We have a reason to use information which is available about such genes in our reproductive decision-making; (3) couples should selec.

Within the latter half of the 30-year history of bioethics there has been an increasing pressure to address bioethical issues globally. Bioethics is not traditionally a theory-based enterprise, rather the focus has been problem related. With the introduction of the global perspective, theory has, however, become more important. One of the best known, probably the best known, theory of bioethics is the one presented by Tom L. Beauchamp and James F. Childress in their PrinciplesofBiomedicalEthics in 1979. This theory is known (...) as the or the approach or It is the attempt to create a global framework for bioethics on the four principlesthat I will scrutinize in this paper. (shrink)

In this article, the place and the nature of an ethical dialogue that develops within Christian healthcare institutions in Flanders, Belgium is examined. More specifically, the question is asked how Christian healthcare institutions should position themselves ethically in a context of a pluralistic society. The profile developed by Caritas Catholica Flanders must take seriously not only the external pluralistic context of our society and the internal pluralistic worldviews by personnel/employees and patients, but also the inherent inspiration of a Christian healthcare (...) institution. This article concludes with ten general orientations that could shape the ethical dialogue from a Christian inspiration in a pluralistic context. (shrink)

First published in 2004. Routledge is an imprint of Taylor & Francis, an informa company.

"Whole brain death" (neurological death) is well-established as a legal standard of death across the country. Recently, New Jersey became the first state to enact a statute recognizing a personal religious exemption (a conscience clause) protecting the rights of those who object to neurological death. The Act also mandates adoption through the regulatory process of uniform and up-to-date clinical criteria for determining neurological death.

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.

: Research by Siminoff and colleagues reveals that many lay people in Ohio classify legally living persons in irreversible coma or persistent vegetative state (PVS) as dead and that additional respondents, although classifying such patients as living, would be willing to procure organs from them. This paper analyzes possible implications of these findings for public policy. A majority would procure organs from those in irreversible coma or in PVS. Two strategies for legitimizing such procurement are suggested. One strategy would be (...) to make exceptions to the dead donor rule permitting procurement from those in PVS or at least those who are in irreversible coma while continuing to classify them as living. Another strategy would be to further amend the definition of death to classify one or both groups as deceased, thus permitting procurement without violation of the dead donor rule. Permitting exceptions to the dead donor rule would require substantial changes in law—such as authorizing procuring surgeons to end the lives of patients by means of organ procurement—and would weaken societal prohibitions on killing. The paper suggests that it would be easier and less controversial to further amend the definition of death to classify those in irreversible coma and PVS as dead. Incorporation of a conscience clause to permit those whose religious or philosophical convictions support whole-brain or cardiac-based death pronouncement would avoid violating their beliefs while causing no more than minimal social problems. The paper questions whether those who would support an exception to the dead donor rule in these cases and those would support a further amendment to the definition of death could reach agreement to adopt a public policy permitting organ procurement of those in irreversible coma or PVS when proper consent is obtained. (shrink)

This review essay examines H. Tristram Engelhardt, Jr.'s The Foundations of Bioethics, a contemporary nonfeminist text in mainstream biomedical ethics. It focuses upon a central concept, Engelhardt's idea of the moral community and argues that the most serious problem in the book is its failure to take account of the political and social structures of moral communities, structures which deeply affect issues in biomedical ethics.

Public bioethics focuses on deliberating about, recommending, or establishing social policies or practices concerning health care and biotechnology. A brace of premises underlies much of the work of public bioethics. First, there is the view that, if one approaches reality and human life as if both were without ultimate significance, one will find that one shares a common public bioethics. That is, if one abstains not only from any religious concerns, but even from philosophical reflections on the circumstance that life (...) might have ultimate meaning, one will be able to articulate a common neutral moral perspective that all persons can share and that can be the basis of a common public bioethics. The second premise is that the controversies in bioethics arise from the presence of religious belief, especially Christian belief, which supports a set of moral commitments that generate controversies that make the framing of public policy difficult. The view is that there is significant disagreement among persons who hold religious positions, particularly Christians, and that in public bioethics we should strive to eliminate these controversies by relying on a neutral moral framework. This paper documents and challenges these premises. It demonstrates that Christian bioethics finds itself already embedded in the field of secular moral controversy before it adds the perspectives it brings. (shrink)

No one really believes that literally all functions of the entire brain must be lost for an individual to be dead. A better definition of death involves a higher brain orientation.

The author of this text argues that the methodological issues in bioethics mirrors the experience of moral pluralism in a secular society. The different methods that have been used in the field reflect the different moral views found in a pluralistic society.

In its October 2001 issue, this journal published a series of articles questioning the Whole-Brain-based definition of death. Much of the concern focused on whether somatic integration - a commonly understood basis for the whole-brain death view - can survive the brain's death. The present article accepts that there are insurmountable problems with whole-brain death views, but challenges the assumption that loss of somatic integration is the proper basis for pronouncing death. It examines three major themes. First, it accepts the (...) claim of the "disaggregators" that some behaviors traditionally associated with death can be unbundled, but argues that other behaviors (including organ procurement) must continue to be associated. Second, it rejects the claims of the "somaticists," that the integration of the body is critical, arguing instead for equating death with the irreversible loss of "embodied consciousness," that is, the loss of integration of bodily and mental function. Third, it defends higher-brain views against the charge that they are necessarily "mentalist," that is, that they equate death with losing some mental function such as consciousness or personhood. It argues, instead, for the integration of bodily and mental function as the critical feature of human life and that its irreversible loss constitutes death. (shrink)

Peter Dabrock argues that western Christian roots have shaped the western European mindset, that of believers and secular thinkers alike, such that (1) western Europeans hold the concept of human dignity as a central moral category and believe that respect for human dignity should frame social and political decisions and respect for human dignity is the foundation of bioethics, (2) Christians and secular thinkers can engage each other on secular terms using the shared language and focus on human dignity, and (...) (3) such engagement using a common moral focus/lens facilitates dialogue and convergence on issues in bioethics. Dabrock's analysis and conclusions raise a number of important points for discussion. This essay examines three elements of his analysis that are particularly important for assessing his overall claim about a common Christian and secular morality in western Europe and for understanding the relationship between such a vision and Christian bioethics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"EVERY MARITAL ACT OUGHT TO BE OPEN TO NEW LIFE'': TOWARD A CLEARER UNDERSTANDING I. INTRODUCTION NE FREQUENTLY encounters misinterpretations of the statement " Every marital act ought to be open to new life " and similar statements in recent Catholic teaching concerning contraception.1 There are two common misinterpretations. One is: No couple may engage in marital intercourse without the intention to procreate. The other is: No couple may (...) engage in marital intercourse at times when they think procreation is impossible. As interpretations of the Church's teaching, these must be mistaken. For the Church teaches that contraception is always wrong and that natural family planning (NFP) is not always wrong. But NFP facilitates intercourse without the intention to procreate at times when procreation is thought to be impossible. Moreover, the Church has never taught that marital intercourse is good only if the couple desires to procreate; indeed, couples known to be sterile have never been forbidden to marry. We think that the only plausible interpretation of "Every marital act ought to be open to new life" is: It is wrong for those who engage in marital intercourse to attempt to impede the transmission of life which they think their act otherwise might bring about. For if they do try to impede that to which their act of itself might lead, they choose to close it to new life. 1 The proposition is formulated somewhat differently by Paul VI, Humanae vitae, 11, AAS 60 (1968), 488 (with references to Gasti connubii and to Pius XII's.Allocution to the Society of Italian Catholic Midwives); and by John Paul II, Familiaris consortia, 29, AAS 74 (1982), 115, following proposition 22 of the 1980 session of the Synod of Bishops. Moreover, the different formulations also are translated diversely. We do not think these differences matter for our present purpose. 365 366 GRISEZ, BOYLE, FINNIS AND MAY Un.derstood in this way, "Every marital act ought to be open to new life" expresses the same proposition as " Contraception is always wrong." Nevertheless, the affirmative formulation helps to clarify what contraception is, for it indicates the precise object of the contraceptive act. "Contraception" signifies only the prevention of conception, but the contraceptive act seeks to impede the beginning of the Zife of a possible person. The distinction is only conceptual, but we think it important, for the explicit reference to new life calls attention to the fact that contraception is a contralife act. The characterization of contraception as a oontralife act is one major element of the unbroken Christian tradition condemning contraception as always wrong. For example, a canon, Si aliquis, concerning contraception was included in the Church's universal law from the thirteenth century until 1917: " I£ anyone for the sake of fulfilling sexual desire or with premediated hatred does something to a man or to a woman, or gives something to drink, so that he cannot generate, or she cannot conceive, or offspring be born, let it be held as homicide." 2 This canon does not say that contraception is homicide ; the tradition made no such mistake. The canon rather says that contraception sihould be regarded as homicide is regarded. To regard contraception as homicide is regarded is not only to make it clear that.contraception is wrong, but also to point to its being contralife as the reason why it is wrong. When contraception is regarded as contralife, it is seen as evil outside marriage as well as within. Historically, contraception probably was more common among the unmarried than the married, and much of the tradition condemned contraception without distinguishing between its uses in and outside mar2 Deoret. Greg. IX, lib. V, tit. 12, cap. v; Oorpus iuris oanonioi, ed. A. L. Richter and A. Friedberg (Leipzig: Tauchnitz, 1881), 2, 794: "Si aliquis causa explendae libidinis vel odii meditatione homini aut mulieri aliquid fecerit, vel ad potandum dederit, ut non possit generare, aut concipere, vel nasci soboles, ut homicida. tenea.tur." Some transla.te "ca.usa explendae libidinis," which is broad enough to cover all motivation by sexual impulse, "to satisfy lust," which unnecessarily limits the motive to habitual vice. " OPEN TO NEW LIFE " 367 riage. But. Casti oonnubii dealt with contraception... (shrink)