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At least 451 records · Page 25Linked to original sources
PubMed1991

Ethical manipulations: an ethical evaluation of the debate surrounding genetic engineering.

"Manipulation" per se is not bad. The crucial question in the moral debate about genetic engineering is: When and how are we allowed to manipulate? Unfortunately, the moral discussion surrounding this question is itself being manipulated. There are moral manipulations (by those who wish to either reassure or to alarm) and there are ethical manipulations (the failed utilitarian calculus and the centering of the discussion only around rules, rights, and duties). A different ethical approach is needed: one based on virtues. The duty of ethics is to help us understand the moral possibilities in each situation, i.e., to develop our moral sensibility. In the area of genetic engineering research we are motivated by a will to know, but at the same time we fear total self knowledge. We want to control, to improve our world and ourselves, but we recoil at obtaining ultimate perfection. Therefore, we must value the unknowable, the uncontrollable. Our everincreasing capacity to mould the world and ourselves is making it more difficult to develop a sensitivity for what is given and cannot be made. It is dangerous for our ethics to assume the activistic traits of our technology. We risk losing a fundamental element of what we are, or ought to be. We should train ourselves in moral passivity.

Attitude↗
PubMed1985

Personhood and human embryos and fetuses.

Public policy decisions concerning embryos and fetuses tend to lack reasoned argument on their moral status. While agreement on personhood is elusive, this concept has unquestioned moral relevance. A stipulated usage of the term, the psychic sense of 'person', applies to early human prenatal life and encompasses morally relevant aspects of personhood. A 'person' in the psychic sense has a minimal psychology, defined as the capacity to retain experiences, which may be nonconscious, through physiological analogs of memory; and the potential to become a person in the full sense. Psychic personhood merits attribution of moral personhood because the experience of a 'person' in the psychic sense has continuity with the experience of a full person; and this experience begins to determine the development of the personal psychological characteristics of that individual. Psychic personhood is a rationally defensible boundary for invasive research involving human embryos and fetuses. Lacking precise empirical knowledge, policy makers could attribute psychic personhood at the time of earliest brainstem activity, that is, during the seventh week of fetal development.

Beginning of Human Life↗
PubMed1985

The logical status of brain death criteria.

This article is an attempt to clarify a confusion in the brain death literature between logical sufficiency/necessity and natural sufficiency/necessity. We focus on arguments that draw conclusions regarding empirical matters of fact from conceptual or ontological definitions. Specifically, we critically analyze arguments by Tom Tomlinson and Michael B. Green and Daniel Wikler, which, respectively, confuse logical and natural sufficiency and logical and natural necessity. Our own conclusion is that it is especially important in discussing the brain death issue to observe the distinction between logical and natural sufficiency/necessity in a strict fashion.

Brain Death↗
PubMed1986

The concept of rational suicide.

Suicide has been condemned in our culture in one way or another since Augustine offered theological arguments against it in the sixth century. More recently, theological condemnation has given way to the view that suicidal behavior must always be symptomatic of emotional disturbance and mental illness. However, suicide has not always been viewed so negatively. In other times and cultures, it has been held that circumstances might befall a person in which suicide would be a perfectly rational course of action, in the same sense that any other course of action could be rational: that it could be sensible, i.e., defensible by good reasons, or that it could be in keeping with the agent's fundamental interests. Indiscriminate use of modern life-sustaining technologies has renewed interest in the possibility of rational suicide. Today proponents of rational suicide tend to equate the rationality of suicide with the competence of the decision to commit suicide.

Altruism↗
PubMed1989

Brain life and brain death: a proposal for a normative agreement.

This paper reviews moral and cultural assessments which led to the definition of brain death and calls for a similar normative consensus regarding the moral recognition and legal protection of embryonal life related to criteria of brain life. This paper differentiates between cortical brain life I, i.e., the first existence of post-mitotic stationary neurons forming the early cortical plate (54th day post conception), and cortical brain life II, i.e., the beginning of cortical neuro-neuronal synapses (after the 70th day p.c.). The latter are preconditional for establishing the communicative network within the cortex and with subcortical structures. The paper conservatively calls for a tentative moral consensus that could recognize brain life I, i.e., the 54th day p.c., as a stage prior to which embryo research generally would be acceptable in accordance with principles similar to those which led to the acceptance of brain death. Other developmental stages such as fertilization, nidation, viability, as well as the 'potentiality' principle are less significant for the moral recognition of early human life.

Beginning of Human Life↗
PubMed1993

The personhood of the human embryo.

My interlocutor is anyone who denies personhood to the embryo on the grounds that a human person can exist only in conscious activity and that in the absence of consciousness a person cannot exist at all. I probe personal consciousness to the point at which the distinction between the being and the consciousness of the human person appears, and argue on the basis of this distinction that the being of a person can exist in the absence of any consciousness. I proceed to argue that it is not only entirely possible for the embryo to be a human person, but that, given the embodied personhood of us human beings, this is the only reasonable assumption which we can make.

Abortion, Induced↗
PubMed1993

Personhood, moral strangers, and the evil of abortion: the painful experience of post-modernity.

The epistemological and sociological consequences of post-modernity include the inability to show moral strangers, in terms they can see as binding, the moral wrongness of activities such as abortion. Such activities can be perceived as morally disordered within a content-full moral narrative, but not outside of the context it brings. Though one can salvage something of the Enlightenment project of justifying a morality that can bind moral strangers, one is left with moral and metaphysical views that can be recognized as impoverished and incomplete by those who live their lives within the embrace of a content-full moral narrative. The cardinal dualism of post-modernity is not that which separates mind from body, but the gulf between the morality binding moral strangers and that binding moral friends.

Abortion, Legal↗
PubMed1997

The moral status of intellectually disabled individuals.

The moral status accorded to an individual (or class of individuals) helps to account for the weight of the moral obligations considered due to an individual (or class of individuals). Strong arguments can be given to indicate that the moral status accorded, justly or unjustly, to individuals with intellectual disabilities is less than that accorded to those considered intellectually able. This paper suggests that such a view of the moral status of intellectually disabled individuals derives from individualism. Ontological and normative components of individualism are identified. It is shown that individualistic, ontological criteria for personhood compromise the integrity of "dependent" individuals. And it is shown that the normative component of individualism further compromises the integrity of intellectually disabled individuals. An alternative view of the self is outlined in which dependence features centrally. It is tentatively suggested that such a view of the self may prove more congenial to enhancing the moral status of individuals with intellectual disabilities.

Ego↗
PubMed1983

'Quality of life' and the analogy with the Nazis.

The introduction of 'quality of life' judgments into treatment decisions is viewed as pernicious by some who claim that these presuppose the Nazi position that those who are 'devoid of value' must be exterminated. 'Quality of life' judgments are said to deny the equal value of human beings and to assume that some lives are not 'worthy to be lived'. It is argued that the analogy misconstrues the senses of 'value' and 'quality' employed by Naziism and a 'quality of life' position. This leads the analogizers incorrectly to claim that both views assimilate the value of human beings to the value of their condition. A 'quality of life' position is grounded in recognition of the logical priority of the value of human beings as self-reflective evaluators and agents, which is a matter of kind, not degree. The 'quality of life' is explicated in terms of the standards of well-being of individuals, which are derived from their basic human needs and their individual priorities and goals. The use of 'quality of life' judgments is morally required to ensure that considerations of justice and individual autonomy govern treatment decisions. The purported analogy misconstrues the views of both the Nazi position and a 'quality of life' position and so is seriously misdirected.

Ethics, Medical↗
PubMed1983

Brain death and personal existence: a reply to Green and Wikler.

It has been argued that neither the biological or the moral justifications commonly given for adoption of brain-death criteria are adequate; and that the only argument that succeeds is an ontological justification based on the fact that one's personal identity terminates with the death of one's brain. But a more satisfactory ontological approach analyzes brain death in terms of the existence of a person in connection with a body, not personal identity. The personal-existence justification does not supplant the usual biological and moral arguments, but acts in concert with them.

Brain Death↗
PubMed1983

Courage and tragedy in clinical medicine.

The relationship between medical clinicians and patients is described as potentially tragic in nature and a context in which courage can be a relevant virtue. Danger, risk, uncertainty, and choice are presented as features of clinical relationships that also function as necessary conditions for courage. The clinician is seen as a 'sustaining presence' who has duties of 'encouragement' with respect to patients. The patient is seen to have a duty to learn the condition of human existence which can be discovered in clinical relations and to develop the virtues necessary to a fitting negotiation of human life. Case examples of courage on the parts of the principal participants in the clinical encounter are provided. In addition, several goods for clinicians and patients as objects of courage are identified.

Attitude of Health Personnel↗
PubMed1984

Liberty, beneficence, and involuntary confinement.

My purpose in this paper is to show that current legal criteria for paternalistic involuntary psychiatric confinement of the mentally ill are both too narrow and too broad. I do this by first developing a principle of justified paternalistic interference with adults, which I take to be acceptably protective of individual liberty, but which does not require unnecessary sacrifices of individual welfare. After offering an analysis of current legal criteria for involuntary confinement, I argue that an acceptable theory of paternalistic interference reveals that those criteria (1) exclude some cases where confinement would be morally permissible, and (2) allow paternalistic confinement of many whose detention is not morally justifiable.

Aged↗
PubMed1984

Volitional disability and physician attitudes toward noncompliance.

We develop the concept of a volitional disability as an aid in understanding those patients who behave in ways that are harmful to themselves in spite of their desire to do otherwise. Using this concept enables us to describe their behavior as intentional but 'involuntary'. We demonstrate the clinical reality of such behavior by giving clinical examples of the behavior of those with phobic, compulsive, and addictive disorders. We then attempt to show how some kinds of self-harming behavior of noncompliant patients are similar to phobic and compulsive behavior. We propose use of the concept of volitional disability to make it easier for physicians to work with these noncompliant patients and thus to improve their ability to provide better care for them.

Adolescent↗
PubMed1984

The conservative use of the brain-death criterion--a critique.

The whole brain-death criterion of death now enjoys a wide acceptance both within the medical profession and among the general public. That acceptance is in large part the product of the contention that brain death is the proper criterion for even a conservative definition of death - the irreversible loss of the integrated functioning of the organism as a whole. This claim - most recently made in the report of the Presidential Commission and in a comprehensive article by James Bernat and others - is based upon a series of fallacious arguments. Chief among these is the argument that whole brain-death is the proper criterion for the conservative definition because the brain is the organ that integrates the rest of the organism. A central part of the paper shows that this argument rests upon a confusion between a function and the mechanism that performs it, and replies to the defenses that the Presidential Commission makes on this point. The concluding portion of the paper argues that this issue is not merely of academic interest, but has the potential for undermining the present consensus that supports the use of whole brain-death criteria.

Advisory Committees↗