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The embryonic stem cell lottery and the cannibalization of human beings.

One objection to embryonic stem (ES) research is that it 'cannibalizes' human beings, that is, kills some human beings to benefit others. I grant for argument's sake that the embryo is a person. Nonetheless, killing it may be justified. I show this through the Embryonic Stem Cell Lottery. Whether killing a person is justified depends on: (1) whether innocent people at risk of being killed for ES cell research also stand to benefit from the research and (2) whether their overall chances of living are higher in a world in which killing and ES cell research is conducted. I call this kind of killing 'risk reductive.'

Cannibalism↗

Embryos, individuals, and persons: an argument against embryo creation and research.

One strategy for arguing that it should be legally permissible to create human embryos, or to use spare human embryos, for scientific research purposes involves the claim that such embryos cannot be persons because they are not human individuals while twinning may yet take place. Being a human individual is considered to be by most people a necessary condition for being a human person. I argue first that such an argument against the personhood of embryos must be rationally conclusive if their destruction in public places such as laboratories is to be countenanced. I base this argument on a popular understanding of the role that the notion of privacy plays in abortion laws. I then argue that such arguments against personhood are not rationally conclusive. The claim that the early embryos is not a human individual is not nearly as obvious as some assert.

Abortion, Induced↗

Using people.

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Beginning of Human Life↗

Human gene therapy: down the slippery slope?

The strength of a slippery slope argument is a matter of some dispute. Some see it as a reasonable argument pointing out what probably or inevitably follows from adopting some practice, others see it as essentially a fallacious argument. However, there seems to be a tendency emerging to say that in many cases, the argument is not actually fallacious, although it may be unsubstantiated. I shall not try to settle this general discussion, but merely seek to assess the strength of the slippery slope argument applied to human gene therapy. The structure of my argument will be the following. First, I shall distinguish between three different versions of the slippery slope argument; two logical versions and an empirical one. Next, I will address human gene therapy in terms of each of the three versions, partly relying on slippery slope arguments against this practice that have already surfaced in the literature. I shall argue that neither version pulls through. The logical versions fail primarily because relevant distinctions can be made between different uses of gene therapy, contrary to what the proponents of the arguments claim. The empirical version fails because there seems to be no evidence supporting the claim that we shall in fact slide down the slope if we engage in gene therapy, and because if we accepted the conclusion that we should not allow gene therapy on the basis of the empirical argument, we should have to make very far-reaching and undesirable modifications in health care in general, in order to be consistent. Or at least so I shall argue.

Altruism↗

Bodyworlds and the ethics of using human remains: a preliminary discussion.

Accepting the claim that the living have some moral duties with regard to dead bodies, this paper explores those duties and how they bear on the popular travelling exhibition Bodyworlds. I argue that the concept of informed consent presupposes substantial duties to the dead, namely duties that reckon with the meaning of the act in question. An attitude of respect and not regarding human remains as mere raw material are non-alienable substantial duties. I found the ethos of Bodyworlds premature but full of promises such as public attitudes to organ donations. At the practical level I conclude that Bodyworlds should use only willed donations or unclaimed bodies for which dignified funerals are not available. In the case of live donations, Bodyworlds has a duty to participate in the medical care of needy donors. However, secrecy with regard to the source of cadavers seems to be the most troublesome aspect of Bodyworlds.

Anatomy, Artistic↗

An analytic approach to resolving problems in medical ethics.

Education in ethics among practising professionals should provide a systematic procedure for resolving moral problems. A method for such decision-making is outlined using the two classical orientations in moral philosophy, teleology and deontology. Teleological views such as utilitarianism resolve moral dilemmas by calculating the excess of good over harm expected to be produced by each feasible alternative for action. The deontological view focuses on rights, duties, and principles of justice. Both methods are used to resolve the 1971 Johns Hopkins case of a baby born with Down's syndrome and duodenal atresia.

Decision Making↗

Dignity and cost-effectiveness: a rejection of the utilitarian approach to death.

Utilitarianism is commonly assumed to be the most appropriate sub-structure for medical ethics. This view is challenged. It is suggested that the utilitarian approach to euthanasia works against the patient's individual advantage and is a corrupting influence in the relationship between the physician and society. Dignity for the individual patient is not easily achieved by assessing that person's worth against the yardstick of others' needs and wishes.

Attitude to Death↗

Arresting but misleading phrases.

This paper discusses some common misconceptions of what a utilitarian approach to medical ethics is and of the conclusions it forces upon those disposed to accept such an approach. It suggests that broad and unargued characterisations of approaches to moral questions as 'utilitarian', 'Hippocratic' or whatever are likely to be misleading and counterproductive. What matters is not what to call the position that people feel inclined to accept but rather what arguments there are in its favour and what arguments there are against it.

Aged↗

Death in Denmark.

Does it matter that the hearts of 'brainstem dead' patients may persist in beating spontaneously? Hostile reactions, to the Danish inclusion of cardiac criteria in the determination of death, betray reductionist views of human life at the core of 'brainstem' conceptions of death. Such views (whether centred on neurological function or on abstractions concerning 'personhood') supplant the richness of human life and death with the poverty of essentialism: and mask the lethal nature of beating-heart organ retrieval. The affirmation of cardiac criteria for death is not an alternative form of essentialism as some critics suppose, but part of an understanding of human life and death which rejects essentialism altogether. The spontaneously persistent heartbeat does not constitute human life, but most certainly counts for it.

Advisory Committees↗

Must doctors save their patients?

Do doctors and other medical staff have an obligation to treat those who need their help? This paper assumes no legal or contractual obligations but attempts to discover whether there is any general moral obligation to treat those in need. In particular the questions of whether or not the obligation that falls on medical staff is different from that of others and of whether doctors are more blameworthy than others if they fail to treat patients are examined. Finally we look at the question of the burden of this obligation and at the responsibility of society to mitigate its hardships.

Contracts↗

Parental consent and the use of dead children's bodies.

It has recently become known that, in Liverpool and elsewhere, parts of children's bodies were taken postmortem and used for research without the parents being told. But should parental consent be sought before using children's corpses for medical purposes? This paper presents the view that parental consent is overrated. Arguments are rejected for consent from dead children's interests, property rights, family autonomy, and religious freedom. The only direct reason to get parental consent is to avoid distressing the parents, which carries implications for the consent process, secret harvesting of body parts, and the weight to be given to parental feelings.

Adult↗

At the edge of humanity: human stem cells, chimeras, and moral status.

Experiments involving the transplantation of human stem cells and their derivatives into early fetal or embryonic nonhuman animals raise novel ethical issues due to their possible implications for enhancing the moral status of che chimeric individual. Although status-enhancing research is not necessarily objectionable from the perspective of the chimeric individual, there are grounds for objecting to it in the conditions in which it is likely to occur. Translating this ethical conclusion into a policy recommendation, however, is complicated by the fact that substantial empirical and ethical uncertainties remain about which transplants, if any, would significantly enhance the chimeric individual's moral status. Considerations of moral status justify either an early-termination policy on chimeric embryos, or, in the absence of such a policy, restrictions on the introduction of pluripotent human stem cells into early-stage developing animals, pending the resolution of those uncertainties.

Animal Experimentation↗