Volume 30, Issue 1, March 2024, Page 83-88.

Nielsen Bush and Mjaaland (“the authors” hereafter) argue that controlled donation after circulatory death (cDCD) protocols that target abdominal organs are consistent with the dead donor rule (DDR...

The themes of this issue—which include the meaning of our health and disease concepts, the so-called “medical gaze” and its embedded power relations, and the epistemic value of mixing therapy with research—are introduced by reflecting on a case about an infant girl whose head is observed to be somewhat flat.

Smith argues that death caused by transplant surgery will not harm permanently unconscious patients, because they will not suffer a setback to their interests in the context of donation. Therefore, so the argument goes, the dead donor rule can be abandoned, because requiring a death declaration before procurement does not protect any relevant interest from being thwarted. Smith contends that a virtue of his argument is that it avoids the controversies over defining and determining death. I argue that it does (...) not and explain why no change in policy is justified. (shrink)

In this paper, I introduce the ideas to be discussed in the articles of this journal with reference to an imaginary case involving a pregnant woman declared dead on the basis of neurological criteria. I highlight the fact that although these ideas have proved useful for advancing certain claims in bioethical debates, their implications are not always well understood and may complicate our arguments. The ideas to be discussed are an ethic internal to the profession of medicine; the difference between (...) killing and letting die; the organism as a whole; and the “lives” and interests of the dead. (shrink)

In a recent article Steven Cowan defended the claim that female subordination and male authority are merely functional differences. Drawing insights from Natural Law, I argue that complementarianism typically speaks of these as proper functions of male and female designs, thus making men and women metaphysically unequal in being. Furthermore, I maintain that the function "serving as a means to an end" is less valuable than the function "having the authority to direct the end." Hence, Cowan fails to defeat the (...) objection that the claim that women are equal to men in being, but subordinate in role is incoherent. (shrink)

The biophilosophic justification for the idea that “brain death” is death needs to support two claims: that what dies in human death is a human organism, not merely a psychological entity distinct from it; that total brain failure signifies the end of the human organism as a whole. Defenders of brain death typically assume without argument that the first claim is true and argue for the second by defending the “integrative unity” rationale. Yet the integrative unity rationale has fallen on (...) hard times. In this article, I give reasons for why we should think of ourselves as organisms, and why the “fundamental work” rationale put forward by the 2008 President’s Council is better than the integrative unity rationale, despite persistent objections to it. (shrink)

Although much has been written on the dead-donor rule in the last twenty-five years, scant attention has been paid to how it should be formulated, what its rationale is, and why it was accepted. The DDR can be formulated in terms of either a Don’t Kill rule or a Death Requirement, the former being historically rooted in absolutist ethics and the latter in a prudential policy aimed at securing trust in the transplant enterprise. I contend that the moral core of (...) the rule is the Don’t Kill rule, not the Death Requirement. This, I show, is how the DDR was understood by the transplanters of the 1960s, who sought to conform their practices to their ethics—unlike today’s critics of the DDR, who rethink their ethics in a question-begging fashion to accommodate their practices. A better discussion of the ethics of killing is needed to move the debate forward. (shrink)

In transplant medicine, the use of normothermic regional perfusion (NRP) in donation after circulatory determination of death raises ethical difficulties. NRP is objectionable because it restores the donor's circulation, thus invalidating a death declaration based on the permanent cessation of circulation. NRP's defenders respond with arguments that are tortuous and factually inaccurate and depend on introducing extraneous concepts into the law. However, results comparable to NRP's—more and higher‐quality organs and more efficient allocation—can be achieved by removing organs from deceased donors (...) and using normothermic machine perfusion (NMP) to support the organs outside the body, without jeopardizing confidence in transplantation's legal and ethical foundations. Given the controversy that NRP generates and the convoluted justifications made for it, we recommend a prudential approach we call “ethical parsimony,” which holds that, in the choice between competing means of achieving a result, the ethically simpler one is to be preferred. This approach makes clear that policy‐makers should favor NMP over NRP. (shrink)

Shavelson et al., argues that California’s End of Life Option Act (ELOA) violates the Americans with Disabilities Act (ADA), because the ELOA requires the patient to “self-administer” their prescri...

Looking to Scripture through the eyes of contemporary medical experience, I analyze the meaning of the criteria used for determining death, specifically in the light of Jesus’ final moments and the resurrection of the Shunammite’s son in 2 Kings, chapter 4. I argue that four theses are consistent with, and informed by, these passages that can help guide Christian belief and decision-making about how death is determined in the clinical context: (1) death is neither permanent nor irreversible; (2) something like (...) the “brain dead” state is, at best, a confounding state that requires one to “pace and pray” or let go; (3) that the case for determining death by neurologic criteria depends on the “working togetherness” of the body's parts for the sake of impacting its environment; and (4) that the practice of neurologically-based death determination is a response to the problem of disaggregation of the human form into its organ systems that modern critical care medicine makes possible. I end with advice about how Christians might approach the debates over the law and practice even if they cannot come to a consensus. (shrink)

The articles by Bernat, Busch, Dudzinski et al., and Derse illustrate the difficulties with reconciling normothermic regional perfusion (NRP) with the dead donor rule (DDR) (Bernat forthcoming; Busch forthcoming; Dudzinski et al. forthcoming; Derse forthcoming). I appreciate their arguments because they help illuminate the issues that generate a dilemma: either reject NRP or the DDR. I am convinced that the dilemma is unavoidable because the procurement team is involved with determining and securing the death of the donor when circulation restarts. (...) Evidence for this is found in the reasons and recommendations given for blocking blood flow to the brain, both of which betray a lack of certainty over the donor’s vital status. The surgical activity in NRP therefore conflicts with the values the DDR protects: respect for the donor’s life and avoidance of conflict of interest. (shrink)

Arian Lewis provides a comprehensive overview of how the United Kingdom’s medicolegal context manages challenges to determining death by neurologic criteria (DNC) and suggests that a well-crafted s...

The dead donor rule (DDR) prohibits retrieval protocols that would be lethal to the donor. Some argue that compliance with it can be maintained by satisfying the requirements of double‐effect reasoning (DER). If successful, one could support organ donation without reference to the definition of death while being faithful to an ethic that prohibits intentionally killing innocent human life. On the contrary, I argue that DER cannot make lethal organ donation compatible with the DDR, because there are plausible ways it (...) fails DER's requirements. A key takeaway is that the theories of intention and proportionality assumed in DER matter for its plausibility as a constraint on practical reasoning. (shrink)

There are increasing calls for rejecting the ‘dead donor’ rule and permitting ‘organ donation euthanasia’ in organ transplantation. I argue that the fundamental problem with this proposal is that it would bestow more worth on the organs than the donor who has them. What is at stake is the basis of human equality, which, I argue, should be based on an ineliminable dignity that each of us has in virtue of having a rational nature. To allow mortal harvesting would be (...) to make our worth contingent upon variable quality of life of judgments that can only be based on properties that come in degrees. Thus, rejecting the ‘dead donor’ rule comes at the expense of our egalitarian principles with respect to the value each individual human life has in relation to the protections against killing. (shrink)

In ‘Dilemma for Appeals to the Moral Significance of Birth’, we argued that a dilemma is faced by those who believe that birth is the event at which infanticide is ruled out. Those who reject the moral permissibility of infanticide by appeal to the moral significance of birth must either accept the moral permissibility of a late-term abortion for a non-therapeutic reason or not. If they accept it, they need to account for the strong intuition that her decision is wrong (...) as well as deny the underlying normative principle that killing a viable fetus requires good reason, and not wanting to care for the child when the child could be easily placed for adoption is not a good enough reason to abort. If they reject the moral permissibility of the late-term abortion, they need to explain why her decision is wrong. Doing so, however, will undermine their own project of denying infanticide by appeal to birth. Walter Veit argues that the dilemma relies too much on intuition and does not live up to biological continuity. We explain why his criticisms are unconvincing. (shrink)

Some of the most difficult consultations for an ethics consultant to resolve are those in which the patient is ready to leave the acute-care setting, but the patient or family refuses the plan, or the plan is impeded by deficiencies in the healthcare system. Either way, the patient is “stuck” in the hospital and the ethics consultant is called to help get the patient “unstuck.” These encounters, which we call “complex discharges,” are beset with tensions between the interests of the (...) institution and the interests of the patient as well as tensions within the ethics consultant whose commitments are shaped both by the values of the organization and the values of their own profession. The clinical ethics literature on this topic is limited and provides little guidance. What is needed is guidance for consultants operating at the bedside and for those participating at a higher organizational level. To fill this gap, we offer guidance for facilitating a fair process designed to resolve the conflict without resorting to coercive legal measures. We reflect on three cases to argue that the approach of the consultant is generally one of mediation in these types of disputes. For patients who lack decision making capacity and lack a surrogate decision maker, we recommend the creation of a complex discharge committee within the organization so that ethics consultants can properly discharge their duties to assist patients who are unable to advocate for themselves through a fair and transparent process. (shrink)

Giubilini and Minerva argue that the permissibility of abortion entails the permissibility of infanticide. Proponents of what we refer to as the Birth Strategy claim that there is a morally significant difference brought about at birth that accounts for our strong intuition that killing newborns is morally impermissible. We argue that strategy does not account for the moral intuition that late-term, non-therapeutic abortions are morally impermissible. Advocates of the Birth Strategy must either judge non-therapeutic abortions as impermissible in the later (...) stages of pregnancy or conclude that they are permissible on the basis of premises that are far less intuitively plausible than the opposite conclusion and its supporting premises. (shrink)

Walter Sinnott-Armstrong and Franklin G Miller recently argued that the wrongness of killing is best explained by the harm that comes to the victim, and that ‘total disability’ best explains the nature of this harm. Hence, killing patients who are already totally disabled is not wrong. I maintain that their notion of total disability is ambiguous and that they beg the question with respect to whether there are abilities left over that remain relevant for the goods of personhood and human (...) worth. If these goods remain, then something more is lost in death than in ‘total disability,’ and their explanation of what makes killing wrong comes up short. But if total disability is equivalent with death, then their argument is an interesting one. (shrink)

Solid organ xenotransplantation may have the potential to help address the shortage of organs for transplantation. There is concern, however, that a novel zoonotic disease could be transmitted from the source organ to the human recipient, and then from the recipient to others. Theoretically, this could result in an epidemic or pandemic. Because of this potential risk, it has been argued that collective consent is required. Our goal is to critically evaluate the claim that collective consent is necessary for xenotransplantation (...) to be ethically permissible. We argue that collective consent is not required and highlight the important roles of public engagement and due diligence in xenotransplant research moving forward. (shrink)

Joshua Mezrich is a practicing transplant surgeon who draws on his experiences, and those of his patients, to provide a "here's where we're at" moment in the story of transplant medicine. In so doing, he explains what it is like to practice while telling the stories of his patients, donors, and the pioneering surgeons who persisted in the face of failure to make what Mezrich does a work of healing. Written for a popular audience, When Death Becomes Life is perhaps (...) the most accessible work yet on the modern history of organ transplantation and what the current "standard of care" actually looks like. Indeed, it rounds out a "trinity" of quality books about the transplant experience, this one from the surgeon's... (shrink)

Benjamin Gregg’s Creating Human Nature: The Political Challenges of Genetic Engineering is a wide-ranging and controversial approach to the politics of genetic engineering. The book consists of thr...

Preclinical xenotransplantation research using genetically engineered pigs has begun to show some promising results and could one day offer a scalable means of addressing organ shortage. While it is a fundamental tenet of ethical human subject research that participants have a right to withdraw from research once enrolled, several scholars have argued that the right to withdraw from xenotransplant research should be suspended because of the public health risks posed by xenozoonotic transmission. Here, we present a comprehensive critical evaluation of (...) the claim that xenotransplant recipients should be required to waive their right to withdraw from lifelong biosurveillance. We conclude that if xenotransplantation requires participants to waive their right to withdraw, then clinical trials may not be justifiable, given the ethical and legal obstacles involved with doing so. Consequently, if clinical trials are permitted with a right to withdraw, then they may pose a significant public health risk. (shrink)

It is envisioned that one day xenotransplantation will bring about a future where transplantable organs can be safely and efficiently grown in transgenic pigs to help meet the global organ shortage. While recent advances have brought this future closer, worries remain about whether it will be beneficial overall. The unique challenges and risks posed to humans that arise from transplanting across the species barrier, in addition to the costs borne by non-human animals, has led some to question the value of (...) xenotransplantation altogether. In response, we defend the value of xenotransplantation research, because it can satisfy stringent welfare conditions on the permissibility of animal research and use. Along the way, we respond to the alleged concerns, and conclude that they do not currently warrant a cessation or a curtailing of xenotransplantation research. (shrink)

n recent years, there has been a resurgence of academic interest in Adam Smith. As a consequence, a large number of PhD dissertations on Smith have been written by international scholars - in different languages, and in many diverse disciplines, including economics, women’s studies, philosophy, science studies, political theory and english literature: diversity which has enriched the area of study. In response to this activity, and in order to making these contributions more easily accessible to other Smith scholars, Leonidas (...) Montes and Eric Schliesser have edited this important new book. Of interest to Smith scholars and those interested in the history of economic thought in general, the contributions to this book are self-consciously interdisciplinary and skilfully employ many different methodologies. (shrink)

Adam Omelianchuk argues that my defense of the distinction between woman’s equality in being and subordinate role fails. I respond that his case misses the point of certain aspects of my argument, that it begs the main question, and that it depends upon an unclear notion of metaphysical equality/inferiority.

Two complete eBooks for one low price! Created and compiled by the publisher, this Philosophy & Ethics bundle brings together two important titles in one, e-only bundle. With this special bundle, you’ll get the complete text of the following two titles: _Philosophy For Dummies_ _Philosophy For Dummies_ is for anyone who has ever entertained a question about life and this world. In a conversational tone, the book's author – a modern-day scholar and lecturer – brings the greatest wisdom of the (...) past into the challenges that we face now. This refreshingly different guide explains philosophical fundamentals and explores some of the strangest and deepest questions ever posed to human beings, such as: How do we know anything? What does the word _good_ mean? Are we ever really free? Do human beings have souls? Is there life after death? Is there a God? Is happiness really possible in our world? _Ethics For Dummies_ An easy-to-grasp guide to addressing the principles of ethics and applying them to daily life How do you define "good" versus "evil?" Do you know the difference between moral "truth" and moral relativity? Whether or not you know Aristotle from Hume, _Ethics For Dummies_ will get you comfortable with the centuries-old study of ethical philosophy quickly and effectively! _Ethics For Dummies_ is a practical, friendly guide that takes the headache out of the often-confusing subject of ethics. In plain English, it examines the controversial facets of ethical thought, explores the problem of evil, demystifies the writings and theories of such great thinkers through the ages as Aristotle, Confucius, Descartes, Kant, Nietzsche, and so much more. You’ll learn how to apply the concepts and theories of ethical philosophy to your everyday life. Whether you're currently enrolled in an ethics course or are interested in living a good life but are vexed with ethical complexities_, Ethics For Dummies_ has you covered! About the Author of _Philosophy For Dummies_ Tom Morris, Ph.D., author of True Success and other books, taught philosophy at Notre Dame University for 15 years and currently heads the Morris Institute for Human Values. About the Authors of _Ethics For Dummies_ Christopher Panza, PhD, is an associate professor of philosophy at Drury University and coauthor of Existentialism For Dummies. Adam Potthast, PhD, is an assistant professor of philosophy at Missouri University of Science and Technology. (shrink)

Are racial slurs always offensive and are racial stereotypes always negative? How, if at all, are racial slurs and stereotypes different and unequal for members of different races? Questions like these and others about slurs and stereotypes have been the focus of much research and hot debate lately, and in a recent article Embrick and Henricks (2013) aimed to address some of the aforementioned questions by investigating the use of racial slurs and stereotypes in the workplace. Embrick and Henricks (2013) (...) drew upon the empirical data they collected at a baked goods company in the southwestern United States to argue that racial slurs and stereotypes function as symbolic resources that exclude minorities but not whites from opportunities or resources and that racial slurs and stereotypes are necessarily considered as negative or derogatory irrespective of their particular context of use (pp. 197–202). They thus proposed an account of slurs and stereotypes that supports the context-insensitive position of Fitten (1993) and Hedger (2013) yet challenges the context-sensitive position of Kennedy (2002) and Croom (2011). In this article I explicate the account of racial slurs and stereotypes provided by Embrick and Henricks (2013), outline 8 of their main claims, and then critically evaluate these claims by drawing upon recent empirical evidence on racial slurs (both in-group and out-group uses) and stereotypes (for both whites and blacks) to point out both strengths and weaknesses of their analysis. Implications of the present analysis for future work on slurs and stereotypes will also be discussed. (shrink)

There is a huge chasm between the notion of lawful determination that figures in fundamental physics, and the notion of causal determination that figures in the "folk physics" of everyday objects. In everyday life, we think of the behavior of an ordinary object as being determined by a small set of simple conditions. But in fundamental physics, no such conditions suffice to determine an ordinary object's behavior. What bridges the chasm is that fundamental physical laws make the folk picture of (...) the world approximately true in certain domains. How? In part, by entailing that many objects are approximately isolated from most of their environments. Dynamical laws yield this result only in conjunction with appropriate statistical assumptions about initial conditions. (shrink)

Adam Graves presents a new framework for understanding the importance of the concept of revelation in the development of phenomenology while also charting a path towards a more fruitful understanding of the relationship between reason and revelation, one that is rooted in a deeper appreciation of the complexities of our linguistic inheritance.

We present a case study of how mathematicians write for mathematicians. We have conducted interviews with two research mathematicians, the talented PhD student Adam and his experienced supervisor Thomas, about a research paper they wrote together. Over the course of 2 years, Adam and Thomas revised Adam’s very detailed first draft. At the beginning of this collaboration, Adam was very knowledgeable about the subject of the paper and had good presentational skills but, as a new PhD (...) student, did not yet have experience writing research papers for mathematicians. Thus, one main purpose of revising the paper was to make it take into account the intended audience. For this reason, the changes made to the initial draft and the authors’ purpose in making them provide a window for viewing how mathematicians write for mathematicians. We examined how their paper attracts the interest of the reader and prepares their proofs for validation by the reader. Among other findings, we found that their paper prepares the proofs for two types of validation that the reader can easily switch between. (shrink)

Believing is not much like premeditated intentional action, but neither is it completely reflexive. If we had no more control over believing than we have over our automatic reflexes, it would be hard to make sense of the idea of epistemic virtues. There is, after all, no excellence of the eye blink or the knee jerk. If there are epistemic virtues, then our degree of voluntary control over believing must lie somewhere between the extremes of what we experience with passive (...) reflexes and intentional actions. Believing is not the only human activity that lies between these extremes. A number of behaviors and bodily processes do. Using some of these as a model, I will give an account of the nature of our voluntary control over believing and argue that it is necessary to ground the conviction that epistemic virtues do make sense. (shrink)

Issues of nature conservation, and socio-cultural movement called ecologism, are vivid becouse o f it’s many controvertions and actual validity in terms o f sustainable development. This paper presents contemporary motives o f preserving the nature, scientific ways of it’s realization, and chosen issues o f so called „ecological spirituality”. Reflection on the abilities and perils of science and spirituality, with reference to philosophy and practical conservation activity, will be led. Finally, there will be an attemption to answer the question (...) about relation between nature preservation, science and ecological spirituality, and to define the spiritual condition and trends in contemporary ecologism. (shrink)

L'anthropologie sud-africaine a historiquement été divisée en deux écoles: l'une, associée aux universités de langue afrikaans, appuyait l'apartheid; l'autre, associée aux universités anglophones, s'opposait à la ségrégation et à la discrimination raciale. L'anthropologie afrikaner se focalisait sur la culture, la tradition et l'ethnicité, tandis que l'école rivale voulait étudier l'Afrique du Sud comme une société unique, en transformation rapide. Cette opposition, qui a parfois été exagérée, a été la plus marquée dans la période de renforcement de l'apartheid, dans les années (...) soixante et soixante-dix, mais il y a toujours eu un débat considérable sur les objets mêmes des recherches en anthropologie, en particulier sur la nature des groupes «raciaux» et «tribaux» en Afrique du Sud. Ces problèmes, fondamentaux d'un point de vue politique, ont forcé les anthropologues à se confronter aux grandes questions posées par les politiques gouvernementales. Cet article retrace l'histoire de ces débats sur la classification des populations en Afrique du Sud. (shrink)

The purpose of this paper is to draw attention to the normative role of conventions in sports. However, the approach I have in mind does not dispatch the theory of interpretivism. What I offer is a synthesis that aims to show how interpretivism works in concert with – and relies heavily on – conventions. To make this point, I will argue that historical, cultural, and even simple preferential needs and desires help to determine what counts as athletic ‘excellence’ in sports.

Philosophy of perception has recently become one of the most important and most central sub-fields of philosophical research. The aim of this volume is to give a representative sample of the new approaches in philosophy of perception that are responsible for this explosion of philosophical interest. Perceiving the World contains eleven original essays, written specially for this book by some of the leading contemporary philosophers of perception: Jonathan Cohen, JTr(me Dokic, Fred Dretske, Andy Egan, Benj Hellie, Sean D. Kelly, M.G.F. (...) Martin, Mohan Matthen, Adam Pautz, Jesse J. Prinz, and Susanna Siegel." "Bence Nanay is BOF Research Professor of Philosophy at the University of Antwerp and Senior Research Associate at Peterhouse, University of Cambridge. He received his PhD at the University of California, Berkeley, in 2006. He has published articles in various journals on philosophy of mind, philosophy of biology, and aesthetics."--BOOK JACKET. (shrink)

ABSTRACTThis essay argues that within competitive sport zero-sum logic and the theory of mutualism are compatible and complementary. Drawing on Robert Simon’s theory of mutualism and Scott Kretchmar’s argument for zero-sum logic, this article shows how athletes can strive for a clear-cut victory and shared benefits such as athletic excellence fully and wholeheartedly at the same time. This paper will also consider how acknowledgment of this dynamic could advance understandings for ethical theories for sport. It will then conclude by describing (...) a subjective approach that will make the affinity of zero-sum logic and mutualism more accessible for sports people. (shrink)

A paradox of self-reference in beliefs in games is identified, which yields a game-theoretic impossibility theorem akin to Russell’s Paradox. An informal version of the paradox is that the following configuration of beliefs is impossible:Ann believes that Bob assumes that.