In a world of rapid technological advances, the moral issues raised by life and death choices in healthcare remain obscure. _Life and Death in Healthcare Ethics_ provides a concise, thoughtful and extremely accessible guide to these moral issues. Helen Watt examines, using real-life cases, the range of choices taken by healthcare professionals, patients and clients which lead to the shortening of life. The topics looked at include: * euthanasia and withdrawal of treatment * the persistent vegetative state * abortion * (...) IVF and cloning * life-saving treatment of pregnant women Clearly written and insightful, _Life and Death in Healthcare Ethics_ presupposes no prior knowledge of philosophy. It will be of interest to anyone confronting healthcare ethics for the first time, or seeking to develop his or her understanding of some core topics in the field. (shrink)

Nozick analyzes fundamental issues, such as the identity of the self, knowledge and skepticism, free will, the foundations of ethics, and the meaning of life.

Those who oppose human embryonic stem cell research argue for a clear position on the metaphysical and moral status of human embryos. This position does not differ whether the embryo is present inside its mother’s reproductive tract or in a cryopreservation tank. It is worth examining, however, whether an embryo in “suspended animation” has the same status as one actively developing in utero. I will explore this question from the perspective of Thomas Aquinas’s metaphysical account of human nature. I conclude (...) that a cryopreserved human embryo counts, both metaphysically and morally, as a person; and thus the utilization of such embryos for inherently destructive research purposes is impermissible. (shrink)

The transplantation of porcine organs to humans could in the future be a solution to the worldwide organ shortage, but is to date still highly experimental. Further research on the potential effects of crossing the species barrier is essential before clinical application is acceptable. However, many crucial questions on efficacy and safety will ultimately only be answered by well designed and controlled solid organ xenotransplantation trials on humans. This paper is concerned with the question under which conditions, given the risks (...) involved and the ethical issues raised, such clinical trials should be resumed. An alternative means of overcoming the safety and ethical issues is suggested: willed body donation for scientific research in the case of permanent vegetative status. This paper argues that conducting trials on such bodies with prior consent is preferable to the use of human subjects without lack of brain function. (shrink)

This new edition includes a substantial postscript by the author, in which he responds to thirty years of discussion, criticism and further work in the field to ...

The introduction of contraceptive technologies hasresulted in the separation of sex and procreation. Theintroduction of new reproductive technologies (mainlyIVF and embryo transfer) has led not only to theseparation of procreation and sex, but also to there-definition of the terms mother and family.For the purpose of this essay, I will distinguishbetween:1. the genetic mother – the donor of the egg;2. the gestational mother – she who bears and gives birth to the baby;3. the social mother – the woman who raises the (...) child.This essay will deal only with the form of gestationalsurrogacy in which the genetic parents intend to bethe social parents, and the surrogate mother has nogenetic relationship to the child she bears anddelivers. I will raise questions regarding medicalethical aspects of surrogacy and the obligation(s) ofthe physician(s) to the parties involved. I will arguethat the gestational surrogate is a womb to rent,that there is great similarity between gestationalcommercial surrogacy and organ transplant marketing.Furthermore, despite claims to freedom of choice andfree marketing, I will claim that gestationalsurrogacy is a form of prostitution and slavery,exploitation of the poor and needy by those who arebetter off. The right to be a parent, although notconstitutional, is intuitive and deeply rooted.However, the issue remains whether this rightoverrules all other rights, and at what price to theparties involved. I will finally raise the followingprovocative question to society: In the interim periodbetween today''s limited technology and tomorrow''sextra-corporeal gestation technology (ectogenesis),should utilizing females in PVS (persistent vehetativestate) for gestational surrogacy be sociallyacceptable/permissible – provided they have leftpermission in writing? (shrink)

In this article, I argue that persons suffering from Body Integrity Identity Disorder (BIID) can give informed consent to surgical measures designed to treat this disorder. This is true even if the surgery seems radical or irrational to most people. The decision to have surgery made by a BIID patient is not necessarily coerced, incompetent or uninformed. If surgery for BIID is offered, there should certainly be a screening process in place to insure informed consent. It is beyond the scope (...) of this work, however, to define all the conditions that should be placed on the availability of surgery. However, I argue, given the similarities between BIID and gender dysphoria and the success of such gatekeeping measures for the surgical treatment of gender dysphoria, it is reasonable that similar conditions be in place for BIID. Once other treatment options are tried and gatekeeping measures satisfied, A BIID patient can give informed consent to radical surgery. (shrink)

This article treats recent bioethical discussions of double effect reasoning (DER), offering a summary account of DER and construing it as rooted in a sensible view of what is central to someone's identity as a moral agent. It then treats objections raised in recent years by Judith Thomson, Alison McIntyre, and Frances Kamm against familiar ways of applying DER to certain controversies within medical ethics, especially, that over physician-assisted suicide. After detailing, interpreting, and attempting to rebut the challenges from these (...) philosophers, who are especially interesting because their criticisms of DER come from allies in DER's struggle against consequentialist reasoning, the essay engages DER's contribution to a recent dispute over treatment of patients in what is called ‘persistent vegetative state.' Near its end, the paper sketches several possible points of entry to DER and sources of justification for it. The essay concludes by indicating a connection between these paths and its opening idea of moral identity. (shrink)

What makes something an embryo—as opposed to what is actually, and not just in biotech parlance, a collection of cells? This question has come to the fore in recent years with proposals for producing embryonic stem cells for research. While some of those opposed to use of standard embryonic stem cells emphasise that adult cells have a clinical track record, others argue that there may be further benefits obtainable from cells very like those of embryos, provided such cells can be (...) derived in new ways. Rather than deriving them in ways that kill or otherwise endanger a living human embryo, they could be obtained from an entity that merely resembles a human embryo sufficiently closely for its cells to be of use. Such an entity might be created after introducing genetic changes to an ovum before it is activated by, for example, a cloning-type procedure, such that a gene essential to embryogenesis will be either absent, blocked in its expression, or overexpressed.1,2 The claim is that the ovum could be made to give rise to embryonic stem cells—mere living parts—without ever giving rise to a whole embryo, who is killed to obtain them. Whereas cloning “proper” winds back the specialisation of the cell nucleus to a point where a whole embryo is formed who has not yet specialised its cells, oocyte-assisted reprogramming , it is claimed, would wind back the specialisation merely to an intermediate point at which no embryo is created. Other methods proposed for deriving pseudoembryonic cells include parthenogenesis, in which an ovum is activated without a sperm, or even the insertion of an adult cell nucleus.1MORAL STATUS OF THE EMBRYOIn this paper, I assume that a genuine …. (shrink)

Ravelingien et al have suggested that early human xenotransplantation trials should be carried out on patients who are in a permanent vegetative state (PVS) and who have previously granted their consent to the use of their bodies in such research in the event of their cortical death. Unfortunately, their philosophical defence of this suggestion is unsatisfactory in its current formulation, as it equivocates on the key question of the status of patients who are in a PVS. The solution proposed by (...) them rests on the idea that it should be up to people themselves to determine when they should be treated as dead. Yet the authors clearly believe (and state) that patients who are in a PVS are in fact dead. Finally, given the public good that their proposal is intended to achieve, the moral importance they place on the consent of a person to the use of his or her body in research is ultimately only defensible in so far as this consent represents the wishes of a living person. It is thus only a gentle caricature of their position to suggest that according to their account, consent to participation in xenotransplantation research is a “right of the living dead”. The equivocation by Ravelingien et al on the question of whether these people are living or dead means that they avoid confronting the implications of their argument. The solution proposed by Ravelingien et al to the problem of how we should proceed with xenotransplantation research is therefore not as neat as it first seems to be. (shrink)