This essay deals with the question of the morality of abortion and infanticide. The fundamental ethical objection traditionally advanced against these practices rests on the contention that human fetuses and infants have a right to life, and it is this claim that is the primary focus of attention here. Consequently, the basic question to be discussed is what properties a thing must possess in order to have a serious right to life. The approach involves defending, then, a basic principle specifying (...) a condition living things must satisfy to have a serious right to life, and the answer given makes it unlikely that this condition is satisfied by human fetuses and infants, though this tentative conclusion could be altered by future scientific studies of the development of the human brain. As things stand at the moment, however, it seems unlikely that developing humans acquire the physical basis of the psychological capacities on which the right to continued existence rests, and therefore unless there are other substantial objections to abortion and infanticide that undercut the above line of thought, the conclusion is that such practices are not intrinsically wrong. (shrink)

The dominant conception of brain death as the death of the whole brain constitutes an unstable compromise between the view that a person ceases to exist when she irreversibly loses the capacity for consciousness and the view that a human organism dies only when it ceases to function in an integrated way. I argue that no single criterion of death captures the importance we attribute both to the loss of the capacity for consciousness and to the loss of functioning of (...) the organism as a whole. This is because the person or self is one thing and the human organism is another. We require a separate account of death for each. Only if we systematically distinguish between persons and human organisms will we be able to provide plausible accounts both of the conditions of our ceasing to exist and of when it is that we begin to exist. This paper, in short, argues for a form of mind-body dualism and draws out some of its implications for various practical moral problems. (shrink)

Challenging, with several powerful arguments, some of our deepest beliefs about rationality, morality, and personal identity, Parfit claims that we have a false view about our own nature. It is often rational to act against our own best interersts, he argues, and most of us have moral views that are self-defeating. We often act wrongly, although we know there will be no one with serious grounds for complaint, and when we consider future generations it is very hard to avoid conclusions (...) that most of us will find very disturbing. (shrink)

Few subjects have generated so many newspaper headlines and such heated controversy as the treatment, or non-treatment, of handicapped newborns. In 1982, the case of Baby Doe, a child born with Down's syndrome, stirred up a national debate in the United States, while in Britain a year earlier, Dr. Leonard Arthur stood trial for his decision to allow a baby with Down's syndrome to die. Government intervention and these recent legal battles accentuate the need for a reassessment of the complex (...) issues involved. This volume--by two authorities on medical ethics--presents a philosophical analysis of the subject based on particular case studies. Addressing the doctrine of the absolute sanctity of life, Singer and Kuhse examine some actual cases where decisions have been reached; consider the criteria for making these decisions; investigate the differences between killing and letting die; compare Western attitudes and practices with those of other cultures; and conclude by proposing a decision-making framework that offers a rational alternative to the polemics and confusion generated by this highly controversial topic. (shrink)

The Diachronic Self fills out and clarifies the account of personal identity presented by Derek Parfit in Reasons and Persons. I go on to draw metaphysical and normative consequences of this psychological reductionist theory. Some of the normative inferences disagree with those of Parfit. I examine several candidates for a necessary causal condition for personal identity or continuity and argue that we should accept one of the most liberal conditions, allowing personal identity to persist even if its cause is abnormal (...) and unreliable. After establishing a causal condition for identity I apply psychological reductionism to critically analyze current conditions of and criteria for the death of persons. I argue that cardiac and consciousness based conceptions are incorrect. In their place I offer an information-based conception. I then go on to examine the relative importance of various psychological connections, including memories, intentions, dispositions, beliefs, desires, values, and projects. It turns out that the significance of passive elements of the self, especially memories, has often been overrated in discussions of identity. Drawing on my metaphysical results, I draw a number of normative conclusions. I differ from Parfit in holding that reductionism does not make life less "deep" nor death less significant. I also argue that Parfit puts too much emphasis on connectedness rather than continuity when assessing the rational apportionment of future-concern. I look at the roles of an ideal self-conception, life plans, and principles in generating and sustaining concern for one's farther future self-stages. The final chapter analyses how we assimilate changes in our selves, especially physical changes resulting from technology. I distinguish augmentative from deteriorative changes, and draw normative inferences about whether rationally we should replace ourselves with a better self, if that were possible. I develop an account of assimilation in terms of functional integration, then go on to distinguish enhancement from supplementation, noting the importance of this for normative concerns. Finally, I determine the role of bodily form and function in a psychological reductionist account of personal identity. (shrink)

INTRODUCTION The Questions of Medical Ethics Call him Andrew. His face is gaunt and unshaven but peaceful. His eyelids are gently closed. ...

In this ground-breaking book, a renowned bioethicist argues that the political left must radically revise its outdated view of human nature. He shows how the insights of modern evolutionary theory, particularly on the evolution of cooperation, can help the left attain its social and political goals. Singer explains why the left originally rejected Darwinian thought and why these reasons are no longer viable. He discusses how twentieth-century thinking has transformed our understanding of Darwinian evolution, showing that it is compatible with (...) cooperation as well as competition, and that the left can draw on this modern understanding to foster cooperation for socially desirable ends. A Darwinian left, says Singer, would still be on the side of the weak, poor, and oppressed, but it would have a better understanding of what social and economic changes would really work to benefit them. It would also work toward a higher moral status for nonhuman animals and a less anthropocentric view of our dominance over nature. (shrink)

The traditional Western understanding of life and death as a strict dichotomy is challenged by a more descriptively accurate model of life's progressive cessation. Dying can be defined by a bounded zone of residual states of life that fits better with moral intuition and more sensitively guides action toward the dying.

In the summer of 1997, I was asked by a leading Japanese newspaper what I thought was the most important thing that had happened in the twentieth century. I found this to be an unusually thought-provoking question, since so many things of gravity have happened over the last hundred years. The European empires, especially the British and French ones that had so dominated the nineteenth century, came to an end. We witnessed two world wars. We saw the rise and fall (...) of fascism and Nazism. The century witnessed the rise of communism, and its fall (as in the former Soviet bloc) or radical transformation (as in China). We also saw a shift from the economic dominance of the West to a new economic balance much more dominated by Japan and East and Southeast Asia. Even though that region is going through some financial and economic problems right now, this is not going to nullify the shift in the balance of the world economy that has occurred over many decades (in the case of Japan, through nearly the entire century). The past hundred years are not lacking in important events. (shrink)

Despite its familiarity and widespread acceptance, the concept of “brain death” remains incoherent in theory and confused in practice. Moreover, the only purpose served by the concept is to facilitate the procurement of transplantable organs. By abandoning the concept of brain death and adopting different criteria for organ procurement, we may be able to increase both the supply of transplantable organs and clarity in our understanding of death.

Professor Cole is correct in his conclusion that the University of Pittsburgh Medical Center (UPMC) protocol does not violate requirements of "irreversibility" in criteria of death, but wrong about the reasons. "Irreversible" in this context is best understood not as an ontological or epistemic term, but as an ethical one. Understood that way, the patient declared dead under the protocol is "irreversibly" so, even though resuscitation by medical means is still possible. Nonetheless, the protocol revives difficult questions about our concept (...) of death. (shrink)

In this paper I argue that a Naturalist conception of personhood, such as the one defended by Derek Parfit, implies that there are degrees of personhood, i.e., that it makes sense to say one individual has a greater degree of personhood than another. I describe both criteria of general personhood, which distinguish between persons and non-persons, and criteria of particular personhood, which distinguish between one person and another. I examine some of the consequences for ethics, including the rights to life, (...) self-determination, and treatment. There may be circumstances in medicine where we have to judge the value of a patient's life in order to decide what medical treatment, if any, to provide, and although it may be emotionally difficult and politically dangerous, one relevant factor is what degree of personhood that individual has. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Multiple Personality and Moral ResponsibilityStephen E. Braude (bio)AbstractThe philosophical literature on multiple personality has focused primarily on problems about personal identity and psychological explanation. But multiple personality and other dissociative phenomena raise equally important and even more urgent questions about moral responsibility, in particular: In what respect(s) and to what extent should a multiple be held responsible for the actions of his/her alternate personalities? Cases of dreaming help illustrate (...) why attributions of responsibility in cases of dissociation do not turn on putative changes in identity, as some have supposed. Instead, it is argued that traditional criteria of rationality and behavioral control apply also to cases of dissociation. It is noted, however, that one can distinguish different kinds of responsibility in cases of dissociation, and that one is responsible for one’s dreams in a different sense from that in which one is responsible for actions one can control and evaluate. It is also argued that in cases of multiple personality it is important to distinguish control over switching of personalities from an alter’s control over its own behavior. Moreover, the author considers reasons for thinking that amnesia is less relevant to attributions of responsibility than many have supposed.Keywordsdissociation, dreaming, rationality, amnesiaIntroductionThe philosophical literature on MPD/DID 1 has focused primarily on problems about personhood, personal identity, and the nature of psychological explanation. Presumably, that is because multiples appear to be (or to harbor) more than one person or more than one distinct moral or prudential agent. But philosophers have had almost nothing to say about problems of responsibility in these cases—in particular, the question: In what respect(s) and to what extent should a multiple be held responsible for the actions of his/her alternate personalities (or alters)?Unlike questions about personhood and identity, this question is not simply an abstract matter that we may ponder at our leisure. Clinicians treating multiples must decide whether it is appropriate—or even just therapeutically beneficial—to hold their patients (or specific alters) responsible for behaviors which they seem unable to control or remember. Similarly, and with increasing frequency, our courts must decide whether a defendant claiming to be a multiple may be held guilty for the actions of one or more alters. In fact, the legal issues can be quite dramatic, and even bizarre. Consider: What sort of individual is standing trial? An alter or the multiple as a whole? Should courts accept the claim that the subject being questioned on the stand is not the same as the subject who committed the crime? If so, other questions come immediately to mind. For example, would it be appropriate for each alter of a criminal defendant to have separate legal council?Undoubtedly, some will have trouble taking that last question seriously. But no matter how [End Page 37] clear its solution may appear to one’s moral or legal intuitions, those intuitions are seldom as straightforward as they seem. Indeed, one cannot explain or defend them without taking a stand, at least provisionally, on a wide range of thorny philosophical problems. Moreover, the aforementioned questions are merely the tip of the iceberg, and our answers to them have implications extending beyond the courtroom. For example, with regard to forensic contexts Slovenko (1991) asks,Should a search or arrest warrant be issued for each personality? Must a Miranda warning be given to each personality of a suspect with MPD? May the other personalities exclude evidence on the ground that they were not properly read their rights at the time of the arrest? Would each one of the personalities have to waive his or her rights, or would one waiver be sufficient? Does the doctrine of double jeopardy bar the trial of a personality when another has been put to trial? Must each personality testifying at trial be sworn in and administered the oath?(22, 25)These questions have obvious analogues in clinical situations, and also in personal contexts, say, between friends or members of a family, one of whom is a multiple. For example, to what extent should a DID patient be held responsible for the sociopathic (or simply counter-therapeutic) behavior of... (shrink)