Thought experiments that concoct bizarre possible world modalities are standard fare in debates on personal identity. Appealing to intuitions raised by such evocations is often taken to settle differences between conflicting theoretical views that, albeit, have practical implications for ethical controversies of personal identity in health care. Employing thought experiments that way is inadequate, I argue, since personhood is intrinsically linked to constraining facts about the actual world. I defend a moderate modal skepticism according to which intuiting across conceptually incongruent (...) worlds constitutes ‘invalid intuitioninferences’—i.e., carrying over intuitions gathered from facts about possible worlds that are at odds with facts about the actual world, for the purpose of making claims about real-life persons and their identity, leads to conceptual incongruences. Such a methodological fallout precludes accurate, informative judgments about personal identity in the actual world, calling into question the adequacy of thought experimental considerations for potential real world applications in medical ethics. (shrink)

In her important and well-known discussion “On the Moral and Legal Status of Abortion,” Mary Anne Warren regrets that “it is not possible to produce a satisfactory defense of a woman’s right to obtain an abortion without showing that the fetus is not a human being, in the morally relevant sense.” Unlike some more cautious philosophers, Warren thinks that we can definitively demonstrate that the fetus is not a person. In this paper, Warren’s argument is critically examined with a focus (...) especially on the question of the foundation and the boundaries of the moral community. The fundamental thesis of the paper is that Warren’s approach is flawed for at least four reasons: (1) that being a person is not as obviously central to having full moral rights as Warren assumes, (2) that her exclusivism regarding moral status has dubious moral consequences independent of the abortion issue, (3) that it is not clear that a fetus is not a person, even on Warren’s own criteria, and (4) her criteria for personhood are themselves suspect. (shrink)

When talking about personal identity in the context of medical ethics, ethicists tend to borrow haphazardly from different philosophical notions of personal identity, or to abjure these abstract metaphysical concerns as having nothing to do with practical questions in medical ethics. In fact, however, part of the moral authority for respecting a patient’s self-regarding decisions can only be made sense of if we make certain assumptions that are central to a particular, psychological picture of personal identity, namely, that patients will (...) remain psychologically connected to a certain degree with their future selves. I draw this out, show problems with approaches in medical ethics based on alternate theories of personal identity that do not recognise this, and explore some important implications. Namely, I show how this recognition can better explain the circumstances under which we should respect advance directives and why, and how it can better make sense of patient fears that they will not "survive" personality-altering deep brain stimulation procedures, and provide guidance on approaching patient decisions concerning this type of procedure in a manner that captures and addresses such concerns. (shrink)

Most religious traditions hold that what makes one a person is the possession of a soul and that this gives one moral status. This status in turn gives persons interests and rights that delimit the set of actions that are permitted to be done to them. In this paper, I identify the soul with the capacity for consciousness and mental life and examine the ethical aspects of medical decision-making at the beginning and end of life in cases of patients who (...) either never have had or have lost this capacity. I argue that, although these patients may lack moral status, they nonetheless have moral value as human organisms and forms of Godgiven biological life. In particular, I explore what this value entails about the permissibility of withholding or withdrawing life-sustaining treatment and of harvesting viable organs from patients with no higher-brain function. (shrink)

What justifies our holding a person morally responsible for some past action? Why am I justified in having a special prudential concern for some future persons and not others? Why do many of us think that maximizing the good within a single life is perfectly acceptable, but maximizing the good across lives is wrong? In these and other normative questions, it looks like any answer we come up with will have to make an essential reference to personal identity. So, for (...) instance, it seems we are justified in holding X responsible for some past action only if X is identical to the person who performed that action. Further, it seems I am justified in my special concern for some future person only if he will be me. Finally, many of us think that while maximization within a life affects only one person, a metaphysical unity, maximization across lives affects many different, metaphysically distinct, persons, and so the latter is wrong insofar as it ignores this fundamental separateness of persons. (shrink)

Preimplantation genetic diagnosis (PGD) raises serious moral questions concerning the parent-child relationship. Good parents accept their children unconditionally: they do not reject/attack them because they do not have the features they want. There is nothing wrong with treating a child as someone who can help promote some other worthwhile end, providing the child is also respected as an end in him or herself. However, if the child's presence is not valued in itself, regardless of any further benefits it brings, the (...) child is not being treated as an end in the full sense of the term. In this paper, I argue that these principles apply to human embryos, as well as to born human offspring: the human moral subject is a bodily being, whose interests and rights begin with the onset of his or her bodily life. The rights of the living, bodily human individual include a right not to be attacked/abandoned because of his or her genetic profile. PGD is harmful to the parent-child relationship, and we give mixed messages to parents by expecting them to show unconditional commitment to offspring after birth, while inviting them to take a very different approach at the prenatal stage. (shrink)

It is often argued that certain metaphysical complications surrounding the phenomenon of monozygotic twinning force us to conclude that, prior to the point at which twinning is no longer possible, the zygote or early embryo cannot be considered an individual human organism. In this essay, I argue, on the contrary, that there are in fact several ways of making sense of monozygotic twinning that uphold the humanity of the original zygote, but also that there is no easy answer to what (...) happens when the human zygote twins. All of the options available carry with them one or more surprising, alarming, or otherwise counterintuitive implications. All things considered, I conclude that the “budding option,” according to which the original human organism present before twinning carries on as one of the resulting embryos but not the other, is the most plausible explanation of what happens when a human zygote twins. (shrink)

This paper presents an account of how human spontaneous embryonic chimeras are formed. On the prevalent view in the philosophical literature, it is said that chimeras are the product of two embryos that fuse to form a new third embryo. We call this version of fusion synthesis. In contrast to synthesis, we present an alternative mechanism for chimera formation called incorporation, wherein one embryo incorporates the cells of a second embryo into its body. We argue that the incorporation thesis explains (...) other types of chimera formation, which are better understood, and is more consistent than synthesis with what is known about embryological development. Incorporation also has different implications than synthesis and so avoids the philosophical puzzles that are often said to accompany embryonic chimera formation—puzzles which pose problems to the human embryo’s persistence from fertilization to the fetal stage of human development. (shrink)

Many people believe that human beings begin to exist with the emergence of the 1-cell zygote at fertilization. I present a novel argument against this belief, one based on recently discovered facts about human embryo development. I first argue that a human zygote is developmentally plastic: A zygote that naturally develops into a singleton (i.e., develops into exactly one infant/adult without twinning) might have naturally developed into a numerically different singleton. From this, I derive the conclusion that a human infant (...) or adult is numerically distinct from the zygote she came from and so did not begin to exist at fertilization. This implies that a zygote does not have a “future like ours” and strongly suggests that it is not a human being. (shrink)

This article responds to Giubilini and Minerva’s article ‘After birth abortion: why should the baby live?’ published in the Journal of Medical Ethics. They argue for the permissibility of ‘after-birth abortion’, based on two conjoined considerations: (1) the fetus or newborn, though a ‘potential person’, is not an actual person, because it is not mature enough to appreciate its own interests, and (2) because we allow parents to terminate the life of a fetus when it is diagnosed with a deformity (...) or fatal illness because of the burden it will place on the child, parent, family or society we should also allow parents to do the same to their newborn, since it is no more a person than the fetus. The author critiques this case by pointing out (a) the metaphysical ambiguity of potential personhood and (b) why the appeal to burdens is irrelevant or unnecessary. (shrink)

Recent scientific advances have indicated that it may be technically feasible to sustain human embryos in vitro beyond 14 days. Research beyond this stage is currently restricted by a guideline known as the 14-day rule. Since the advances in embryo culturing there have been calls to extend the current limit. Much of the current debate concerning an extension has regarded the 14-day rule as a political compromise and has, therefore, focused on policy concerns rather than assessing the philosophical foundations of (...) the limit. While there are relevant political considerations, I maintain that the success of extension arguments will ultimately depend on the strength of the justifications supporting the current 14-day limit. I argue that the strongest and most prevalent justifications for the 14-day rule—an appeal to individuation and neural development—do not provide adequate support for the limit of 14 days. I instead suggest that an alternative justification based on sentience would constitute a more defensible basis for embryo protection and that a consideration of such grounds appears to support an amendment to the current limit, rather than the retention of it. While these conclusions do not establish conclusively that the current limit should be extended; they do suggest that an extension may be warranted and permissible. As such, this paper offers grounds on which a reassessment of the 14-day rule may be justified. (shrink)

Some philosophers argue that, because it is subject to twinning and fusion, the early human embryo cannot hold strong moral standing. Supposedly, the fact that an early human embryo can twin or fuse with another embryo entails that it is not a distinct individual, thus precluding it from holding any level of moral standing. I argue that appeals to twinning and fusion fail to show that the early human embryo is not a distinct individual and that these appeals do not (...) provide us with plausible reasons for denying the strong moral standing of the early human embryo. I recognize one possible exception to this general assessment, a particular version of the appeal to fusion. Embryo fusion that results in tetragametic chimerism provides some reason for doubting the early human embryo's moral standing. But twinning and fusion are otherwise irrelevant in this context. (shrink)

ABSTRACT Massimo Reichlin, in an earlier article in this journal, defended a version of the ‘argument from potential’ (AFP), which concludes that the human embryo should be protected from the moment of conception. But R. Alta Charo, in her essay entitled ‘Every Cell is Sacred: Logical Consequences of the Argument from Potential in the Age of Cloning’, claims that versions of the AFP like Reichlin’s are vulnerable to a rather embarrassing problem: with the advent of human cloning, such versions of (...) the AFP entail that every somatic cell in the human body ought to be protected. Since this entailment is clearly absurd, Charo argues, these versions of the AFP should be rejected. I argue that the reasons Charo cites for believing in this entailment are inconclusive. For example, the four reasons she gives for doubting any differences between the nature of skin cells and zygotes are ultimately unconvincing. Against Charo, I maintain that there is a relevant distinction between the sort of potential possessed by the somatic cell and the sort of potential possessed by the early human embryo. Since only the latter sort of potential falls within the scope of the AFP, the alleged absurd entailment Charo invites us to consider is no entailment at all. Hence the AFP cannot be rejected on the grounds Charo advances. Even in an age of cloning, the claim that some cells are ‘sacred’ because of their potential does not entail the claim that every cell is sacred. (shrink)

ZusammenfassungDas Potenzialitätsargument ist das wohl wichtigste Argument der Gegner der verbrauchenden Embryonenforschung und des Schwangerschaftsabbruchs. Weil schon der frühe Embryo eine potenzielle Person sei, so das Argument, besitze er bereits den moralischen Status einer Person. Mit der Möglichkeit, aus differenzierten somatischen Zellen „ethisch unproblematische“ induzierte pluripotente Stammzellen zu gewinnen, schien diese PA-Problematik zumindest für die Forschung umgangen. Indessen zeigen neuere wissenschaftliche Erkenntnisse, dass auch aus pluripotenten Zellen neue Organismen erwachsen können. Der Beitrag argumentiert dafür, dass nach der Logik von PA (...) nicht nur iPS-Zellen, sondern auch die somatischen Zellen, aus denen diese entstehen, als potenzielle Personen mit Würde und Lebensrecht anzusehen wären. Aufgrund dieser Implikationen ist PA auch nicht als Argument für ein Lebensrecht von Embryonen geeignet. (shrink)

How many individuals are present where we see a pregnant individual? Within a substance ontological framework, there are exactly two possible answers to this question. The standard answer—two individuals—is typically championed by scholars endorsing the predominant Containment View of pregnancy, according to which the foetus resides in the gestating organism like in a container. The alternative answer—one individual—has recently found support in the Parthood View, according to which the foetus is a part of the gestating organism. Here I propose a (...) third answer: a pregnant individual is neither two individuals nor one individual but something in between one and two. This is because organisms are better understood as processes than as substances. With a special focus on the Parthood View, I explain why a Process View of pregnancy, according to which a pregnant individual is a bifurcating hypercomplex process, surpasses the substance ontological approaches. (shrink)

Das Potenzialitätsargument (PA) ist das wohl wichtigste Argument der Gegner der verbrauchenden Embryonenforschung und des Schwangerschaftsabbruchs. Weil schon der frühe Embryo eine potenzielle Person sei, so das Argument, besitze er bereits den moralischen Status einer Person. Mit der Möglichkeit, aus differenzierten somatischen Zellen „ethisch unproblematische“ induzierte pluripotente Stammzellen (iPS-Zellen) zu gewinnen, schien diese PA-Problematik zumindest für die Forschung umgangen. Indessen zeigen neuere wissenschaftliche Erkenntnisse, dass auch aus pluripotenten Zellen neue Organismen erwachsen können. Der Beitrag argumentiert dafür, dass nach der Logik (...) von PA nicht nur iPS-Zellen, sondern auch die somatischen Zellen, aus denen diese entstehen, als potenzielle Personen mit Würde und Lebensrecht anzusehen wären. Aufgrund dieser Implikationen ist PA auch nicht als Argument für ein Lebensrecht von Embryonen geeignet. (shrink)