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From Chance to Choice
Genetics and Justice
Paperback | 8 April 2002
At a Glance
414 Pages
22.86 x 15.24 x 2.34
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| Preface | p. xiii |
| Introduction | p. 1 |
| Challenges of the Genetic Age | p. 1 |
| Previews of Perplexities | p. 1 |
| Genetic Communitarianism | p. 2 |
| Personal Choice or Public Health Concern? | p. 2 |
| The Quest for the Perfect Baby | p. 2 |
| Health Care in the Age of Genetic Intervention | p. 3 |
| The Genetic Enhancement Certificate | p. 3 |
| The Need for Systematic Ethical Thinking | p. 4 |
| Genomic Research and Genetic Intervention | p. 5 |
| The Human Genome Project and Related Genetic Research | p. 5 |
| Modes of Genetic Intervention | p. 6 |
| The Shadow of Eugenics | p. 9 |
| Two Models for Genetic Intervention | p. 11 |
| The Public Health Model | p. 11 |
| The Personal Service Model | p. 12 |
| A Third Approach | p. 13 |
| Ethical Analysis and Ethical Theory | p. 14 |
| Principles for Institutions | p. 15 |
| Justice | p. 15 |
| Preventing Harm | p. 18 |
| Limits on the Pursuit of "Genetic Perfection" | p. 19 |
| The Morality of Inclusion | p. 20 |
| Ethical Theory and Public Policy | p. 21 |
| Science Fiction Examples, Reflective Equilibrium and the Ideological Uses of Genetic Determinism | p. 22 |
| The Risk of Reinforcing "Gene-Mania" | p. 23 |
| Genetic Determinist Fallacies | p. 24 |
| Ideological Functions of Genetic Determinism | p. 24 |
| Eugenics and its Shadow | p. 27 |
| The Relevance of Eugenics | p. 27 |
| Optimism and Anxiety | p. 27 |
| Eugenics as a Cautionary Tale | p. 28 |
| Eugenics: A Brief History | p. 30 |
| Origins and Growth | p. 30 |
| Varieties of Eugenics | p. 32 |
| The Nazi Debacle | p. 37 |
| Decline and Fall | p. 38 |
| Common Themes of Eugenicists | p. 40 |
| Degeneration | p. 40 |
| Heritability of Behavioral Traits | p. 41 |
| Eugenic Ends | p. 42 |
| Ethical Autopsy | p. 42 |
| A Creature of Its Time | p. 43 |
| Why Was Eugenics Wrong? Five Theses | p. 46 |
| The Public Health and Personal Service Models | p. 53 |
| Cost-Benefit Justifications for Genetic Intervention | p. 54 |
| The Social Dimension of Genetics | p. 55 |
| Genetics Constrained by Justice | p. 57 |
| Genetics in Pursuit of Justice | p. 59 |
| Conclusion | p. 60 |
| Genes, Justice, and Human Nature | p. 61 |
| Distributive Justice Issues Raised by Genetic Intervention | p. 61 |
| Including the Distribution of Natural Assets in the Domain of Justice | p. 63 |
| The Traditional View: Natural Inequalities Are Not a Concern of Justice | p. 63 |
| Challenging the Traditional View | p. 64 |
| Equality of Opportunity | p. 65 |
| Two Variants of the Level Playing Field Conception | p. 66 |
| Resource Egalitarianism and the Domain of Justice | p. 76 |
| Individual Liberty and Genetic Intervention | p. 77 |
| Genetic Equality? | p. 79 |
| A "Genetic Decent Minimum"? | p. 81 |
| Points of Convergence | p. 82 |
| The Colonization of the Natural by the Just | p. 82 |
| Blurring the Distinction Between the Subjects and Objects of Justice | p. 84 |
| Justice, Human Nature, and the Natural Bases of Inequality | p. 86 |
| Three Conceptions of the Relation of Human Nature to Ethics | p. 88 |
| Genetic Causation, Freedom, and the Possibility of Morality | p. 90 |
| Human Nature and the Idea of Moral Progress | p. 94 |
| Genetic Intervention in the Name of Justice | p. 95 |
| Intervening to Prevent Limitations on Opportunity | p. 95 |
| Regulating Access to Interventions to Prevent a Widening of Existing Inequalities | p. 96 |
| Ratcheting Up the Standard for Normal Species Functioning | p. 98 |
| Tailoring Environments to Special Genetic Needs | p. 99 |
| The Obligation to Prevent Harm | p. 99 |
| Conclusions | p. 100 |
| Positive and Negative Genetic Interventions | p. 104 |
| Old Distinctions in New Clothes | p. 104 |
| Positive and Negative Eugenic Goals for Populations | p. 104 |
| Positive and Negative Interventions and the Health and Welfare of Individuals | p. 105 |
| Moral Boundaries and the Positive/Negative Distinction | p. 107 |
| Treatment Versus Enhancement: Wide Use, Hard Cases, Strong Criticism | p. 110 |
| Insurance Coverage and "Medical Necessity" | p. 110 |
| Treatment/Enhancement and Moral Hazard | p. 112 |
| Treatments and the Limits of Obligations | p. 113 |
| Hard Cases and Expansion of Obligations | p. 115 |
| The Microstructure of the Normal and Moral Arbitrariness | p. 116 |
| Two Objections to the Treatment/Enhancement Distinction | p. 118 |
| A Limited Defense of the Treatment/Enhancement Distinction and Its Circumscribed Use | p. 119 |
| Treatment/Enhancement and the Obligatory/Nonobligatory Boundary | p. 119 |
| The Primary Rationale for Medical Obligations | p. 121 |
| Hard Cases and Expansive Views of Medical Obligations | p. 124 |
| Three Philosophical Models of the Relationship Between Equal Opportunity and the Goals of Health Care | p. 126 |
| The Normal Function Model as Better Public Policy | p. 141 |
| Is the Normal Function Model a Moral "Second-Best"? | p. 144 |
| Is the Treatment/Enhancement Distinction a Natural Baseline? | p. 149 |
| Positive Versus Negative Genetic Interventions and the Permissible/Impermissible Boundary | p. 152 |
| A Reminder about Science Fiction | p. 152 |
| Negative and Positive and the Permissible/Impermissible Boundary | p. 153 |
| Treatment/Enhancement and Moral Warning Flags | p. 154 |
| Why Not the Best? | p. 156 |
| Having the Best Children We Can | p. 156 |
| What Could Be More Natural Than Parents Seeking the Best? | p. 156 |
| Environmental Versus Genetic Pursuits | p. 159 |
| What Is the Best and Who Decides? | p. 161 |
| A Moral Distinction Between Actions | p. 161 |
| Pursuing the Best for the Child | p. 164 |
| Harms, Benefits, and General-Purpose Means | p. 167 |
| The Right to an Open Future | p. 170 |
| Limits on Pursuit of the Best | p. 172 |
| Pluralism and Liberalism | p. 176 |
| Virtues and the Best | p. 179 |
| Constraints on Permissions Allowed Parents | p. 181 |
| Enhancements, Coordination Problems, and Harms to Others | p. 182 |
| Enhancements and Fairness | p. 187 |
| Uncertainty and the Risks of Pursuing the Best | p. 191 |
| Cloning | p. 196 |
| Conclusion | p. 202 |
| Reproductive Freedom and the Prevention of Harm | p. 204 |
| The Wider Context: Conflicts Between Liberty and Harm Prevention | p. 204 |
| What Is Reproductive Freedom? | p. 206 |
| Rights and Freedoms | p. 206 |
| Positive and Negative Freedom | p. 207 |
| Summary of the Scope of Concern | p. 213 |
| The Interests and Values That Determine the Moral Importance of Reproductive Freedom | p. 214 |
| Self-Determination | p. 214 |
| Individual Good or Well-Being | p. 219 |
| Equality of Expectations and Opportunity | p. 220 |
| Use of Genetic Information to Prevent Harm | p. 222 |
| Distinguishing Cases | p. 223 |
| Post-Conception Interventions to Prevent Harms Compatible with a Worthwhile Life | p. 226 |
| Prevention of Harms across Many Generations | p. 230 |
| Pre- and Post-Conception Interventions to Prevent Harms Incompatible with a Worthwhile Life | p. 232 |
| Pre-Conception Interventions to Prevent Conditions Compatible with a Worthwhile Life | p. 242 |
| Conclusion | p. 256 |
| Genetic Intervention and the Morality of Inclusion | p. 258 |
| Objectives | p. 258 |
| The Morality of Inclusion | p. 258 |
| Neglect of the Morality of Inclusion in Ethical Theory | p. 260 |
| The Allegation That the New Genetics is Exclusionary | p. 261 |
| The Public Promise of the New Genetics: Better Lives for All Through Medical Genetics | p. 263 |
| Challenging the Rhetoric: The Radical Disabilities Rights Advocates' Complaints | p. 264 |
| Sorting Out the Concerns of Disabilities Rights Advocates | p. 266 |
| The Loss of Support Argument | p. 266 |
| The Justice Trumps Beneficence Argument | p. 270 |
| The Expressivist Objection | p. 272 |
| The Deaf Culture Argument | p. 281 |
| The Social Construction of Disability and the Morality of Inclusion | p. 284 |
| Distinguishing Disabilities from Impairments | p. 285 |
| Options for Eliminating Disabilities | p. 288 |
| Choosing a Dominant Cooperative Framework | p. 288 |
| The Concept of a Dominant Cooperative Framework | p. 288 |
| Why the Choice Is a Matter of Justice | p. 291 |
| How Genetic Interventions Might Affect the Character of the Dominant Cooperative Scheme | p. 296 |
| Knowledge of Genetic Differences and the Morality of Inclusion | p. 298 |
| Conclusion | p. 302 |
| Policy Implications | p. 304 |
| Where Does the Shadow of Eugenics Fall? | p. 306 |
| The Inevitable Comparison | p. 306 |
| Public Concern about Genetic Research | p. 306 |
| Beyond Rules of Thumb | p. 307 |
| Distributive Justice | p. 309 |
| The Right to Health Care | p. 309 |
| Additional Arguments for Access to Genetic Interventions | p. 314 |
| Securing Equality | p. 315 |
| If People Are Not Equal Should We Treat Them So? Should We Make Them So? | p. 315 |
| Will Human Genomic Research Push Society to the Right? | p. 317 |
| Must Everyone Have Access to Enhancements? | p. 318 |
| Enhancements versus Treatments | p. 321 |
| Families | p. 321 |
| Reproductive Freedom and Coercive Eugenics | p. 322 |
| Restrictions on Parental Choice | p. 324 |
| Citizenship and Inclusion | p. 325 |
| A Ghetto Walled by Data | p. 326 |
| Devaluing the Less Than Perfect | p. 327 |
| Reducing the Risk of Exclusion | p. 329 |
| State, Society, Individual, and Markets | p. 333 |
| The Threat of the Eugenic State | p. 333 |
| Eugenics as a Moral Obligation? | p. 333 |
| Eugenic Public Policy? | p. 336 |
| Utopian Eugenics? | p. 337 |
| Markets and Individual Liberty | p. 339 |
| Commercial Genetics | p. 341 |
| Liberal Neutrality and Democratic Decisionmaking | p. 343 |
| The Permissibility of Rights-Respecting Genetic Perfectionist Policies | p. 345 |
| The Meaning of Genetic Causation | p. 347 |
| Three Modes of Intervention | p. 349 |
| Four Key Questions | p. 353 |
| Do Genes Causally Contribute to the Trait? | p. 355 |
| How Much Do Genes, as Opposed to Environment, Contribute to the Trait? | p. 356 |
| Which Genes Contribute to the Trait? | p. 364 |
| How Do These Genes Contribute to the Trait? | p. 367 |
| Conclusion | p. 369 |
| Acknowledgments | p. 370 |
| Methodology | p. 371 |
| The Method of Reflective Equilibrium | p. 371 |
| The Charge of Parochialism | p. 371 |
| The Communitarian Challenge | p. 373 |
| The Limits of "Principlism" | p. 375 |
| A Liberal Framework | p. 378 |
| Negative and Positive Rights: Freedom and Well-Being | p. 380 |
| Justifying the Liberal Framework | p. 382 |
| References | p. 383 |
| Index | p. 395 |
| Table of Contents provided by Syndetics. All Rights Reserved. |
ISBN: 9780521669771
ISBN-10: 0521669774
Published: 8th April 2002
Format: Paperback
Language: English
Number of Pages: 414
Audience: General Adult
Publisher: Cambridge University Press
Country of Publication: GB
Dimensions (cm): 22.86 x 15.24 x 2.34
Weight (kg): 0.61
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This product is categorised by
- Non-FictionPhilosophyEthics & Moral Philosophy
- Non-FictionMedicineMedicine in GeneralMedical ProfessionMedical Ethics & Professional Conduct
- Non-FictionMedicinePre-Clinical Medicine & Basic SciencesMedical Genetics
- Non-FictionReference, Information & Interdisciplinary SubjectsEncyclopaedias & Reference Works
- Non-FictionPhilosophyPhilosophy of The Mind
- Non-FictionPhilosophySocial & Political Philosophy
























