There are increasing calls for rejecting the ‘dead donor’ rule and permitting ‘organ donation euthanasia’ in organ transplantation. I argue that the fundamental problem with this proposal is that it would bestow more worth on the organs than the donor who has them. What is at stake is the basis of human equality, which, I argue, should be based on an ineliminable dignity that each of us has in virtue of having a rational nature. To allow mortal harvesting would be (...) to make our worth contingent upon variable quality of life of judgments that can only be based on properties that come in degrees. Thus, rejecting the ‘dead donor’ rule comes at the expense of our egalitarian principles with respect to the value each individual human life has in relation to the protections against killing. (shrink)

Although much has been written on the dead-donor rule in the last twenty-five years, scant attention has been paid to how it should be formulated, what its rationale is, and why it was accepted. The DDR can be formulated in terms of either a Don’t Kill rule or a Death Requirement, the former being historically rooted in absolutist ethics and the latter in a prudential policy aimed at securing trust in the transplant enterprise. I contend that the moral core of (...) the rule is the Don’t Kill rule, not the Death Requirement. This, I show, is how the DDR was understood by the transplanters of the 1960s, who sought to conform their practices to their ethics—unlike today’s critics of the DDR, who rethink their ethics in a question-begging fashion to accommodate their practices. A better discussion of the ethics of killing is needed to move the debate forward. (shrink)

Having encountered landmines in offering a critique of philosophy based on my experience as the mother of a cognitively disabled daughter, I ask, “Should I continue?” I defend the idea that pursuing this project is of a piece with the invisible care labor that is done by people with disabilities and their families. The value of attempting to influence philosophical conceptions of cognitive disability by virtue of this experience is justified by an inextricable relationship between the personal, the political, and (...) the philosophical. If one grants that the “special relationship” between mother and child requires moral recognition, then I need first to make vivid the case that this relationship in the case of a child who lacks some “normal capacities” is indistinguishable from any mother‐child relationship. If this is so, then I believe I can make a case that has as its conclusion that the moral personhood of even the severely cognitively disabled must be granted. Moreover, such recognition, I argue, necessitates the recognition of others who bear no special relationships to the child. (shrink)

Personhood is a foundational concept in ethics, yet defining criteria have been elusive. In this article we summarize attempts to define personhood in psychological and neurological terms and conclude that none manage to be both specific and non-arbitrary. We propose that this is because the concept does not correspond to any real category of objects in the world. Rather, it is the product of an evolved brain system that develops innately and projects itself automatically and irrepressibly onto the world whenever (...) triggered by stimulus features such as a human-like face, body, or contingent patterns of behavior. We review the evidence for the existence of an autonomous person network in the brain and discuss its implications for the field of ethics and for the implicit morality of everyday behavior. (shrink)

Un fait Mooréen, selon l'expression de David Lewis, est « l'une des choses que nous savons mieux que toute prémisse d'une argumentation philosophique visant à é tablir le contraire. » Le sujet des faits Mooréens soulève des questions profondes, à la fois de méthode philosophique et d'épistémologie de premier ordre. Comment devrions-nous répondre aux arguments qui remettent en question des croyances dont nous sommes extrêmement confiants ? Dans quelle mesure ces arguments – ou plutôt ceux qui les avancent – peuvent-ils (...) espérer avoir une emprise ou une traction rationnelle sur nous ? Dans quelle mesure, si même c'est le cas, notre point de départ limite-t-il les types de révisions de nos croyances que la philosophie pourrait légitimement inspirer ? Quand sommes-nous justifiés (si jamais nous le sommes) à refuser de se laisser influencer par un argument qui, pour autant qu'on puisse en juger, est sans faille, et quand un tel refus relève-t-il simplement du dogmatisme ? Ce sont là de vastes questions, auxquelles je ne tenterai pas ici de répondre complétement. Mon ambition, plus modeste, est de tenter de progresser sur ces questions, et d'autres questions connexes, en examinant la notion de fait Mooré que je trouve chez Lewis et chez d'autres. (shrink)

The mainstream concept of death—the biological one—identifies death with the cessation of an organism. In this article, I challenge the mainstream position, showing that there is no single well-established concept of an organism and no universal concept of death in biological terms. Moreover, some of the biological views on death, if applied in the context of bedside decisions, might imply unacceptable consequences. I argue the moral concept of death—one similar to that of Robert Veatch—overcomes such difficulties. The moral view identifies (...) death with the irreversible cessation of a patient’s moral status, that is, a state when she can no longer be harmed or wronged. The death of a patient takes place when she is no longer capable of regaining her consciousness. In this regard, the proposal elaborated herein resembles that of Veatch yet differs from Veatch’s original project since it is universal. In essence, it is applicable in the case of other living beings such as animals and plants, provided that they have some moral status. (shrink)

This article examines an Australian campaign to increase organ and tissue donation for transplantation. It analyses the use of the gift rhetoric to promote community awareness and resources, target migrant groups, and recruit cultural and religious leaders to endorse organ and tissue donation as an altruistic act. In unpacking this ‘gift of life’ approach to organ donation, it explores the convergence of medical and religious bodies and pushes beyond uniform determinations of death to reveal how multiple deaths transpire in organ (...) donation. Drawing on recent advances in the anthropology of becoming as a critical lens to examine death and organ donation, it examines how the ‘unfinishedness’ of donor bodies produces new possibilities for understanding donation. This article thus attends to the situated, layered and contradictory sensibilities that open up multiple and malleable understandings of the donation of body parts. (shrink)

This paper criticizes Jerome Wakefield’s harmful dysfunction analysis of disorder by arguing that the conceptual linkage it establishes between the medical concepts of health and disorder and the prudential notions of well-being and harm makes the account inapplicable to nonsentient organisms, such as plants, fungi, and many invertebrate animals. Drawing on a previous formulation of this criticism by Christopher Boorse, and noting that Wakefield could avoid it if he adopted a partly biofunction-based account of interests like that often advocated in (...) the field of environmental ethics, I argue that integrating such an account of interests into the HDA would generate serious concerns. Specifically, it would make dysfunction sufficient for disorder and so reestablish between dysfunction and disorder precisely the kind of sufficiency relation that harm-requiring accounts of disorder strive to avoid; blur the line between the HDA’s dysfunction and harm components and, in so doing, deprive the HDA of its alleged main advantage over monistic dysfunction-based accounts of disorders like Boorse’s; and tie the HDA to an understanding of harm that is in itself problematic. I argue that these three concerns, and the dilemmas they generate, rob the HDA of much of its prima facie appeal, ultimately indicating that a satisfactory account of disorder should most likely eschew all references to prudential notions of well-being and harm. (shrink)

Innovation processes are extremely complex and opaque, which makes it tough or even impossible to govern them. Innovators lack control of large parts of these developments and lack of foreknowledge about the possible consequences of emerging technologies. Because of these features some scholars have argued that innovation processes should be structurally reformed and the agent-centered model of responsibility for innovation should be dismissed altogether. In the present article it will be argued that such a structural idea of responsible research and (...) innovation presumes rational agents who can be motivated by reasons. Instead of dismissing the agent-centered approach to responsibility for innovation processes a virtue ethical approach will be developed. Virtues should be considered as the intellectual and moral dispositions presumed for good decision making. It will be shown that creativity and eagerness are creditable character traits that have a distinct positive value for managing the opaqueness of innovation processes. Such traits are mandatory for change and betterment. Furthermore, it will be argued that the notion of responsibility of innovators should not be understood merely as means for constraining them but also as a tool to perpetuate their integrity and happiness. Through discussing the captivating examples of Steve Jobs and the protagonist of Mary Shelley’s Frankenstein it will be shown how to apply this virtue ethical framework for innovators in practice. (shrink)

Mind perception is the essence of moral judgment. Broadly, moral standing is linked to perceptions of mind, with moral responsibility tied to perceived agency, and moral rights tied to perceived experience. More specifically, moral judgments are based on a fundamental template of two perceived minds—an intentional agent and a suffering patient. This dyadic template grows out of the universal power of harm, and serves as a cognitive working model through which even atypical moral events are understood. Thus, all instances of (...) immorality are perceived to involve both blameworthy agents (i.e., acts) and suffering victims (i.e., consequences). Because moral cognition simultaneously concerns acts and consequences, theories which focus primarily on acts (i.e., deontology) or consequences (i.e., utilitarianism) do not accurately describe moral cognition. Indeed, the phenomenon of dyadic completion suggests that deontological and utilitarian concerns are not only simultaneously active, but also typically compatible and reinforcing: wrong acts have harmful consequences, and harmful consequences stem from wrong acts. The cognitive fusion of acts with consequences suggests that normative conflicts between deontology and utilitarianism are not reflected in everyday moral judgment. This in turn suggests that empirical conclusions drawn from moral dilemmas that pit utilitarianism against deontology—i.e., trolley problems—give an skewed account of moral cognition. (shrink)

According to the mainstream position in the bioethical definition of death debate, death is to be equated with the cessation of an organism. Given such a perspective, some bioethicists uphold the position that brain-dead patients are dead, while others claim that they are alive. Regardless of the specific opinion on the status of brain-dead patients, the mere bioethical concept of death, according to many bioethicists, has the merit of being unanimous and univocal, as well as grounded in biology. In the (...) present article, we challenge such a thesis. We provide evidence that theoretical biology operates with a plurality of equally valid organismic concepts, which imply different conclusions regarding the organismal status of a brain-dead patient. Moreover, the theoretical biology concepts of an organism are very distant from the view on an organism that appears by way of bioethicists theorizing on death. We conclude that if death is to be understood as the cessation of an organism, there is no single correct answer to the question of whether a brain-dead patient is alive or dead. (shrink)

En este artículo presento una clasificación de las teorías éticas acerca del aborto provocado. En esa clasificación utilizo dos criterios que, aunque inseparables, se pueden tratar relativamente disociados uno del otro. En primer lugar, presento las teorías ordenadas según el estatuto ontológico y ético que otorgan a los gametos, cigotos, preembriones, embriones, fetos y neonatos, y discuto las teorías basadas en la idea de potencialidad. En segundo lugar, me refiero a las teorías centradas en la libertad de la madre. En (...) las consideraciones finales reconozco explícitamente el partidismo de la teoría de teorías propuesta. (shrink)

Science is a discipline defined by empiricism and reliable methodologies that result in predictable outcomes. Yet, cutting-edge experiments inevitably involve an element of the unknown, an aspect which science fiction exploits for dramatic effect. Furthermore, fictional science is freed from the ethical constraints that regulate real-world experimentation and is therefore often transgressive. Even as films capitalize on unethical practices and cutting-edge scenarios for dramatic and commercial reasons, the origin of the filmmaker and/or place of production may affect a film’s content. (...) A film is also obviously subject to legal constraints, according to the country of origin, and classification codes in its place of exhibition. Thus, while the very nature of science fiction may cause it to appear morally unbridled, there are nonetheless multiple inhibitions entrenched in such depictions. By drawing on relevant cinematic examples, including Prometheus, The Hunger Games and District 9, and scientific scenarios on which these films are based, this essay explores how the unpredictable nature of advances in science, in combination with a lack of ethics, foregrounds the dangerous dimensions of science fiction. (shrink)

The reemergence of the question of suicide in the medical context of physician-assisted suicide seems to me one of the most interesting and fertile facets of late modernity. Aside from the disruption which this issue may cause in the traditional juridical relationship between individuals and the state, it may also help to transform the dominant conception of subjectivity that has been erected upon modernity's medicalized order of death. To enhance this disruptive potential, I am going to examine the perspectives on (...) death offered by two contemporary writers: Zygmunt Bauman and Jean Baudrillard. Each of these writers recognizes the centrality of death to modern culture, as Heidegger did, but they also go beyond him in specifying the ways in which death maintains a presence in late modernity, despite efforts to conceal it. In particular, both of these writers recognize the important role that medicine has played in ordering the modern conception of death. After situating these two perspectives in relation to each other, and in relation to Heidegger, who will serve here as a sort of benchmark, I will return to the issue of suicide. Given the differences in their readings of the role that death and medicine play in modern culture, these post-Heideggerians take strikingly different positions on this issue. By engaging these perspectives, I intend not only to point out the tremendous potential which this issue holds for a fundamental rethinking of modern subjectivity, but also reveal some of the dangers that may beset any naive optimism about the right to die. (shrink)

An increasing shortage of transplant donor organs currently results in an escalating number of preventable human deaths. Xenotransplantation. the use of animal organs for transplantation into humans, is now heralded as medicine's most viable answer to the urgent and insurmountable human organ scarcity. Although claimed to be a biomedical prerogative, xenotransplantation is a cultural phenomenon - a procedure engaging both the physical and symbolic manipulation of human and nonhuman bodies, thereby transforming corporeality, identity, and culture. Biomedical and scientific discourses about (...) xenografts have obscured issues related to nonhuman animals and also could be distressful to human organ recipients, revealing that the xenograft may not be widely embraced. (shrink)

The debate over surgical abortion is certainly one of the most divisive in ethical discourse and for many it seems interminable. However, this paper argues that a primary reason for this is confusion with regard to what issues are actually under dispute. When looking at an entrenched and articulate figure on one side of the debate, Peter Singer, and comparing his views with those of his opponents, one finds that the disputed issue is actually quite a narrow one: the moral (...) status of potential persons. Finding this common ground clears the conceptual space for a fruitful argument: the thesis of which is that most, including Singer, who argue that potential persons do not have full personal moral status fail to make the necessary distinction between natural potential (which confers moral status) and practical potential (which admittedly does not). (shrink)

This essay has two purposes. The first is to argue that our moral duties towards human embryos should be assessed in light of the Golden Rule by asking the normative question, “how would I want to be treated if I were an embryo?” Some reject the proposition “I was an embryo” on the basis that embryos should not be recognized as persons. This essay replies to five common arguments denying the personhood of human embryos: (1) that early human embryos lack (...) ontological individuation; (2) that they are members of the species Homo sapiens but not yet human persons; (3) that the argument for personhood commits the “heap argument” fallacy; (4) that since human procreation in nature is inefficient, human embryos cannot be persons; and (5) the “burning building” scenario proves that all arguments for personhood are irrational or inconsistent. The second purpose is to set forth and criticize in light of the normative judgement defended in part one the present legal situation of cryo-preserved embryos in the U.S. The essay ends by proposing legislative reforms to protect ex utero human embryos. (shrink)

For the sake of consistency with settled principles from other theological and ethical questions, there is a need for a Christian reexamination of in vitro fertilization (IVF). Both Old and New Testaments demonstrate that human personal life begins at conception or fertilization. Additionally, the Bible teaches that human beings are persons in the image of God from the very beginning of their existence. Thus, it can be concluded that the embryos created via IVF are persons in God’s image. Applying this (...) to the destruction and freezing of embryos, several limitations or restrictions present themselves—embryos should not be purposefully destroyed or wasted, all embryos ought to be implanted, and embryos should not be frozen. Ultimately, however, due to the immense quantity of embryo wastage, it is concluded that Christians should avoid this form of assisted reproductive technology and consider it a pro-life issue. (shrink)

Much of the debate over the definition and criteria for determining our death has focused on disagreement over the correct biological account of death, i.e., what it means for any organism to die. In this paper, we argue that this exclusive focus on the biology of death is misguided, because it ignores ethical and social factors that bear on the acceptability of criteria for determining our death. We propose that attention shift from strictly biological considerations to ethical and social considerations (...) that bear on the determination of what we call “civil death.” We argue for acceptance of a neurological criterion for determining death on grounds that it is the most reasonable way to synthesize biological, ethical, and social considerations about our death.. (shrink)

The concept of rational suicide argues that suicide could be a rational choice, in certain circumstances. Such an argument faces criticism when there is an accompanying mental illness, as many view suicide as a symptom of mental illness rather than as a rational choice about one's life. More specifically, the rational suicide debate has mostly excluded individuals with schizophrenia, as it is widely seen as a disorder that impairs rational decision making. This paper aims to examine the concept of rational (...) suicide in schizophrenia: Could it be possible that some acts of suicide are driven from a rational choice by patients suffering from schizophrenia? This paper does not include discussions related to physician-assisted dying in schizophrenia. (shrink)

“ >. Das hiess doch: Wenn du dir gewisse Tatsachen anders denkst,sie anders beschreibst, als sie sind, dann kannst du die Anwendung gewisser Begriffe dir nicht mehr vorstellen, weil die Regeln ihrer Anwendung kein Analogon unter den neuen Umständen haben.”.

In recent time the critique of the whole brain death as the criterion of human death, that was introduced in 1968, has been growing. The paper aims to show in systematically that there are good reasons based on empirical findings combined with Thomistic Christian anthropology to accept the traditional cardiopulmonary criterion as the criterion of human death. This will be shown through a systematic critique of other criteria of death: whole brain death, higher brain death, brain stem death, and controlled (...) cardiac/circulatory death. The traditional cardiopulmonary criterion of death provides the opportunity to maintain the dead donor rule for organ transplantation. This also affirms the respect for human life required by the ethics of the sanctity of human life. The paper further provides a justification of dead donor rule. The paper proposes 35 minutes period after cardiac arrest to declare the patient dead, since at that time there is no possibility to autoresuscitate the heart. (shrink)

Singer claims that there are two ways of challenging the fact that brain-dead patients, from whom organs are usually retrieved, are in fact biologically alive. By means of the first, the so called dead donor rule may be abandoned, opening the way to lethal organ donation. In the second, it might be posited that terms such as “life” and “death” do not have any primary biological meaning and are applicable to persons instead of organisms. This second possibility permits one to (...) acknowledge that brain-dead patients are deceased because they are irreversibly unconscious. In the commentary which follows, I will argue that Singer’s second option is preferable since it provides a higher amount of organs available for transplant, and is better suited to the meaning of “death” which occurs in ordinary language. I will also defend such a concept of death against the objections raised by Michael Nair-Collins in the article Can the brain-dead be harmed or wronged? On the moral status of brain death and its implications for organ transplantation. (shrink)

Peter Singer’s recent appointment to Princeton University created considerable controversy, most of it focused on his proposal for active euthanasia of disabled infants. Singer articulates utilitarian ideas that often appear in public discussions of euthanasia. Drawing on Pope John Paul II’s work on ethics and suffering, I argue that Singer’s utilitarian theory of value is impoverished. After introducing the Pope’s ethic based on the imago dei, I discuss love as self-gift. I show how this concept supports a theory of value (...) in which spiritual goods are preeminent over material goods. I then describe how suffering reveals spiritual goods, discussing how participation in Christ’s suffering can alter our perception of value. I also consider how communal responses to suffering provide opportunities for self-giving. Third, I consider Singer’s proposal for killing infants with hemophilia, arguing that it arbitrarily ignores spiritual goods. I then discuss proposals to kill anencephalic infants, discussing how parental response to their suffering can demonstrate an extraordinary love in seemingly hopeless circumstances. I conclude by calling for a more sustained social response to euthanasia initiatives. (shrink)

In the UK and elsewhere suicide presents a major cause of death. In 2008 in the UK the topic of suicide rarely left the news. Controversy surrounding Daniel James and Debbie Purdy ensured that the problem of assisted suicide received frequent media discussion. This was fuelled also by reports of a higher than usual number of suicides by young people in South Wales. Attention attracted by cases such as that of Daniel James and Debbie Purdy can lead to a neglect (...) of the problem of how to respond to the vast majority of suicides, in which there is no obvious accompanying health problem. This paper seeks to redress that balance to some degree. Its focus is primarily on the provision of assisted suicide when the person seeking such assistance has no accompanying health problem. It is argued that a network of suicide centres (SCs) should be established, the purpose which in certain circumstances, will extend to assisting suicide in cases where a competent person has a definite, sustained intention to end their own life. Arguments in support of this proposal are provided, focusing on respect for autonomy, relief of suffering and respect for the ‘life-plan’ of a person. Considerations relating to reduction of harms to third parties are also recruited. Eight responses to the proposal are considered. But none is found compelling, nor are they found jointly compelling. (shrink)

This essay is a reply to Martha Nussbaum's “Capabilities and Disabilities.” It endorses Nussbaum's critique of the social‐contract tradition and proposes that it might be productively contrasted with Michael Walzer's critique of John Rawls in Spheres of Justice. It notes that Nussbaum's emphasis on surrogacy and guardianship with regard to people with severe and profound cognitive disabilities poses a challenge to disability studies, insofar as the field tends to emphasize the self‐representation of people with disabilities and to concentrate primarily on (...) the aesthetic and political representation of physical disability. The essay concludes with an account of a recent exchange with Peter Singer on the question of our social expectations of people with Down syndrome. (shrink)

We discuss the meaning of “being alive” and “being dead.” Our primary aim is to pave the way for a sound and accurate ethical debate concerning these two concepts. In particular, we analyze a metabolic approach and a genetic one and discuss the reasons for their failure to constitute a good starting point for successive debates. We argue that any ethical or social discussion of topics involving life and death must introduce cultural constructs such as, on the one hand, the (...) concept of clinical death and, on the other hand, the concept of existence. We argue that these two cultural constructs, although consistent with biomedical knowledge, cannot be ontologically grounded in it. To conclude, we apply our findings to the case of human embryos. (shrink)

Animal advocates cannot allow the idea to take hold that only the great apes and certain other “higher” animals are fit to be “persons.” Working to change the moral status of the great apes or sea mammals; for example; is a legitimate and important undertaking; but it should not be done at the expense of other animals. Such thinking is not only disconnected from real animals in the real world; it perpetuates the view that beings belonging to species deemed “nonpersons” (...) or “merely conscious” are of lesser; or no; moral significance until or unless; through an institutionalized system of painful; stressful; and demeaning experiments over decades or centuries; some of them might “prove” themselves worthy of being called persons or semi-persons or sort-of-persons entitled to whatever privileges such designations may confer. (shrink)

Liberal articulations of the right to die generally focus on balancing individual rights against state interests, but this approach does not take full advantage of the disruptive potential of this contested right. This article develops an alternative to the liberal approach to the right to die by engaging the seemingly discordant philosophical perspectives of Michel Foucault and Thomas Hobbes. Despite Foucault’s objections, a rapprochement between these perspectives is established by focusing on their shared emphasis on the role that death plays (...) in the order of modernity. After the article has established the complementarity of Foucault and Hobbes, Hobbes’ unique stance toward suicide is first viewed in the context of the early-modern hostility toward suicide, and then contrasted with Foucault’s Stoic-inspired affirmation of suicide. This comparison of these two philosophers’ positions on suicide opens to contestation dimensions of modern subjects that remain undisturbed by liberal approaches to the right to die Key Words: bio-power • Michel Foucault • governmentality • Thomas Hobbes • liberalism • right to die • self-preservation • Seneca • Stoicism • suicide. (shrink)

ZusammenfassungDer vorliegende Artikel plädiert dafür, die meist auf die Aspekte Todesdefinition, -kriterium und -feststellung fokussierte Diskussion über die moralische (Un-)Zulässigkeit der Spende und Transplantation vitaler Organe aufzubrechen und beim Nachdenken darüber das zum Ausgangspunkt der Überlegungen zu machen, was mit dem Tod eigentlich verloren geht, nämlich das Leben. Nach einer Antwort auf die Frage „Was ist Leben?“ suchend wird hierbei aufgezeigt, dass Leben nicht auf das Vorhandensein gewisser beobachtbarer physiologischer Größen reduzierbar ist, sondern in seinem wesentlichen Kern nur mit den (...) Mitteln der Philosophie als der actus primus alles Lebendigen und das, was wir gemeinhin Seele nennen, erklärt werden kann. Auf Basis der so gewonnenen Erkenntnisse wird geschlussfolgert, dass die Entnahme vitalen organischen Materials aus einer Person, deren Gehirnaktivitäten ausgefallen sind, immer prämortal erfolgt und damit einen Verstoß gegen die Tote-Spender-Regel bedeutet. (shrink)

In his paper “The challenge of brain death for the sanctity of life ethic”, Peter Singer advocates two options for dealing with death criteria in a way that is compatible with efficient organ transplantation policy. He suggests that we should either redefine death as cortical death or go back to the old cardiopulmonary criterion and scrap the Dead Donor Rule. We welcome Singer’s line of argument but raise some concerns about the practicability of the two alternatives advocated by him. We (...) propose adding a third alternative that also – as the two previous alternatives – preserves and extends the possibility of organ transplantation without using anyone without their consent. Namely, we would like to draw readers’ attention to a proposal by Robert Veatch, formulated 42 years ago in his 1976 book “Death, dying, and the biological revolution” and developed further in his later publications. Veatch argues for a conscience clause for the definition of death that would permit people to pick from a reasonable range of definitional options. This autonomy-based option, we believe, is more likely to be practicable than the two options advocated by Singer. Furthermore, we present data from a study with Lithuanian participants that suggest that there is quite pronounced variation of preferences concerning death determination. (shrink)

Physicians have long aided their patients in dying in an effort to ease human suffering. It is only in the nineteenth and twentieth centuries that the prolongation of life has taken on new meaning due to the powers now available to physicians, through new drugs and high technology interventions. Whereas earlier physicians and patients could readily acknowledge that nothing further could be done, today that judgment is problematic.Most often, aiding the dying took the form of not doing anything further to (...) prolong life. Morally, this act of restraint was not difficult, because few options could have been considered. However, some physicians, rarely, would help patients die either by hastening death directly or by increasing pain control with the risk of hastening death, the so-called double effect. When directly hastening death, physicians either directly caused the death of the patient through euthansia, or supplied the means to the patient to bring about death with or without encouragement to use these means. The latter is physician-assisted suicide. (shrink)

This paper forms part of the feminist critique of the regulatory consequences of biomedicine’s systematic exclusion of the role of women’s bodies in the development of reprogenetic technologies. I suggest that strategic use of notions of the sacred to decontextualise and delimit disagreement fosters this marginalisation. Here conceptions of the sacred and sacralisation afford a means by which pragmatic consensus over regulation may be achieved, through the deployment of a bricolage of dense images associated with cultural loyalties to solidify support (...) or exclude contradictory elements. Hence an explicit renegotiation of the symbolic order structuring salient debates is necessary to disrupt and enrich the entrenched and exclusionary dominant discourse over reprogenetic regulation. I draw upon previous analyses of strategic rhetoric associated with the regulation of infertility treatment and embryo research in the United Kingdom, the cultural anthropology of biomedicine and feminist ethnographies of reprogenetics to illustrate these claims. (shrink)

In Peter Singer’s article “The Challenge of Brain Death for the Sanctity of Life Ethic”, he articulates that ethics has always played an important role in defining death. He claims that the demand for redefining death spreads rather from new ethical challenges than from a new, scientifically improved understanding of the nature of death. As thorough as his plea for dismissal of the brain-death definition is, he does not avoid the depiction of the complementary relationship between science and ethics. Quite (...) the opposite, he tends to formulate a stronger, philosophically more consistent argument to help science and medical practitioners to define life, death, and the quality of life. In my commentary, I would like to focus on two issues presented in Singer’s study. Firstly, I will critically analyze the relationship between science and ethics. Secondly, I will follow on from Singer’s arguments differentiating between end of life as an organism and end of life as a person. The latter case is necessarily linked with man’s participation in her/his life, setting life goals, and fulfilling her/his idea of good life. Through the consequential definition of the dignity in ethics of social consequences, I will try to support Singer’s idea. (shrink)

In this article we will be arguing in favour of legislating to protect doctors who bring about the deaths of PVS patients, regardless of whether the death is through passive means or active means. We will first discuss the ethical dilemmas doctors and lawmakers faced in the more famous PVS cases arising in the US and UK, before exploring what the law should be regarding such patients, particularly in Australia. We will continue by arguing in favour of allowing euthanasia in (...) the interests of PVS patients, their families, and finally the wider community, before concluding with some suggestions for how these ethical arguments could be transformed into a set of guidelines for medical practice in this area. (shrink)

Der vorliegende Artikel plädiert dafür, die meist auf die Aspekte Todesdefinition, -kriterium und -feststellung fokussierte Diskussion über die moralische (Un-)Zulässigkeit der Spende und Transplantation vitaler Organe aufzubrechen und beim Nachdenken darüber das zum Ausgangspunkt der Überlegungen zu machen, was mit dem Tod eigentlich verloren geht, nämlich das Leben. Nach einer Antwort auf die Frage „Was ist Leben?“ suchend wird hierbei aufgezeigt, dass Leben nicht auf das Vorhandensein gewisser beobachtbarer physiologischer Größen reduzierbar ist, sondern in seinem wesentlichen Kern nur mit den (...) Mitteln der Philosophie als der actus primus alles Lebendigen und das, was wir gemeinhin Seele nennen, erklärt werden kann. Auf Basis der so gewonnenen Erkenntnisse wird geschlussfolgert, dass die Entnahme vitalen organischen Materials aus einer Person, deren Gehirnaktivitäten ausgefallen sind, immer prämortal erfolgt und damit einen Verstoß gegen die Tote-Spender-Regel bedeutet. (shrink)

This essay discusses the use of analogies drawn from the Holocaust in cultural representations and critical scholarship on dementia. The paper starts with a discussion of references to the death camp in cultural narratives about dementia, specifically Annie Ernaux’s account of her mother’s dementia in I Remain in Darkness. It goes on to develop a critique of Italian philosopher Giorgio Agamben’s work on biopolitics and “bare life,” focusing specifically on the linguistic foundations of his thinking. This underpins a consideration of (...) the limitations of his philosophy and ontologically derived notions of weakness and passivity in imagining life with dementia as a potential site of agency or as the locus for transformative ideas about care, community, and non-instrumentalist conceptions of human value. (shrink)

The law of England and Wales provides that an adult with capacity has the right to refuse medical treatment both contemporaneously and in an advance refusal. Legislation separates general advance refusals of treatment from advance refusals of life-sustaining treatment. The law, outlined in ss.24 to 26 of the Mental Capacity Act 2005, is stricter for creation of the latter. These sections brought with them a new age of interests by purporting to elevate individual autonomy as the primary concern. Beginning with (...) the classical tale of Odysseus and a general discussion of the value to be found in a law seeking to preserve individual autonomy, this thesis seeks to act as a critique of the current enactment in practice. The provisions are already under-used and under-applied; without change, they may never reach the stage where they are ethically and practically viable. It is argued that the advance refusals provisions are not taking full effect due to a combination of lacking moral grounding and general dismissal of key ethical dilemmas at the forefront of application. Building on this, the moral basis for this thesis is found in Alan Gewirth’s Principle of Generic Consistency (PGC) which links directly with the general application of human rights. The PGC becomes a compass for determining how best to treat persons when addressing the three most prominent challenges faced by the 2005 Act which are: the debate between the conferred right of autonomy versus the right to life; the issue of personhood; and, the personal identity problem. Ultimately, unless framework provisions are strengthened, and the Mental Capacity Act 2005 is rethought in light of prominent ethical, legal and social considerations, the constraints of the Act on paper will continue to suppress the important underlying values promulgating individual autonomy. (shrink)