The non-identity problem and genetic harms -- the case of wrongful handicaps

The Human Genome Project will produce information permitting increasing opportunities to prevent genetically transmitted harms, most of which will be compatible with a life worth living, through avoiding conception or terminating a pregnancy. Failure to prevent these harms when it is possible for parents to do so without substantial burdens or costs to themselves or others are what I call "wrongful handicaps". Derek Parfit has developed a systematic difficulty for any such cases being wrongs -- when the harm could be prevented only by preventing the existence of the individual who would have a worthwhile life even with the handicap, then bringing him into existence with the handicap does not make him worse off and so does not wrong him. I argue that a non "person-affecting" principle requiring the avoidance of suffering and limited opportunity correctly accounts for cases of wrongful handicaps without requiring that the individuals with the handicap have been made worse off and therefore wronged. It is an advantage, not a difficulty, of this account that it does not imply that the person with the handicap has been wronged or is a victim with a special moral complaint.     

REPRODUCTIVE AUTONOMY, THE NON-IDENTITY PROBLEM, AND THE NON-PERSON PROBLEM

The Non-Identity Problem is the problem of explaining the apparent wrongness of a decision that does not harm people, especially since some of the people affected by the decision would not exist at all were it not for the decision. One approach to this problem, in the context of reproductive decisions, is to focus on wronging, rather than harming, one's offspring. But a Non-Person Problem emerges for any view that claims (1) that only persons can be wronged and (2) that the person-making properties allow for there to be human non-persons. Consider an individual human organism that is prevented from ever possessing the person-making properties. On person-only accounts of the victims of wronging, this organism cannot be wronged by anyone. Hence even individuals whose decisions prevent it from ever possessing the person-making properties cannot wrong it. But this is counter-intuitive. We can think of examples where a human organism is wronged by precisely those decisions that prevent it from possessing the person-making properties. The best solution to this problem, in the case where the person-making property is rational self-governance in pursuit of a meaningful life, is to adjust the concept of a person so that it refers, not merely to those with the immediate capacity for rational self-governance in pursuit of a meaningful life, but also to those with a higher-order capacity for such self-governance. Any solution to the Non-Identity Problem that focuses on wronging rather than harming should incorporate this sort of solution to the Non-Person Problem.     

CHEAP LISTENING? – REFLECTIONS ON THE CONCEPT OF WRONGFUL DISABILITY1

This paper investigates the concept of wrongful disability. That concept suggests that parents are morally obligated to prevent the genetic transmission of certain conditions and so, if they do not, any resulting disability is 'wrongful'. In their book From Chance to Choice, Buchanan, Brock, Daniels and Wikler defend the concept of wrongful disability using the principle of avoidability via substitution. That principle is scrutinised here. It is argued that the idea of avoidability via substitution is both conceptually problematic and rather insensitive. Instead, it is suggested that the question of whether or not bringing a particular disability about is wrongful does not simply hinge on whether or not substitution takes place. Rather, it involves an evaluation of parental aspirations and responsibilities. It is argued that the desire need not be responsible for creating challenges for others that lie outside what is perceived to be an acceptable range provides a justification for termination of pregnancy on the grounds of projected disability that neither commits one to wrongful life claim, nor requires that one substitute a non-disabled child instead. The ramifications of such an approach are explored. The paper concludes by suggesting that the question of what is considered to be an acceptable range of human capability is an increasingly important one. It is argued that, when addressing that question, we should be acutely aware of the social context that may go some way to define what we consider to be an acceptable range.     

SEXUAL SELECTION BY THE HANDICAP MECHANISM

The handicap mechanism of sexual selection by female choice has been strongly criticized because it does not cause sexual selection to reinforce viability selection and it cannot account for the origin of mating preferences. However, several models indicate that the handicap mechanism can have important effects when operating in conjunction with Fisher's mechanism in polygynous populations. These models have been criticized because they require that fitness remains heritable indefinitely. I develop a simple haploid model of the handicap mechanism based on nonheritable variation in paternal investment, thus eliminating the problem of heritable fitness. This model produces the same evolutonary dynamics as both simple and quantitative genetic models of the handicap mechanism based on heritable fitness. If the parameters are such that Fisherian runaway selection does not occur in the null model (i.e., the polymorphic equilibria, which lie along the “Fisher line,” are stable), then the handicap mechanism turns the Fisher line into an evolutionary trajectory upon which all other trajectories converge. This occurs because Fisher's mechanism generates no net selection on female preference when the population is on the Fisher line, so that any additional source of selection (direct or indirect) on female choice causes the population to evolve deterministically along the Fisher line. This change in the evolutionary dynamics has the important consequence of eliminating the potential for rapid population divergence for mating systems via genetic drift along the Fisher line.     

Prenatal wrongful death

In Tebbutt v. Virostek (1985), the New York Court of Appeals dismissed a suit for emotional distress caused by the stillbirth of an infant allegedly resulting from medical malpractice. Steinbock argues that parents should be able to recover for emotional anguish in cases like Tebbutt. Some states currently allow them to do so by recognizing prenatal wrongful death suits, which focus on the unborn. Steinbock maintains that a better legal approach would be to allow recovery for the negligent infliction of emotional distress upon the parent(s). She presents a six-part argument that discusses: (1) the facts of Tebbutt; (2) wrongful death actions and their extension to the unborn; (3) prenatal torts and prenatal wrongful death; (4) the recognition of harms or wrongs to nonviable fetuses; (5) the legal implications of recognizing fetal personhood; and (6) recognizing parental rights in cases like Tebbutt without recognizing the fetus as a person.     

Identifying harms

Moral disagreements often revolve around the issue of harm to others. Identifying harms, however, is a contested enterprise. This paper provides a conceptual toolbox for identifying harms, and so possible wrongdoing, by drawing several distinctions. First, I distinguish between four modes of human vulnerability, forming four ways in which one can be in a harmed state. Second, I argue for the intrinsic disvalue of harm and so distinguish the presence of harm from the fact that it is instrumental to or constitutive of a valued act, practice or way of life. Finally, I distinguish between harm and wrongdoing, arguing that while harm is a normative concept requiring justification, not all harmed states are automatically unjustified. The advantage of this view is that it refocuses the moral debate on the normative issues involved while establishing a common basis to which both sides can agree: the presence of harm to others.     

Signalling among relatives. I. Is costly signalling too costly?

Zahavi''s handicap principle,originally proposed as an explanation for sexual selection ofelaborate male traits, suggests that a sufficient cost to dishonest signals can outweigh the rewards of deception and allow individuals to communicate honestly. Maynard Smith (1991) and Johnstone and Grafen (1992) introduce the Sir Philip Sidney game in order to extend the handicap principle to interactions among related individuals, and to demonstrate that stable costly signalling systems can exist among relatives.In this paper we demonstrate that despite the benefits associated with honest information transfer, the costs incurred in a stable costly signalling system may leave all participants worse off than they would be in a system with no signalling at all. In both the discrete and continuous forms of the Sir Philip Sidney game, there exist conditions under which costly signalling among relatives, while stable, is so costly that it is disadvantageous compared with no signalling at all. We determine the factors which dictate signal cost and signal benefit in a generalized version of this game, and explain how signal cost can exceed signal value. Such results raise concerns about theevolutionary pathways which could have led to the existence of signalling equilibria in nature. The paper stresses the importance of comparing signalling equilibria with other possible strategies, beforedrawing conclusions regarding the optimality of signalling.     

THE HIGH SCHOOL FOOTBALL TEAM PHYSICIAN

Mutual confidence is necessary between the football coach and the team physician. The physician''s decision in the matter of a boy''s condition must always be final. The coach should also consider the physician''s advice in shaping his psychological appeals to the players in before-game and between-halves talks. The physician should be on his way to a man injured on the field as soon as the play is ended. It is up to him and not the trainer or coach to make the diagnosis. The physician must have the ability to make an immediate evaluation of the extent of injury and use appropriate measures to get the player off the field. To see a semi-conscious man with dangling head being half dragged off the field is far worse from the patient''s standpoint and from the spectator''s standpoint than removal by stretcher.     

Sex-dependent frequency and consequences of natural handicaps in American Kestrels

Natural selection theory suggests that there should be fitness consequences for animals that possess morphological abnormalities such as missing or deformed appendages and other structures. As these characters are expected to be detrimental, morphological abnormalities could be considered “handicaps”. However, little information exists about the nature, prevalence or consequences of naturally occurring handicaps in birds, even though experimental handicapping has been used in some behavioural studies. Here, we document and describe the frequency of natural handicaps in American Kestrels Falco sparverius, and investigate their influence on condition and survival. We considered three different categories of handicap that should negatively impact falcons: missing remiges and rectrices, broken remiges and rectrices, and foot handicaps. Broken feathers, followed by missing feathers, were the most common handicaps detected in kestrels and their prevalence increased throughout the breeding season. Foot handicaps were relatively rare and showed no seasonal trends. There was no effect of any handicap type on body condition or return rates of male kestrels. In contrast, females with either foot handicaps or broken feathers were in significantly poorer condition than control females, and females with broken feathers were less likely than control females to return to the study area in years following initial capture. Given that female kestrels with broken feathers have more fault bars than those without broken feathers, and fault bar formation is related to stresses in a bird's past, we suggest that female kestrels that had broken feathers were of poorer quality than those without broken feathers or those with missing feathers. Females with broken feathers may therefore have been in poorer condition initially than other birds, or if broken feathers are indicative of poor quality, then females with broken feathers may have been less able to cope with the negative impacts of feather loss on flight performance compared to birds with missing feathers.     

Medical Care of the Alcoholic Patient

Alcoholism is an illness that constitutes a major health problem at all levels of society. The physician should accept his responsibility to prevent it and to care for the alcoholic. If he knows that one of his patients is drinking immoderately, he should warn him of the outlook. A patient''s acquired dependence on alcohol may be overt, or revealed only on examination for organic disease or emotional disturbance. The diagnosis may be accepted reluctantly, or denied despite positive evidence, but the patient should be persuaded to give up drinking. He may require psychiatric help or advice from a social worker. He may be so ill as to require treatment in hospital, and hospitals must recognize the urgency of such admissions. Discharge from hospital does not end treatment, for alcoholism is a chronic disease, requiring long-term planning, persistent follow-up and enduring sympathy by the physician, who must always be as available to his alcoholic patient as he is to his patient with diabetes, epilepsy or cardiac disease.     

In search of the missing subject: narrative identity and posthumous wronging

With the advanced methods of analysing old biological material, it is pressing to discuss what should be allowed to be done with human remains, particularly for well documented historical individuals. We argue that Queen Christina of Sweden, who challenged the traditional gender roles, has an interest in maintaining her privacy when there are continued attempts to reveal her ‘true’ gender. In the long-running philosophical debate on posthumous wronging, the fundamental question is: Who is wronged? Our aim is to find this ‘missing subject’ using narrative theory.Narrative identity emphasises the fact that no person is alone in knowing or telling their life story. People’s lives are entangled and parts of the life story of a deceased person can remain in the living realm. Since the narrative identity of a person does not necessarily end upon their death, and this narrative continues to relate directly to the person who once existed, it is the narrative subject that can continue to be posthumously wronged. Queen Christina can no longer maintain her own identity, but we maintain it by our research into her life. We propose three duties relevant for posthumous wronging: the duty of truthfulness, the duty of recognition and the duty to respect privacy.     

Mate selection-a selection for a handicap.

It is suggested that characters which develop through mate preference confer handicaps on the selected individuals in their survival. These handicaps are of use to the selecting sex since they test the quality of the mate. The size of characters selected in this way serve as marks of quality. The understanding that a handicap, which tests for quality, can evolve as a consequence of its advantage to the individual, may provide an explanation for many puzzling evolutionary problems. Such an interpretation may provide an alternative to other hypotheses which assumed complicated selective mechanisms, such as group selection or kin selection, which do not act directly on the individual.     

WHEN DOES POTENTIALITY COUNT? A COMMENT ON LOCKWOOD

Michael Lockwood's essay, "Warnock v. Powell (and Harradine): when does potentiality count?," and Hare's response are two of three articles in this issue of Bioethics discussing potentiality and its implications for experimentation with human embryos. (See also Stephen Buckle's "Arguing from potential.") Hare responds to Lockwood's arguments on potential, an embryo's "interests," and what obligations these interests entail. In Hare's view, the interests are those of the grown person the embryo (or fetus or neonate) will become. In formulating regulations on embryo research, legislators ought to be concerned chiefly with the interests of the persons who may come into existence, grading harms differently for gametes, embryos, fetuses, and neonates, and balancing these against the expected good from the experiments.     

Birds' tails as signaling devices: markings, shape, length, and feather quality

While exaggerated length and ornamental shapes are confirmed sexually selected tail traits in birds, the signal function of tail markings has received less study. Signal roles for tail markings as amplifiers of length, shape, and feather quality are discussed, and the role of tail markings as feather-quality handicaps is proposed: absence of melanin increases damage and abrasion. Predicted correlations of tail markings with other tail traits are derived for these signal roles. A comparative study of the relationships between these tail traits in an entire avifauna, the western Palearctic, tested the predictions. Tail displays were present in nearly 80% of species, associated with greater long-tailedness, but not all displayed tails had markings or ornamental shape. The incidence of marks across tail shapes and the combinations of marks indicate that tail markings act as handicaps or amplifying handicaps of tail feather quality. Tail elongation and ornamental shapes could act as additional handicaps of feather quality-that is, they could be multipurpose signals. Incorporation of revealing indicators such as feather damage and associated handicap and/or amplifying traits may allow a reduction in the cost of signaling while maintaining signal reliability and, hence, influence sexual selection in complex signaling systems.     

ONTOLOGY OR PHENOMENOLOGY? HOW THE LVAD CHALLENGES THE EUTHANASIA DEBATE

This article deals with the euthanasia debate in light of new life‐sustaining technologies such as the left ventricular assist device (LVAD). The question arises: does the switching off of a LVAD by a doctor upon the request of a patient amount to active or passive euthanasia, i.e. to ‘killing’ or to ‘letting die’? The answer hinges on whether the device is to be regarded as a proper part of the patient's body or as something external. We usually regard the switching off of an internal device as killing, whereas the deactivation of an external device is seen as ‘letting die’. The case is notoriously difficult to decide for hybrid devices such as LVADs, which are partly inside and partly outside the patient's body. Additionally, on a methodological level, I will argue that the ‘ontological’ arguments from analogy given for both sides are problematic. Given the impasse facing the ontological arguments, complementary phenomenological arguments deserve closer inspection. In particular, we should consider whether phenomenologically the LVAD is perceived as a body part or as an external device. I will support the thesis that the deactivation of a LVAD is to be regarded as passive euthanasia if the device is not perceived by the patient as a part of the body proper.     

Names and naming: Instances from the ORU-IGBO

Conclusion People have many names. But, changing one's name is no small thing. It can signify a major step in life or an embarrassing story, as in the last case.A person has a complex individual identity. His collective identity is clear from the moment he is conceived. He is one with a body of people, his kinsmen, who share one common ancestor and through him access to land and resources. The continuation of this group and its name is perpetuated through paternal descent.Kingroup membership ensures a person's place in life, his right to exist, eat, live and enjoy. But, who is he, apart from being a kinsman? Which kinsman is he? How are people going to interact with him? His individual identity will become clear through time. He is a re-incarnation of ancestor x. The circumstances of his birth were such. He behaves like this. He has these personal traits. This has happened to him. He has achieved that. There is no permanent role attached to an individual. He is neither bound to class nor caste. He is dynamic and changes constantly. His life is one of achievement, constant striving and upward mobility till death — when it all begins again. His name signals his state of being in time and existence.Sabine Jell-Bahlsen is an anthropologist and filmmaker.     

Patients with multiple needs for healthcare and priority to the worse off

There is a growing body of literature which suggests that decisions about healthcare priority setting should take into account the extent to which patients are worse off. However, such decisions are often based on how badly off patients are with respect to the condition targeted by the treatment whose priority is under consideration (condition‐specific severity). In this paper I argue that giving priority to the worse off in terms of condition‐specific severity does not reflect the morally relevant sense of being worse off. I conclude that an account of giving priority to the worse off relevant for healthcare priority setting should take into account how badly off patients are when all of their conditions are considered (holistic severity).     

Sexually selected signals are not similar to sports handicaps

The handicap principle is a simple but powerful metaphor that has had a major impact on how biologists study and understand sexual selection. Here, I show that its application to signalling in sexual selection is not a valid generalization from its roots in economics. Although some signalling systems, with additive costs and benefits, have solutions that resemble sports handicaps, the signalling in sexual selection has multiplicative costs and benefits, and solutions that do not resemble sports handicaps. The sports analogy is technically incorrect, metaphorically misleading and a poor guide for empirical research on the signalling in sexual selection. The evolution of sexually selected signals is not a missing piece of Darwin's puzzle; it is an integral piece of the process of evolution by natural selection, and it should be approached with the same tools that we bring to bear on the evolution of other correlated traits involved in social interactions.     

Error-proneness as a handicap signal

This paper describes two discrete signalling models in which the error-proneness of signals can serve as a handicap signal. In the first model, the direct handicap of sending a high-quality signal is not large enough to assure that a low-quality signaller will not send it. However, if the receiver sometimes mistakes a high-quality signal for a low-quality one, then there is an indirect handicap to sending a high-quality signal. The total handicap of sending such a signal may then still be such that a low-quality signaller would not want to send it. In the second model, there is no direct handicap of sending signals, so that nothing would seem to stop a signaller from always sending a high-quality signal. However, the receiver sometimes fails to detect signals, and this causes an indirect handicap of sending a high-quality signal that still stops the low-quality signaller of sending such a signal. The conditions for honesty are that the probability of an error of detection is higher for a high-quality than for a low-quality signal, and that the signaller who does not detect a signal adopts a response that is bad to the signaller. In both our models, we thus obtain the result that signal accuracy should not lie above a certain level in order for honest signalling to be possible. Moreover, we show that the maximal accuracy that can be achieved is higher the lower the degree of conflict between signaller and receiver. As well, we show that it is the conditions for honest signalling that may be constraining signal accuracy, rather than the signaller trying to make honest signals as effective as possible given receiver psychology, or the signaller adapting the accuracy of honest signals depending on his interests.