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PubMed1993

Human gene therapy: down the slippery slope?

The strength of a slippery slope argument is a matter of some dispute. Some see it as a reasonable argument pointing out what probably or inevitably follows from adopting some practice, others see it as essentially a fallacious argument. However, there seems to be a tendency emerging to say that in many cases, the argument is not actually fallacious, although it may be unsubstantiated. I shall not try to settle this general discussion, but merely seek to assess the strength of the slippery slope argument applied to human gene therapy. The structure of my argument will be the following. First, I shall distinguish between three different versions of the slippery slope argument; two logical versions and an empirical one. Next, I will address human gene therapy in terms of each of the three versions, partly relying on slippery slope arguments against this practice that have already surfaced in the literature. I shall argue that neither version pulls through. The logical versions fail primarily because relevant distinctions can be made between different uses of gene therapy, contrary to what the proponents of the arguments claim. The empirical version fails because there seems to be no evidence supporting the claim that we shall in fact slide down the slope if we engage in gene therapy, and because if we accepted the conclusion that we should not allow gene therapy on the basis of the empirical argument, we should have to make very far-reaching and undesirable modifications in health care in general, in order to be consistent. Or at least so I shall argue.

Altruism↗

PubMed1999

Prenatal diagnosis and discrimination against the disabled.

Two versions of the argument that prenatal diagnosis discriminates against the disabled are distinguished and analysed. Both are shown to be inadequate, but some valid concerns about the social effects of prenatal diagnosis are highlighted.

Abortion, Induced↗

PubMed1997

Moral community and animal research in medicine.

The invocation of moral rights in moral/social debate today is a recipe for deadlock in our consideration of substantive issues. How we treat animals and humans in part should derive from the value of their lives, which is a function of the quality of their lives, which in turn is a function of the richness of their lives. Consistency in argument requires that humans with a low quality of life should be chosen as experimental subjects over animals with a higher quality of life.

Anencephaly↗

PubMed1998

Discussing HUGO: the German debate on the ethical implications of the Human Genome Project.

The current German criticism of HUGO centers around the term 'human dignity'; consenquentialist and autonomy-based arguments are used. The debate culminates in questioning the integrity of bioethics as a scholarly discipline and has created a heterogeneous coalition of disparate political and social groups that oppose any research that would facilitate genetic pre-selection of human characteristics.

Bioethics↗

PubMed1995

Human gene therapy and slippery slope arguments.

Any suggestion of altering the genetic makeup of human beings through gene therapy is quite likely to provoke a response involving some reference to a 'slippery slope'. In this article the author examines the topography of two different types of slippery slope argument, the logical slippery slope and the rhetorical slippery slope argument. The logical form of the argument suggests that if we permit somatic cell gene therapy then we are committed to accepting germ line gene therapy in the future because there is no logically sustainable distinction between them. The rhetorical form posits that allowing somatic cell therapy now will be taking the first step on a slippery slope which will ultimately lead to the type of genocide perpetrated by the Nazis. The author tests the validity of these lines of argument against the facts of human gene therapy and concludes that because of their dependence on probabilities that cannot be empirically proven they should be largely disregarded in the much more important debate on moral line-drawing in gene therapy.

Advisory Committees↗

PubMed2000

Regulating germ-line gene therapy to avoid sliding down the slippery slope.

Many arguments can be made for or against various regulatory approaches towards germ-line gene therapy and its associated research. A popular conclusion is that it ought to be prohibited, and this is commonly defended by use of a slippery slope argument. This paper will begin by outlining the regulatory approaches adopted towards germ-line gene therapy in EU countries, demonstrating the popularity of the restrictive approach. The slippery slope argument will then be examined. A number of variants of the slippery slope argument will be distinguished, highlighting the conceptually different claims made by each. Finally, examples of slippery slope arguments often invoked to support the prohibition of germ-line gene therapy will be examined with regard to the conditions that each must satisfy to form a theoretically sound argument. I will argue that these conditions are rarely given sufficient consideration. For the purposes of this paper, "germ-line gene therapy" is defined as the deliberate genetic modification of germ cells (sperm or oocytes), their precursors, or the cells of early embryos where the germ-line has yet to be segregated.

Empirical Research↗

PubMed1997

Using clients.

An important part of the student nurse's training involves reflection on practice, as expressed in written assignments and seminar discussions. In this, students make use of material drawn from their work with clients. A key ethical question is, therefore: should clients' permission be sought by students for this use of case material in coursework assignments. This article examines in some detail the arguments both for and against seeking clients' permission and concludes that, in view of the principle of respect for autonomy, there is a moral obligation to gain consent. It is argued, however, that there may be legitimate exceptions to this.

Confidentiality↗

PubMed1981

Ethical problems in the management of some severely handicapped children.

This paper examines some of the arguments advanced and acted upon by doctors concerned in decisions about whether severely handicapped patients should live or die. It criticises the view that 'selective treatment' is morally preferable to infanticide and shows how the standard arguments advanced for this preference fail to sustain it. It argues that the self-deception, which is sometimes cited as a sign of humanity in these cases, and which is implicit in the term 'selective treatment' is more dangerous than is the remote chance of brutalisation which is often cited as the danger of active euthanasia.

Child↗

PubMed1993

Euthanasia, dying well and the slippery slope.

Arguments in favour of voluntary euthanasia tend to be put in utilitarian terms. This paper suggests an alternative, neo-Aristotelian argument justifying certain individual acts of both suicide and voluntary euthanasia. It goes on to examine the slippery slope arguments against legalizing euthanasia. It is suggested that such arguments cut both ways. However, the suggestion that we ought therefore to permit a social experiment in voluntary euthanasia is set alongside the Dutch experience. The latter seems to imply that if such experiments are to take place then great caution needs to be applied.

Ethical Analysis↗

PubMed2001

Nancy B and Nancy F.

In this article I provide a virtuous slippery slope argument which shows that there is no morally significant difference between passive and active euthanasia. At the top of the slope is an example of passive euthanasia; at the bottom, an example of active euthanasia. For each pair of cases down the slope there is nothing that sensibly makes a morally significant difference between the pair of cases. Thus, there is no morally significant difference between passive euthanasia and active euthanasia.

Ethics↗

PubMed1991

Privacy (or liberty) and assisted suicide.

There is renewed professional and popular interest in the questions surrounding the legality of assisted suicide. With the U.S. Supreme Court's decision in the Cruzan case, the legal questions will be determined by state courts and legislatures. This article examines the arguments underlying the claim for legalization of assisted suicide. Although it appears to come within the confines of privacy, assisted suicide constitutes a more radical change in the law than its proponents suggest. Assisted suicide in the context of its own complexities and other problems facing society, represents a dubious advance in patient rights or social justice.

Beneficence↗

PubMed2001

Do physicians have an inviolable duty not to kill?

An important part of the debate over physician-assisted suicide concerns moral duties that are specific to physicians. It is sometimes argued that physicians, by virtue of special commitments rooted in the nature of their profession, may never intentionally kill a patient, and that therefore, whether or not assisted suicide may be justifiable, it can never be right for a physician to take part in such an act. I examine four types of argument that have been offered in support of this conclusion, and find that none succeeds. Each attempts to show why the duty to conserve life must be unconditional for physicians, yet a consideration of the ways in which contemporary medicine has evolved shows that such a duty is now no more fundamental to the profession than a duty to relieve suffering, which may in some cases override it.

Ethics, Medical↗

PubMed1988

Philosophy, medicine and its technologies.

There is a need to bring ethics and medical practice closer together, despite the risk and problems this may involve. Deontological ethics may promote sanctity of life considerations against the quality of life considerations favoured by consequentialists or utilitarians; while talk of respect for life and the value of life may point to more qualified ethical positions. This paper argues for a respect-for-life position, dismissing a utilitarian cost-benefit outlook as too simplistic; but an unqualified fixed principles approach is also ruled out, both because of its unacceptable consequences in individual cases and also because of its reliance on the slippery slope argument which, it is argued, is logically and psychologically deficient. The case of genetic engineering provides an example in which the notion of respect may operate, but in which broad general principles also apply. A cautious conservatism towards accepted principles is recommended in the development of medical technologies.

Aborted Fetus↗

PubMed1995

Persons of lesser values--moral argument and the "final solution".

For many persons, 'Holocaust-abomination' is a fixed point on their moral compass: if anything can be evil, it was. Yet at least one of the justifications deployed by its perpetrators (the eugenics argument) involves widely-held values concerning human health and procreation. Hence persons endorsing many current activities based on those values (e.g. genetic counselling) have been charged with being on a morally deplorable slippery slope. This paper sketches the necessary structure of a moral position capable of consistently embracing those values without placing its occupants on that slippery slope.

Ethical Analysis↗

PubMed2005

Passive euthanasia.

The idea of passive euthanasia has recently been attacked in a particularly clear and explicit way by an "Ethics Task Force" established by the European Association of Palliative Care (EAPC) in February 2001. It claims that the expression "passive euthanasia" is a contradiction in terms and hence that there can be no such thing. This paper critically assesses the main arguments for the Task Force's view. Three arguments are considered. Firstly, an argument based on the (supposed) wrongness of euthanasia and the (supposed) permissibility of what is often called passive euthanasia. Secondly, the claim that passive euthanasia (so-called) cannot really be euthanasia because it does not cause death. And finally, a consequence based argument which appeals to the (alleged) bad consequences of accepting the category of passive euthanasia.We conclude that although healthcare professionals' nervousness about the concept of passive euthanasia is understandable, there is really no reason to abandon the category provided that it is properly and narrowly understand and provided that "euthanasia reasons" for withdrawing or withholding life-prolonging treatment are carefully distinguished from other reasons.

Attitude of Health Personnel↗

PubMed1998

The 'more-abortions' objection to fetal tissue transplantation.

One common objection to fetal tissue transplantation (FTT) is that, if it were to become a standard form of treatment, it would encourage or entrench the practice of abortion. This claim is at least factually plausible, although it cannot be definitively established. However, even if true, it does not constitute a compelling ethical argument against FTT. The harm allegedly brought about by FTT, when assessed by widely accepted non-consequentialist criteria, has limited moral significance. Even if FTT would cause more abortions to be performed, and abortion is taken to be a serious moral wrong, this is not sufficient in itself to make FTT wrong.

Aborted Fetus↗

PubMed1985

Politics and bioethical commissions: "muddling through" and the "slippery slope".

When they have addressed highly controversial subjects, the bioethical commissions of the last decade have tended to avoid explaining the ethical justifications for their recommendations. This omission is consistent with the typical preference of policymakers for "muddling through," because it is often possible to reach agreement on specific decisions even when disagreeing sharply on principles. In bioethical policy, this omission of reasons has some special consequences. It allows commission members to ignore "slippery slope" arguments, which are based on the claim that the logic of justification adopted to address the current problem will ultimately lead us to great harms. Case-by-case decision-making--along with the omission of reasons for decisions--will tend to highlight the benefits of innovation, and downplay possible long-term effects that might be ethically upsetting.

Advisory Committees↗

PubMed1996

Assisted suicide: is there a future? Ethical and nursing considerations.

It is imperative that nurses take a personal and professional stand in the debate regarding physician-assisted suicide. Through case examples, this article defines and illustrates forms of euthanasia, including active and passive, voluntary and involuntary, double-effect, physician-assisted suicide, and physician aid-in-dying. Ethical arguments against assisted suicide based on pain and suffering, quality of life, patient autonomy, and the common good are presented. The anticipated negative effects that legalized physician-assisted death would pose to the health professions and society are discussed. Guidelines and nursing implications conclude the article.

Adolescent↗