarly advocates of organ markets, James Stacey Taylor, has a ready riposte. Schweda and Schicktanz’s argument purports to reframe the organ market debate. However, Taylor claims that their arguments do not reframe the debate at all. Rather, they merely support an already traditional alternative in the debates: that organ supply should be increased through financial compensation in an organ market. What their studies do show, argues Taylor, is that empirical premises in fact support organ markets.

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accept.6 Hence, a common strategy in the debate is to concede important premises to the other party—if only for the sake of argument. This is seen at least as early as Judith Jarvis Thompson’s (1971) highly influential article “A Defense of Abortion,” where she concedes the key premise that the fetus has a right to life, then goes on to argue that even if that’s the case, this does not trump a woman’s right to personal bodily autonomy. In very different ways, the next two articles engage in this same argumentative strategy, in hopes of advancing—even if not settling—the debate rationally. One such key premise, for which many proponents of the pro-life view argue (recently, Beckwith, 2007; Kaczor, 2011), is that the unborn child is from conception a full-fledged member of the human community, so that it is at least prima facie—if not categorically—wrong to kill it. In this connection, our next article by Friberg-Fernros (2014) focuses on the Precautionary Argument, which purports to establish the prohibition against abortion, while not relying on this key pro-life premise. The Precautionary Argument tells us that, given our uncertainty about whether the fetus is a person, we should err on the side of life, because the consequences are so bad, should it turn out that the fetus is in fact a person. Thus, the argument claims to establish a prohibition against abortion despite—and in part because of—our uncertainty about the status of the embryo. Friberg-Fernros aims to contribute to the debate in two ways. First, he notes that although the argument is widely used by authors such as Francis Beckwith (2007), David Oderberg (2008), Patrick Lee (2010), and even the late John Paul II (1995), very little space is devoted in their discussions to articulating the argument in as precise a way as possible. Second, Friberg-Fernros notes that potent objections have been leveled against the argument in David Boonin’s important book, A Defense of Abortion (2003)—which was called by a reviewer in Ethics “a truly wonderful piece of applied analytic moral philosophy” (Cudd, 2006, 784). For example, it seems that the precautionary principle should prevent us from mowing our lawn since we would “thereby risk killing plants and animals because it is imaginable that such an activity would be on par with mass murder” (Friberg-Fernros, 2014, 230–31; cf. Boonin, 2003, 315). Surely, such conclusions from the precautionary argument are unacceptable. More specifically, such conclusions are but a glimpse of the three objections Boonin offers against the Precautionary Argument. First, it leads to unreasonable implications. Second, its conclusions are too weak. Third, it undermines the integrity of moral reasoning. In the bulk of his paper, FribergFernros goes through each of these objections in detail, offering responses. Further, Friberg-Fernros takes us through other plausible objections against the Precautionary Argument beyond Boonin’s. Thus, whatever our views on the matter, what results is a more elaborate and thoughtful defense of the principle of precaution and its pro-life implications than has been seen in contemporary debates thus far. In the next article, Walter Block (2014) continues this strategy of conceding premises—though in a very different way. Block notes that the abortion



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IV.  Work, Humility, and Cognitive Enhancement Robert Goodman’s essay, “Humility Pills: Building An Ethics of Cognitive Enhancement,” tackles ethical issues surrounding the use of cognitive enhancement drugs (CEDs). Specifically, Goodman focuses on CEDs that are both available by prescription—such as those known by the brand-names Adderall, Ritalin, and Provigil—and which are used off-label, or contrary to indications, as cognitive enhancers. It is important to bring to light ethical issues surrounding such off-label uses, claims Goodman, because CEDs are widely used in academic and business settings, and because, even where there are implicit prohibitions against them, such prohibitions are rarely enforced. Thus, Goodman considers two versions of an argument against the use of CEDs, which he calls the Accomplishment Argument. One version can be seen in the Presidents’ Council on Bioethics (PCBE, 2003), which makes the claim that the use of CEDs decreases the value of the individual’s work. Another version of the Accomplishment Argument is by a former council

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debate is usually framed in terms of two radically opposed camps. He considers the most extreme versions of these camps. On the one hand, the extreme pro-life view holds that abortion is always murder, because this involves taking the life of an innocent human being, and it remains murder even if we are considering the more extreme cases of rape or incest. On the flip-side, the extreme pro-choice view holds that the woman has a right to abortion at any stage of the pregnancy, a right extending even to the controversial partial-birth abortion. There are surely less extreme positions, but Block claims that these very same positions allow very little room for compromise. What is more, the abortion debate “threatens to tear our society apart” (Block, 2014, 249). In his article, Block invites the reader to rethink the categories of the debate by offering a creative alternative, which he claims is a genuine via media. His view is this: that the fetus, although a full human being with all the attendant human rights, is a trespasser in the womb who must be evicted as gently as possible, if the woman chooses not to go to term. Hence, he also concedes a key premise—although in a way radically different from Friberg-Fernros—that the fetus is a full-fledged human being. Block’s view, as he makes explicit, is based on two clusters of assumptions. First, there are two libertarian principles: (a) individual property rights and (b) the nonaggression principle. Second, there is the assumption that the fetus is a human being with all the attendant human rights. Yet, despite this second assumption in particular, Block claims that his proposal will lead to conclusions that can be palatable to both pro-lifers and pro-choicers. Further and crucially, Block affirms that even those who deny his two assumptions have good reason to look at his proposal.

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V. Art, Science, and Clinical Medicine In his article, “On Art and Science: An Epistemic Framework for Integrating Social Science and Clinical Medicine,” Jason Wasserman points to an enduring problem in the relation between social scientists and medical practitioners. Social scientists claim to have information that is relevant to medical practice, without its being clear how the practitioner is actually to use this information. Wasserman addresses some important impediments to sociological knowledge being relevant to medical practice. Quite centrally, the generalized results of sociological studies only have a certain probability—higher or lower—of actually being relevant to the individual people with whom the physician deals. It is misguided to impose such results without recognizing their uncertainty in particular cases. To address this, he proposes an alternative and suggestive way in which sociological studies can be relevant to clinical judgment. To pave his way toward his solution, Wasserman points us to what he considers two seemingly conflicting aspects of clinical judgment. On the one hand, there is the tendency toward an “objective scientific demeanor prescribing universal remedies,” such as we find might find in medical textbooks (Wasserman, 2014, 283). On the other hand, there is the tendency to attend to the particularities of the individual patient with whom a physician is dealing—such as his or her values, and biography. The former way of thinking Wasserman labels “scientific,” the latter “artistic.” Ultimately, “[c]linical judgment fundamentally is about bringing the two together” (Wasserman, 2014, 283). Relatedly, he distinguishes between medical knowledge and the application of that knowledge in medical practice. With these distinctions in mind, Wasserman affirms that a main problem in making sociological knowledge relevant to medical practice is that it remains as mere knowledge, and says little about how that ought to be applied to particular patients hic et nunc. But this problem points us to the solution. The author suggests that the solution is in teaching physicians how to “think sociologically rather than what social scientists think” (Wasserman, 2014, 290). That is, a key to the solution is not in adding more knowledge

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member and political philosopher Michael Sandel, who claims that CEDs tarnish our character, especially the virtue of humility (Sandel, 2004). But the argument from the PCBE rests on a mistaken view of human work, argues Goodman. Against this mistaken view, the author argues for a view which, whatever its merits, claims to have the intellectual pedigree of such greats as Mark Twain, C. S. Lewis, and T. S. Eliot—and perhaps even J. S. Bach and John Milton (Goodman, 2014). Further, Goodman twists Sandel’s argument as well: CEDs do not endanger our humility, but should rather lead us to greater humility. Thus, Goodman provocatively calls for a cultural transformation, for a culture of open CED use.



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but in changing the physician’s way of thinking so that he can generate a new kind of knowledge specifically directed at dealing with individual patients. The reader will be interested to see how Wasserman develops this proposal through the analysis of a case via the lens of a particular sociological model. VI. Intention and Double Effect

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The doctrine of double effect is used to consider particular actions that might have two effects—one good and the other bad, only one of which is intended. When, if ever, is it permissible to bring about the good effect, all the while knowing that the bad effect will occur? Obviously, this occurs throughout medicine: an appendectomy removes an appendix about to rupture, but it also entails pain and risks of death for the patient. Double-effect reasoning has been used to address such questions, and it is argued that, given certain specific conditions, the agent may do the good so long as he does not intend the attendant bad effect.7 Perhaps, in part because of its bioethical applications—for example, to cases of ectopic pregnancy—the doctrine of double effect, both in terms of how precisely to articulate its principles and what the application of those principles entails, has been the subject of great scholarly debate, much of which has appeared in the Journal of Medicine and Philosophy (e.g., Bole 1991; Boyle 1991; Kamm 1991; Marquis 1991; Kaczor 2001; Garcia 2007). The last essay in this issue continues this conversation. The authors Charles Douglas, Ian Kerridge, and Rachel Ankeny take issue with a paper by Lynn Jansen (2010), “Disambiguating Clinical Intentions: The Ethics of Palliative Sedation,” published in the Journal of Medicine and Philosophy. A key presupposition in double-effect reasoning is that there is, in fact, an important distinction between foreseeing and intending. Yet, two empirical studies challenge the truth of this distinction, claiming that it is sometimes blurred in significant ways (cf. Skene, 1998, 10.13; Cantor and Thomas, 2000, 113, footnote 108). With this in mind, the thesis of Jansen’s article is that there is an important ambiguity in the use of the word “intention,” so that we should be suspect of the conclusions of the aforementioned studies. According to Jansen, in commonsense use the word “intention” can mean either something like “aimed at,” “planned to,” “tried to,” or something much weaker like “foresaw (but did not aim/plan/try to).” Thus, we should doubt the empirical studies because those who conducted the studies failed to take into account these two senses of intention. Douglas, Kerridge, and Ankeny (2014) grant Jansen that there might indeed be an important ambiguity with respect to the use of the adjective and adverb “intentional” and “intentionally.” Yet, they argue that Jansen cannot rightly claim that this ambiguity carries over to the noun and verb “intention” and “to intend.” Hence, if their argument is sound, one cannot object to empirical studies as Jensen does. Thus, the authors of this article invite the

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reader to look at the empirical studies Jansen rejects. Surely, such empirical studies will continue to be the subject of more debate by those interested in (though not necessarily friendly to) the intention-foresight distinction and double effect, key concepts in contemporary bioethics. VII. Conclusion

Notes 1. MacIntyre argues for the view that “even when the protagonists of two or more rival moral traditions do not share enough by way of premises or standards of argument to settle their agreements, one may nonetheless be shown to be rationally superior to its rivals” (2009, 4; cf. 1988, 1990). 2. For several relevant statistics from the National Kidney Foundation, see: https://www.kidney. org/news/newsroom/factsheets/Organ-Donation-and-Transplantation-Stats.cfm (accessed March 26, 2014). 3. To get a clear idea of the extent of the opposition at the time of writing, see Cherry (2005, ix–x). 4. However, it should be noted that proponents of organ markets have argued that there is no tension between altruism and organ markets. For example, see Cherry (2005, 152). 5. In the years leading up to and after the 1973 Roe v. Wade decision, one sees a number of important articles and books. There is, of course, the influential article by Thompson (1971) where she argues that, even if the fetus has a right to life, this right is not enough to trump the woman’s autonomy. Her article was followed by several responses; among the most prominent ones, see Brody (1971) and Finnis (1973). 6. For recent statements of this, see Boonin (2003, 3) and Beckwith (2007, xiv). 7. The locus classicus for the doctrine of double effect is St. Thomas Aquinas, Summa Theologiae, IIa-IIae Q. 64, art. 7, where he defends the moral permissibility of killing in self-defense, assuming certain conditions, though some have argued that there are important roots to the principles behind double effect thinking in Aristotle’s Nicomachean Ethics, Book III (cf. Pakaluk, 2011). A landmark contemporary discussion of the concept of intention is found in Anscombe’s (1957) Intention, although its relevance is only beginning to be appreciated (cf. Ford, Hornsby, and Stoutland, 2011). 8. I want to thank the referees and the Senior Editor for their extensive and valuable feedback on this introduction.

References Anscombe, G. E. M. 1957. Intention. Oxford: Blackwell. Beauchamp, T. L. 2004. Does ethical theory have a future in bioethics? Journal of Law, Medicine, and Ethics 32: 209–217. Beckwith, F. 2007. Defending Life: A Moral and Legal Case Against Abortion Choice. Cambridge: Cambridge University Press.

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As the articles in this issue demonstrate, bioethics is a field marked by deep moral disagreements. It has certainly not been the aim of this issue to adjudicate competing first principles that are at the background of many of these disagreements—to adjudicate issues of the superiority of one moral tradition over another (MacIntyre, 1988, 1990, 2009). Neither does this cluster of articles purport to resolve the cardinal disputes each involves. But what the articles do achieve is giving us a better picture of the character of the disputes.8



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Block, W. 2014. Evictionism and libertarianism. Journal of Medicine and Philosophy 39(3): 248–57. Bole, T. J. 1991. The theoretical tenability of the doctrine of double effect. Journal of Medicine and Philosophy 16: 467–73. Boonin, D. 2003. A Defense of Abortion. Cambridge: Cambridge University Press. Boyle, J. 1991. Who is entitled to double effect? Journal of Medicine and Philosophy 16: 475–94. Brody, B. 1971. Thompson on abortion. Philosophy and Public Affairs 1: 335–40. Cantor, N. L. and G. C. Thomas. 2000. The legal bounds of physician conduct hastening death. Buffalo Law Review 48: 83–173. Cherry, M. J. 2005. Kidney for Sale by Owner. Washington, DC: Georgetown University Press. ———. 2012. Bioethics as political ideology. In Bioethics Critically Considered, ed. by H. T. Engelhardt, Jr., 99–122. Dordrecht: Springer. ———. 2013. It is morally acceptable to buy and sell organs for human transplantation: Moral puzzles and policy failures. In Contemporary Debates in Bioethics, ed. by R. Arp and A. Caplan, 47–58. New York: Wiley-Blackwell. Cudd, A. 2006. A defense of abortion by David Boonin. Ethics 116: 781–85. Davis, D. F. and S. J. Crowe. 2009. Organ markets and the ends of medicine. Journal of Medicine and Philosophy 34(6): 586–605. Douglas, C., I. Kerridge, and R. Ankeny. 2014. Double meanings will not save the principle of double effect. Journal of Medicine and Philosophy 39(3): 304–16. Engelhardt, H. T., Jr., ed. 2012. Bioethics Critically Considered. Dordrecht: Springer. Finnis, J. 1973. The rights and wrongs of abortion: A reply to Judith Thompson. Philosophy and Public Affairs 2: 117–45. Ford, A., J. Hornsby, and F. Stoutland, eds. 2011. Essays on Anscombe’s Intention. Cambridge, MA: Harvard University Press. Friberg-Fernros, H. 2014. Taking precautionary concerns seriously: A defense of a misused anti-abortion argument. Journal of Medicine and Philosophy 39(3): 228–47. Garcia, J. L. A. 2007. Health vs. harm: Euthanasia and physician’s duties. Journal of Medicine and Philosophy 32(1): 7–24. Goodman, R. 2014. Humility pills: Building an ethics of cognitive enhancement. Journal of Medicine and Philosophy 39(3): 258–78. Hippen, B., ed. 2009. Symposium on a regulated market in transplantable organs. Special Issue, Journal of Medicine and Philosophy 34(6). Hughes, P. M. 2009. Constraint, consent, and well-being in human kidney sales. Journal of Medicine and Philosophy 34(6): 606–31. Jansen, L. 2010. Disambiguating clinical intentions: The ethics of palliative sedation. Journal of Medicine and Philosophy 35(1): 19–31. Jonsen, A. R. 1998. The Birth of Bioethics. New York: Oxford University Press. ———. 2000. A Short History of Medical Ethics. New York: Oxford University Press. John Paul II. 1995. Evangelium Vitae. Vatican City: Libreria Vaticana Editrice. Kaczor, C. 2001. Moral absolutism and ectopic pregnancy. Journal of Medicine and Philosophy 26(1): 61–74. ———. 2011. The Ethics of Abortion: Women’s Rights, Human Life, and the Question of Justice. New York: Routledge. Kamm, F. M. 1991. The doctrine of double effect: Reflections on theoretical and practical issues. Journal of Medicine and Philosophy 16(5): 571–85.

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Kerstein, S. J. 2009. Autonomy, moral constraints, and markets in kidneys. Journal of Medicine and Philosophy 34(6): 573–85. Lee, P. [1996] 2010. Abortion and Unborn Human Life. Washington, DC: Catholic University of America Press. MacIntyre, A. 1984. After Virtue, 2nd ed. South Bend, IN: University of Notre Dame Press. ———. 1988. Whose Justice? Which Rationality? South Bend, IN: University of Notre Dame Press. ———. 1990. Three Rival Versions of Moral Inquiry. South Bend, IN: University of Notre Dame Press. ———. 2009. Intractable moral disagreements. In Intractable Disputes About the Natural Law: MacIntyre and His Critics, ed. L. Cunningham, 1–52. South Bend, IN: University of Notre Dame Press. Marquis, D. 1991. Four versions of double effect. Journal of Medicine and Philosophy 16(5): 515–44. Oderberg, D. S. 2008. The metaphysical status of the embryo: Some arguments revisited. Journal of Applied Philosophy 25: 263–76. Pakaluk, M. 2011. Mixed actions and double effect. In Moral Psychology and Human Action in Aristotle, eds. M. Pakaluk and G. Pearson, 211–32. New York: Oxford University Press. President’s Council on Bioethics. 2003. Beyond Therapy: Biotechnology and the Pursuit of Happiness. Washington, DC: Government Printing Office. Sandel, M. J. 2004. The case against perfection: What’s wrong with designer children, bionic athletes, and genetic engineering. The Atlantic. [On-line]. Available: www.theatlantic. com/past/docs/issues/2004/04/sandel.htm (accessed March 26, 2013). Savulescu, J. 2003. Is the sale of body parts wrong? Journal of Medical Ethics 29: 138–9. Schicktanz, S. and M. Schweda. 2009. “One man’s trash is another man’s treasure”: Exploring economic and moral subtexts of the “organ shortage” problem in public views on organ donation. Journal of Medical Ethics 35: 473–6. Schweda, M. and S. Schicktanz. 2009. Public ideas and values concerning the commercialization of organ donation in four European countries. Social Science & Medicine 68: 1129–36. ———. 2014. Why public moralities matter: The relevance of socio-empirical premises for the ethical debate on organ markets. Journal of Medicine and Philosophy 39(3): 217–22. Skene, L. 1998. Law and Medical Practice: Rights, Duties, Claims and Defences. London: Butterworths. Taylor, J. S. 2005. Stakes and Kidneys: Why Markets in Human Body Parts are Morally Imperative. Aldershot: Ashgate. ———. 2014. Public moralities and markets in organs. Journal of Medicine and Philosophy 39(3): 223–27. Thompson, J. 1971. A defense of abortion. Philosophy and Public Affairs 1: 47–66. Wasserman, J. 2014. On art and science: An epistemic framework for the integrating social science and clinical medicine. Journal of Medicine and Philosophy 39(3): 279–303.

Bioethics and disagreement: organ markets, abortion, cognitive enhancement, double effect, and other key issues in bioethics.

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