Should advance directives (ADs) such as living wills be employed to direct the care of the severely demented? In considering this question, I focus primarily on the claims of Rebecca Dresser who objects in principle to the use of ADs in this context. Dresser has persuasively argued that ADs are both theoretically incoherent and ethically dangerous. She proceeds to advocate a Best Interest Standard as the best way for deciding when and how the demented ought to be treated. I put forth a compromise position: both ADs and the Best Interest Standard have roles to play in guiding the care of the severely demented.

Two interpretations of Hobbes's theory of morals dominate the subject: the Egoistic Reading (ER) and the Naturalist Reading (NR). According to ER, all of Hobbes's moral concepts are self-interested at their core. According to NR, Hobbes's Laws of Nature set down genuine moral obligations/virtues both inside of the state of nature and out. This article rejects both of these interpretations in favor of a Voluntarist Reading (VR). On this reading, morality is an artifact of human endeavor, specifically covenanting. Unlike both ER and NR, VR takes seriously Hobbes's claim that there is “no obligation on any man which ariseth not from some act of his own”.

John Robertson has famously argued that the right to reproductive autonomy is exceedingly broad in scope. That is, as long as a particular reproductive preference such as having a deaf child is "determinative" of the decision to reproduce then such preferences fall under the protective rubric of reproductive autonomy rights. Importantly, the deafness in question does not constitute a harm to the child thereby wrought since unless the child could be born deaf he or she would otherwise never have existed--his or her prospective parents would simply have chosen to abort. As such, for this child, being born deaf counts as a benefit, albeit of the "backhanded" variety, since the only other practical alternative is nonexistence. In what follows, I want to investigate this argument in detail. The target of my investigation will be the possible future use of gene therapy technology to "disenhance" one's offspring. I intend to show that the apparently unlimited right to reproductive autonomy, that is, the right to choose both the quantity and qualities of future offspring, entailed by the argument from backhanded benefit can in fact be "sidestepped" through considering what sorts of reproductive practices we as a society ought to allow.

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