Zusammenfassung Der Begriff der Privatheit markiert eine erstaunliche Leerstelle in der Diskussion um die Pflege von Menschen mit Demenz (MmD). Der sonst intensiv geführte pflegeethische Diskurs über Fragen der Privatheit scheint hier nahezu vollständig zu verstummen, so als verlören MmD im Verlauf ihrer Erkrankung jedes nachvollziehbare Interesse an einer Privatsphäre und verfügten über keinerlei privaten Bereich mehr, den man bei ihrer pflegerischen Versorgung beachten oder schützen müsste. Eine solche Vorstellung widerspricht allerdings nicht nur verbreiteten moralischen Intuitionen, sondern auch den Auffassungen (...) und Bedürfnissen der Betroffenen selbst. Vor diesem Hintergrund gehen wir der Frage nach, inwieweit sich die Bedeutung von Privatheit für MmD ethisch verständlich und plausibel machen lässt. Zu diesem Zweck werden zunächst die Herkunft und die verschiedenen Bedeutungsdimensionen des Privatheitsbegriffs selbst umrissen, um anschließend seine Schwierigkeiten und Grenzen im Kontext demenzieller Erkrankungen aufzuzeigen. Wie sich dabei herausstellt, kann insbesondere der ausgeprägte Autonomiebezug vorherrschender liberaler Privatheitskonzepte ein erhebliches Hindernis für eine angemessene Konzeptualisierung der Bedeutung der Privatheit für MmD darstellen. Aus diesem Grund loten wir im Anschluss unterschiedliche Möglichkeiten aus, wie sich der „Wert des Privaten“ im Kontext demenzieller Erkrankungen auch losgelöst vom Recht auf individuelle Selbstbestimmung konzeptualisieren ließe. Während autonomiebasierte Konzepte von Privatheit in frühen Stadien noch tragen mögen, wird mit Blick auf den weiteren Krankheitsverlauf daher auch der Relevanz von erkennbaren persönlichen Präferenzen sowie objektiven Bedingungen von Würde und Wohlergehen nachgegangen. Auf diesem Weg lässt sich differenziert aufzeigen, inwiefern Privatheit auch für MmD von Bedeutung sein und im pflegerischen Umgang mit ihnen angemessen berücksichtigt werden kann. (shrink)

Even where willingness-to-pay as a measure of welfare impact is adjusted for diminishing marginal utility, welfare economics is shown to favour policies that add to the life expectancy or that enhance the quality of life of persons who are already better-off. I propose an alternative, Equal Respect methodology, under an axiomatic claim that at the point of decision the prospective life years of all individuals are of equal intrinsic social value. This justifies equal valuation of risk mitigation across all persons; (...) similarly, all appraised impacts should be scaled to accord equal respect to difficult but no-less-valuable lives. (shrink)

In this paper, we analyze the legal situation regarding physician-assisted suicide in the world. Our hypothesis is that the prohibitive stance on physician-assisted suicide in most societies in the world today seems to be related to our moral attitudes toward suicide. This brings us to a discussion about life itself. We claim that the total lack of legal protection for physician-assisted suicide from international organizations and most countries in the world lies in a philosophical assumption that supports much of our (...) common beliefs about what life really is. This assumption states that life must be thought of as not belonging exclusively to the individual. We argue that this assumption is a misconception that can be heard in the debate on suicide. Consequently we endorse a different conception of life which tends to favor a pro-choice stance towards suicide and assisted death in general. This position takes the patient’s decision about when to die more seriously. We conclude that there is no reason why physician-assisted suicide does not deserve legal protection as an individual right to die under international law. (shrink)

A core challenge for contemporary bioethics is how to address the tension between respecting an individual’s autonomy and promoting their wellbeing when these ideals seem to come into conflict (Not...

Decision-making Capacity matters to whether a patient’s decision should determine her treatment. But why it matters in this way isn’t clear. The standard story is that dmc matters because autonomy matters. And this is thought to justify dmc as a gatekeeper for autonomy – whereby autonomy concerns arise if but only if a patient has dmc. But appeals to autonomy invoke two distinct concerns: concern for authenticity – concern that a choice is consistent with an individual’s commitments; and concern for (...) sovereignty – concern that an individual exercises control over that which is hers to control. Here, I argue, neither concern can alone explain why dmc matters. Instead, dmc matters because it indicates a harmony between the two concerns – the demands of each concern are more likely to agree if a patient has dmc. This vindicates the standard story, but also makes clear that dmc is an inappropriate gatekeeper for autonomy. (shrink)

CAMILO, Bruno. Aspectos metafísicos na física de Newton: Deus. In: DUTRA, Luiz Henrique de Araújo; LUZ, Alexandre Meyer (org.). Temas de filosofia do conhecimento. Florianópolis: NEL/UFSC, 2011. p. 186-201. (Coleção rumos da epistemologia; 11). Através da análise do pensamento de Isaac Newton (1642-1727) encontramos os postulados metafísicos que fundamentam a sua mecânica natural. Ao deduzir causa de efeito, ele acreditava chegar a uma causa primeira de todas as coisas. A essa primeira causa de tudo, onde toda a ordem e leis (...) tiveram início, a qual para ele assume um caráter divino, Newton aponta para um Deus sábio e poderoso e responsável pela ordem inteligente e pela a harmonia das leis físicas e universais de tudo o que existe – Deus como criador e preservador da ordem do universo. Há ainda a analogia do conceito de Deus com o espaço e o tempo, na medida em que ambos comunicam infinitude e onipresença. Por fim, nas considerações finais apontarei a importância de Newton para a metafísica moderna e como os seus estudos contribuíram para uma visão posterior do universo e suas leis e do homem enquanto ser pensante. (shrink)

In this commentary, I critique three aspects of Emily Walsh's proposal to reduce the moral and legal weight of advance directives: (1) the ambiguity of its initial thesis, (2) its views about the ethics and legality of clinical practice, and (3) its interpretation and application of Ronald Dworkin’s account of advance directives and L.A. Paul's view on transformative experience. I also consider what Walsh’s proposal would mean for people facing the prospect of dementia. I conclude that our reasons to honor (...) many advance directives survive the move to a transformative experience framework. (shrink)

This text focuses on selected basic arguments of libertarianism that could be found in certain debates on the moral issues of euthanasia and the application of moral fictionalism in bioethics. Firstly, I devote my article to the criticism of libertarian arguments (as one of the dominant discourses related to the debate over euthanasia) in a wider perspective of moral philosophy. The article is based on an approach that understands morality as a kind of social practice and the primary goal is (...) to grasp the key theoretical concepts which are included in the mechanism for identifying and assessing our moral intuitions. This text is primarily an analysis of selected arguments of current normative theories of libertarianism on two levels: first it examines the idea of self-ownership in connection with certain debates over euthanasia, while the latter part of the article concerns an analysis of the critique of libertarian arguments and a comparison of the alternative arguments of moral fictionalism. The last part of this text, focusing on moral fictionalism and its general application in bioethics, is the core of the article. (shrink)

Most people who defend physician-assisted death (PAD) endorse the Joint View, which holds that two conditions—autonomy and welfare—must be satisfied for PAD to be justified. In this paper, we defend an Autonomy Only view. We argue that the welfare condition is either otiose on the most plausible account of the autonomy condition, or else is implausibly restrictive, particularly once we account for the broad range of reasons patients cite for desiring PAD, such as “tired of life” cases. Moreover, many of (...) the common objections to an Autonomy Only view fail once we understand the extent of the autonomy condition’s requirements—in particular, the importance of one’s values for autonomous choices. If our view is correct, then the scope of permissible PAD is broader than is currently accepted in both the philosophical literature and the law, and therefore poses an important challenge to this widely accepted view on justified PAD. (shrink)

Habermas’s postmetaphysical reading of Kierkegaard is paradigmatic for his understanding of religion. It shows, why Habermas reduces religion to fideism. Therefore the paper reconstructs Habermas’s reception of Kierkegaard and compares it with the accounts of Dieter Henrich and Michael Theunissen. Furthermore it demonstrates how Habermas makes use of Kierkegaard’s dialectics of existence to formulate his postmetaphysical thesis of a cooperative venture.

advanced directivesend-of-life decisionsharming the deadposthumous reproductiontransplant ethics.

Dignity may just be the most promiscuous normative abstraction. This article, informed by dignity’s historical variability, political theoretic multipurpose, and conflicting jurisprudence, focuses on a particular but influential invocation of the term: dignity as the normative ground for the ‘capabilities approach’ (CA) model of social justice. We ask whether or not the CA, in particular the influential version propounded by philosopher Martha Nussbaum, requires dignity as its foundational premise, and whether or not dignity may be more costly than beneficial for (...) the CA’s vision of a minimally just society. The first section of this article rehearses the warrants of and criticisms against the dignity-basis of Nussbaum’s CA. We canvass the relatively sparse scholarship on dignity within the CA to situate our contribution. The next two sections are case studies, demonstrating dignity’s shortcomings for assessing and regulating sex and abortion, respectively. The fourth section rebuts two possible objections to our criticisms of dignity. The fifth and final section gestures toward another normative abstraction, ‘minimum conditions of individuation’, less polysemic than dignity, which might alternatively ground the CA. (shrink)

Preimplantation genetic diagnosis allows the detection of genetic abnormalities in embryos produced through in vitro fertilization. Current funding models in Australia provide governmental subsidies for couples undergoing IVF, but do not extend to PGD. There are strong reasons for publicly funding PGD that follow from the moral principles of autonomy, beneficence and justice for both parents and children. We examine the objections to our proposal, specifically concerns regarding designer babies and the harm of disabled individuals, and show why these are (...) substantially outweighed by arguments for subsidizing PGD. We argue that an acceptance of PGD is aligned with present attitudes towards procreative decision making and IVF use, and that it should therefore receive government funding. (shrink)

This paper takes a novel approach to the active bioethical debate over whether advance medical directives have moral authority in dementia cases. Many have assumed that advance directives would lack moral authority if dementia truly produced a complete discontinuity in personal identity, such that the predementia individual is a separate individual from the postdementia individual. I argue that even if dementia were to undermine personal identity, the continuity of the body and the predementia individual’s rights over that body can support (...) the moral authority of advance directives. I propose that the predementia individual retains posthumous rights over her body that she acquired through historical embodiment in that body, and further argue that claims grounded in historical embodiment can sometimes override or exclude moral claims grounded in current embodiment. I close by considering how advance directives grounded in historical embodiment might be employed in practice and what they would and would not justify. (shrink)

Viele Menschen halten Patientenverfügungen für ein geeignetes Mittel, um selbstbestimmt zu entscheiden, wie mit ihnen im Fall schwerer Demenz umgegangen werden soll. Die meisten Bioethiker stimmen ihnen zu: Demenzverfügungen seien Ausdruck der „verlängerten Autonomie“ der Patientin. Doch ob sie recht haben, ist unklar. Dem viel beachteten Identitätseinwand zufolge sind die Ausstellerin der Verfügung und ihre schwer demente Nachfolgerin numerisch verschieden: Sie sind zwei und nicht eins. Wenn das stimmt, kann die Ausstellerin nicht verfügen, wie mit ihr im Falle schwerer Demenz (...) umgegangen werden soll. Die Demenzverfügung ist ungültig. In meinem Aufsatz möchte ich eine neue Replik auf diesen Einwand vorstellen. Ihr Ansatzpunkt ist der menschliche Organismus, den wir sehen, wenn wir in den Spiegel blicken. Er kann schwer dement werden, und auch er hat die Patientenverfügung unterschrieben. Warum sollte sie dann ungültig sein? Auf den ersten Blick hat diese Replik eine Reihe von Vorzügen. Insbesondere akzeptiert sie die populären Annahmen, auf denen der Identitätseinwand basiert. Bei näherem Hinsehen zeigen sich jedoch Probleme, die so gravierend sind, dass wir von ihr Abstand nehmen sollten. (shrink)

This article focuses on the interrelationship of law and life in human rights. It does this in order to theorize the normative status of contemporary biopower. To do this, the case law of Article 2 on the right to life of the European Convention on Human Rights is analysed. It argues that the juridical interpretation and application of the right to life produces a differentiated governmental management of life. It is established that: 1) Article 2 orients governmental techniques to lives (...) in order to ensure that both deprivation and protection of lives is lawful; 2) A proper application of Article 2 grounds itself on a proper discrimination of lives which causes Article 2 to be applied universally but not uniformly to all juridical subjects; 3) The jurisprudence of Article 2 is theoretically appreciable only in a ‘politics of life’. Finally, the article ends with a plea to analyse other fundamental human rights in the context of ‘biopolitical governmentality’. (shrink)

Patients in the vegetative state are wholly unaware of themselves, or their surroundings. However, a minority of patients diagnosed as vegetative are actually aware. What is the well-being of these patients? How are their lives going, for them? It has been argued that on a reasonable conception of well-being, these patients are faring so poorly that it may be in their best interests not to continue existing. I argue against this claim. Standard conceptions of well-being do not clearly support the (...) conclusion that these patients would be better off having life-sustaining treatment withdrawn, and in fact, it may be possible for these patients to retain a passable level of well-being. I suggest that further research into the subjective experiences of these patients will allow us to better promote their well-being. (shrink)

This paper analyses J.S. Mill's theory on the relationships between individual autonomy and State powers. It will be argued that there is a significant discrepancy between Mill's general liberal statements aimed to secure individual largest possible autonomy and the specific examples which provide the government with quite wide latitude for interference in the public and private spheres. The paper outlines the boundaries of government interference in the Millian theory. Subsequently it describes Mill's elastic paternalism designed to prevent people from inflicting (...) harm upon others as well as upon themselves, from soft paternalism on issues like compulsory education to hard paternalism on very private matters such as marriage, having children, and divorce by consent. (shrink)

In this paper, we will discuss the prospect of human reproduction achieved with gametes originating from only one person. According to statements by a minority of scientists working on the generation of gametes in vitro, it may become possible to create eggs from men’s non-reproductive cells and sperm from women’s. This would enable, at least in principle, the creation of an embryo from cells obtained from only one individual: ‘solo reproduction’. We will consider what might motivate people to reproduce in (...) this way, and the implications that solo reproduction might have for ethics and policy. We suggest that such an innovation is unlikely to revolutionise reproduction and parenting. Indeed, in some respects it is less revolutionary than in vitro fertilisation as a whole. Furthermore, we show that solo reproduction with in vitro created gametes is not necessarily any more ethically problematic than gamete donation—and probably less so. Where appropriate, we draw parallels with the debate surrounding reproductive cloning. We note that solo reproduction may serve to perpetuate reductive geneticised accounts of reproduction, and that this may indeed be ethically questionable. However, in this it is not unique among other technologies of assisted reproduction, many of which focus on genetic transmission. It is for this reason that a ban on solo reproduction might be inconsistent with continuing to permit other kinds of reproduction that also bear the potential to strengthen attachment to a geneticised account of reproduction. Our claim is that there are at least as good reasons to pursue research towards enabling solo reproduction, and eventually to introduce solo reproduction as an option for fertility treatment, as there are to do so for other infertility related purposes. (shrink)

In Memory of Ed PellegrinoEuthanasia in Belgium is not limited to terminally ill patients. It may be applied to patients with chronic degenerative diseases. Currently, people in Belgium wish to make it possible to euthanize incompetent patients who suffer from dementia. This article explains the Belgian law and then explores arguments for and against euthanasia of patients with dementia. It probes the dementia paradox by elucidating Dworkin’s distinction between critical and experiential interests, arguing that at the end-of-life this distinction is (...) not clearcut. It argues against euthanasia for patients with dementia, for respecting patients’ humanity and for providing them with more care, compassion, and good doctoring. (shrink)

Vaccine refusers often seem motivated by disgust, and they invoke ideas of purity, contamination and sanctity. Unfortunately, the emotion of disgust and its companion ideas are not directly responsive to the probabilistic and statistical evidence of research science. It follows that increased efforts to promulgate the results of vaccine science are not likely to contribute to increased rates of vaccination among persons who refuse vaccines because of the ‘ethics of sanctity’. Furthermore, the fact that disgust-based vaccine refusal is not monolithic (...) – vaccine refusers manifest disgust at different objects and invoke different ideas about purity and contamination – further complicates public health efforts to increase vaccination rates. (shrink)

According to standard comparativist views, death is bad insofar as it deprives someone of goods she would otherwise have had. In The Ethics of Killing, Jeff McMahan argues against such views and in favor of a gradualist account according to which how bad it is to die is a function of both the future goods of which the decedent is deprived and her cognitive development when she dies. Comparativists and gradualists therefore disagree about how bad it is to die at (...) different ages. In this paper I examine two prominent criticisms of gradualism and show that both misconstrue McMahan. I develop a related criticism that seems to show that a gradualist cannot coherently relate morbidity and mortality. This criticism also fails, but has an instructive implication for how policy-makers setting priorities for health care investments should regard choices between life-saving interventions and interventions against non-fatal diseases in the very young. (shrink)

Loss of self is widely regarded to be a consequence of dementia, and this perceived loss presents a variety of problems - not least because a clear understanding of the concept of self is elusive. This paper suggests a way to cut through problems that arise because we rely on conceptions of self in our understanding of the effects of dementia. It is proposed that we can avoid reliance on the concept of self through an approach based in in bio-phenomenology. (...) Such an approach would help us better understand the inner life of those with dementia and assist us to recognize that even in late stage dementia they are semiotic subjects with unique value. (shrink)

In this chapter, our focus is the role played by notions of rationality in the diagnosis of mental disorders, and in the practice of overriding patient autonomy in psychiatry. We describe and evaluate different hypotheses concerning the relationship between rationality and diagnosis, raising questions about what features underpin psychiatric categories. These questions reinforce widely held concerns about the use of diagnosis as a justification for overriding autonomy, which have motivated a shift to mental incapacity as an alternative justification. However, this (...) approach too has recently been criticized from a mental disability rights perspective. Our analysis of the relationship between mental capacity and rationality is used to illuminate these concerns, and to investigate further the relationship between rationality and psychiatric diagnosis. (shrink)

“de-extinction” refers to the process of resurrecting extinct species by genetic methods. This science-fiction-sounding idea is in fact already in early processes of scientific implementation. Although this recent “revival of the dead” raises deep ethical questions, the ethics of de-extinction has barely received philosophical treatment. Rather than seeking a verdict for or against de-extinction, this paper attempts an overview and some novel analyses of the main ethical considerations. Five dimensions of the ethics of de-extinction are explored: (a) the possible contribution (...) of de-extinction to promoting ecological values, (b) the deontological argument that we owe de-extinction to species we rendered extinct, (c) the question of “playing God” through de-extinction, (d) the utilitarian perspective, and (e) the role of aesthetic considerations in the ethics of de-extinction. A general feature arising from the paper’s discussion is that, due to de-extinction’s special character, it repeatedly tests the limits of our ethical notions. (shrink)

Jon Shields's finding—that certain evangelical pro‐life activist groups are more interested in deliberative discussions about abortion than are pro‐choice activists—is wrong on methodological, normative, and philosophical grounds. He generalizes about pro‐life civility from a small, trained sample group, and ignores possibly important variables that would explain pro‐choicers' incivility. Further, politeness is not necessarily a requirement of democratic deliberation—which entails not forcing one's own beliefs on the public, as pro‐lifers manifestly are trying to do, despite their calm demeanor. Conversely, some pro‐choicers' (...) refusal to engage in debates is not a deliberative failure, as Shields suggests, as deliberation includes such things as campaigning and canvassing. Lastly, Shields, and the pro‐lifers he has observed, use the weakest of the pro‐choice arguments, instead of focusing on the best academic work in the field. (shrink)

There is an important moral difference between laws that criminalize drugs and prostitution and laws that make them illegal in other ways: criminalization violates our moral rights in a way that nonlegalization does not. Criminalization is defined as follows. Drugs are criminalized when there are criminal penalties for using or possessing small quantities of drugs. Prostitution is criminalized when there are criminal penalties for selling sex. Legalization is defined as follows. Drugs are legalized when there are no criminal penalties for (...) manufacturing, selling and possessing large quantities of drugs. Prostitution is legalized when there are no criminal penalties for owning or operating a brothel or escort service, no criminal penalties for working as a paid agent for sex work, and no criminal penalties for paying someone for sex who is above the age of legal employment and sexual consent. The criminalization of drugs and prostitution violate the right of self-sovereignty in depriving individuals of important forms of control over their own minds and bodies, but nonlegalization does not violate this right. It is therefore consistent, as a matter of principle, to advocate decriminalization but to oppose legalization. (shrink)

This paper examines two models of thinking relating to the issue of the right to die in dignity: one takes into consideration the rights and interests of the individual; the other supposes that human life is inherently valuable. I contend that preference should be given to the first model, and further assert that the second model may be justified in moral terms only as long as it does not resort to paternalism. The view that holds that certain patients are not (...) able to comprehend their own interests in a fully rational manner, and therefore ‘we’ know what is good for these patients better than ‘they’ do, is morally unjustifiable. I proceed by refuting the ‘quality of life’ argument, asserting that each person is entitled to decide for herself when it is worth living and when it is not. In this connection, a caveat will be made regarding the role of the family. (shrink)

Though the reputation of eugenics has been tarnished by history, eugenics per se is not necessarily a bad thing. Many advocate a liberal new eugenics—where individuals are free to choose whether or not to employ genetic technologies for reproductive purposes. Though genetic interventions aimed at the prevention of severe genetic disorders may be morally and socially acceptable, reproductive liberty in the context of enhancement may conflict with equality. Enhancement could also have adverse effects on utility. The enhancement debate requires a (...) shift in focus. What the equality and/or utility costs of enhancement will be is an empirical question. Rather than philosophical speculation, more social science research is needed to address it. Philosophers, meanwhile, should address head-on the question of how to strike a balance between liberty, equality, and utility in cases of conflict (in the context of genetics). (shrink)

Autonomy is a concept that holds much appeal to social and legal philosophers. Within a medical context, it is often argued that it should be afforded supremacy over other concepts and interests. When respect for autonomy merely requires non-intervention, an adult’s right to refuse treatment is held at law to be absolute. This apparently simple statement of principle does not hold true in practice. This is in part because an individual must be found to be competent to make a valid (...) refusal of consent to medical treatment, and capacity to decide is not an absolute concept. But further to this, I argue that there are three relevant understandings of autonomy within our society, and each can demand in differing cases that different courses of action be followed. Judges, perhaps inadvertently, have been able to take advantage of the equivocal nature of the concept to come tacitly to decisions that reflect their own moral judgments of patients or decisions made in particular cases. The result is the inconsistent application of principle. I ask whether this is an unforeseen outcome or if it reflects a wilful disregard for equal treatment in favour of silent moral judgments in legal cases. Whatever the cause, I suggest that once this practice is seen to occur, acceptable justification of it in some cases is difficult to find. (shrink)

Medical clinicians – doctors, nurses, nurse practitioners etc. – are charged to act for the good of their patients. But not all ways of acting for a patient's good are on par: some are paternalistic; others are not. What does it mean to act paternalistically, both in general and specifically in a medical context? And when, if ever, is it permissible for a clinician to act paternalistically? -/- This paper deals with the first question, with a special focus on paternalism (...) in medicine. While it is easy to give a rough characterization of paternalism (i.e. acting for another's good against that person's will), it is surprisingly difficult to provide a unified account of the myriad of actions that seem to count as paternalistic. After surveying four accounts of paternalism, I argue that two – what I call the authority and beneficence accounts – are the strongest on offer. According to the authority account, a clinician acts paternalistically when, for her patient's good, she usurps his decision-making authority. According to the beneficence account, a clinician acts paternalistically when, for her patient's good, she acts only or overrindingly out of concern for his good. I show how the difference between these accounts matters (in part) for how we should think about the nature of surrogate decision making in medicine. I argue that there are reasons – albeit hardly decisive – to prefer the beneficence account to the authority account. I conclude by considering whether attempts by clinicians to rationally persuade their patients to pursue a particular course of action should be thought of as paternalistic. (shrink)

Medical clinicians – doctors, nurses, nurse practitioners etc. – are charged to act for the good of their patients. But not all ways of acting for a patient's good are on par: some are paternalistic; others are not. What does it mean to act paternalistically, both in general and specifically in a medical context? And when, if ever, is it permissible for a clinician to act paternalistically? In Medical Paternalism Part 1, I answered the first question. This paper answers the (...) second. The place of paternalism in clinical medicine is best understood, I argue, in terms of the potential for conflict between the autonomy principle and the beneficence principle. The first enjoins clinicians to respect the decisions of patients with respect to their (the patients') own care. The second enjoins clinicians to act for the good of their patients. Clinicians act paternalistically, I argue, when they act on the beneficence principle to the exclusion of the autonomy principle. Understanding just what these principles amount to (particularly the autonomy principle) reveals that the autonomy principle defeasibly trumps the beneficence principle and that, as a result, acting paternalistically (at least when it comes to competent patients) is presumptively impermissible. (shrink)

ABSTRACT:We argue that Confucianism makes a fundamental contribution to understanding why civility is necessary for a morally decent workplace. We begin by reviewing some limits that traditional moral theories face in analyzing issues of civility. We then seek to establish a Confucian alternative. We develop the Confucian idea that even in business, humans may be sacred when they observe rituals culturally determined to express particular ceremonial significance. We conclude that managers and workers should understand that there is a broad range (...) of morally important rituals in organizational life and that managers should preserve and develop the intelligibility and integrity of many of these rituals. (shrink)

A number of areas of biology raise questions about what is of value in the natural environment and how we ought to behave towards it: conservation biology, environmental science, and ecology, to name a few. Based on my experience teaching students from these and similar majors, I argue that the field of environmental ethics has much to teach these students. They come to me with pent-up questions and a feeling that more is needed to fully engage in their subjects, and (...) I believe some exposure to environmental ethics can help focus their interests and goals. I identify three primary areas in which environmental ethics can con- tribute to their education. The first is an examination of who (or what) should be considered to be part of our moral community (i.e., the community to whom we owe direct duties). Is it humans only? Or does it include all sentient life? Or all life? Or ecosystems considered holistically? Often, readings implicitly assume one or more of these answers; the goal is to make the student more sensitive to these implicit claims and to get them to think about the different reasons that support them. The second area, related to the first, is the application of the different answers concerning the extent of the ethical community to real environmental issues and problems. Students need to be aware of how the different answers concerning the moral community can imply conflicting answers for how we should act in certain cases and to think about ways to move toward conflict resolution. The third area in which environmental ethics can contribute is a more conceptual one, focusing on central concepts such as biodiversity, sustainability, species, and ecosystems. Exploring and evaluating various meanings of these terms will make students more reflective and thoughtful citizens and biologists, sensitive to the implications that different conceptual choices make. (shrink)

This paper explores the claim that someone can reasonably consider themselves to be under a duty to respect the autonomy of a person who does not have the capacities normally associated with substantial self-governance.

For about five decades the phrase "sanctity-of-life" has been part of the Anglo-American biomedical ethical discussion related to abortion and end-of-life questions. Nevertheless, the concept's origin and meaning are unclear. Much controversy is based on the mistaken assumption that the concept denotes the absolute value of human life and thus dictates a strict prohibition on euthanasia and physician-assisted suicide. In this paper, I offer an analysis of the religious and philosophical history of the idea of "sanctity-of-life." Drawing on biblical texts (...) and interpretation as well as Kant's secularization of the concept, I argue that "sanctity" has been misunderstood as an ontological feature of biological human life, and instead locate the idea within the historical virtue-ethical tradition, which understands sanctification as a personal achievement through one's own actions. (shrink)

This article reviews the Dutch societal debate on euthanasia/assisted suicide in dementia cases, specifically Alzheimer's disease. It discusses the ethical and practical dilemmas created by euthanasia requests in advance directives and the related inconsistencies in the Dutch legal regulations regarding euthanasia/assisted suicide. After an initial focus on euthanasia in advanced dementia, the actual debate concentrates on making euthanasia/assisted suicide possible in the very early stages of dementia. A review of the few known cases of assisted suicide of people with so-called (...) early dementia raises the question why requests for euthanasia/assisted suicide from patients in the early stage of Alzheimer's disease are virtually non-existent. In response to this question two explanations are offered. It is concluded that, in addition to a moral discussion on the limits of anticipatory choices, there is an urgent need to develop research into the patient's perspective with regard to medical treatment and care-giving in dementia, including end-of-life care. (shrink)

Welfarism is the view that morality is centrally concerned with the welfare or well-being of individuals. The division between welfarist and non-welfarist approaches underlies many important disagreements in ethics, but welfarism is neither consistently defined nor well understood. I survey the philosophical work on welfarism, and I offer a suggestion about how the view can be characterized and how it can be embedded in various kinds of moral theory. I also identify welfarism's major rivals, and its major attractions and weaknesses.

Proponents of human reproductive cloning do not dispute that cloning may lead to violations of clones' right to self-determination, or that these violations could cause psychological harms. But they proceed with their endorsement of human reproductive cloning by dismissing these psychological harms, mainly in two ways. The first tactic is to point out that to commit the genetic fallacy is indeed a mistake; the second is to invoke Parfit's non-identity problem. The argument of this paper is that neither approach succeeds (...) in removing our moral responsibility to consider and to prevent psychological harms to cloned individuals. In fact, the same commitment to personal liberty that generates the right to reproduce by means of cloning also creates the need to limit that right appropriately. Discussion of human reproductive cloning ought to involve a careful and balanced consideration of both the relevant aspects of personal liberty – the parents' right to reproductive freedom and the cloned child's right to self-determination. (shrink)

We argue in this essay that (1) the embryo is an irredeemably ambiguous entity and its ambiguity casts serious doubt on the arguments claiming its full protection or, at least, its protection against its use as a means fo research, (2) those who claim the embryo should be protected as "one of us" are committed to a position even they do not uphold in their practices, (3) views that defend the protection of the embryo in virtue of its potentiality to (...) become a person fail, and (4) the embryo does not have any rights or interests to be protected. Given that many are willing to treat the embryo as a means in other practices, and that human embryonic stem cell (hESC) research holds the potential to benefit many people, one cannot but conclude that hESC research is permissible and, because of its immense promise for alleviating human even obligatory. (shrink)

One goal of the transplant community is to seek ways to increase the number of people who are willing and able to donate organs. People in states between life and death are often medically excellent candidates for donating organs. Yet public policy surrounding organ procurement is a delicate matter. While there is the utilitarian goal of increasing organ supply, there is also the deontologic concern about respect for persons. Public policy must properly mediate between these two concerns. Currently the dead (...) donor (dd) rule is appealed to as an attempt at such mediation. I argue that given the lack of consensus on a definition of death, the dd rule is no longer successful at mediating utilitarian and deontologic concerns. I suggest instead that focusing on a particular person's history can be successful. (shrink)

Proponents of the legalization of assisted suicide often appeal to our supposed right to "die with dignity" to defend their case. I examine and assess different notions of "dignity" that are operating in many arguments for the legalization of assisted suicide, and I find them all to be deficient. I then consider an alternative conception of dignity that is based on Aristotle's conception of the conditions on the best life. I conclude that, while such a conception of dignity fits best (...) with our intuitions about the conditions under which a life has dignity, it supports the legalization of assisted suicide only under very limited circumstances. (shrink)

ABSTRACT Don Marquis argues that abortion is morally wrong in most cases since it deprives the fetus of the value of its future. I criticize Marquis’s argument for the modified conservative view by adopting an argumentative strategy in which I work within his basic account: if it is granted that his fundamental idea is sound, what follows about the morality of abortion? I conclude that Marquis is faced with a dilemma: either his position must shift towards the extreme conservative view (...) on which abortion is never morally permissible, or he must abandon any recognizably conservative view. This dilemma suggests that Marquis’s view is either deeply implausible or that he cannot use this argument to successfully support his preferred position. (shrink)

This article is a critical review of David Boonin's book, A Defense of Abortion (Cambridge University Press, 2002), a significant contribution to the literature on this subject and arguably the most important monograph on abortion published in the past twenty years. Boonin's defense of abortion consists almost exclusively of sophisticated critiques of a wide variety of pro-life arguments, including ones that are rarely defended by pro-life advocates. This article offers a brief presentation of the book's contents with extended assessments of (...) those arguments of Boonin's that are his unique contributions to the abortion debate and with which the author disagrees: (1) Boonin's critique of the conception criterion and his defense of organized cortical brain activity as the acquired property that imparts to the fetus a right to life: (2) Boonin's defense of J. J. Thomson's violinist argument and his distinction between responsibility for existence and responsibility for neediness and its application to pregnancy. (shrink)

I introduce a new distinction between two types of paternalism, which I call ‘internal’ and ‘external’ paternalism. The distinction pertains to the question of whether the paternalized subject’s current evaluative judgments are mistaken relative to a standard of correctness that is internal to her evaluative point of view—which includes her ‘true’ or ‘ideal’ self—as opposed to one that is wholly external. I argue that this distinction has important implications for (a) the distinction between weak and strong paternalism; (b) the distinction (...) between soft and hard paternalism; and (c) medical practice, where internal paternalism can, and probably often does, occur. (shrink)