Recently a well-known magazine published an article entitled ‘Moral Specialist.’ This article recounts the activities of Russell McIntyre, described by the authors as a theologian and philosopher who specializes in bioethics. McIntyre is routinely consulted by physicians for help in solving ethical problems. He is asked for moral advice on such matters as abortion, euthanasia, and sterilization for teenagers. McIntyre even wears an electronic ‘beeper’ so that when untimely moral quandaries arise he can easily be reached. McIntyre says that ultimately such moral decisions should be made by the people involved — the physician, the patient, and the family. However, he claims that there are still many gray areas in bioethics ‘where it is best to call in an expert for consultation.’

Included among the many topics on which Aristotle writes in the Nicomacheon Ethics is an account of incontinence or akrasia. Many controversies have arisen among interpreters of Aristotle on this issue, and a few of these disputes will be discussed in this paper. In the first part of this paper I shall indicate the usual way of reading Aristotle's account of incontinence, which I shall call the natural interpretation. In the second section I shall raise some apparent difficulties with the natural interpretation by pointing out three passages in the Nicomacheon Ethics which seem to be inconsistent with it. Finally, in the concluding three sections of this paper I shall argue that the three passages allegedly inconsistent with the natural interpretation can be shown to be consistent with the general line of argument that the natural interpretation takes Aristotle to be following. In showing how these passages can be reconciled with the usual way of reading Aristotle's account of akrasia, a much clearer and more complete picture of what his view is emerges. In addition, this reading makes Aristotle's account of incontinence more philosophically acceptable - though it is not without its problems - than it is normally supposed to be.

Recently it has been argued that there are genuine moral dilemmas and that any theory which does not account for this fact is an unrealistic one. This represents a challenge to an assumption that most moral theorists have held: an adequate ethical theory must not allow for genuine moral quandaries. John Stuart Mill, for example, in the last paragraph of the second chapter of Utilitarianism, seems to be committed to such an assumption. Many others have also assented to this view. The consensus among those who hold this view seems to be that if a theory allows for moral dilemmas then there is some sense in which it is incoherent or inconsistent. Yet, oddly enough, the sense in which such a view would be incoherent is rarely, if ever, spelled out. Put another way, there seem to be no arguments for the belief that genuine moral dilemmas must be ruled out.

Consent forms given to potential subjects in research protocols typically contain a sentence like this: “You have a right to withdraw from this study at any time without penalty.” If you have ever served on an institutional review board (IRB) or a research ethics committee, you have no doubt read such a sentence often. Moreover, codes of ethics governing medical research endorse such a right. For example, paragraph 24 of the Declaration of Helsinki says, “The subject should be informed of the right… to withdraw consent to participate at any time without reprisal.” Similarly, section C of the Belmont Report says that subjects must be informed that they have the right “to withdraw at any time from the research.” And in section 46.116 of the Common Rule (issued by the United States Department of Health and Human Services), it says that one of the elements of informed consent must include a statement that “the subject may discontinue participation at any time without penalty or loss of benefit to which the subject is otherwise entitled.”

Over the past decade, genetic tests have become available for a wide variety of disorders. As a result we are able to predict, with some degree of certainty, whether or not an individual will develop such diseases as breast cancer, Huntington's disease, polycystic kidney disease, and familial adenomatous polyposis. The ability to predict disease poses several unique ethical considerations for clinical decisionmaking regarding the provision of genetic testing. Patients must be able to comprehend the complexities of genetic testing and the potential meaning of the results. Patients must consider the emotional, social, and economic consequences of revelations regarding their risk status. Also, obtaining information on risk status may have implications for persons other than the individual seeking genetic testing.