Winner of the 1975 National Book Award, this brilliant and widely acclaimed book is a powerful philosophical challenge to the most widely held political and social positions of our age--liberal, socialist, and conservative.

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

In Enhancing Evolution, leading bioethicist John Harris dismantles objections to genetic engineering, stem-cell research, designer babies, and cloning and makes an ethical case for biotechnology that is both forthright and rigorous. Human enhancement, Harris argues, is a good thing--good morally, good for individuals, good as social policy, and good for a genetic heritage that needs serious improvement. Enhancing Evolution defends biotechnological interventions that could allow us to live longer, healthier, and even happier lives by, for example, providing us with immunity (...) from cancer and HIV/AIDS. Further, Harris champions the possibility of influencing the very course of evolution to give us increased mental and physical powers--from reasoning, concentration, and memory to strength, stamina, and reaction speed. Indeed, he says, it's not only morally defensible to enhance ourselves; in some cases, it's morally obligatory. In a new preface, Harris offers a glimpse at the new science and technology to come, equipping readers with the knowledge to assess the ethics and policy dimensions of future forms of human enhancement. (shrink)

Most people, including philosophers, tend to classify human motives as falling into one of two categories: the egoistic or the altruistic, the self-interested or the moral. According to Susan Wolf, however, much of what motivates us does not comfortably fit into this scheme. Often we act neither for our own sake nor out of duty or an impersonal concern for the world. Rather, we act out of love for objects that we rightly perceive as worthy of love--and it is these (...) actions that give meaning to our lives. Wolf makes a compelling case that, along with happiness and morality, this kind of meaningfulness constitutes a distinctive dimension of a good life. Written in a lively and engaging style, and full of provocative examples, Meaning in Life and Why It Matters is a profound and original reflection on a subject of permanent human concern. (shrink)

We normally take it for granted that other people will live on after we ourselves have died. Even if we do not believe in a personal afterlife in which we survive our own deaths, we assume that there will be a "collective afterlife" in which humanity survives long after we are gone. Samuel Scheffler maintains that this assumption plays a surprising - indeed astonishing - role in our lives.

What makes a person's life meaningful? Thaddeus Metz offers a new answer to an ancient question which has recently returned to the philosophical agenda. He proceeds by examining what, if anything, all the conditions that make a life meaningful have in common. The outcome of this process is a philosophical theory of meaning in life. He starts by evaluating existing theories in terms of the classic triad of the good, the true, and the beautiful. He considers whether meaning in life (...) might be about such principles as fulfilling God's purpose, obtaining reward in an afterlife for having been virtuous, being attracted to what merits attraction, leaving the world a better place, connecting to organic unity, or transcending oneself by connecting to what is extensive. He argues that no extant principle satisfactorily accounts for the three-fold significance of morality, enquiry, and creativity, and that the most promising theory is a fresh one according to which meaning in life is a matter of intelligence contoured toward fundamental conditions of human existence. (shrink)

Most people, including philosophers, tend to classify human motives as falling into one of two categories: the egoistic or the altruistic, the self-interested or the moral. According to Susan Wolf, however, much of what motivates us does not comfortably fit into this scheme. Often we act neither for our own sake nor out of duty or an impersonal concern for the world. Rather, we act out of love for objects that we rightly perceive as worthy of love--and it is these (...) actions that give meaning to our lives. Wolf makes a compelling case that, along with happiness and morality, this kind of meaningfulness constitutes a distinctive dimension of a good life. Written in a lively and engaging style, and full of provocative examples, Meaning in Life and Why It Matters is a profound and original reflection on a subject of permanent human concern. (shrink)

Proposals to make us smarter than the greatest geniuses or to add thousands of years to our life spans seem fit only for the spam folder or trash can. And yet this is what contemporary advocates of radical enhancement offer in all seriousness. They present a variety of technologies and therapies that will expand our capacities far beyond what is currently possible for human beings. In _Humanity's End,_ Nicholas Agar argues against radical enhancement, describing its destructive consequences. Agar examines the (...) proposals of four prominent radical enhancers: Ray Kurzweil, who argues that technology will enable our escape from human biology; Aubrey de Grey, who calls for anti-aging therapies that will achieve "longevity escape velocity"; Nick Bostrom, who defends the morality and rationality of enhancement; and James Hughes, who envisions a harmonious democracy of the enhanced and the unenhanced. Agar argues that the outcomes of radical enhancement could be darker than the rosy futures described by these thinkers. The most dramatic means of enhancing our cognitive powers could in fact kill us; the radical extension of our life span could eliminate experiences of great value from our lives; and a situation in which some humans are radically enhanced and others are not could lead to tyranny of posthumans over humans. (shrink)

Proposals to make us smarter than the greatest geniuses or to add thousands of years to our life spans seem fit only for the spam folder or trash can. And yet this is what contemporary advocates of radical enhancement offer in all seriousness. They present a variety of technologies and therapies that will expand our capacities far beyond what is currently possible for human beings. In _Humanity's End,_ Nicholas Agar argues against radical enhancement, describing its destructive consequences. Agar examines the (...) proposals of four prominent radical enhancers: Ray Kurzweil, who argues that technology will enable our escape from human biology; Aubrey de Grey, who calls for anti-aging therapies that will achieve "longevity escape velocity"; Nick Bostrom, who defends the morality and rationality of enhancement; and James Hughes, who envisions a harmonious democracy of the enhanced and the unenhanced. Agar argues that the outcomes of radical enhancement could be darker than the rosy futures described by these thinkers. The most dramatic means of enhancing our cognitive powers could in fact kill us; the radical extension of our life span could eliminate experiences of great value from our lives; and a situation in which some humans are radically enhanced and others are not could lead to tyranny of posthumans over humans. (shrink)

A lengthy introduction to the issue of meaning in life, aimed at undergraduates and generally educated readers. It includes summary 'bullet' points, lists of recommended reading, questions for the class, and short excerpts from philosophers such as William James, Leo Tolstoy, John Cottingham, Susan Wolf and Robert Nozick.

In this article I use Kantian moral philosophy to develop a concept of meaningful work. Specifically, a Kantian would argue that work is meaningful if (1) it is freely entered into, (2) it allows the worker to exercise her autonomy and independence, (3) it enables the worker to develop her rational capacities, (4) it provides a wage sufficient for physical welfare, (5) it supports the moral development of employees and (6) it is not paternalistic. I then provide examples of contemporary (...) management practices that provide meaningful work in this sense. (shrink)

This paper argues that an adequate conception of a good life should recognize, in addition to happiness and morality, a third dimension of meaningfulness. It further proposes that we understand meaningfulness as involving both a subjective and an objective condition, suitably linked. Meaning arises when subjective attraction meets objective attractiveness. In other words one’s life is meaningful insofar as one is gripped or excited by things worthy of one’s love, and one is able to do something positive about it. The (...) paper concludes with some speculations about how this conception of meaningfulness might help to explain the conditions under which social volunteering can be especially rewarding. (shrink)

It is widely recognized that lives and activities can be meaningful or meaningless, but few have appreciated that they can also be anti-meaningful. Anti-meaning is the polar opposite of meaning. Our purpose in this essay is to examine the nature and importance of this new and unfamiliar topic. In the first part, we sketch four theories of anti-meaning that correspond to leading theories of meaning. In the second part, we argue that anti-meaning has significance not only for our attempts to (...) theorize about meaning in life, but also for our ability to lead meaningful lives in the modern world. (shrink)

Many philosophers believe that the relationship between a parent and a child is objectively valuable, but few believe that there is any objective value in first creating a child in order to parent her. But if it is indeed true that all of the objective value of procreative-parenting comes from parenting, then it is hard to see how procreative-parenting can overcome two particularly pressing philosophical challenges. A first challenge is to show that it is morally permissible for prospective parents to (...) procreate given that adoption takes us much closer to both environmental and social justice. A second challenge is to show that it is morally permissible for biological parents to parent their biological child given that other prospective parents are willing and able to do a much better job at furthering the child's interests. In this essay, I argue that there is value in procreative-parenting, and that this value is of sufficient magnitude so as to block both the case against procreation and the case in favour of child re-distribution. (shrink)

We normally take it for granted that other people will live on after we ourselves have died. Even if we do not believe in a personal afterlife in which we survive our own deaths, we assume that there will be a "collective afterlife" in which humanity survives long after we are gone. Samuel Scheffler maintains that this assumption plays a surprising - indeed astonishing - role in our lives.

Part of the Elements Philosophy of Religion series, this short book focuses on the spiritual dimensions of life’s meaning as they have been discussed in the recent English and mainly analytic philosophical literature. The overarching philosophical question that this literature has addressed is about the extent to which, and respects in which, spiritual realities such as God or a soul would confer meaning on our lives. There have been four broad answers to the question, namely: God or a soul is (...) necessary for meaning in our lives; they are not necessary for it; one or both would enhance the meaning in our lives; and they would detract from it. These views have been largely advanced in chronological order through the history of Western philosophy, with the view that life would be meaningless without God and a soul having been most prominent in the medieval period, the rejection of this claim having arisen in the modern era, and then sophisticated positions about enhancement or reduction having appeared in earnest only in the past 20 years. This book addresses all four positions, paying particular attention to the more recent views. Beyond familiarizing readers with these positions, it presents prima facie objections to them, points out gaps in research agendas, and suggests argumentative strategies that merit development. (shrink)

This paper discusses the role of consent in decision making generally and its role in end of life decisions in particular. It outlines a conception of autonomy which explains and justifies the role of consent in decision making and criticises some misapplications of the idea of consent, particular the role of fictitious or “proxy” consents.Where the inevitable outcome of a decision must be that a human individual will die and where that individual is a person who can consent, then that (...) decision is ethical if and only if the individual consents. In very rare and extreme cases such a decision will be ethical in the absence of consent where it would be massively cruel not to end life in order to prevent suffering which is in no other way preventable.Where, however, the human individual is not a person, as is the case with abortion, the death of infants like Mary , or in the very rare and extreme cases of those who have ceased to be persons like Tony Bland, such decisions are governed by the ethics of ending the lives of non-persons. (shrink)

When is it permissible to allow a newborn infant to die on the basis of their future quality of life? The prevailing official view is that treatment may be withdrawn only if the burdens in an infant's future life outweigh the benefits. In this paper I outline and defend an alternative view. On the Threshold View, treatment may be withdrawn from infants if their future well-being is below a threshold that is close to, but above the zero-point of well-being. I (...) present four arguments in favor of the Threshold View, and identify and respond to several counterarguments. I conclude that it is justifiable in some circumstances for parents and doctors to decide to allow an infant to die even though the infant's life would be worth living. The Threshold View provides a justification for treatment decisions that is more consistent, more robust, and potentially more practical than the standard view. (shrink)

According to several authors, the enhancement project incorporates a quest for hyperagency - i.e. a state of affairs in which virtually every constitutive aspect of agency (beliefs, desires, moods, dispositions and so forth) is subject to our control and manipulation. This quest, it is claimed, undermines the conditions for a meaningful and worthwhile life. Thus, the enhancement project ought to be forestalled or rejected. How credible is this objection? In this article, I argue: “not very”. I do so by evaluating (...) four different versions of the “hyperagency” objection from four different authors. In each case I argue that the objection either fails outright or, at best, provides weak and defeasible grounds for avoiding enhancement. In addition to this, I argue that there are plausible grounds for thinking that enhancement helps, rather than hinders, us in living the good life. (shrink)

Bioethical Prescriptions collects F.M. Kamm's articles on bioethics -- revised for publication in book form -- which have appeared over the last 25 years and which have made her among the most widely-respected philosophers working in this field.

Some people feel distressed reflecting on human extinction. Some people even claim that our efforts and lives would be empty and pointless if humanity becomes extinct, even if this will not occur for millions of years. In this essay, I will attempt to demonstrate that this claim is false. The desire for long-lastingness or quasi-immortality is often unwittingly adopted as a standard for judging whether our efforts are significant. If we accomplish our goals and then later in life conclude that (...) these accomplishments were of no significance, then this is a sign that the desire for long-lastingness has crept into our standards. By recognizing this, and refraining from adopting an unreasonable standard to judge whether our efforts are significant, it will be to our advantage. Then, when we look back on life from an external perspective that encompasses times after humanity has become extinct, we will not conclude that our efforts amounted to nothing. Rather, we will conclude that many people made significant accomplishments that made their lives and the lives of other people better than they would have been if their goals had never been pursued. (shrink)

Much more than just an anthology, this survey of humanity's search for the meaning of life includes the latest contributions to the debate, a judicious selection of key canonical essays, and insightful commentary by internationally respected philosophers. Cutting-edge viewpoint features the most recent contributions to the debate Extensive general introduction offers unprecedented context Leading contemporary philosophers provide insightful introductions to each section.

The debate on how an individual human life can be understood as being more or less meaningful has been pursued for a considerable time now. Despite extensive discussion some important aspects remain under-explored, namely the relation between meaningfulness and morality – even though many authors implicitly assume a connection between these two value dimensions. But how does morality contribute to a meaningful life? Is it a necessary condition? Or is it not necessary but sufficient or contributive? Or is there, when (...) explored further, no connection at all? This article discusses the relation between morality and meaning by outlining the central positions in the debate, explains the main arguments for and against, and offers some indications for future work in the field. (shrink)

It would be terrible for us if humanity ceased to exist after we all die. But of course, eventually humanity will go out of existence. Does this result in a vicious regress if our flourishing hangs on what happens after us? Mark Johnston thinks so. In this note, I explain how Johnston's objection can be avoided. Briefly, our activities have a meaning horizon that extends for some generations after us. What matters is that we make a positive difference to the (...) lives of those generations, not that they themselves necessarily flourish. (shrink)

Requests by patients or their families for treatment which the patient's physician considers to be "inappropriate" are becoming more frequent than refusals of treatment which the physician considers appropriate. Such requests are often based on the patient's religious beliefs about the attributes of God (sovereignty, omnipotence), the attributes of persons (sanctity of life), or the individual's personal relationship with God (communication, commands, etc). We present four such cases and discuss some of the basic religious tenets of the three Abrahamic faith (...) traditions as they relate to such requests. We suggest that religious reasons for requesting "inappropriate" treatment are "special" and deserve serious consideration. We offer guidance to assist clinicians and clinical ethicists as they attempt to resolve these conflicts, emphasising the importance of understanding the religious beliefs of the patient/surrogate and suggesting the assistance of a religious interpreter. We suggest open discussion with patients and families of both the clinical situation and the theological basis for these requests. We also suggest that clinicians use additional religious doctrines or principles from patients' own traditions to balance the reasons behind the requests. We conclude that most persistent requests for "inappropriate" treatment should be honoured. (shrink)

Some philosophers have thought that life could only be meaningful if there is no God. For Sartre and Nagel, for example, a God of the traditional classical theistic sort would constrain our powers of self-creative autonomy in ways that would severely detract from the meaning of our lives, possibly even evacuate our lives of all meaning. Some philosophers, by contrast, have thought that life could only be meaningful if there is a God. God and the Meanings of Life is interested (...) in exploring the truth in both these schools of thought, seeking to discover what God could and couldn't do to make life meaningful (as well as what he would and wouldn't do). Mawson espouses a version of the 'amalgam' or 'pluralism' thesis about the issue of life's meaning – in essence, that there are a number of different legitimate meanings of 'meaning' (and indeed 'life') in the question of life's meaning. According to Mawson, God, were he to exist, would help make life meaningful in some of these senses and hinder in some others. He argues that whilst there could be meaning in a Godless universe, there could be other sorts of meaning in a Godly one and that these would be deeper. (shrink)

Picture this. You are having your regular medical checkup, when, all of a sudden, the physician turns to you and says: “Oh, did I remember to mention that you can now live forever?” You look at the doctor enquiringly and she goes on: “Well, it’s not actual immortality, you know, but they’ve invented this treatment—I don’t have the full details—that stops aging, getting physically older. It might not be for everyone, but you seem to be a suitable candidate. You could (...) still die of accidents and illness, of course, but they’ve calculated that with care and any luck you should live to be a thousand, as opposed to the hundred or so that you would now have. And in a millennium, techniques will advance further, so there could be more in store for you after that.”. (shrink)

The social consequences of extending the human life span might be quite bad; perhaps the worst outcome is that power could be concentrated into ever fewer hands, as those who wield it gave way more slowly to death and disease. But the worry that more life would damage individuals' quality of life is not persuasive. Depending on what the science of aging makes possible, and on how people plan their lives, longer life might even facilitate a richer and deeper life.

The wish to extend the human lifespan has a long tradition in many cultures. Optimistic views of the possibility of achieving this goal through the latest developments in medicine feature increasingly in serious scientific and philosophical discussion. The authors of this paper argue that research with the explicit aim of extending the human lifespan is both undesirable and morally unacceptable. They present three serious objections, relating to justice, the community and the meaning of life.

Taking the good (generosity), the true (enquiry), and the beautiful (creativity) as exemplars of what can make a life noticeably meaningful, elsewhere I have advanced a principle that entails and plausibly explains all three. Specifically, I have proffered the view that great meaning in life, at least insofar as it comes from this triad, is a matter of positively orienting one’s rational nature towards fundamental conditions of human existence, conditions of human life responsible for much else about it. Iddo Landau (...) has raised important objections to this principle, arguing in particular that contouring one’s rationality towards fundamentality is neither necessary nor sufficient for great meaning in life. In this article, I reply to Landau’s objections to the fundamentality account of what makes life very meaningful. I thereby aim to enrich reflection about what it is about the lives of Neslon Mandela, Mother Teresa, Albert Einstein, and Pablo Picasso that made them so significant as well as to indicate how fundamentality implicitly plays a key role in theistic conceptions of meaning in life. (shrink)

When people suffer they always suffer as a whole human being. The emotional, cognitive and spiritual suffering of human beings cannot be completely separated from all other kinds of suffering, such as from harmful natural, ecological, political, economic and social conditions. In reality they interact with each other and influence each other. Human beings do not only suffer from somatic illnesses, physical pain, and the lack of decent opportunities to satisfy their basic vital, social and emotional needs. They also suffer (...) when they are not able to experience and grasp any meaning of life even if such suffering is not quite as obvious as most forms of physical, social and emotional suffering. Suffering from the lack for the sense of the meaning of life is a special form of emotional, cognitive, and spiritual suffering. Although all human beings share the same basic human need for some meaning of life, the fulfilment of this need is highly individual and personal. Although all forms of human suffering can be a challenge to the meaning of life, the personal conditions of suffering usually are a stronger challenge for the meaning of life. Among the personal conditions of human suffering, the Grenzsituationen cannot be cancelled or raised at all, but only accepted and coped with as existential aspects of the conditio humana. According to Karl Jaspers these are: death, suffering, struggling, guilt, and failing. The challenge for human beings to cope with these Grenzsituationen is a way to move from the mere Being-there to true human Existence. (shrink)

Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for the review; (3) (...) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL—as a condition, as an experience, and as a process of inner growth—leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions—everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity—further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life. (shrink)

Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for the review; (3) (...) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL—as a condition, as an experience, and as a process of inner growth—leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions—everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity—further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life. (shrink)

Featuring nine new articles chosen by coeditor Steven M. Cahn, the third edition of E. D. Klemke's The Meaning of Life offers twenty-two insightful selections that explore this fascinating topic. The essays are primarily by philosophers but also include materials from literary figures and religious thinkers. As in previous editions, the readings are organized around three themes. In Part I the articles defend the view that without faith in God, life has no meaning or purpose. In Part II the selections (...) oppose this claim, defending instead a nontheistic, humanistic alternative--that life can have meaning even in the absence of theistic commitment. In Part III the contributors ask whether the question of the meaning of life is itself meaningful. The third edition adds substantial essays by Moritz Schlick, Joel Feinberg, and John Kekes as well as selections from the writings of Louis P. Pojman, Emil L. Fackenheim, Robert Nozick, Susan Wolf, and Steven M. Cahn. The only anthology of its kind, The Meaning of Life: A Reader, Third Edition, is ideal for courses in introduction to philosophy, human nature, and the meaning of life. It also offers general readers an accessible and stimulating introduction to the subject. (shrink)

Should perfectionist ideals of meaningful work play a significant part in the design of economic systems? In an influential article (Meaningful Work and Market Socialism), Richard Arneson rejected this traditional socialist view. Instead, he maintained, it should be left to the market, as a system that is consistent with the principle of neutrality, to determine the extent to which such work is available, and socialists should restrict their normative concerns primarily to issues of distributive justice. Against this it is argued (...) here that market economies appear to be neutral only if understood in neo-classical, rather than institutionalist terms. From the latter perspective, market economies can be shown to take a number of institutionally distinct forms, which differ significantly in how far they favour the satisfaction of preferences for meaningful work. Collective choices between these alternative systems should take account of these differences, and the adoption of market economies does not avoid the need for perfectionist judgments in politics. (shrink)

Opponents of voluntary euthanasia and physician-assisted suicide often maintain that the procedures ought not to be accepted because ending an innocent human life would both be morally wrong in itself and have unfortunate consequences. A gravely suffering patient can grant that ending his life would involve such harm but still insist that he would have reason to continue living only if there were something to him in his abstaining from ending his life. Though relatively rarely, the notion of meaning of (...) life has figured in recent medical ethical debate on voluntary euthanasia and physician-assisted suicide. And in current philosophical discussion on meaning of life outside the medical ethical debate on voluntary euthanasia and physician-assisted suicide several authors have argued that being moral and having a meaningful existence are connected to each other. In this article, I assess whether his intentionally refraining from causing the harm related to voluntary euthanasia and physician-assisted suicide would involve something to such a patient in the sense that it would promote the meaningfulness of his life. (shrink)

The ethical problems surrounding voluntary assisted suicide remain formidable, and are unlikely to be resolved in pluralist societies. An examination of historical attitudes to suicide suggests that modernity has inherited a formidable complex of religious and moral attitudes to suicide, whether assisted or not. Advocates usually invoke the ending of intolerable suffering as one justification for euthanasia of this kind. This does not provide an adequate justification by itself, because there are (at least theoretically) methods which would relieve suffering without (...) causing the physical death of the suffering person. Carried to extremes, these methods would finish the life worth living, but leave a being which was technically alive. Such acts, however, would provide no moral escape, since they would create beings without meaning. Arguments seeking to justify ending the lives of others need some grounding in concepts of the meaning of a life. The euthanasia discourse therefore needs to take at least some account of the meaning we construct for our lives and the lives of others. (shrink)

​The goal of this open access book is to develop an approach to clinical health care ethics that is more accessible to, and usable by, health professionals than the now-dominant approaches that focus, for example, on the application of ethical principles. The book elaborates the view that health professionals have the emotional and intellectual resources to discuss and address ethical issues in clinical health care without needing to rely on the expertise of bioethicists. The early chapters review the history of (...) bioethics and explain how academics from outside health care came to dominate the field of health care ethics, both in professional schools and in clinical health care. The middle chapters elaborate a series of concepts, drawn from philosophy and the social sciences, that set the stage for developing a framework that builds upon the individual moral experience of health professionals, that explains the discontinuities between the demands of bioethics and the experience and perceptions of health professionals, and that enables the articulation of a full theory of clinical ethics with clinicians themselves as the foundation. Against that background, the first of three chapters on professional education presents a general framework for teaching clinical ethics; the second discusses how to integrate ethics into formal health care curricula; and the third addresses the opportunities for teaching available in clinical settings. The final chapter, "Empowering Clinicians", brings together the various dimensions of the argument and anticipates potential questions about the framework developed in earlier chapters. (shrink)

Substitute decision-makers for severely disabled neonates who can be kept alive but who will require constant medical interventions and will die at the latest in their teens are faced with a difficult decision when trying to decide whether to keep the infant alive. By and large, the primary focus of their decision-making centers on what is in the best interests of the newborn. The best-interests criterion, in turn, is importantly conditioned by quality-of-life considerations. However, the concept of quality of life (...) is logically and ethically different for patients with a developing as opposed to a developed awareness. Unfortunately, this difference is ignored by current quality-of-life considerations, there are no quality-of-life measures that take this difference into account, and decision-making proceeds entirely without acknowledging this fact. This note outlines why this is a problem and why there is a need for a new set of tools that incorporates this distinction if the substitute decision-makers are to apply the best-interest criterion in a meaningful way. (shrink)

This article provides a deeper understanding of how meaning can be created in everyday life at a nursing home. It is based on a primary study concerning dignity involving 12 older people living in two nursing homes in Sweden. A secondary analysis was carried out on data obtained from three of the primary participants interviewed over a period of time (18—24 months), with a total of 12 interviews carried out using an inductive hermeneutic approach. The study reveals that sources of (...) meaning were created by having a sense of: physical capability, cognitive capability, being needed, and belonging. Meaning was created through inner dialogue, communication and relationships with others. A second finding is that the experience of meaning can sometimes be hard to realize. (shrink)

In this critical notice of Samuel Scheffler’s Death and the Afterlife, I focus on his intriguing suggestion that we reasonably care more about the fate of an unidentifiable, future humanity than of ourselves and our loved ones. Scheffler’s main rationale for this claim is that meaning in our lives crucially depends on contributing to the well-being of the human race down the road, with many commentators instead arguing that advancing the good of ourselves or existing loved ones would be sufficient. (...) In contrast, I argue for a different kind of rationale for Scheffler’s conclusion, contending that it is our attachment to, not contribution towards, humanity’s flourishing that plausibly constitutes a large part of the meaning in our lives. (shrink)

In this paper I use William James's understanding of significance in life to show that for certain patients euthanasia and assisted suicide can be importantly meaningful acts that family, friends, and health care professionals must acknowledge and even, at times, aid in bringing to fruition. Dying with meaning is transformative. It reshapes the lives of others that are left behind, giving to their lives new groundings by engaging them in the meaning of dying for us. For the patient, dying with (...) meaning takes the seemingly formless void in the abyss of death and gives it a significant purpose in the last stages of life itself; it turns potential nothingness into actual significance. To the extent that we outsiders do not help the dying, we condemn terminally ill patients to a meaningless existence until they die. (shrink)

The emergent new science of synthetic biology is challenging entrenched distinctions between, amongst others, life and non-life, the natural and the artificial, the evolved and the designed, and even the material and the informational. Whenever such culturally sanctioned boundaries are breached, researchers are inevitably accused of playing God or treading in Frankenstein’s footsteps. Bioethicists, theologians and editors of scientific journals feel obliged to provide an authoritative answer to the ambiguous question of the ‘meaning’ of life, both as a scientific definition (...) and as an explication with wider existential connotations. This article analyses the arguments mooted in the emerging societal debates on synthetic biology and the way its practitioners respond to criticism, mostly by assuming a defiant posture or professing humility. It explores the relationship between the ‘playing God’ theme and the Frankenstein motif and examines the doctrinal status of the ‘playing God’ argument. One particularly interesting finding is that liberal theologians generally deny the religious character of the ‘playing God’ argument—a response which fits in with the curious fact that this argument is used mainly by secular organizations. Synthetic biology, it is therefore maintained, does not offend so much the God of the Bible as a deified Nature. While syntheses of artificial life forms cause some vague uneasiness that life may lose its special meaning, most concerns turn out to be narrowly anthropocentric. As long as synthetic biology creates only new microbial life and does not directly affect human life, it will in all likelihood be considered acceptable. (shrink)

Today, the frequency and the rate of success resulting from advances in medicine have made organ transplantations an everyday occurrence. Still, organ transplantations and donations modify the subjective experience of human beings as regards the image they have of themselves, of body, of life and of death. If the concern of the quality of life and the survival of the patients is a completely human phenomenon, the fact remains that the possibility of organ transplantation and its justification depend a great (...) deal on the culture in which we live. The exploration of the philosophical tradition allows for a reconsideration of organ transplantation. If we listen to people who have experienced the decline of one of their organs and their own rebirth through the organ of someone else, we arrive at the conclusion that they went through an extreme experience in which nothing appeared as before. All those experiences intensify philosophical questionings on the meaning of life with respect to self fulfilment. The concept of nature as the experience of others can be an authentic source from which to nourish our thoughts about organ transplantation. However, and this is our hypothesis, we need something more if we are to decide something about our own life. We need a hermeneutical stance in relation to ourselves and to our world. Philosophical counselling, as a long established tradition originating with Pythagoras and later reframed by the German philosopher Achenbach could be useful in inspiring a reflection on the good life, chiefly as it takes the form of a Socratic dialogue. (shrink)