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The notion of "killing". Causality, intention, and motivation in active and passive euthanasia.

As a new approach to the still unsettled problem of a morally significant difference between active and passive euthanasia, the meanings of the notion of killing are distinguished on the levels of causality, intention, and motivation. This distinction allows a thorough analysis and refutation of arguments for the equality of killing and letting die which are often put forward in the euthanasia debate. Moreover, an investigation into the structure of the physician's action on those three levels yields substantial differences between the two ways of acting. As can be demonstrated, only a teleological notion of the organism is able to grasp the characteristic feature of active euthanasia. On this basis it is argued that an action against the organism as a whole must, on the interpersonal level, be at once directed against the patient as a person himself.

Attitude↗

Defining death for persons and human organisms.

This paper discusses how alternative concepts of personhood affect the definition of death. I argue that parties in the debate over the definition of death have employed different concepts of personhood, and thus have been talking past each other by proposing definitions of death for different kinds of things. In particular, I show how critics of the consciousness-related, neurological formation of death have relied on concepts of personhood that would be rejected by proponents of that formulation. These critics rest on treating persons as qualitative specifications of human organisms (Bernat, Culver, and Gert) or as identical to human organisms (Capron, Seifert, and Shewmon). Since advocates of the consciousness-related, neurological formulation of death are not committed to either of these views of personhood, these critics commit the fallacy of attacking a straw man. I then clarify the "substantive" concept of personhood (Boethius, Strawson, and Wiggins) that may be invoked in the consciousness-related, neurological formulation of death, and argue that, on this view and contra Bernat, Culver, and Gert, persons have always been the kind of thing that can literally die. I conclude by suggesting that the discussion of defining death needs to focus on which approach to personhood makes the most sense metaphysically and morally.

Attitude to Death↗

Abortion, intimacy, and the duty to gestate.

In this article, I urge that mainstream discussions of abortion are dissatisfying in large part because they proceed in polite abstraction from the distinctive circumstances and meanings of gestation. Such discussions, in fact, apply to abortion conceptual tools that were designed on the premiss that people are physically demarcated, even as gestation is marked by a thorough-going intertwinement. We cannot fully appreciate what is normatively at stake with legally forcing continued gestation, or again how to discuss moral responsibilities to continue gestating, until we appreciate in their own terms the goods and evils distinctive of gestational connection. To underscore the need to explore further the meanings of gestation, I provide two examples of the difference it might make to legal and moral discussions of abortion if we appreciate more fully that gestation is an intimacy.

Abortion, Induced↗

Genetics' dreams in the post genomics era.

In this paper I explore the heuristic limits of human genetics, in particular the claim that it is possible to manipulate human germ cells in a pre-ordinate way (Gordon, 1999). I argue that this claim is unrealistic based on genetic reductionism and a wrong concept of genetic diseases.

Ethics, Medical↗

Human gene therapy and the slippery slope argument.

The article investigates the validity of two different versions of the slippery slope argument construed in relation to human gene therapy: the empirical and the conceptual argument. The empirical version holds that our accepting somatic cell therapy will eventually cause our accepting eugenic medical goals. The conceptual version holds that we are logically committed to accepting such goals once we have accepted somatic cell therapy. It is argued that neither the empirical nor the conceptual version of the argument can provide a conclusive moral reason for banning somatic cell therapy. According to a third interpretation, referred to as the arbitrary result argument, the many apparent similarities between somatic cell therapy and eugenic-based human genetic engineering drive us to make principled choices concerning what differences and similarities between the two practices should be regarded as morally (ir)relevant. Decisions of this kind are likely to have unpredictable moral consequences. Thus formulated, the slippery slope argument has much plausibility. One objects to somatic cell therapy not so much because of what is at the bottom of the slope on which it lies, but because it is on a slope of which one does not know what is at the bottom. While the arbitrary result argument does not provide a conclusive reason for prohibiting human gene therapy, it reminds of a very important thing: when making bioethical decisions, we should be as specific and as consistent as possible about our basic moral and medical concepts.

Ethical Analysis↗

Precedent autonomy and subsequent consent.

Honoring a living will typically involves treating an incompetent patient in accord with preferences she once had, but whose objects she can no longer understand. How do we respect her "precedent autonomy" by giving her what she used to want? There is a similar problem with "subsequent consent": How can we justify interfering with someone's autonomy on the grounds that she will later consent to the interference, if she refuses now? Both problems arise on the assumption that, to respect one's autonomy, any preferences we respect must be among that person's current preferences. I argue that this is not always true. Just as we can celebrate an event long after it happens, so can we respect someone's wishes long before or after she has that wish. In the contexts of precedent autonomy and subsequent consent, the wishes are often preferences about which of two other, conflicting preferences to satisfy. When someone has two conflicting preferences, and a third preference on how to resolve that conflict, to respect his autonomy, we must respect that third preference. People with declining competence may have a resolution preference earlier, favoring the earlier conflicting preference (precedent autonomy), whereas those with rising competence may have it later, favoring the later conflicting preference (subsequent consent). To respect autonomy in such cases we must respect not a current, but a former or later preference.

Advance Directive Adherence↗

Genetic equity.

This paper proposes, elaborates and defends a principle of genetic equity. In doing so it articulates, explains and justifies what might be meant by the concept of 'human dignity' in a way that is clear, defensible and consistent with, but by no means the same as, the plethora of appeals to human dignity found in contemporary bioethics, and more particularly in international instruments on bioethics. We propose the following principle of genetic equity: humans are born equal; they are entitled to freedom from discrimination and equality of opportunity to flourish; genetic information may not be used to limit that equality.

Bioethics↗

The 'more-abortions' objection to fetal tissue transplantation.

One common objection to fetal tissue transplantation (FTT) is that, if it were to become a standard form of treatment, it would encourage or entrench the practice of abortion. This claim is at least factually plausible, although it cannot be definitively established. However, even if true, it does not constitute a compelling ethical argument against FTT. The harm allegedly brought about by FTT, when assessed by widely accepted non-consequentialist criteria, has limited moral significance. Even if FTT would cause more abortions to be performed, and abortion is taken to be a serious moral wrong, this is not sufficient in itself to make FTT wrong.

Aborted Fetus↗

The identity of clones.

A common concern with respect to cloning is based on the belief that cloning produces identical individuals. This is a fundamental misunderstanding of what type of identity-relation cloning involves. The concept "identity" is ambiguous, and the statement that cloning produces "identical" individuals is not meaningful unless the notion of identity is clarified. This paper distinguishes between numerical and qualitative; relational and intrinsic: logical and empirical identity, and discusses the empirical individuation of clones in terms of genetics, physiology, perception, cognition and personality. I argue that the only relation of identity cloning involves is qualitative, intrinsic and empirical: genetic indiscernibility, unlikely to include identity under other aspects mentioned. A popular argument against cloning claims our "right" to a "unique identity". This objection either implies (absurdly) the right not to be an identical twin, or assumes (incorrectly) that cloning involves identity other than genetic. Either way, the argument is untenable.

Animals↗