to the deity, saying perhaps that “good” means “in accordance with the wishes of the deity.” In that case, sentences such as “God is good” would be a meaningless tautology. “God is good” could mean no more than “God is in accordance with God’s wishes.” As we have already seen, there are ideas of what it is for something to be “good” that are not rooted in any religious belief. While religions typically encourage or instruct their followers to obey a particular ethical code, it is obvious that others who do not follow any religion can also think and act ethically.
To say that ethics is independent of religion is not to deny that theologians or other religious believers may have a role to play in bioethics. Religious traditions often have long histories of dealing with ethical dilemmas, and the accumulation of wisdom and experience that they represent can give us valuable insights into particular problems. But these insights should be subject to criticism in the way that any other proposals would be. If in the end we accept them, it is because we have judged them sound, not because they are the utterances of a pope, a rabbi, a mullah, or a holy person.
Ethics is also independent of the law, in the sense that the rightness or wrongness of an act cannot be settled by its legality or illegality. Whether an act is legal or illegal may often be relevant to whether it is right or wrong, because it is arguably wrong to break the law, other things being equal. Many people have thought that this is especially so in a democracy, in which everyone has a say in making the law. Another reason why the fact that an act is illegal may be a rea‐ son against doing it is that the legality of an act may affect the consequences that are likely to flow from it. If active voluntary euthanasia is illegal, then doctors who practice it risk going to jail, which will cause them and their families to suffer, and also mean that they will no longer be able to help other patients. This can be a powerful reason for not practicing voluntary euthanasia when it is against the law, but if there is only a very small chance of the offense becoming known, then the weight of this consequentialist reason against breaking the law is reduced accordingly. Whether we have an ethical obligation to obey the law, and, if so, how much weight we should give it, is itself an issue for ethical argument.
Though ethics is independent of the law, in the sense just specified, laws are subject to evaluation from an ethical perspective. Many debates in bioethics focus on questions about what practices should be allowed – for example, should we allow research on stem cells taken from human embryos, sex selection, or cloning? – and committees set up to advise on the ethical, social, and legal aspects of these questions often recommend legislation to prohibit the activity in question, or to allow it to be practiced under some form of regulation. Discussing a question at the level of law and public policy, however, raises somewhat different considerations than a discussion of personal ethics, because the consequences of adopting a public policy generally have much wider ramifications than the consequences of a personal choice. That is why some healthcare professionals feel justified in assisting a terminally ill patient to die, while at the same time opposing the legalization of physician‐assisted suicide. Paradoxical as this position may appear – and it is certainly open to criticism – it is not straightforwardly inconsistent.
Many of the essays we have selected reflect the times in which they were written. Since bioethics often comments on developments in fast‐moving areas of medicine and the biological sciences, the factual content of articles in bioethics can become obsolete quite rapidly. In preparing this 4th edition, we have taken the opportunity to cover some new issues and to include some more recent writings. Part X, on Disability, is new, as are the section in Part VII on Academic Freedom and Research and the essays in Part IX on Doctors’ Duty to Treat. There are new articles in almost every other section as well, on gene editing, the morality of ending the lives of newborns, brain death, the eligibility of mentally ill patients for assisted dying and experiments on humans and on animals, and on public health.
Some authors of articles that have become dated in their facts have kindly updated them especially for this edition. An article may, however, be dated in its facts but make ethical points that are still valid, or worth considering, so we have not excluded older articles for this reason.
Other articles are dated in a different way. During the past few decades we have become more sensitive about the ways in which our language may exclude women, or reflect our prejudices regarding race or sexuality. We see no merit in trying to disguise past practices on such matters (although we have made minor changes to some of the older writings in this anthology, in order to bring the terminology used in line with contemporary usage), so we have not excluded otherwise valuable works in bioethics on these grounds. If they are jarring to the modern reader, that may be a salutary reminder of the extent to which we all are subject to the conventions and prejudices of our times.
Helga Kuhse was a co‐editor of the first three editions of this anthology. She has now retired from academic work, and so decided not to join us in co‐editing this edition. Nevertheless, her influence remains present, in the articles carried over from earlier editions. We thank her for helping to establish Bioethics: An Anthology as a comprehensive and widely used collection of the best articles in the field.
Katherine Carr did a stellar job as the copy‐editor of this volume. The number of errors she spotted in previously published peer‐reviewed (and presumably copy‐edited and proof‐read) journal articles is extraordinary.
Last, but not least, we thank two Graduate Students in the Queen’s University Department of Philosophy who assisted us in sourcing possible materials for inclusion in the 3rd edition of this text (Nikoo Najand) and in this current edition (Chris Zajner).
Notes
1 1 See Van Rensselaer Potter, Bioethics: Bridge to the Future (Englewood Cliffs, NJ: Prentice‐Hall, 1971).
2 2 Fritz Jahr, Bio‐Ethik: Eine Umschau über die ethischen Beziehungen des Menschen zu Tier und Pflanze. Kosmos. Handweiser für Naturfreunde, 1927, 24:2–4.
3 3 The Karamazov Brothers, trans. Ignat Avsey (Oxford: Oxford University Press, 1994), vol. I, part 2, bk. 5, ch. 4. First published in 1879.
Introduction
The view that human life has special value is deeply rooted in most people’s thinking and no serious ethical theory allows a person to be killed without strong moral justification. Abortions terminate the lives of fetuses. Given that these fetuses are human, and of course innocent of any wrongdoing, it is easy to see why some people consider abortion to be unjustifiable homicide. In some respects fetuses are like persons; but in other respects they are very different. Therefore we need to ask whether they have the same moral status as those human beings we think of as persons.
In the first article in this Part, Michael Tooley provides a challenge to the view that fetuses are persons. In his 1972 landmark article “Abortion and Infanticide,” he seeks to articulate and defend an ethically significant criterion that confers personhood and a right to life. To have a right to life, Tooley argues, an entity needs to possess a concept of self, that is, be “capable of desiring to continue existing as a subject of experiences and other mental states.” An entity that has this capability is a person, whereas one that lacks it is not. This view has implications that enable us to defend abortion, but also challenge the moral views of most people who accept abortion; for on this view neither fetuses nor newborn infants are persons, whereas some
