Philosophers who specialize in bioethics face a distinctive set of challenges in our work: to bring the theoretical insights of philosophical work and methodology to practical dilemmas affecting a diverse group of stakeholders every day. This article describes some of the key contributions that philosophy can make to the field of bioethics. It also identifies some of the pitfalls that can undermine the value of a philosophical approach when used to analyze questions arising in the real world. Recognition of the (...) importance of individual context, practical implications, and social considerations can help successfully bridge the gap between theory and practice. Using this wide-angle lens to view bioethical problems can enable philosophers working in our field to offer insights that are both rigorous and relevant. (shrink)

Along with the growing utilization of the total artificial heart comes a new set of ethical issues that have, surprisingly, received little attention in the literature: How does one apply the criteria of irreversible cessation of circulatory function given that a TAH rarely stops functioning on its own? Can one appeal to the doctrine of double effect as an ethical rationale for turning off a TAH given that this action directly results in death? And, On what ethical grounds can a (...) physician turn off a TAH in view of the fact that either the intent of such an action or the outcome is always, and necessarily, death? The aim of this article is not to answer these questions but to highlight why these questions must be explored in some depth given the growing use of TAH technology. (shrink)

The present paper argues that abortion ban advocates can justify an exception for rape. Recently, Blackshaw offered an interesting argument that if abortion ban advocates modified their position along the lines of Thomson’s analysis of rights, they could make an exception for rape. However, doing so would require making concessions they would be unlikely to make, the crucial one being subscribing to an absurd view that abortion in the case of rape is permissible but only if it is performed in (...) a certain way, that is, in a way that withdraws life support from the fetus. Agreeing first with Blackshaw’s premises, we argue that the view in question is hardly absurd. Thus, relying on Boonin’s acknowledgment that although very rare, a position according to which abortion should be legal but only if it is performed in a way that lets the fetus die rather than kills it is a possible position, we argue, first, that it is Blackshaw’s position that is inconsistent, second, that since deontology sees permissibility of a given result as path-dependent, deontologically oriented abortion ban advocates should find the view in question appealing rather than absurd and, third, that although there are indeed scenarios in which withdrawing life support is morally equivalent to killing, extraction abortions in the case of rape are not amongst them. Since in the case of rape the fetus is not entitled to life support, extraction abortions are better classified as permissible non-omissive allowings than impermissible killings. Thus, there is nothing absurd in the view that abortion in the case of rape is permissible but only if it is performed in a certain way. Accordingly, adopting this view does not seem to be much of a concession for abortion ban advocates who can therefore make an exception for rape. (shrink)

The moral significance of the distinction between killing and allowing to die has played a key role in debates about euthanasia and physician assisted suicide. Since the withdrawal of life-sustaining treatment is held as morally permissible in the medical community, it follows that if there is no morally significant difference between killing and allowing to die, then there is no morally significant difference between withdrawing life-sustaining treatment or administering a lethal injection to end a patient’s life. Consistency then requires that (...) voluntary active euthanasia is also morally permissible. The debates over whether the distinction is morally significant have carried on for decades with little hope of consensus. We begin by surveying the literature to identify common argumentative strategies used in defending or rejecting the distinction’s significance. We observe, based on our review, that many of these strategies operate in ways that are conceptually removed from the concrete clinical situation of physicians involved in practices that lead to patient death. We conclude by arguing for a novel way of moving the debate forward indicated by our reading of the literature, namely, by paying careful attention to the moral experience of physicians involved in end-of-life interventions to understand how they experience these practices. Exploring physician experience can reveal how the distinction may or may not be useful for moral deliberation and can provide the needed context to theorize about the distinction in a more empirically informed and practically useful way. (shrink)