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On the Very Idea of Genetic Justice

Why Farrelly’s Pluralistic Prioritarianism Cannot Tackle Genetic Complexity

Published online by Cambridge University Press:  13 December 2011

MICHELE LOI
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Extract

Innovations in science and technology are often the source of public concern, but few have generated debates as intense and at the same time with such a popular fascination as those surrounding genetic technologies. Unequal access to preimplantation diagnosis could give some individuals the opportunity to select children with more advantageous predispositions.

Type
Special Section: Open Forum
Information
Cambridge Quarterly of Healthcare Ethics , Volume 21 , Issue 1 , January 2012 , pp. 64 - 77
Copyright
Copyright © Cambridge University Press 2011

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References

1. Buchanan, AE, Brock, DW, Daniels, N, Wikler, D.From Chance to Choice: Genetics and Justice. Cambridge: Cambridge University Press; 2000:96–7.CrossRefGoogle Scholar

2. Mehlman, MJ.The law of above averages: Leveling the new genetic enhancement playing field. Iowa Law Review 2000;85(2):517–93.Google ScholarPubMed

3. Buchanan, A.Enhancement and the ethics of development. Kennedy Institute of Ethics Journal 2008;18(1):1–34, at 7–10.CrossRefGoogle ScholarPubMed

4. Brighouse, H, Swift, A.Equality, priority, and positional goods. Ethics 2006;116(3):471–97.CrossRefGoogle Scholar

5. See note 3, Buchanan 2008, at 7–10.

6. Rawls, J.A Theory of Justice. 2nd ed.Cambridge, MA: Harvard University Press; 1999:54–5.Google Scholar The moral importance of general-purpose means, in contrast to narrow-range instrumental goods, is explained by the fact that it would be rational to desire more of them whatever one’s ends in life, for a large range of human ends. Thus their goodness is alleged to be explained by a “thin theory of the good” valid for every rational person (see Rawls 1999:347–50).

7. In Political Liberalism, for example, primary goods are regarded as things citizens need, if they see themselves as free and equal persons. See Rawls J. Political Liberalism. exp. ed. New York: Columbia University Press; 1996:187–90. The inclusion of leisure time and freedom from physical pain as additional primary goods (in Rawls 1996:181–2) is only contemplated as a possibility but never definitively endorsed.

8. See note 6, Rawls 1999:54.

9. Arrow, KJ.Some ordinalist-utilitarian notes on Rawls’s theory of justice. Journal of Philosophy 1973;70(9):245–63.Google Scholar

10. Sen, A. Equality of what? In: Sen A. Choice, Welfare and Measurement. Cambridge: Cambridge University Press; 1982:353–69.Google Scholar

11. These problems were central to the debate concerning the “currency of egalitarian justice.” See note 10, Sen 1982.

12. Daniels, N.Equality of what: Welfare, resources, or capabilities? Philosophy and Phenomenological Research 1990;50:273–96.CrossRefGoogle Scholar

13. Arneson, RJ.Equality and equality of opportunity for welfare. Philosophical Studies 1989;56(1):77–93.CrossRefGoogle Scholar

14. Cohen, GA.On the currency of egalitarian justice. Ethics 1989;99(4):906–44.CrossRefGoogle Scholar

15. See note 1, Buchanan et al. 2000:83.

16. Farrelly, C.Genes and social justice: A Rawlsian reply to Moore. Bioethics 2002;16:72–83, at 78.CrossRefGoogle ScholarPubMed

17. See note 16, Farrelly 2002, at 81; cf. Farrelly C. The genetic difference principle. American Journal of Bioethics 2004;4:W21–W28, at W26.

18. Notice that the analogies and relationships between certain genetic characteristics or natural abilities and general-purpose means (primary goods) are used by different philosophers to make different points. See for instance, note 1, Buchanan et al. 2000:167–8.

19. Allhoff, F.Germ-line genetic enhancement and Rawlsian primary goods. Kennedy Institute of Ethics Journal 2005;15(1):39–56.CrossRefGoogle ScholarPubMed

20. Lewontin, RC.Biological determinism. Tanner Lectures on Human Values 1983;4:147–83, at 165.Google Scholar

21. This is the view of John Rawls, who claims that “even if an equal distribution of natural assets seemed more in keeping with the equality of free persons, the question of redistributing these assets (were this conceivable) does not arise, since it is incompatible with the integrity of the person.” See note 7, Rawls 1996:283.

22. See note 16, Farrelly 2002, at 80.

23. See note 16, Farrelly 2002, at 81.

24. Farrelly, C.Genetic justice must track genetic complexity. Cambridge Quarterly of Healthcare Ethics 2008;17(01):45–53, at 48.CrossRefGoogle ScholarPubMed

25. See note 17, Farrelly 2004, at 47.

26. See note 24, Farrelly 2008, at 50.

27. See note 17, Farrelly 2004, at W26.

28. See note 17, Farrelly 2004, at W26.

29. See note 17, Farrelly 2004, at W24.

30. See note 24, Farrelly 2008, at 48–50.

31. See note 17, Farrelly 2004, at W26, emphasis in the original.

32. See note 17, Farrelly 2004, at W26.

33. See note 24, Farrelly 2008, at 47, emphasis in the original.

34. See note 24, Farrelly 2008, at 48.

35. Arneson, RJ.Luck egalitarianism and prioritarianism. Ethics 2000 Gen;110(2):339–49.CrossRefGoogle Scholar

36. See note 35, Arneson 2000, at 343.

37. See note 35, Arneson 2000, at 343.

38. Another feature of Arneson’s approach is that it attaches a different moral weight to “altering a state of affairs in a way that makes someone better off or worse off” according to a person’s “degree of responsibility . . . for her present condition” (344), hence the qualification of “responsibility sensitive” in its label. See note 35, Arneson 2000.

39. See note 17, Farrelly 2004, at W26.

40. Farrelly has stated very clearly that his ambition is not to provide a set of serially ordered principles of justice, like those of Rawls’s theory. Serial ordering is only one possible way in which trade-offs between principles could be defined (one could do it, in theory, by providing a set of logical and mathematical functions). Yet, Farrelly does not seem to aim to provide any comprehensive theory of justice, one in which the problem of evaluating trade-offs is explicitly dealt with. He claims that the lax genetic difference principle “is designed so that it can be balanced against the demands of other principles of justice” (see note 17, Farrelly 2004, at W26), via a reasonable genetic intervention model. This is offered as a procedural solution (a fair deliberative procedure) through which different stakeholders contribute to determine the trade-off between the costs and benefits of restricting reproductive freedom for the sake of other values. See Farrelly, C.Preimplantation genetic diagnosis, reproductive freedom, and deliberative democracy. Journal of Medicine and Philosophy 2009;34(2):135–54.CrossRefGoogle ScholarPubMed By analogy, Farrelly could propose a procedural solution for the problem of assessing interactions between different goods. So far, however, this goal seems to lie outside the horizon of his preoccupations.

41. See note 24, Farrelly 2008, at 46, emphasis in the original.

42. See note 24, Farrelly 2008, at 46, emphasis in the original.

43. Duncan, G, Kalil, A, Mayer, SE, Tepper, R, Payne, M. The apple does not fall far from the tree. In: Bowles, S, ed. Unequal Chances: Family Background and Economic Success. Princeton, NJ: Princeton University Press; 2005:23–79.Google Scholar

44. Marmot, M.Social differentials in health within and between populations. Daedalus 1994;123(4):197.Google Scholar

45. Marmot, M.The Status Syndrome: How Social Standing Affects Our Health and Longevity. 1st ed.New York: Times Books; 2004.Google Scholar

46. Merikangas, KR, Risch, N.Genomic priorities and public health. Science 2003;302(5645):599–601, at 600.CrossRefGoogle ScholarPubMed

47. See note 46, Merikangas, Risch 2003, at 601.

48. Khoury, MJ, Davis, R, Gwinn, M, Lindegren, ML, Yoon, P.Do we need genomic research for the prevention of common diseases with environmental causes? American Journal of Epidemiology 2005;161(9):799–805, at 800.CrossRefGoogle ScholarPubMed

49. Berrettini, W, Bierut, L, Crowley, TJ, Cubells, JF, Frascella, J, Gelernter, J, et al. . Setting priorities for genomic research. Science 2004;304(5676):1445–7.CrossRefGoogle ScholarPubMed

50. See note 24, Farrelly 2008, at 49.

51. Tabery, J.From a genetic predisposition to an interactive predisposition: Rethinking the ethical implications of screening for gene-environment interactions. Journal of Medicine and Philosophy 2009;34(1):27–48, at 35, emphasis in the original.CrossRefGoogle Scholar

52. See note 51, Tabery 2009, at 32, emphasis in the original.

53. Caspi, A, McClay, J, Moffitt, TE, Mill, J, Martin, J, Craig, IW, et al. . Role of genotype in the cycle of violence in maltreated children. Science 2002;297(5582):851–54.CrossRefGoogle ScholarPubMed

54. See note 51, Tabery 2009, at 28, emphasis in the original.

55. See note 51, Tabery 2009, at 32, emphasis in the original.

56 Here I speak loosely about P and R, regarding them as different genes. It would be more appropriate to regard them as two different alleles, that is to say, versions of the same gene.

57. It could be objected that, in the scenario in question, improving educational conditions for half of the population qualifies as a goal of justice independently from duties of genetic justice and that, for that reason, the scenario in question could never occur in a fully just society. This might be true in ideal theory, but not in the context of nonideal theory, for which Farrelly’s principles are intended. E.g., when international monetary institutions require a balanced budget, educational justice might have to be compromised with other legitimate goals of justice.

58. See note 51, Tabery 2009, at 41–3.

59. See note 24, Farrelly 2008, at 49.