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PubMed1985

Baby Fae: a beastly business.

The Baby Fae experiment has highlighted the growing trend in medicine of using animal parts in the treatment of humans. This paper raises the question of the logical and moral justification for these current practices and their proposed expansion. We argue that the Cognitive Capacity Principle establishes morally justified necessary and sufficient conditions for the use of non-human animals in medical treatments and research. Some alternative sources for medical uses are explored as well as some possible programmes for their implementation.

Adult↗
PubMed1988

Philosophy, medicine and its technologies.

There is a need to bring ethics and medical practice closer together, despite the risk and problems this may involve. Deontological ethics may promote sanctity of life considerations against the quality of life considerations favoured by consequentialists or utilitarians; while talk of respect for life and the value of life may point to more qualified ethical positions. This paper argues for a respect-for-life position, dismissing a utilitarian cost-benefit outlook as too simplistic; but an unqualified fixed principles approach is also ruled out, both because of its unacceptable consequences in individual cases and also because of its reliance on the slippery slope argument which, it is argued, is logically and psychologically deficient. The case of genetic engineering provides an example in which the notion of respect may operate, but in which broad general principles also apply. A cautious conservatism towards accepted principles is recommended in the development of medical technologies.

Aborted Fetus↗
PubMed2003

A virtue ethics approach to moral dilemmas in medicine.

Most moral dilemmas in medicine are analysed using the four principles with some consideration of consequentialism but these frameworks have limitations. It is not always clear how to judge which consequences are best. When principles conflict it is not always easy to decide which should dominate. They also do not take account of the importance of the emotional element of human experience. Virtue ethics is a framework that focuses on the character of the moral agent rather than the rightness of an action. In considering the relationships, emotional sensitivities, and motivations that are unique to human society it provides a fuller ethical analysis and encourages more flexible and creative solutions than principlism or consequentialism alone. Two different moral dilemmas are analysed using virtue ethics in order to illustrate how it can enhance our approach to ethics in medicine.

Adult↗
PubMed2003

Frankensteins and cyborgs: visions of the global future in an age of technology.

This paper draws attention to the role of representation in the depiction of scientific and technological innovation as a means of understanding the narratives that circulate concerning the shape of things to come. It considers how metaphors play an important part in the conduct of scientific explanation, and how they do more than describe the world in helping also to shape expectations, normalise particular choices, establish priorities and create needs. In surveying the range of metaphorical responses to the digital and biotechnological age, we will see how technologies are regarded both as 'endangerment' and 'promise.' What we believe 'technology' is doing to 'us' reflects important implicit philosophies of technology and its relationship to human agency and political choice; yet we also need to be alert to the assumptions about 'human nature' itself which inform such reactions. The paper argues that embedded in the various representations implicit in the new technologies are crucial issues of identity, community and justice: what it means to be (post)human, who is (and who is not) entitled to the rewards of technological advancement, what priorities (and whose interests) will inform the shape of global humanity into the next century.

Biomedical Technology↗
PubMed1986

Applying Rawls to medical cases: an investigation into the usages of analytical philosophy.

John Rawls's Theory of Justice has been widely and correctly recognized as a tremendous intellectual accomplishment. It has been applauded as a comprehensive and satisfying approach to the problem of defining justice. Health policy analysts and medical ethicists have thus been inspired to apply Rawls's principles to various health care issues. The result has not been greater coherence in approaches to issues of policy and ethics, leading the author to question the validity of Rawls's analytical approach.

Abortion, Legal↗
PubMed1990

The moral meaning of religion for bioethics.

Religion's fundamental involvement with questions of disease, health, and medicine has given rise to concepts making substantial contributions to the field of bioethics. The purpose of this article is to examine such ongoing contributions in a general way, and then to review how the issue of whether medical technology should be used to prolong life might be approached from the standpoint of several different religious traditions.

Beneficence↗
PubMed1986

Principles and the search for moral certainty.

In medical ethics, principles have an important but frequently overextended role. The need for exact answers and moral formulae sometimes leads to the misuse of principles, such that they usurp the central place of persons and become ends in themselves. The Baby Jane Doe case is discussed as a prominent instance of both the proper uses and abuses of principles. A more fitting role for principles is described and illustrated, stressing the use of principles as tools of moral discernment and the time-laden character of moral judgments.

Abnormalities, Multiple↗
PubMed1985

Trust.

Explore the source record for details and available documents.

Complementary Therapies↗
PubMed1986

An argument that all prerandomized clinical trials are unethical.

Conversion of slowly accruing conventionally randomized studies to a prerandomized design has apparently been successful in increasing accrual enough so that some of these studies can be completed. Ellenberg (1984) has pointed out some of the ethical dangers of prerandomization. This paper argues that prerandomization must be either unsuccessful or unethical: either conversion to prerandomization will result in no significant increase in the rate of completion of the study or a significant increase in accrual rate will be achieved either at the price of an inadequate attempt to obtain informed consent, at the price of the deceit of patients, or at the price of violations of patient autonomy. The argument of the paper can be sketched as follows: For any given randomized study, either patients prefer one treatment arm to the other or they do not. On the one hand, if they do, then conventional randomization fails. But prerandomization, if done ethically, will fail also. Hence, if prerandomization succeeds in this sort of case, then the trial has been conducted unethically. On the other hand, if patients do not prefer one arm to the other, then prerandomization will succeed. So will conventional randomization. Hence, prerandomization is either unnecessary or unethical. Ellenberg's concerns count as good moral reasons for not prerandomizing if prerandomization is unnecessary. It follows that prerandomization is always wrong.

Clinical Trials as Topic↗
PubMed1989

The use of fetal and anencephalic tissue for transplantation.

Advances in transplantation have extended the life and relieved the suffering of thousands of individuals. The prospect of being able to use tissues from embryos, as well as from anencephalic newborns, offers the promise of further relief of suffering. However, these possibilities raise significant moral and public policy issues. The question arises of the extent to which those who disapprove of abortion may make use of tissues derived from abortion in order to treat serious diseases. This essay argues that, with proper safeguards, such tissue can be used without cooperating in abortion. That is, even those who oppose abortion can benefit from the use of tissue procured during abortion. Questions also arise regarding the probity of maintaining a pregnancy in order to produce an anencephalic newborn whose biological existence will be maintained so as better to secure organs once death is declared. It is argued that, since no harm can be done to a being that has neither a sense of self or the capacity to feel pain, and since women have a right to forego abortions, there is no legitimate ground for opposing women's seeking meaning in their pregnancy through maximizing the opportunity of others to use the organs of their anencephalic newborn once death has been declared. Finally, it is argued that, since the capacities for sentience, a minimal condition for personhood, are never realized by an anencephalic, the entity has never been alive as a person. Therefore, there should be no opposition in principle to aborting anencephalics nor, after proper declaration, to making their organs available as one would after whole-brain death, despite the continued functioning of the brain stem.

Aborted Fetus↗