Critics of organ donation after circulatory death (DCD) argue that, even if donors are past the point of autoresuscitation, they have not satisfied the “irreversibility” requirement in the circulatory and respiratory criteria for determining death, since their circulation and respiration could be artificially restored. Thus, removing their vital organs violates the “dead-donor” rule. I defend DCD donation against this criticism. I argue that practical medical-ethical considerations, including respect for do-not-resuscitate orders, support interpreting “irreversibility” to mean permanent cessation of circulation and (...) respiration. Assuming a consciousness-related formulation of human death, I then argue that the loss of circulation and respiration is significant, because it leads to the permanent loss of consciousness and thus to the death of the human person. The DNR request by an organ donor should thus be interpreted to mean “do not restore to consciousness.” Finally, I respond to an objection that if “irreversibility” has a medical-ethical meaning, it would entail the absurd possibility that one of two individuals in the same physical state could be alive and the other dead—an implication that some think is inconsistent with understanding death as an objective biological state of the organism. I argue that advances in medical technology have created phenomena that challenge the assumption that human death can be understood in strictly biological terms. I argue that ethical and ontological considerations about our nature bear on the definition and determination of death and thus on the permissibility of DCD. (shrink)

Each of the 13 articles in this collection wrestles with intricate metaphysical and moral aspects of the widespread belief that a thing’s potential—what it could, would, might, or will be, but isn’t yet—matters for how we should treat that thing. As John Lizza explains in his lucid introduction, the articles are grouped into three parts according to their aims and theoretical constraints. In this review, I briefly summarize and offer some critical discussion of each part.

There's a student in my philosophy class who has "real potential." I might express this thought in any of the following ways: "She is potentially a philosopher"; "She is a potential philosopher"; "She has the potential to be a philosopher." The first way uses a cognate of "potential" as an adverb to modify "is." The second ways uses "potential" as an adjective to modify "philosopher." However, the third way uses "potential" as a noun to refer to something that the student (...) has. What kind of thing is this potential? One worry about even asking this question is that this nominalization of the adjective "potential" suggests a metaphysical picture that is an artifact of language. This is even more strongly suggested by the less ambiguous nominalization "potentiality." Once we have the term "potentiality," we have a new kind of entity to countenance, and questions about its nature arise. One might argue, just because we use the word "potentiality," we should not think that it refers to a "thing" that someone can "have." There is something disingenuous about such an argument. It proceeds as if the adverbial and adjectival uses of "potential" are unproblematic, and questions only arise with the nominalization. But it is not obvious what it means to potentially be something, or what it means to be a potential something. To say that someone "is potentially" a philosopher is to talk about a way of being that falls short of actuality. And a "potential philosopher" is not a kind of philosopher at all. So what is it? Each of the three above formulations is a modal claim. If there is anything philosophical puzzling about a potentiality claim, it is not going to go away by translating it into an equivalent modal claim. In this chapter I defend the existence of potentialities against anti-realist arguments, and make a proposal as to their nature. The proposal, in short, is that potentialities are properties, specifically dispositions, though more needs to be said about properties and dispositions. I will do this in Part I. In Part II, I will address two lines of argument against potentialities: that they are reducible, and that they are causally inert. (shrink)