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Book
reviews
353
Due
Consideration:
Controversy
in
the
Age
of
Medical
Miracles
Arthur
Caplan,
New
York,
John
Wiley,
1998,
282
pages,
US$17.95.
We
live
in
an
age
where
biomedical
research
will
dramatically
change
the
way
humans
live.
Cloning,
genetic
engineering
and
"designer"
children
are
no
longer
science
fiction.
Every
day
media
headlines
report
techno-
logical
advances
that
challenge
the
way
we
think
about
our
future
and
what
that
future
ought
to
hold.
In
Due
Consideration
Arthur
Caplan,
in
his
inimitable
style,
takes
a
look
at
the
current
and
future
ethical
challenges
in
biomedicine
and
at
the
conse-
quences
they
may
have
on
our
lives.
With
wit,
clarity
and
insight
Caplan
explores
the
controversial
moral
ques-
tions
of
the
day.
If
a
woman
could
have
some
of
the
cells
of
her
aborted
fetus
frozen
in
order
to
grow
a
genetically
identical
fetus
at
some
time
in
the
future,
would
we
still
consider
that
she
had
killed
her
fetus?
Should
research-
ers
be
permitted
to
remove
and
fertilise
eggs
from
the
mummified
body
of
a
500-year-old
Inca
girl?
When
a
man
dies
should
sperm
retrieval
be
offered
to
his
relatives?
Should
eggs
from
aborted
fetuses
be
used
to
help
infertile
women
conceive?
Should
smokers
be
allowed
to
be
adoptive
parents?
This
book
is
suc-
cessful
not
only
in
its
analysis
of
such
controversial
moral
questions
but
also
as
a
chronicle
of
the
social
context
that
produced
them.
In
his
analysis,
Cap-
lan
sets
the
latest
from
medical
journals
against
the
background
of
more
everyday
details
of
Oprah,
gang
violence,
Thighmaster,
inflatable
San-
tas,
CNN,
Cyberporn
and
the
0
J
Simpson
trial.
Caplan
is
not
shy
of
expressing
strong
opinions
on
some
of
the
most
crucial
issues
in
bioethics.
Although
forthright
in
his
views,
he
presents
an
optimistic
vision
of
the
future.
He
suggests
that
"One
could
make
a
pretty
fair
living
forecasting
and
be-
moaning
the
horrors
that
await
us
if
biomedicine
is
permitted
to
proceed
at
its
current
rate
of
success.
And
many
ethicists
do"(page
2).
Caplan,
how-
ever,
dismisses
the
idea
that
science
cannot
be
modulated
by
ethics
and
that
progress
will
inevitably
end
in
disaster
and
invites
us
to
contemplate
a
world
where
biomedical
advances,
while
forcing
us
to
consider
what
we,
as
human
persons,
ought
to
allow,
will
enable
us
to
live
longer,
healthier
and
happier
lives.
He
provides
a
view
not
only
of
the
rational
and
the
ethical
but
also
of
the
human
perspective,
where
quality
of
life
often
involves
indul-
gence
in
activities
that
may
be
bad
for
us,
in
the
medical
sense
but
are
"good
for
the
soul".
He
gives
hope
in
the
face
of
the
health
fanaticism
which,
while
perhaps
justified
in
its
attempt
to
encourage
us
to
quit
smoking,
seems
to
be
trying
to
prohibit
all
other
human
pleasures
too.
Sunshine,
fatty
foods,
television
and
fine
wines
are
all
targets
of
this
fanaticism
and
Caplan
enthusiastically
cites
Professor
James
McCormick
of
Community
Health
and
General
Practice
at
Trinity
Col-
lege
in
Dublin,
who,
in
The
Lancet
writes
that
members
of
his
profession
"would
do
better
to
encourage
people
to
live
lives
of
modified
hedonism,
so
that
they
may
enjoy,
to
the
full,
the
only
life
they
are
likely
to
have"(page
277).
You
may
not
agree
with
all
of
Caplan's
answers
to
these
vexing
questions
of
our
time
but
this
wide
ranging
and
enjoyable
book
will
cer-
tainly
force
you
to
consider
moral
questions
you
may
never
have
consid-
ered
before
and
reconsider
ethical
views
that
you
have
previously
held.
REBECCA
BENNETT
The
Centre
for
Social
Ethics
and
Policy,
University
of
Manchester
How
Are
We
To
Live?
Ethics
in
an
Age
of
Self-Interest
Peter
Singer,
Oxford,
Oxford
Univer-
sity
Press,
1997,
xviii
+
318
pages,
£8.99.
This
is
not
a
book
directly
about
medical
ethical
issues,
which
are,
Singer
says
in
Practical
Ethics,'
within
ethics.
Concerning
these
we
may
have
moral
disagreements,
such
as
those
over
abortion.
In
How
Are
We
To
Live?
Singer
turns
to
a
question
about
ethics.
The
principal
philosophical
challenge
is
Singer's
attempt
to
give
a
non-ethical
reason
for
choosing
the
ethical
life.
This
non-ethical
reason
is
that
the
ethical
life
is
in
our
own
best
interests,
an
answer
at
least
as
old
as
The
Republic,2
as
Singer
recognises.
But
Singer
thinks
contemporary
self-
interest,
identified
with
"the
decade
of
greed"
(the
1980s
in
Western
devel-
oped
nations)
is
discordant
with
eth-
ics.
For,
it
was
motivated
by
competi-
tive
material
acquisition,
a
motivation
insensitive
to
the
community
possible
among
beings,
but
consistent
with
Hobbes's
vision
of
humans
in
the
state
of
nature.
We
need
to
rethink
self-
interest.
Singer
has
also
to
see
off
contempo-
rary
sociobiology
which
he
conceives
will
view
genuine
moral
behaviour
as
impossible,
let
alone
optional.
Here
he
points
out
that
we
probably
evolved
to
care
for
people
other
than
ourselves,
our
children
for
instance,
and
perhaps
wider
groups
too:
there
is
good
reason
to
believe
that
cooperation
contributes
to
the
survival
of
individuals.
As
Singer
points
out,
this
evolutionary
fact
is
consistent
with
genuinely
ethi-
cal
motivation.
We
can,
then,
opt
to
live
ethically.
"The
decade
of
greed"
appears
to
show
we
can
opt
to
live
selfishly.
There
is
a
genuine
choice
to
be
made.
For
Singer,
it
is
a
rational
choice,
though
not
a
Kantian
choice.
Singer's
objection
to
Kant
is
that
he
refuses
in
effect
to
answer
the
question
how
are
we
to
live.
Kant
says
we
are
ethical
if
we
do
our
ethical
duty
for
duty's
sake.
But
this
is
no
reason,
and
is
consistent
with
the
most
trivial
and
the
most
appalling
content
of
those
duties:
plausibly,
Adolph
Eichmann
was
in
some
sense
dutiful.
Nevertheless,
Eichmann
did
not
judge
ethically,
according
to
Singer,
since
he
did
not
universalise,
but
made
his
judgments
from
a
limited
perspec-
tive.
However,
universality,
though
the
mark
of
ethical
judgments,
is
not
a
reason
for
making,
or
acting
in
accord-
ance
with,
them.
Singer
adds
that
it
is
the
consequences
that
flow
from
an
ethical
act
which
really
matter.
These
fill
out
the
content
of
the
ethical
life.
What
gives
meaning
and
purpose
to
people's
lives
are
the
right
causes
to
which
they
dedicate
themselves:
anti-
corruption,
animal
liberation,
wom-
en's
rights,
and
the
environment.
Singer
has
a
problem
here.
For
the
judgment
that
these
are
right
causes
is
an
ethical
one.
It
is
presumably
based
on
the
goodness
of
their
conse-
quences,
but
this
too
is
an
ethical
judgment.
So,
these
are
choices
we
make
from
within,
rather
than
of,
the
ethical
life,
whereas
what
Singer
says
he
wants
is
something
from
outside
ethics.
Singer's
rational
response
is,
he
admits,
only
partial.
Others
(humans
and
animals)
have
senses,
and
like
us,
feel
suffering
and
pain.
Having
ac-
