Introduction

Abstract

The articles in this nonthematic issue of the Journal are united by their common aim of engaging highly controversial debates in contemporary bioethics and philosophy of medicine. In the first article, entitled “On a Bioethical Challenge to Disability Rights” (Amundson & Tresky, 2007), Ron Amundson and Shari Tresky seek to defend the disability rights movement against a number of challenges posed to it by the authors of From Chance to Choice: Genetics and Justice (Buchanan, Brock, Daniels, & Wickler, 2000). A careful reading of FCTC, Amundson and Tresky contend, shows that the authors of FCTC advance arguments that go beyond a mere “defense of genetic policies from the criticisms of disability rights advocates,” and instead “challenge” the Disability Rights movement by way of mischaracterizing it. In response, Amundson and Tresky seek both to document, and to illuminate the flaws embedded in, the arguments advanced by the authors of FCTC.

In “Can It Be a Good Thing to Be Deaf?” (Cooper, 2007), Rachel Cooper considers the question whether it can be considered a “good” thing for someone to be born deaf. After establishing the permissibility of non-deaf individuals querying whether being deaf can be a good thing, Cooper goes on to consider the foundational question of what it means for something to be a “good thing for an individual.” To arrive at an answer to this question, she considers in turn each of the putative advantages and disadvantages associated with being born deaf, on the basis of which she seeks to render a judgment vis-à-vis the “net cost or benefit” of this condition. Cooper argues to the conclusion that it is plausible to think that being born deaf may be good for some people, but not for others.

Lurking behind many of the debates surrounding disability is a more fundamental dispute concerning what it means to be “disabled”—and, for that matter, what it means to be a “human being” or a “person.” The next two articles included in this issue of the Journal address some of these questions. In “The Potential of the Human Embryo” (Brown, 2007), Mark T. Brown seeks to navigate the stormy waters surrounding research on human embryos by introducing and developing a theoretical distinction between orders of potentiality (First Order Potential, Second Order Potential, etc.) and applying that distinction to ontological questions surrounding the moral status of human embryos. Brown argues, inter alia, to the conclusion that the success of arguments supporting or opposing embryo research will in large measure turn on whether the relation between orders of potentiality is transitive or intransitive.

In our own contribution to this issue, entitled “Disability, Humanity, and Personhood: A Survey of Moral Concepts” (Ralston & Ho, 2007) we highlight some of the important normative implications of the key terms – “disability,” “humanity,” and “personhood” – that feature so centrally in the aforementioned articles. To that end, we reconstruct the argument of each of the articles, and then offer some brief critical analysis intended to stimulate further thought about and discussion of the issues that each raises.

Finally, in “Defensive Medicine or Economically Motivated Corruption? A Confucian Reflection on Physician Care in China Today” (Chen, 2007), Xiao-Yang Chen extends the discussion at the nexus of bioethics and public policy in the context of the Chinese medical system. Specifically, Chen considers whether the routine practice of ordering a greater number of diagnostic work-ups and prescribing more expensive medications than is clearly medically indicated is best characterized as “defensive medicine” or as “economically motivated corruption.”

In response to this question, the author argues that the overuse of expensive diagnostic and therapeutic interventions must be attributed at least in part, and perhaps primarily, to the corruption of medical decision-making by a desire on the part of physicians to earn supplementary income, given the constraints of an ill-structured governmental policy that encourages such overuse. The author goes on to suggest a number of reforms that are needed in order to counteract effectively such “economically motivated corruption,” and argues that a Confucian moral account offers resources that are particularly well-suited for responding to the problems illuminated in the article. Though aimed explicitly at the Chinese context, the problems identified in this article, and the proposed solutions to them, are worth considering in light of their potential salience for relevantly-similar bioethical and public policy debates in other contexts.