Fetuses are not adult humans: a response to Miller on abortion.

Miller has recently argued that fetuses have the same inherent value as non-disabled adults. However, we do not need to postulate some property possessed equally by all humans, including fetuses, in order to explain the equality of non-disabled adults. It would suffice if there were some property possessed by all non-disabled adults, but not by fetuses.

Opt-out, mandated choice and informed consent.

A number of authors criticise opt-out (or 'deemed consent') systems for failing to secure valid consent to organ donation. Further, several suggest that mandated choice offers a more ethical alternative. This article responds to criticisms that opt-out does not secure informed consent. If we assume current (low) levels of public awareness, then the explicit consent secured under mandated choice will not be informed either. Conversely, a mandated choice policy might be justifiable if accompanied by a significant public education campaign. However, if this entitles us to assume that members of the public are informed, then an opt-out system would also be justified in the same circumstances. The alleged advantages of mandated choice seem to rest on an unfair comparison, between mandated choice with a public education campaign and an opt-out system without one. While it may be that some countries with opt-out systems should do more to inform their publics, I see no reason to assume that this cannot be done. Indeed, advocates of mandated choice seem committed to thinking it possible to raise awareness. If opt-out systems adopt the same methods, such as writing to every individual, this should also address concerns about whether consent is informed.

A sufficiency threshold is not a harm principle: A better alternative to best interests for overriding parental decisions.

Douglas Diekema influentially argues that interference with parental decisions is not in fact guided by the child's best interests, but rather by a more permissive standard, which he calls the harm principle. This article first seeks to clarify this alternative position and defend it against certain existing criticisms, before offering a new criticism and alternative. This 'harm principle' has been criticized for (i) lack of adequate moral grounding, and (ii) being as indeterminate as the best interest standard that it seeks to replace. I argue that these are not serious problems. I take Diekema's negative point to be right-our actual standard for intervention is not literally the best interests of the child-but I disagree with his proposed replacement. First, Diekema's proposed harm threshold should be more carefully distinguished from Mill's harm principle. Second, there is no reason to assume that the standard for permissible intervention coincides with the threshold for harm (or serious harm). Thus, I propose that the best alternative to the best interests standard is not a harm principle, but rather a sufficiency threshold between adequate (or 'good enough') and inadequate (or 'substandard') parenting.

Who are 'we' to speak of benefits and harms? And to whom do we speak? A (sympathetic) response to Woollard on breast feeding and language.

In a recent article, Fiona Woollard draws attention to a number of problems, both theoretical and pragmatic, with current discourse around infant feeding. References both to the 'benefits of breastfeeding' and 'harms of formula' are problematic, since there is no obvious baseline of comparison against which to make these evaluations. Further, she highlights the pragmatic consequences of these linguistic choices. Saying that formula feeding harms babies, for instance, is likely to exacerbate feelings of guilt and shame felt by many mothers who use formula, for various reasons. Since I agree with much that Woollard says, this response is mostly sympathetic, but I wish to draw attention to one point that is largely missing from her analysis. The pragmatic effect of an utterance depends significantly on who is speaking, to whom, and in what context. Thus, we might differentiate between what it is appropriate to say in a professional context, such as an academic journal, from what one might say in a policy document or to a new mother. While we should always be careful about the language that we use, we need not assume that the same language is appropriate in all contexts nor that equal care is always required.

Upsetting the balance on sex selection.

It is widely assumed that the strongest case for permitting non-medical sex selection is where parents aim at family balance. This piece criticizes one representative attempt to justify sex selection for family balance. Kluge (2007) assumes that some couples may seek sex selection because they hold discriminatory values, but this need not impugn those who merely have preferences, without evaluative commitments, for a particular sex. This is disputed by those who see any sex selection as inherently sexist because it upholds stereotypes about the sexes. This article takes an alternative approach. I argue that, even if we accept that preference-based selection is unobjectionable, a policy permitting selection for family balancing does a poor job of distinguishing between value-based and preference-based selection. If we wish to permit only preference-based sex selection we should seek to identify parents' motives. If we wish to justify a family balancing policy, other arguments are needed.

How altruistic organ donation may be (intrinsically) bad.

It has traditionally been assumed that organ donation must be altruistic, though the necessity of altruistic motivations has recently been questioned. Few, however, have questioned whether altruism is always a good motive. This paper considers the possibility that excessive altruism, or self-abnegation, may be intrinsically bad. How this may be so is illustrated with reference to Tom Hurka's account of the value of attitudes, which suggests that disproportionate love of one's own good-either excessive or deficient-is intrinsically bad. Whether or not we accept the details of this account, recognising that altruistic motivations may be intrinsically bad has important implications for organ procurement. One possible response is to say that we should take further measures to ensure that donors have good motives-that they are altruistic is no longer enough. An alternative is to say that, since altruistic donation need not be intrinsically good, we have less reason to object to other motivations.

First, do no harm: Generalized procreative non-maleficence.

New reproductive technologies allow parents some choice over their children. Various moral principles have been suggested to regulate such choices. This article starts from a discussion of Julian Savulescu's Principle of Procreative Beneficence (PPB), according to which parents ought to choose the child expected to have the best quality of life, before combining two previously separate lines of attack against this principle. First, it is suggested that the appropriate moral principles of guiding reproductive choices ought to focus on general wellbeing rather than prioritizing that of the child and, second, that they ought to be non-maximizing (e.g. seeking the 'good enough' or to avoid harm). Though neither of these suggestions is entirely novel, combining them results in a new, and arguably more plausible, principle to regulate procreative choices, which I call the Principle of Generalized Procreative Non-Maleficence (PGPNM). According to this principle, the primary obligation on parents is not to cause harm to other people through their reproductive choices.

Is procreative beneficence obligatory?

Julian Savulescu defends the principle of procreative beneficence, according to which parents have a prima facie moral obligation to choose the child with the best expected life. In this paper, I argue that Savulescu fails to show that procreative beneficence is genuinely obligatory, because of his equivocation between moral reason and moral obligation. Savulescu assumes that morality requires us to do what we have most (moral) reason to do, but many deny this, for instance because they believe we have reasons (but no obligation) to perform supererogatory actions. Even if parents have moral reasons to choose the child with the best expected life, they may not be under any obligation to do so.

Polyvictimization, income, and ethnic differences in trauma-related mental health during adolescence.

PURPOSE: The purpose of the present study was to investigate ethnic differences in trauma-related mental health symptoms among adolescents, and test the mediating and moderating effects of polyvictimization (i.e., number of types of traumas/victimizations experienced by an individual) and household income, respectively. METHODS: Data were drawn from the first wave of the National Survey of Adolescents-replication study (NSA-R), which took place in the US in 2005 and utilized random digit dialing to administer a telephone survey to adolescents ages 12-17. Participants included in the current analyses were 3312 adolescents (50.2 % female; mean age 14.67 years) from the original sample of 3614 who identified as non-Hispanic White (n = 2346, 70.8 %), non-Hispanic Black (n = 557, 16.8 %), or Hispanic (n = 409, 12.3 %). Structural equation modeling was utilized to test hypothesized models. RESULTS: Non-Hispanic Black and Hispanic participants reported higher levels of polyvictimization and trauma-related mental health symptoms (symptoms of posttraumatic stress and depression) compared to non-Hispanic Whites, though the effect sizes were small (γ ≤ 0.07). Polyvictimization fully accounted for the differences in mental health symptoms between non-Hispanic Blacks and non-Hispanic Whites, and partially accounted for the differences between Hispanics and non-Hispanic Whites. The relation between polyvictimization and trauma-related mental health symptoms was higher for low-income youth than for high-income youth. CONCLUSIONS: Disparities in trauma exposure largely accounted for racial/ethnic disparities in trauma-related mental health. Children from low-income family environments appear to be at greater risk of negative mental health outcomes following trauma exposure compared to adolescents from high-income families.

Why Procreative Preferences May be Moral - And Why it May not Matter if They Aren't.

There has been much argument over whether procreative selection is obligatory or wrong. Rebecca Bennett has recently challenged the assumption that procreative choices are properly moral choices, arguing that these views express mere preferences. This article challenges Bennett's view on two fronts. First, I argue that the Non-Identity Problem does not show that there cannot be harmless wrongs - though this would require us to abandon the intuitively attractive 'person-affecting principle', that may be a lesser cost than abandoning some more firmly-held intuition. But, even if we accept Bennett's claim that these choices are not moral, that does not show them to be mere personal preferences. I argue that there is a class of non-moral 'categorical preferences' that have much the same implications as moral preferences. If a moral preference for able-bodied children is problematic (as Bennett claims), then so is a non-moral categorical preference. Thus, showing that these preferences are not moral does not show that they are not problematic, since they may still be categorical.

Procreative Beneficence, Intelligence, and the Optimization Problem.

According to the Principle of Procreative Beneficence, reproducers should choose the child, of those available to them, expected to have the best life. Savulescu argues reproducers are therefore morally obligated to select for nondisease traits, such as intelligence. Carter and Gordon recently challenged this implication, arguing that Savulescu fails to establish that intelligence promotes well-being. This paper develops two responses. First, I argue that higher intelligence is likely to contribute to well-being on most plausible accounts. Second, I argue that, even if it does not, one can only resist the conclusion that reproducers should select on the basis of intelligence if its expected net effect is neutral. If intelligence reduces expected well-being, then reproducers should select offspring of low intelligence. More likely, the effect of increased intelligence on expected well-being varies at different levels, which makes identifying an optimum for well-being more complex than hitherto appreciated.

A Millian Case for Censoring Vaccine Misinformation.

The spread of vaccine misinformation may contribute to vaccine refusal/hesitancy and consequent harms. Nonetheless, censorship is often rejected on the grounds of free expression. This article examines John Stuart Mill's influential defence of free expression but finds that his arguments for freedom apply only to normal, reasonably favourable circumstances. In other cases, it may be permissible to restrict freedom, including freedom of speech. Thus, while Mill would ordinarily defend the right to express false views, such as that vaccines cause autism, he might have accepted restrictions on anti-vaccine misinformation during the present pandemic. This illustrates that even the staunchest defenders of free speech can permit temporary restrictions in exceptional circumstances.

Opt-out organ donation without presumptions.

This paper defends an 'opt-out' scheme for organ procurement, by distinguishing this system from 'presumed consent' (which the author regards as an erroneous justification of it). It, first, stresses the moral importance of increasing the supply of organs and argues that making donation easier need not conflict with altruism. It then goes on to explore one way that donation can be increased, namely by adopting an opt-out system, in which cadaveric organs are used unless the deceased (or their family) registered an objection. Such policies are often labelled 'presumed consent', but it is argued that critics are right to be sceptical of this idea-consent is shown to be an action, rather than a mental attitude, and thus not something that can be presumed. Either someone has consented or they have not, whatever their attitude to the use of their organs. Thankfully, an opt-out scheme need not rest on the presumption of consent. Actual consent can be given implicitly, by one's actions, so it is argued that the failure to register an objection (given certain background conditions) should itself be taken as sign of consent. Therefore, it is permissible to use the organs of someone who did not opt out, because they have-by their silence-actually consented.

Opt-out donation and tacit consent: a reply to Wilkinson and De Wispelaere.

In this reply to Wilkinson and De Wispelaere, I argue that an opt-out donation system can be regarded as tacit consent. I first separate the opt-in/opt-out issue from that of the role that the family ought to play. I then argue that what De Wispelaere calls minimal approval-tracking is not obviously necessary and that, even if it were, opt-out schemes can satisfy this requirement.

Altruism or solidarity? The motives for organ donation and two proposals.

Proposals for increasing organ donation are often rejected as incompatible with altruistic motivation on the part of donors. This paper questions, on conceptual grounds, whether most organ donors really are altruistic. If we distinguish between altruism and solidarity--a more restricted form of other-concern, limited to members of a particular group--then most organ donors exhibit solidarity, rather than altruism. If organ donation really must be altruistic, then we have reasons to worry about the motives of existing donors. However, I argue that altruism is not necessary, because organ donation supplies important goods, whatever the motivation, and we can reject certain dubious motivations, such as financial profit, without insisting on altruism. Once solidaristic donation is accepted, certain reforms for increasing donation rates seem permissible. This paper considers two proposals. Firstly, it has been suggested that registered donors should receive priority for transplants. While this proposal appears based on a solidaristic norm of reciprocity, it is argued that such a scheme would be undesirable, since non-donors may contribute to society in other ways. The second proposal is that donors should be able to direct their organs towards recipients that they feel solidarity with. This is often held to be inconsistent with altruistic motivation, but most donation is not entirely undirected in the first place (for instance, donor organs usually go to co-nationals). While allowing directed donation would create a number of practical problems, such as preventing discrimination, there appears to be no reason in principle to reject it.

How Mandatory Can We Make Vaccination?

The novel coronavirus (SARS-CoV-2) pandemic has refocused attention on the issue of mandatory vaccination. Some have suggested that vaccines ought to be mandatory, while others propose more moderate alternatives, such as incentives. This piece surveys a range of possible interventions, ranging from mandates through to education. All may have their place, depending on circumstances. However, it is worth clarifying the options available to policymakers, since there is sometimes confusion over whether a particular policy constitutes a mandate or not. Further, I illustrate a different kind of alternative to mandatory vaccination. Rather than seeking less coercive alternatives to a mandate, we might instead employ an alternative mandate, which requires people to do something less than get vaccinated. For instance, we might merely require people to attend an appointment at a vaccine clinic. Whether this mandatory attendance policy is justified will depend on specific circumstances, but it represents another way to promote vaccination, without mandating it. In some cases, this may represent an appropriate balance between promoting public health goals and respecting individual liberty.

Quantification of Interdependent Dynamics during Laser Additive Manufacturing Using X-Ray Imaging Informed Multi-Physics and Multiphase Simulation.

Laser powder bed fusion (LPBF) can produce high-value metallic components for many industries; however, its adoption for safety-critical applications is hampered by the presence of imperfections. The interdependency between imperfections and processing parameters remains unclear. Here, the evolution of porosity and humps during LPBF using X-ray and electron imaging, and a high-fidelity multiphase process simulation, is quantified. The pore and keyhole formation mechanisms are driven by the mixing of high temperatures and high metal vapor concentrations in the keyhole is revealed. The irregular pores are formed via keyhole collapse, pore coalescence, and then pore entrapment by the solidification front. The mixing of the fast-moving vapor plume and molten pool induces a Kelvin-Helmholtz instability at the melt track surface, forming humps. X-ray imaging and a high-fidelity model are used to quantify the pore evolution kinetics, pore size distribution, waviness, surface roughness, and melt volume under single layer conditions. This work provides insights on key criteria that govern the formation of imperfections in LPBF and suggest ways to improve process reliability.