Some brain injured patients are left in a permanent vegetative state, i.e., they have irreversibly lost their capacity for consciousness but retained some autonomic physiological functions, such as breathing unaided. Having discussed the controversial nature of the permanent vegetative state as a diagnostic category, we turn to the question of the patients’ ontological status. Are the permanently vegetative alive, dead, or in some other state? We present empirical data from interviews with relatives of patients, and with experts, to support the (...) view that the ontological state of permanently vegetative patients is unclear: such patients are neither straightforwardly alive nor simply dead. Having defended this view from counter-arguments we turn to the practical question as to how these patients ought to be treated. Some relatives and experts believe it is right for patients to be shifted from their currently unclear ontological state to that of being straightforwardly dead, but many are concerned or even horrified by the only legally sanctioned method guaranteed to achieve this, namely withdrawal of clinically assisted nutrition and hydration. A way of addressing this distress would be to allow active euthanasia for these patients. This is highly controversial; but we argue that standard objections to allowing active euthanasia for this particular class of permanently vegetative patients are weakened by these patients’ distinctive ontological status. (shrink)

Many philosophers, psychologists, and medical practitioners believe that killing is no worse than letting die on the basis of James Rachels's Bare-Difference Argument. I show that his argument is unsound. In particular, a premise of the argument is that his examples are as similar as is consistent with one being a case of killing and the other being a case of letting die. However, the subject who lets die has both the ability to kill and the ability to let die (...) while the subject who kills lacks the ability to let die. Modifying the latter example so that the killer has both abilities yields a pair of cases with morally different acts. The hypothesis that killing is worse than letting die is the best explanation of this difference. (shrink)

Kopeikin (forthcoming a, forthcoming b) and Rachels’ (1975) bare-difference cases elicit the intuition that killing is no different than letting die. Hill’s (2018) bare-difference cases elicit the intuition that killing is worse than letting die. At least one of the intuitions must be mistaken. This calls for an error theory. Hill has an error theory for the intuition elicited by the Kopeikin/Rachels’ cases. Kopeikin and Rachels have an error theory for the intuition elicited by Hill’s cases. A natural thought is (...) that we are at an impasse. There is no plausible basis for preferring one error theory to the other. I argue that this natural thought is mistaken. Not all error theories are equal. Preliminary considerations favor Hill’s error theory and disfavor the Kopeikin/Rachels error theory. But preliminary considerations are not decisive. The way forward in the bare-difference debate is not to evaluate intuitions. The intuitions are in. What is left to do now is evaluate the comparative status of the Hill and the Kopeikin/Rachels error theories. (shrink)

The State may require an autopsy when foul play is suspected in the death of one of its citizens.[1] This is so regardless of any objections to such invasive procedures expressed by the deceased before their deaths or afterward by their families. There is not even a religious exemption. The most obvious explanation for why consent is not needed is that apprehending a murderer with information obtained from the autopsy can save lives. However, taking organs without consent from the deceased (...) for transplantation into those suffering vital organ failures can also save lives. But doing so is considered beyond the pale. The question then becomes why are mandatory autopsies permitted but organ conscription prohibited? Our aim is to explore whether such divergent attitudes can be justified. (shrink)