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1. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Susan Anderson

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I examine five concerns held by the general population regarding human cloning and argue that they show either a misunderstanding about the process and/or result of cloning, or else ignorance about what we already do. Put differently, I argue that human cloning is not in principle more questionable than other current practices. However, I do have serious concerns about the uses to which the new technology will be put. I argue that the reasons currently proposed for human cloning are not persuasive. My position is that human cloning is not objectionable in principle, but practical application of the technology raises serious concerns. In my opinion, present circumstances do not seem to warrant it.

2. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Dieter Birnbacher

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Research on the human embryo is one of the most obstinately controversial issues of international bioethical debate. There has not been enough of a consensus on this issue to allow for more than a formal compromise within Europe. I argue in this paper for a pragmatic approach to the problem which accords priority to "want-regarding" considerations but does not fail, as most utilitarian approaches do, to give due weight to the "morality-dependent harms" caused by the practice of embryo research to those rejecting it from other than want-regarding principles. I suggest that in deeply controversial bioethical issues a consistent want-regarding perspective should be prepared, under certain narrow conditions, to make pragmatic tradeoffs between the inherent merits of the practice in question and the averse emotions of the public. These conditions are that the averse emotions are widespread, felt to be of existential importance, and stable under additional information, and that the costs in terms of reduced freedom and foregone humane progress do not seem excessive.

3. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Michele A. Carter

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Bioethics, viewed as both a form of reflective practice and a developing discipline, is concerned with the moral aspects of health care practice and research. With its steady maturation in the domain of moral discourse, bioethics has presided over a number of questions about the nature of human illness and how problems imposed by illness can be understood in an age marked not only by progress, but also by the concomitant fear that such progress will outstrip our humanity and our dignity as persons. I discuss some of the current tensions and ambiguities inherent in the field of bioethics as it continues to mature. In particular I focus on the present tendency in bioethics to bifurcate ethical theory and practice. I analyze some of the dichotomies resulting from such bifurcation. Finally, I call for an approach to bioethical discourse defined by the rigor of systematic and critical thinking characteristic of ethical theory, the disciplined eloquence and persuasive power of rhetoric, and the principles of Renaissance humanism. A new model of bioethics is proposed, one that synthesizes the analytic functions of moral theory with the practical and therapeutic functions of rhetorical humanism; such a model bridges the divide between theory and practice. This synthetic model of bioethical inquiry emerges from both ancient and contemporary debates about the possibility and nature of moral knowledge as well as from the moral teachings of humanists and rhetoricians throughout the history of ideas.

4. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
L. Collins

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How should we think about cloning as philosophers and feminists? Reproduction by cloning is not, in itself, morally inferior to human sexual reproduction. Moral criticism of cloning rests on condemnation of its "unnaturalness" or "impiety," but this kind of criticism should not persuade non-believers. I evaluate cloning in two phases. First, some hypothetical situations involving private choices about cloning are examined within a liberal framework. From this individualistic perspective, cloning appears no more morally problematic than sexual reproduction. A liberal feminist may welcome the possibility of human cloning as an expansion of the range of reproductive options open to women. The second phase argues for a shift in the framework of analysis in order to get a more complete evaluation of the ethical implications of human cloning, including questions of distributive justice and the ideology of reproduction.

5. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Dennis R. Cooley

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Recently, Sidney Wolfe, director of Public Citizen’s Health Research Group (PCHRG), charged the National Institute of Health (NIH) and Center for Disease Control (CDC) with sponsoring fifteen immoral HIV studies in sub-Saharan Africa. The trials are being conducted to determine if certain alternate medical procedures or a short course of treatment with AZT, zidovudine or other drugs prevent some mother-child HIV transmissions. Since the control group receives only placebos rather than AZT, Wolfe claims that the tests give suboptimal treatment that will result in more children contracting HIV and AIDS. Public Citizen’s Health Research Group and others are calling for an immediate cessation of these important experiments. Public Citizen raises an important moral question. Is it morally permissible to lower testing standards for the Third World? Unlike PCHRG, I contend that the answer to this question is yes, if the trials meet certain conditions. I explain both the First Best and Second Best Method (FBM and SBM, respectively) of testing new drugs and then compare the two. Next, I show the FBM’s impracticality in developing countries releases researchers from the moral obligation to use it. I then propose a new set of criteria — the Second Best Criteria (SBC) — that show if a test is moral or not. Finally, I argue that imposing a developed country’s moral standards for clinical trials in the Third World is immorally insensitive to the needs and conditions present in the latter area.

6. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Alfonso Flórez, Claudia Escobar

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The case of nonvoluntary euthanasia shows that the current definition of euthanasia must be more accurately determined. Euthanasia refers necessarily to the ending of life due to serious illness which must be expanded to include the lack of any capacity to give sense to life. A person in this latter position would be under lasting and unbearable suffering, perhaps unconscious, and incapable of leading her own life. The ethics of euthanasia must take these considerations into account. The will does not found the ethical decision. This is based instead on the reasonableness of continuing life under these circumstances. Voluntary euthanasia, as well as nonvoluntary, is founded on the right that every person who suffers under these conditions has to put an end to her life. It is understood that this is the only way to escape from such misfortune when life does not make sense any longer. The topic of euthanasia has a political dimension that is associated with the contemporary practice of medicine and the defense of human rights in our society. At the foundational level, euthanasis is unitary; the distinction between voluntary and nonvoluntary establishes only further precision, not a fundamental one.

7. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Ronnie Hawkins

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The ecofeminist critique of dualism is applied to a consideration of two alternative paths that we might take in transplantation medicine: the utilization of organs and tissues taken from nonhuman animals, and/or further development of techniques for employing human organs and tissues, including human fetal tissue. It is concluded that from an evolutionary perspective, the assumption of a vast value disparity between human and nonhuman life is untenable, and from a moral point of view the establishment of yet another institution based on a dualistic opposition between human life, postulated to be of ultimate value, versus devalued, disposable "other" life is unacceptable. We are urged to forego xenotransplantation and instead take responsibility for whatever manipulations we choose, respectfully, to make with life that is already valued as "self" rather than "other."

8. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Heta Häyry, Tuija Lehto

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Recent developments in biology have made it possible to acquire more and more precise information concerning our genetic makeup. There are four groups of people who may want to know about our genes. First, we ourselves can have an interest in being aware of own health status. Second, there are people who are genetically linked with us, and who can have an interest in the knowledge. Third, individuals with whom we have contracts and economic arrangements may have an interest in knowing about our genetic makeup. Fourth, society as a whole can have an interest in the composition of our genes. As regards the question of motivation, the term ‘should’ can be interpreted in three ways. Prudentially speaking, to say that individuals should act in a certain manner is to say that the actions in question promote the longterm self-interest of these individuals. From the viewpoint of morality, we should do what is right and avoid doing what is wrong. When it comes to legal thinking, it is held in most liberal societies that grave other-regarding harm should be the primary justification for the use of coercion and constraint. In the paper, all these aspects are examined in more detail.

9. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Matti Häyry, Tuija Lehto

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There are many risks involved in genetic engineering. The release of genetically altered organisms in the environment can increase human suffering, decrease animal welfare, and lead to ecological disasters. The containment of biotechnological material in laboratories and industrial plants contributes to the risk of accidental release, especially if the handling and storage are inadequate. The purely political dangers include intensified economic inequality, the possibility of large-scale eugenic programs, and totalitarian control over human lives. How should the acceptability of these risks be determined? We argue that the assessment should be left to those who can be harmed by the decisions in question. Economic risks are acceptable, if they are condoned by the corporations and governments who take them. The risks imposed on laboratory personnel by the containment of dangerous materials ought to be evaluated by the laboratory personnel themselves. All other risks are more or less universal, and should therefore be assessed as democratically as possible. If risk-taking is based on the choices of those who can be harmed by the consequences, then, even if the undesired outcome is realized, the risk is acceptable, because it is embedded in their own system of ethical and epistemic values.

10. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Paul Hoyt-O’Connor

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Since Alasdair MacIntyre’s landmark book After Virtue, there has been renewed interest in the role of the virtues in the moral life and attention paid to reappropriating the Aristotelian notion of "practice." Recent reappropriations of the virtues and virtue theory in medical ethics have contributed to conceiving more adequately the nature of good medicine. I wish to explore some of these insights and the special relevance the notion of practice has in an account of good medicine. Yet, I also want to suggest that much remains to be done. This renewed attention to the virtues needs to be supplemented by a similar reappropriation and transposition of the notion of nature in order to navigate successfully the Dardanelles of an ahistorical essentialism and the Bosphorus of a historical relativism.

11. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Victor M. Idoate García

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La determinación genética permite establecer que personas tienen mayor probabilidad de padecer enfermedades degenerativas o tumores. El problema ético se suscita cuando se utilizan las determinaciones para elegir personas con baja probabilidad de padecer enfermadades para que desarrollen actividades. En el análisis, cabe la posibilidad de estudiarlo desde el punto de vista antropológico y desde el punto de vista bioético. Desde el punto de vista antropológico, cuando se produce una discriminación de las personas en relación a su carga genética, no se tienen en cuenta la biografía y el proyecto de la persona (sólo se considera el aspecto animal), la relación entre la persona y la sociedad sufre deficiencias por considerarlo instrumento, y la relación médico enfermo es defectuosa. Desde el punto de vista bioético, la discriminación no cumple los principios bioéticos del primer nivel, que son de obligado cumplimiento, y los del segundo, también se encuentran insatisfactoriamente cumplidos. Mejorando la relación médico enfermo y sus valores de confidencialidad y veracidad pueden realizarse mejor los aspectos bioéticos.

12. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Mary B. Mahowald

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Helping people to die may involve killing and/or alleviation of pain in a dying person. A dual commitment to the avoidance of killing and the alleviation of pain raises the question of whether these two ways of helping people are always compatible. This paper addresses the question through use of sources in classical American pragmatism and contemporary bioethics. First, I apply Charles Peirce’s notion of pragmatism to the concept of killing through consideration of the empirical consequences of alternative interpretations. James Rachels’ account of the distinction between active and passive euthanasia is critiqued in this analysis. Second, I examine what it means to relieve pain by relating Jane Addams’ concept of maternal nurturance to an ethic of care and opposition to killing. Utilizing these concepts, I apply William James’ notion of pragmatism as a method of mediating or straddling different theoretical approaches to resolve the apparent incompatibility between pain relief and the avoidance of killing. To address social concerns raised by the practice of helping people to die, I propose a corrective insight of Addams, along with John Dewey, about the role of the philosopher as social critic. Thus understood, pragmatism is a means of avoiding abuses that may occur in the process. I conclude that so long as permissive practices are restrained sufficiently to avoid injustices, it is morally both possible and desirable to resist killing while relieving pain.

13. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Patricia S. Mann

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I examine the ways in which our cultural expectations with respect to death may be transformed by the legalization of assisted suicide. I suggest the inadequacy of the philosophical framework currently taken as the basis for discussing the advantages as well as the dangers of legalizing assisted suicide. I do not believe that individual autonomy is any sort of possibility for dying patients, regardless of the social policies that surround death in a society, insofar as our individual agency in this situation is necessarily intertwined with that of various relevant others. By means of a theory of agency relations, I attempt to show the dynamic ways in which we may all adjust to the option of assisted suicide as a preferred end-of-life option. My theory of agency relations does not deny individual choice; rather it explains the qualitative complexity of individual choice, as well as its dynamic social process of evolving.

14. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Márcio Mariguela

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I will analyze the links that have been established between sexuality and death in the social representation of AIDS, formerly expressing the silent agreements in the "risk groups" category. The increasing number of women infected with the HIV virus reveals that for individuals who do not identify themselves within the "risk group" category, AIDS is "someone else's" illness. To make this hypothesis explicit, I will start with an interview with former basketball player "Magic" Johnson who in 1991 publicly announced that he was HIV positive. In a sentence, Johnson revealed the significance of social discourse about AIDS in the eighties: "Now we are talking about life and death . . . AIDS was for me a gays and drug-addicts disease, formerly, not of a person like me." This revelation of an American idol showed that the HIV virus had reached those who identified themselves as heterosexuals. What happened after this announcement? The first response was to identify individuals who behaved bisexually, as their contagion certainly would have happened as a result of relations with the "risk group." This imaginary identification of sexual behaviors served to sustain the social representation of AIDS as a disease of marginal groups.

15. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Kevin McDonnell

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How may children and other dependent individuals are subjects in research projects to which they cannot consent and from which they cannot benefit? This topic was much discussed in the United States about twenty-five years ago, but has recently reemerged in the discussion of the European Convention on bioethics and through current discussion in the medical literature of the kinds of consent and experiments appropriate in the Third World. I summarize the U.S. discussion and "solution," present the current European discussion, and conclude with a proposal for understanding and organizing the participation of dependent people in medical experiments. Most of the attempts to understand dependent individuals’ participation in nontherapeutic experiments have attempted to assimilate that participation to a model of informed consent appropriate for adults. I argue that such understanding is false to the nature both of dependency and non-therapeutic experiments. The dependency of childhood, which serves my model, is best viewed in the context of a family committed to the full development of children. Given that commitment, the family involves itself in many activities in the hope of the physical, intellectual and moral development of its members. Non-therapeutic experiments are best seen, not in terms of risk, but in terms of the time and energy commitments they require of participants. Given these understandings of dependency and non-therapeutic experiments, I argue that care-givers are competent to involve themselves and their dependents in scientific work.

16. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Ellen M. McGee, G. Q. Maguire, Jr.

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My purpose is to initiate a discussion of the ethics of implanting computer chips in the brain and to raise some initial ethical and social questions. Computer scientists predict that within the next twenty years neural interfaces will be designed that will not only increase the dynamic range of senses, but will also enhance memory and enable "cyberthink" — invisible communication with others. This technology will facilitate consistent and constant access to information when and where it is needed. The ethical evaluation in this paper focuses on issues of safely and informed consent, issues of manufacturing and scientific responsibility, anxieties about the psychological impacts of enhancing human nature, worries about possible usage in children, and most troubling, issues of privacy and autonomy. Inasmuch as this technology is fraught with perilous implications for radically changing human nature, for invasions of privacy and for governmental control of individuals, public discussion of its benefits and burdens should be initiated, and policy decisions should be made as to whether its development should be proscribed or regulated, rather than left to happenstance, experts and the vagaries of the commercial market.

17. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Sylvia Nagl

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Today, biology is instrumental in the epistemological restructuring of the human sciences. This ‘biology,’ however, does not signify the body itself, but a metaphorical, linguistic construction of the self around which many aspects of contemporary life are becoming organized. The central metaphor of one’s biology is one’s genes, and ‘one’s genes’ are seen as the essence of the person. For complex historical, political and cultural reasons, the human genome is increasingly equated with the ‘essence’ of humanness. But, not only are genetic definitions of humanness, personality and identity the product of a historical discourse, the self they seek to define is a construct to begin with, arising from an essentialist epistemology, and is historically situated itself. Scientists who are involved in human genetics and the human genome project are confronted with this epistemological reconstruction of the self in unique ways, since they find themselves in the roles of the knowers and the known. Any definition of the human self will simultaneously affect the object of their research and their own agency. The issues about moral-agency-of-life scientists that need to be considered in this context can fruitfully be discussed from one postmodernist perspective. Drawing on Foucauldian analysis, Susan Hekman reminds us that no one is ever offered only one discourse. We are self-creating subjects who refuse to be scripted, and create our self out of the many discourses that are available. I will employ aspects of her theory of the discursive subject, and recent perspectives arising from postcolonial science studies, to develop a twofold strategy for transformation in molecular biology.

18. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Peter Novak

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How philosophy is educating humanity will be explained regarding an actual example concerning the new public health paradigm or health promoting research. The central point of reference is the discussion of the decisive substantiation of the work of medical sociologist, Aaron Antonovsky; his approach to salutogenesis is opposed to the usual approach of pathogenesis. Here, emphasis is put on "Sense of Coherence" (SoC). It will be shown that, in contrast to Antonovsky's original intention, the relation to the natural sciences and scientific medicine is sufficient to substantiate neither his central arguments nor the relation to the continental traditions of philosophy, especially to existential philosophy and to philosophical hermeneutics mentioned in his latest works. Therefore, referring to a prominent sociological representative of modern health science, means-end rationality is no longer able to assert its dominant position in this field, but must be legitimized by value rationality. Antonovsky's concept of SoC also inevitably includes the argument that methodologically oriented explanation (Erklären) of health related problems can never be replaced by sense-oriented understanding (Verstehen).

19. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Maria Patrão Neves

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Nowadays, man possess a power of intervention on nature without precedent, bearing not only upon the physical environment, but also upon the biological environment. In this study we intend to reflect first on the ethical and legal implications of the utilization of "genetic engineering" on plants and animals. On that point of view, we will insist on the issue of the relations between man and nature. Secondly, we will deal with the ways of application of genetic engineering to humans. We will be positioned, not anymore at the level of the relationship that man has with its natural environment, but at that relationship man has with human nature. We will examine the ethical and legal implications of the human genome project (analysis and screening), and of genetic therapy (somatic cells and germinal cells). On that point of view we will insist on the issue of the relations of man, in its singularity, with mankind, in its universality. We will conclude for the affirmation of an indispensable respect for Nature, which builds up as an inalienable ethics, which law institutes as unavoidable obligation.

20. The Paideia Archive: Twentieth World Congress of Philosophy: Volume > 4
Maja E. Pellikaan-Engel

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Over two millennia of Western philosophy has not yet contributed much to the education of humanity. Philosophy has almost always been the exclusive domain of a small group of men. This elite character makes the assumption that philosophy could contribute to the education of human beings towards humanity — a humanity of human rights — improbable. If we want to educate human beings towards humanity, we will first have to teach them a sense of responsibility. The power of persuasion needed in order to teach such a sense of responsibility requires that we demonstrate our involvement in and co-responsibility for their concrete problems by presenting clear analyses of these problems and by setting a good example wherever possible. One of the most universal and concrete problems of life is the issue of procreation. As regards this issue, however, philosophers have failed miserably: they themselves have often exhibited irresponsible procreation and have, in fact, only recently begun to consider the issue a subject for philosophy. I will try to analyze when a decision to procreate or abort may be called responsible and whether and to what extent the applications of modern techniques such as in vitro fertilization are in line with our views of human rights.