Two ethical frameworks have dominated the discussion of organ donation for long: that of property rights and that of gift-giving. However, recent years have seen a drastic rise in the number of philosophical analyses of the meaning of giving and generosity, which has been mirrored in ethical debates on organ donation and in critical sociological, anthropological and ethnological work on the gift metaphor in this context. In order to capture the flourishing of this field, this article distinguishes between four frameworks (...) for thinking about bodily exchanges in medicine: those of property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. These frameworks represent four different ways of making sense of donation of organs as well as tissue, gametes and blood, draw on different conceptions of the relations between the self and the other, and bring out different ethical issues as core ones. The article presents these frameworks, argues that all of them run into difficulties when trying to make sense of reciprocity and relational interdependence in donation, and shows how the three gift-giving frameworks (of heroism, sacrifice and aporia) hang together in a critical discussion about what is at stake in organ donation. It also presents and argues in favour of an alternative intercorporeal framework of giving-through-sharing that more thoroughly explicates the gift metaphor in the context of donation, and offers tools for making sense of relational dimensions of live and post mortem donations. (shrink)

The role of property theory as a framework for analysis and regulation of body parts has become a debate of topical importance because of the emergence of biomedical technologies that utilise body parts, and also because the application of the concept of property, even with respect to historically and traditionally accepted forms of property, raises serious challenges to the property analyst. However, there is another reason for the topicality of property in relation to body parts: a proprietary approach confers on (...) a claimant the advantage of continuing control that is tellingly lacking in non-property frameworks underpinned, for instance, by consent, negligence, privacy and unjust enrichment rules. In some circumstances, such as an unauthorised blood test performed on a blood sample obtained with consent, the continuing control provided by property law might be the only chance a claimant has to obtain a remedy. Economy of space, however, requires that only a prolegomenon on body parts and property theory is given below. Thus, the analysis begins by providing in outline a framework for comprehensive analysis of body parts within the realm of property theory; thereafter, the author engages with the normative question of whether body parts or rights exercisable over body parts could be admitted into the category of property. (shrink)

Deepfake technology can be used to produce videos of real individuals, saying and doing things that they never in fact said or did, that appear highly authentic. Having accepted the premise that Deepfake content can constitute a legitimate form of expression, it is not immediately clear where the rights of content producers and distributors end, and where the rights of individuals whose likenesses are used in this content begin. This paper explores the question of whether it can be plausibly argued (...) that Deepfake content involving the likenesses of real individuals violates the rights of these individuals. (shrink)

Technological advances are making devices that functionally replace body parts—artificial organs and limbs—more widely used, and more capable of providing patients with lives that are close to “normal.” Some of the ethical issues this is likely to raise relate to how such prostheses are conceptualized. Prostheses are ambiguous between being inanimate objects and sharing in the status of human bodies—which already have an ambiguous status, as both objects and subjects. At the same time, the possibility of replacing body parts with (...) artificial objects puts pressure on the normative status typically accorded to human bodies, seemingly confirming that body parts are replaceable objects. The paper argues that bodies’ normative status relies on the relation of a body to a person and shows that persons could have similar relations to prostheses. This suggests that in approaching ethical issues surrounding prostheses, it is appropriate to regard them as more like body parts than like objects. (shrink)

It has been argued that organs should be treated as individual tradable property like other material possessions and assets, on the basis that this would promote individual freedom and increase efficiency in addressing the shortage of organs for transplantation. If organs are to be treated as property, should they be inheritable? This paper seeks to contribute to the idea of organs as inheritable property by providing a defence of a default of the family of a dead person as inheritors of (...) transplantable organs. In the course of discussion, various succession rules for organs and their justifications will be suggested. We then consider two objections to organs as inheritable property. Our intention here is to provoke further thought on whether ownership of one's body parts should be assimilated to property ownership. (shrink)

The use of genetically modified organisms in agriculture makes great promises of better seeds, but also raises many controversies about ownership of seeds and about potential hazards. I suggest that owners of these seeds bear the responsibility to do no harm in using these seeds. After defining the nature of this responsibility, this paper asks, if ownership entails moral responsibility, and ownership can be transferred, then how is moral responsibility transferred? Building on the literature on use plans, I suggest five (...) conditions for a good transfer of moral responsibility for genetically modified seeds. I also look at the Monsanto Technology Use Guide and Technology/Stewardship Agreement, as an examplar of a use plan, to explore the extent to which these conditions are present. I conclude that use plans can play a role in the distribution and transfer of moral responsibility for technologies with high benefits and potential harmful uncertainties. (shrink)

Until now, the debates around genetically modified seeds in agriculture have converged towards two main issues. The first is about hazards that this new technology brings about, and the second is about the ownership of seeds and the distribution of their economic benefits. In this paper, I explore an underdeveloped topic by linking these two issues: how ownership shapes the distribution of moral responsibility for the potential hazards of genetically modified seeds. Indeed, while ownership is debated in terms of economic (...) rights and hazards in terms of “good” or “bad” science, no one has looked at whether or not we could and should ascribe and distribute moral responsibility for hazards based on ownership of genetically modified seeds. I argue that we should. Using the notion of ownership as a bundle of rights, I argue that from a moral perspective, the genetically modified seed has several owners at the same time. Although different owners may not have the same economic rights over the seed, they all have a moral responsibility, possibly to varying degrees, for the potential hazards brought about by the seed. Secondly, I argue that, as long as a seed carries the character trait that was intentionally modified, then it calls for moral responsibility. All in all, I formulate a way for linking issues of ownership and hazards of genetically modified seeds in agriculture through the concept of moral responsibility. (shrink)

BackgroundWith the increased use of implanted medical devices follows a large number of explantations. Implants are removed for a wide range of reasons, including manufacturing defects, recovery making the device unnecessary, battery depletion, availability of new and better models, and patients asking for a removal. Explantation gives rise to a wide range of ethical issues, but the discussion of these problems is scattered over many clinical disciplines.MethodsInformation from multiple clinical disciplines was synthesized and analysed in order to provide a comprehensive (...) approach to the ethical issues involved in the explantation of medical implants.ResultsDiscussions and recommendations are offered on pre-implantation information about a possible future explantation, risk–benefit assessments of explantation, elective explantations demanded by the patient, explantation of implants inserted for a clinical trial, patient registers, quality assurance, routines for investigating explanted implants, and demands on manufacturers to prioritize increased service time in battery-driven implants and to market fewer but more thoroughly tested models of implants.ConclusionSpecial emphasis is given to the issue of control or ownership over implants, which underlies many of the ethical problems concerning explantation. It is proposed that just like transplants, implants that fulfil functions normally carried out by biological organs should be counted as supplemented body parts. This means that the patient has a strong and inalienable right to the implant, but upon explantation it loses that status. (shrink)

Background Posthumous organ procurement is hindered by the consenting process. Several consenting systems have been proposed. There is limited information on public relative attitudes towards various consenting systems, especially in Middle Eastern/Islamic countries. Methods We surveyed 698 Saudi Adults attending outpatient clinics at a tertiary care hospital. Preference and perception of norm regarding consenting options for posthumous organ donation were explored. Participants ranked (1, most agreeable) the following, randomly-presented, options from 1 to 11: no-organ-donation, presumed consent, informed consent by donor-only, (...) informed consent by donor-or-surrogate, and mandatory choice; the last three options ± medical or financial incentive. Results Mean(SD) age was 32(9) year, 27% were males, 50% were patients’ companions, 60% had ≥ college education, and 20% and 32%, respectively, knew an organ donor or recipient. Mandated choice was among the top three choices for preference of 54% of respondents, with an overall median[25%,75%] ranking score of 3[2,6], and was preferred over donor-or-surrogate informed consent (4[2,7], p vs. 11[6,11], respectively, p = 0.002). Compared to females, males more perceived donor-or-surrogate informed consent as the norm (3[1,6] vs. 5[3,7], p vs. 8[4,9], p vs. 5[2,7], p Conclusions We conclude that: 1) most respondents were in favor of posthumous organ donation, 2) mandated choice system was the most preferred and presumed consent system was the least preferred, 3) there was no difference between preference and perception of norm in consenting systems ranking, and 4) financial (especially in females) and medical (especially in males) incentives reduced preference. (shrink)

Following Wesley Hohfeld's pioneering analyses, which demonstrated that the concept of ownership conflated a variety of distinct legal relations, a deflationary regarding those relations as essentially unconnected held sway for much of the subsequent century. In recent decades, this theory has been thought too diffuse; it seems counterintuitive to insist, for instance, that rights of possession and alienation over a property are associated only contingently. Accordingly, scholars such as James Penner and James Harris have advanced theories that revive the concept (...) of ownership, identifying some instances of property as and regarding others as conceptually subsidiary. I propose a new interpretation of the bundle theory, based on David Lewis's idea of among physical particles. I critically examine the major antibundle positions, arguing that their criticisms result from confusion about the claims of the bundle theory, which remains the best account of property rights available. (shrink)

Background Reasonable disagreement about the role awarded to gamete donors in decision-making on the use of embryos created by gamete donation for research purposes emphasises the importance of considering the implementation of participatory, adaptive, and trustworthy policies and guidelines for consent procedures. However, the perspectives of gamete donors and recipients about decision-making regarding research with EGDs are still under-researched, which precludes the development of policies and guidelines informed by evidence. This study seeks to explore the views of donors and recipients (...) about who should take part in consent processes for the use of EGDs in research. Methods From July 2017 to June 2018, 72 gamete donors and 175 recipients completed a self-report structured questionnaire at the Portuguese Public Bank of Gametes. Agreement with dual consent was defined as the belief that the use of EGDs in research should be consented by both donors and recipients. Results The majority of participants were willing to donate embryos for research. Almost half of the donors and half of the recipients considered that a dual consent procedure is desirable. This view was more frequent among employed recipients than among non-employed. Donors were less likely to believe that only recipients should be involved in giving consent for the use of EGDs in research and were more frequently favourable to the idea of exclusive donors’ consent. Conclusions Divergent views on dual consent among donors and recipients indicate the need to develop evidence-based and ethically sustainable policies and guidelines to protect well-being, autonomy and reproductive rights of both stakeholder groups. More empirical research and further theoretical normative analyses are needed to inform people-centred policy and guidelines for shared decision-making concerning the use of EGDs for research. (shrink)

The overall aim of this thesis is to show how some ideas in Aristotle’s Nicomachean Ethics can be interpreted and used as a productive way to approach a number of pressing issues in bioethics. Articles I-II introduce, and endorse, a social constructivist perspective on rights. It is investigated if the existence of property-like rights to biological material would include the moral right to commodification and even commercialisation. Articles III-V discuss similar questions and more specifically champion the application of an Aristotelian (...) virtue ethics perspective. The articles are preceded by an introductory essay on some of the central themes in the Nicomachean Ethics. This section also includes a very brief account of what the connection between virtue ethics and a theory of social construction, including rights, could look like. The thesis seeks to show that if read somewhat creatively many of the ideas in the Nicomachean Ethics make for a highly useful approach to modern moral problems. It should be noted, however, that this thesis in no way claims to be an exegetic, or a complete, study of the Nicomachean Ethics. Article I deals with ownership of biological material from a philosophical, as opposed to a legal, perspective. It is argued that a strand in liberal political theory that treats property relations as socially constructed bundles of rights, as developed by e.g. Felix Cohen and Tony Honoré, is well suited for discussions on ownership of biological material. Article II investigates which differences in biological material might motivate differences in treatment and ownership rights. The article draws on the social constructivist theory of ownership which was developed in Article I. Article III employs virtue ethics to explain why it is morally permissible to donate but not to sell organs such as kidneys. It is suggested that the former action will bring the agent closer to a state of human flourishing. Article IV argues that virtues like philia, justice, beneficence and generosity — traditionally all seen as other-regarding — contain strong self-regarding aspects. The central claim is that these self-regarding aspects of the other-regarding virtues are necessary components of complete virtue and thus that the fully virtuous agent has to act virtuously both in her dealings with herself and others. Article V applies the ideas that were developed in Article IV to the case of living organ donations to next of kin. It is proposed that such an act, although noble and fine, is supererogatory, rather than obligatory, as the donor is morally entitled to be partial to herself. This argument is made against the backdrop of a discussion on some Aristotelian ideas on philia and partiality. (shrink)