The neurosciences not only challenge assumptions about the mind’s place in the natural world but also urge us to reconsider its role in the normative world. Based on mind-brain dualism, the law affords only one-sided protection: it systematically protects bodies and brains, but only fragmentarily minds and mental states. The fundamental question, in what ways people may legitimately change mental states of others, is largely unexplored in legal thinking. With novel technologies to both intervene into minds and detect mental activity, (...) the law should, we suggest, introduce stand alone protection for the inner sphere of persons. We shall address some metaphysical questions concerning physical and mental harm and demonstrate gaps in current doctrines, especially in regard to manipulative interferences with decision-making processes. We then outline some reasons for the law to recognize a human right to mental liberty and propose elements of a novel criminal offence proscribing severe interventions into other minds. (shrink)

Conversations with patients and families about the allow-natural-death (AND) order, along with the standard do-not-resuscitate (DNR) order during end-of-life (EOL) decision-making, may create engagement and understanding while promoting care that can be defended using enduring notions of autonomy, beneficence, and professional duty. Ethical, legal, and pragmatic issues surrounding EOL care decision-making seem to suggest discussion of AND orders as one strategy clinicians could consider at the individual practice level and at institutional levels. A discussion of AND orders, along with traditional (...) DNR orders is presented. This is followed by argument and counter-argument focused on ethical, legal, and practical issues germane to EOL care decision-making associated with use of AND orders. (shrink)

Emerging technologies are increasingly used in an attempt to “enhance the human body and/or mind” beyond the contemporary standards that characterize human beings. Yet, such standards are deeply controversial and it is not an easy task to determine whether the application of a given technology to an individual and its outcome can be defined as a human enhancement or not. Despite much debate on its potential or actual ethical and social impacts, human enhancement is not subject to any consensual definition. (...) This paper proposes a timely and much needed examination of the various definitions found in the literature. We classify these definitions into four main categories: the implicit approach, the therapy-enhancement distinction, the improvement of general human capacities and the increase of well-being. After commenting on these different approaches and their limitations, we propose a definition of human enhancement that focuses on individual perceptions. While acknowledging that a definition that mainly depends on personal and subjective individual perceptions raises many challenges, we suggest that a comprehensive approach to define human enhancement could constitute a useful premise to appropriately address the complexity of the ethical and social issues it generates. (shrink)

Debates over the politicization of science have led some to claim that scientists have or should have a “right to research.” This article examines the political meaning and implications of the right to research with respect to different historical conceptions of rights. The more common “liberal” view sees rights as protections against social and political interference. The “republican” view, in contrast, conceives rights as claims to civic membership. Building on the republican view of rights, this article conceives the right to (...) research as embedding science more firmly and explicitly within society, rather than sheltering science from society. From this perspective, all citizens should enjoy a general right to free inquiry, but this right to inquiry does not necessarily encompass all scientific research. Because rights are most reliably protected when embedded within democratic culture and institutions, claims for a right to research should be considered in light of how the research in question contributes to democracy. By putting both research and rights in a social context, this article shows that the claim for a right to research is best understood, not as a guarantee for public support of science, but as a way to initiate public deliberation and debate about which sorts of inquiry deserve public support. (shrink)

Ce dossier traite de l‘influence et de l‘impact de l‘amélioration humaine sur notre société ainsi que sur notre conception de ce que c‘est que d‘être humain. Quels enjeux les technosciences engendrent-elles ? D‘où vient ce besoin de vouloir s‘améliorer ? Quelles libertés a-t-on face à ces nouvelles technologies? Et quelle place tient l‘humain dans ce débat ?

When should humans enhance themselves? We try to answer this question by engaging in a conceptual analysis of the nature of different activities. We think that cognitive enhancement is morally impermissible in some practice-oriented activities, such as some educational activities, when it is the case both that cognitive enhancement would negatively affect the point of those activities and that we have good reasons to value that point. We then argue that cognitive enhancement should be allowed in two groups of cases, (...) namely in practice-oriented activities, such as recreational activities on which little moral value or social import hangs, and in some prominently goal-directed activities, such as high-responsibility professions, the goal of which has significant moral or social value. Finally, we argue that the use of efficacious and relatively safe cognitive enhancers may even be obligatory in those high-responsibility professions under certain special circumstances. (shrink)

The debate on the ‘right to know’ has simmered on for over 30 years. New examples where a right to be informed is contrasted to a right to be kept in ignorance occasionally surface and spark disagreement on the extent to which patients and research subjects have a right to be self-determining concerning the health related information they receive. Up until now, however, this debate has been unsatisfactory with regard to the question what type of rights—if any—are in play here (...) and to what extent they can provide a normative basis for informed consent. This paper provides an analysis of informed consent in the context of ‘epistemic interventions’: interventions which involve the communication of information. First, I offer an analysis of the concept of a ‘right not to know’ in the context of consent to epistemic interventions. I argue that the scope of the consent is determined by the extent to which this intervention can be seen as an infringement of the private sphere. After that I show how this analysis affects the scope and standards of informed consent. (shrink)

Hasta la fecha, el significado de salud y por lo tanto de tratamiento y rehabilitación está referenciado al cuerpo normal o típico de la especie. Las intervenciones terapéuticas tienen cada vez más el potencial de generar habilidades corporales más allá de las ‘normales’ (mejoras terapéuticas). El campo de la rehabilitación, el deseo de disfrutar de habilidades corporales especialmente más allá de las típicas para la especie y la dirección y gobernanza de la ciencia y la tecnología están cada vez más (...) interrelacionadas. Cómo juzgamos y hacemos frente a habilidades corporales o falta de ellas, entre otros, influencia la dirección y gobernanza de los procesos de ciencia y tecnología, productos e investigación y desarrollo e influencia el sentido y el alcance de la salud y la rehabilitación, la identidad y la descripción de los profesionales de salud y rehabilitación, los deseos de los clientes de salud y rehabilitación para recabar sus puntos de vista sobre cuestiones relativas a la mejora del cuerpo y su impacto sobre los profesiones de salud y rehabilitación. La mayoría de encuestados perciben las mejoras humanos más allá de lo ‘normal’ y los cambios asociados como algo inevitable. Los resultados indican que ya es hora de que el discurso de mejora se mueva fuera de la esfera ética y de que el análisis de impacto de mejoras más allá de lo normal se lleve a cabo, que incluya a los hasta ahora prácticamente invisibles profesionales de la salud y la rehabilitación, sus clientes y académicos la política de discapacidad. (shrink)

Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the (...) underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the "moral fiction" that donors are dead when vital organs are procured. (shrink)

We investigated the acceptability and frequency of the use of cognitive enhancement (CE) drugs and three different types of academic misconduct (plagiarism, cheating in exams, and falsifying/fabricating data). Data from a web-based survey among German university students were used. Moral acceptability was relatively low for CE drug use and moderate for academic misconduct, while the correlation of their respective acceptability was moderately weak. Prevalence of CE drug use was lower than for academic misconduct and (very) lightly correlated with the prevalence (...) of plagiarism and fabrication/falsification. Acceptability of the investigated behaviors was associated with higher prevalence rates of each behavior. (shrink)

The concept of dignity figures prominently in legal and moral discussion on such topics as human rights, euthanasia, abortion, and criminal punishment. Yet the notion has been criticized for being indeterminate and either insufficient or redundant (or both) in justifying the kinds of legal and moral rights and views its proponents use it to vindicate. The criticisms have inspired some novel conceptions of dignity. One of them is Tarunabh Khaitan’s proposal that dignity should be understood as an expressive norm. In (...) this article, I assess Khaitan’s suggestion. I maintain that it faces two challenges that its advocates should be able to solve for the proposal to be plausible. (shrink)

Medicine increasingly envisions health promotion in terms of reducing risk as determined by quantitative risk factors, such as blood pressure, blood lipids, or genetic variants. This essay argues that this vision of health care as risk reduction is dangerous for Christian bioethics, since risk can be infinitely reduced leading to a self-defeating spiral of iatrogenic effects. Moreover, it endangers character because this vision of health is connected to a reductionist vision of the body and an understanding of individual risk that (...) undermines the more communal virtue of solidarity. The essay concludes by discussing how recent Thomistic analyses in favor of physical enhancements illustrate some of the problems that envisioning health care in terms of risk reduction holds for Christian bioethics. (shrink)

Growing powers to manipulate human bodies and minds, not merely to heal disease but to satisfy desires, control deviant behavior, and to change human nature, make urgent questions of whether and how to regulate their use, not merely to assure safety and efficacy but also to safeguard our humanity. Oversight in democratic societies rightly belongs to the polity, not merely to self-appointed experts, scientific or ethical. Yet the task of governing the uses of dangerous knowledge is daunting, and there is (...) little evidence that we have the will or the wisdom to do it well. (shrink)

As has become tradition, executive directors of United States’ presidential bioethics committees offer reflections about their experience shortly after the orderly shutdown of the commission staff. After the records are filed according to government records regulations; after all the staff members, who are hired into temporary positions that must be renewed every two years, have secured permanent employment; after preparations are made to ensure that the next commission staff (should there be one) has a budget and standard operating procedures in (...) order to begin its work in a timely manner; after the lights are turned out for the last time, the executive director makes the final climb up the stairs into the sunlight and reflects on the whirlwind. There is much about my work with the Presidential Commission for the Study of Bioethical Issues that deserves comment, but one aspect of the commission that has been especially valuable to me is its work to educate the nation on bioethical issues. This is, moreover, a contribution in which the commission staff was central, and it is one that, as an ethics educator myself, I will cherish deeply. (shrink)

Organ donation after cardiac or circulatory death (DCD) has been introduced to increase the supply of transplantable organs. In this paper, we argue that the recovery of viable organs useful for transplantation in DCD is not compatible with the dead donor rule and we explain the consequential ethical and legal ramifications. We also outline serious deficiencies in the current consent process for DCD with respect to disclosure of necessary elements for voluntary informed decision making and respect for the donor's autonomy. (...) We compare two alternative proposals for increasing organ donation consent in society: presumed consent and mandated choice. We conclude that proceeding with the recovery of transplantable organs from decedents requires a paradigm change in the ethics of organ donation. The paradigm change to ensure the legitimacy of DCD practice must include: (1) societal agreement on abandonment of the dead donor rule, (2) legislative revisions reflecting abandonment of the dead donor rule, and (3) requirement of mandated choice to facilitate individual participation in organ donation and to ensure that decisions to participate are made in compliance with the societal values of respect for autonomy and self-determination. (shrink)

The President’s Council on Bioethics has addressed the moral status of human preembryos in its reports on stem cell research and human therapeutic cloning. Although the Council has been criticized for being hand-picked to favor the right-to-life viewpoint concerning human preembryos, it has embraced the idea that the right-to-life position should be defended in secular terms. This is an important feature of the Council’s work, and it demonstrates a recognition of the need for genuine engagement between opposing sides in the (...) debate over stem cell research. To promote this engagement, the Council has stated in secular terms several arguments for the personhood of human preembryos. This essay presents and critiques those arguments, and it concludes that they are unsuccessful. If the best arguments in support of the personhood of human preembryos have been presented by the Council, then there are no reasonable secular arguments in support of that view. (shrink)

With multi-year funding from the U.S. National Science Foundation (NSF), a team of researchers has just released a comprehensive report detailing ethical issues arising from human enhancement (Allhoff et al. 2009). While we direct the interested reader to that (much longer) report, we also thank the editors of this journal for the invitation to provide an executive summary thereof. This summary highlights key results from each section of that report and does so in a self-standing way; in other words, this (...) summary presupposes no familiarity with the report and offers the opportunity to gain quick familiarity with its most central findings. (shrink)