We argue that all human beings have a special type of dignity which is the basis for (1) the obligation all of us have not to kill them, (2) the obligation to take their well-being into account when we act, and (3) even the obligation to treat them as we would have them treat us, and indeed, that all human beings are equal in fundamental dignity. We give reasons to oppose the position that only some human beings, because of their (...) possession of certain characteristics in addition to their humanity (for example, an immediately exercisable capacity for self-consciousness, or for rational deliberation), have full moral worth. What distinguishes human beings from other animals, what makes human beings persons rather than things, is their rational nature, and human beings are rational creatures by virtue of possessing natural capacities for conceptual thought, deliberation, and free choice, that is, the natural capacity to shape their own lives. (shrink)

One goal of the transplant community is to seek ways to increase the number of people who are willing and able to donate organs. People in states between life and death are often medically excellent candidates for donating organs. Yet public policy surrounding organ procurement is a delicate matter. While there is the utilitarian goal of increasing organ supply, there is also the deontologic concern about respect for persons. Public policy must properly mediate between these two concerns. Currently the dead (...) donor (dd) rule is appealed to as an attempt at such mediation. I argue that given the lack of consensus on a definition of death, the dd rule is no longer successful at mediating utilitarian and deontologic concerns. I suggest instead that focusing on a particular person's history can be successful. (shrink)

Many accounts of the historical development of neurological criteria for determination of death insufficiently distinguish between two strands of interpretation advanced by advocates of a "whole-brain" criterion. One strand focuses on the brain as the organ of integration. Another provides a far more complex and nuanced account, both of death and of a policy on the determination of death. Current criticisms of the whole-brain criterion are effective in refuting the first interpretation, but not the second, which is advanced in the (...) 2008 President's Council report on the determination of death. In this essay, I seek to further develop this second strand of interpretation. I argue that policy on determination of death aligns moral, biological, and ontological death concepts. Morally, death marks the stage when respect is no longer owed. Biologically, death concerns integrated functioning of an organism as a whole. But the biological concepts are underdetermined. The moral concerns lead to selection of strong individuality concepts rather than weak ones. They also push criteria to the "far side" of the dying process. There is a countervailing consideration associated with optimizing the number of available organs, and this pushes to the "near side" of death. Policy is governed by a conviction that it is possible to align these moral and biological death concepts, but this conviction simply lays out an agenda. There is also a prescription—integral to the dead donor rule—that lexically prioritizes the deontic concerns and that seeks to balance the countervailing tendencies by using science-based refinements to make the line between life and death more precise. After showing how these concerns have been effectively aligned in the current policy, I present a modified variant of a "division" scenario and show how an "inverse decapitation problem" leads to a conclusive refutation of the nonbrain account of death. (shrink)

Organ donation after cardiac or circulatory death (DCD) has been introduced to increase the supply of transplantable organs. In this paper, we argue that the recovery of viable organs useful for transplantation in DCD is not compatible with the dead donor rule and we explain the consequential ethical and legal ramifications. We also outline serious deficiencies in the current consent process for DCD with respect to disclosure of necessary elements for voluntary informed decision making and respect for the donor's autonomy. (...) We compare two alternative proposals for increasing organ donation consent in society: presumed consent and mandated choice. We conclude that proceeding with the recovery of transplantable organs from decedents requires a paradigm change in the ethics of organ donation. The paradigm change to ensure the legitimacy of DCD practice must include: (1) societal agreement on abandonment of the dead donor rule, (2) legislative revisions reflecting abandonment of the dead donor rule, and (3) requirement of mandated choice to facilitate individual participation in organ donation and to ensure that decisions to participate are made in compliance with the societal values of respect for autonomy and self-determination. (shrink)

During the past 50 years since the first successful organ transplant, waiting lists of potential organ recipients have expanded exponentially as supply and demand have been on a collision course. The recovery of organs from patients with circulatory determination of death is one of several effective alternative approaches recommended to reduce the supply-and-demand gap. However, renewed debate ensues regarding the ethical management of the overarching risks, pressures, challenges and conflicts of interest inherent in organ retrieval after circulatory determination of death. (...) In this article, the author claims that through the engagement of a Heideggerean existential phenomenological and hermeneutic framework what are perceived as ethical problems dissolve, including collapse of commitment to the dead donor rule. The author argues for a revisioned socially constructed conceptual and philosophical responsibility of humankind to recognize the limits of bodily finitude, to responsibly use the capacity of the transplantable organs, and to grant enhanced or renewed existence to one with diminished or life-limited capacity; thereby making the locus of ethical concern the donor–recipient as unitary ‘‘life.’ What ethically matters in the life-cycle (life-world) of donor–recipient is the viability of the organs transplanted; thereby granting reverence to all life. (shrink)

Jeff McMahan has long shown himself to be a vigorous and incisive critic of speciesism, and in his essay “Our Fellow Creatures” he has been particularly critical of speciesist arguments that draw inspiration from Wittgenstein. In this essay I consider his arguments against speciesism generally and the species-norm account of deprivation in particular. I argue that McMahan's ethical framework is more nuanced and more open to the incorporation of speciesist intuitions regarding deprivation than he himself suggests. Specifically, I argue that, (...) given his willingness to include a comparative dimension in his “Intrinsic Potential Account” he ought to recognize species as a legitimate comparison class. I also argue that a sensible speciesism can be pluralist and flexible enough to accommodate many of McMahan's arguments in defense of “moral individualist” intuitions. In this way, I hope to make the case for at least a partial reconciliation between McMahan and the “Wittgensteinian speciesists”, e.g. Cora Diamond, Stephen Mulhall, and Raimond Gaita. (shrink)

Philippa Foot has for many years been one of the most distinctive and influential thinkers in moral philosophy. Long dissatisfied with the moral theories of her contemporaries, she has gradually evolved a theory of her own that is radically opposed not only to emotivism and prescriptivism but also to the whole subjectivist, anti-naturalist movement deriving from David Hume. Dissatisfied with both Kantian and utilitarian ethics, she claims to have isolated a special form of evaluation that predicates goodness and defect only (...) to living things considered as such; she finds this form of evaluation in moral judgements. Her vivid discussion covers topics such as practical rationality, erring conscience, and the relation between virtue and happiness, ending with a critique of Nietzsche's immoralism. This long-awaited book exposes a highly original approach to moral philosophy and represents a fundamental break from the assumptions of recent debates. Foot challenges many prominent philosophical arguments and attitudes; but hers is a work full of life and feeling, written for anyone intrigued by the deepest questions about goodness and human. (shrink)

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

This paper examines the ethical difficulties of organ donation from living donors and the problem of causing harm to patients or research subjects at their request. Graham Greene explored morally similar questions in his novella, The Tenth Man.

Many debates about the moral status of things—for example, debates about the natural rights of human fetuses or nonhuman animals—eventually migrate towards a discussion of the capacities of the things in question—for example, their capacities to feel pain, think, or love. Yet the move towards capacities is often controversial: if a human’s capacities are the basis of its moral status, how could a human having lesser capacities than you and I have the same "serious" moral status as you and I? (...) This book answers this question by arguing that if something is human, it has a set of typical human capacities; that if something has a set of typical human capacities, it has serious moral status; and thus all human beings have the same sort of serious moral status as you and I. Beginning from what our common intuitions tell us about situations involving "temporary incapacitation"—where a human organism has, then loses, then regains a certain capacity—this book argues for substantive conclusions regarding human fetuses and embryos, humans in a permanent vegetative state, humans suffering from brain diseases, and humans born with genetic disorders. Since these conclusions must have some impact on our ongoing moral and political debates about the proper treatment of such humans, this book will be useful to professionals and students in philosophy, bioethics, law, medicine, and public policy. (shrink)

This is the earliest critical discussion in the context of modern/contemporary philosophy in the analytical tradition arguing that somebody with a reasonably stable character and the company of the right people would be able to enjoy eternity.

Applied Ethics focuses the central concepts of traditional morality from the companion book Moral Theory - rights, justice, the good, virtue, and the fundamental value of human life - on a number of pressing contemporary problems, including abortion, euthanasia, animals, capital punishment, and war.

Since the birth of the first test-tube baby, Louise Brown, in 1977, we have seen truly remarkable advances in biotechnology. We can now screen the fetus for Down Syndrome, Spina Bifida, and a wide range of genetic disorders. We can rearrange genes in DNA chains and redirect the evolution of species. We can record an individual's genetic fingerprint. And we can potentially insert genes into human DNA that will produce physical warning signs of cancer, allowing early detection. In fact, biotechnology (...) has progressed to such a point that virtually any kind of genetic manipulation, if not already possible, is just around the corner. But these breakthroughs also raise serious ethical and moral dilemmas that we are only now beginning to confront. In Wonderwoman and Superman, noted medical ethicist John Harris offers the first thorough analysis of the moral dilemmas created by the revolution in molecular biology. Covering a wide array of recent innovations, Harris discusses, for example, the moral decisions involved and the consequences of creating egg and embryo banks. Who should be allowed to use such resources? Should recipients be screened? Should such banks be open for public or private use? And does it cheapen life to make embryos available for sale? In another chapter, Harris examines the question of conceiving children chiefly for organ donation, focusing on the recent case of a woman who wanted to have a second child to provide a bone marrow donor for her first child sick with leukemia (she intended to abort the fetus if its bone marrow did not genetically match that of her living child). In this case, the medical staff had to decide whether they should perform in-vitro fertilization, knowing that the mother did not satisfy the clinic's criteria (there was no father), and also knowing the potential for abortion. Discussing the ethics of the mother's choice and the clinic's choice, Harris asks whether it is morally correct to create a child as an organ donor, whether the future child would suffer, whether it is worth any suffering to be born, and who has the right to weigh the various factors (both moral and physiological) involved in making these decisions. Delving into a multitude of issues such as when life begins, when suffering is needless, and whether we should play God, Wonderwoman and Superman provides not only a thought-provoking inquiry into the potential and actual ethical dilemmas created by the many advances in biotechnology, but challenges us to learn to choose responsibly and to face the moral implications of the choices that confront us. (shrink)

The Philosophy of Death is a discussion of the basic philosophical issues concerning death, and a critical introduction to the relevant contemporary philosophical literature. Luper begins by addressing questions about those who die: What is it to be alive? What does it mean for you and me to exist? Under what conditions do we persist over time, and when do we perish? Next, he considers several questions concerning death, including: What does dying consist in; in particular, how does it differ (...) from ageing? Must death be permanent? By what signs may it be identified? Is death bad for the one who dies? If so why? Finally he discusses whether, and why, killing is morally objectionable, and suggests that it is often permissible; in particular, suicide, euthanasia and abortion may all be morally permissible. His book is a lively and engaging philosophical treatment of a perennially fascinating and relevant subject. (shrink)

Though Kant calls the prohibition against suicide the first duty of human beings to themselves, his arguments for this duty lack his characteristic rigor and systematicity. The lack of a single authoritative Kantian approach to suicide casts doubt on what is generally regarded as an extreme and implausible position, to wit, that not only is suicide wrong in every circumstance, but is among the gravest moral wrongs. Here I try to remedy this lack of systematicity in order to show that (...) Kant's position on suicide is more appealing and credible than it seems at first glance. Kant in fact offers three distinct lines of argument against suicide. The first, the chief argument in his Lectures on Ethics, holds that suicide violates the divine will, for in willing our own deaths we usurp God's right to determine the duration of our existence; as God's property, we are not entitled to end our own lives willfully. The second, rooted in the Groundwork, holds that suicide is incompatible with a system of willed ends conceived analogously with a system of nature, so a maxim to commit suicide cannot be coherently willed as a universal practical principle. The third argument, drawn from the Metaphysics of Morals, holds that because suicide obliterates the rational will from the world, and as the rational will is the source of moral worth, suicide cannot be consistently willed by beings subject to moral requirements. To authorize oneself to take one's own life, Kant claims, is to attempt 'to withdraw from all obligation.' We cannot, under the color of morality, seek to cancel the will that authorizes all obligation in the first place. This third argument is demonstrably superior to the other two in being both more philosophically plausible in its own right and more Kantian in flavor. (shrink)