Five studies examined the extent to which autobiographical memory retrieval is hierarchical, whether a hierarchical search depends on central executive resources, and whether retrieving memories that are “higher” in the hierarchy impairs problem‐solving ability. The first study found that random generation (assessed using a button‐pressing task) was sensitive to changes in memory load (digit span). The second study showed that when participants fail to retrieve a target event, they respond with a memory that is higher up the hierarchy. The (...) third study showed that memory is more generic only when participants use low imageable cues under cognitive load. The final two experiments showed that experimental manipulation of memory specificity affects problem solving (MEPS performance). The data are consistent with Conway and Pleydell‐Pearce's hierarchical retrieval model of autobiographical memory, and suggest that overgeneral memory in nonclinical participants is associated with reduced executive capacity only when retrieval is “top‐down” (generative). (shrink)

Over the past several decades, scholars of liberal and democratic theory have shown a heightened interest in the role that various virtues might play in promoting the good/free society. Yet within this recent "return" to the virtues, one quality that has been almost entirely left out of the discussion is humility. In this essay, I critically address this lacuna and offer a defense of a particular form of humility, what I call democratic humility. After considering a range of moral and (...) political objections to the concept of humility, Iprovide an account that seeks to address some of these long-standing difficulties while arguing that the idea of humility, recuperated as an ethos of civic attentiveness, may be one of the most important virtues for late-modern societies marked by ethical and cultural pluralism. (shrink)

This paper defends an in principle understanding of the authority of persons over themselves and, in consequence, argues for significant limits on morally permissible state authority. It also defends an account of the limits of permissible state action that distinguishes between the ability of persons to convey authority to common projects and what may be judged virtuous, good, safe, or proper to do. In terms of organ transplantation policy, it concludes that it is morally acceptable, and should be legally permissible, (...) for individuals to sell one of their kidneys while living, pocketing the cash to use as that person sees fit to advance their own understanding of their own best interests. Morally objectionable policy proposals, I argue, are not those that encourage individuals to sell a redundant kidney while living or families to sell the organs of a recently deceased loved one, but those that seek coercively to confiscate the organs of the recently deceased. Recognizing the authority of persons over themselves, and their ability to convey moral authority to common projects, including the sale of human organs for transplantation, would shed light on the medical marketplace and clarify public policy, while increasing the efficiency and effectiveness of procuring human organs for transplantation. (shrink)

Bioethics functions within a world of deep moral pluralism; a universe of discourse debating ethical analysis, public policy, and clinical practice in which a common, generally accepted morality does not exist. While religious thinkers are often approached within a hermeneutic of suspicion for assuming moral standards that cannot be justified in rational terms, secular bioethicists routinely find themselves in exactly the same intellectual predicament. That ethical theory, proposed values, or normative content is secular, that it does not invoke God or (...) any particular religious perspective, does not mean that it is rationally grounded, necessarily true, or universally binding. As the authors in this issue of The Journal of Medicine and Philosophy make clear, this normative reality directly impacts debates regarding concepts of health, illness, and disease, accounts of socially acceptable health-risky behaviors, and the political frameworks that shape public policy. As a result, honest discussion of diverse moral, religious, and political perspectives remains essential in clarifying the intellectual challenges, ethical intuitions, and ideological judgments that shape clinical practice and healthcare policy. Depending on which moral, political, or scientific concepts are guiding bioethical analysis, careful scrutiny will tend to support rather different policies and practices, each of which is likely to be worth careful consideration. (shrink)

"Explores the concept of the social contract and how it shapes citizenship. Argues that the modern social contract is an account of the ethical and cultural conditions upon which modern citizenship depends"--Provided by publisher.

Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and the education of medical (...) students. The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine — prevention of disease, relief of suffering, care of the ill, and avoidance of premature death — and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health. The Goals of Medicine clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless. (shrink)

The legal basis of informed consent in Texas may on first examination suggest an unqualified affirmation of persons as the source of authority over themselves. This view of individuals in the practice of informed consent tends to present persons outside of any social context in general and outside of their families in particular. The actual functioning of law and medical practice in Texas, however, is far more complex. This study begins with a brief overview of the roots of Texas law (...) and public policy regarding informed consent. This surface account is then contrasted with examples drawn from the actual functioning of Texas law: Texas legislation regarding out-of-hospital do-not-resuscitate (DNR) orders. As a default approach to medical decision-making when patients lose decisional capacity and have failed to appoint a formal proxy or establish their wishes, this law establishes a defeasible presumption in favor of what the law characterizes as “qualified relatives” who can function as decision-makers for those terminal family members who lose decisional capacity. The study shows how, in the face of a general affirmation of the autonomy of individuals as if they were morally and socially isolated agents, space is nevertheless made for families to choose on behalf of their own members. The result is a multi-tier public morality, one affirming individuals as morally authoritative and the other recognizing the decisional standing of families. (shrink)

This paper critically explores key aspects of the gulf between traditional Christian bioethics and the secular moral reflections that dominate contemporary bioethics. For example, in contrast to traditional Christian morality, the established secular bioethics judges extramarital sex acts among consenting persons, whether of the same or different sexes, as at least morally permissible, affirms sexual freedom for children to develop their own sexual identity, and holds the easy availability of abortion and infanticide as central to the liberty interests of women. (...) Secular bioethics seeks to separate children from the authority of their parents, placing children themselves as in authority to make their own judgments about appropriate lifestyle choices, including sexual behaviors. As I argue, however, absent God, there exists no standpoint outside of our own cultural sociohistorically conditioned understanding from which to communicate any deeper perspective of reality or the bioethics that such a perspective would secure. Consequently, rather than discerning moral truth, secular bioethics merely affirms its own particular cultural sociohistorically conditioned ideological perspective. It is a social and political worldview bereft of definitive moral foundation, independent moral authority, or unambiguous content. (shrink)

The essays in this issue of The Journal of Medicine and Philosophy explore an innovative voucher program for encouraging kidney donation. Discussions cluster around a number of central moral and political/theoretical themes: What are the direct and indirect health care costs and benefits of such a voucher system in human organs? Do vouchers lead to more effective and efficient organ procurement and allocation or contribute to greater inequalities and inefficiencies in the transplantation system? Do vouchers contribute to the inappropriate commodification (...) of human body parts? Is there a significant moral difference between such a voucher system and a market in human organs for transplantation? This paper argues that while kidney vouchers constitute a step in the right direction, fuller utilization of market-based incentives, including, but not limited to, barter exchanges, would save more lives and further reduce human suffering. (shrink)

Several axiom systems for preference among acts lead to a unique probability and a state-independent utility such that acts are ranked according to their expected utilities. These axioms have been used as a foundation for Bayesian decision theory and subjective probability calculus. In this article we note that the uniqueness of the probability is relative to the choice of whatcounts as a constant outcome. Although it is sometimes clear what should be considered constant, in many cases there are several possible (...) choices. Each choice can lead to a different "unique" probability and utility. By focusing attention on statedependent utilities, we determine conditions under which a truly unique probability and utility can be determined from an agent's expressed preferences among acts. Suppose that an agent's preference can be represented in terms of a probability P and a utility U.That is, the agent prefers one act to another iff the expected utility of that act is higher than that of the other. There are many other equivalent representations in terms of probabilities Q, which are mutually absolutely continuous with P, and state-dependent utilities V, which differ from U by possibly different positive affine transformations in each state of nature. We describe an example in which there are two different but equivalent state-independent utility representations for the same preference structure. They differ in which acts count as constants. The acts involve receiving different amounts of one or the other of two currencies, and the states are different exchange rates between the currencies. It is easy to see how it would not be possible for constant amounts of both currencies to have simultaneously constant values across the differentstates. Savage (1954, sec. 5.5) discovered a situation in which two seemingly equivalent preference structures are represented by different pairs of probability and utility. He attributed the phenomenon to the construction of a "small world." We show that the small world problem is just another example of two different, but equivalent, representations treating different actsas constants. Finally, we prove a theorem (similar to one of Karni 1985) that shows how to elicit a unique state-dependent utility and does not assume that there are prizes with constant value. To do this, we define a new hypothetical kind of act in which both the prize to be awarded and the state of nature are determined by an auxiliary experiment. (shrink)

Nineteenth-century American political thinkers like Emerson, Thoreau, and Whitman advocated for and sought to exemplify a life of self-direction and critical self-reflection, or personal autonomy, as a means of contesting entrenched routines of democratic-capitalist normalization and as a way of resisting a host of institutional disciplinary pressures. Today, the ideal of personal autonomy within a diverse liberal society is branded by many as a form of “comprehensive” disciplinary normalization in its own right. In this essay I offer a reconsideration of (...) this reversal in the appraisal of the value of autonomy within pluralistic democratic societies and argue that the abandonment of autonomy is a symptom of a mistaken understanding of the personal-ethical qualities upon which a democratic culture depends and a maladaptive concession to neoliberal norms. To confront these challenges, I draw upon a range of Emerson’s writings to offer some ideas about how a reconstructed ideal of aspirational autonomy might inform contemporary politics without unduly constraining moral pluralism or undermining toleration. (shrink)

Mark J. Cherry; Foundations of the Culture Wars: Compassion, Love, and Human Dignity, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume 7.

This paper challenges the foundational claim that the human family is no more than a social construction. It advances the position that the family is a central category of experience, being, and knowledge. Throughout, the analysis argues for the centrality of the family for human flourishing and, consequently, for the importance of sustaining family-oriented practices within social policy, such as more family-oriented approaches to consent to medical treatment. Where individually oriented approaches to medical decision-making accent an ethos of isolated personal (...) autonomy family-oriented approaches acknowledge the central social and moral reality of the family. I argue that the family ought to be appreciated as more than a mere network of personal relations and individual undertakings; the family possesses a being that is social and moral such that it realizes a particular structure of human good and sustains the necessary conditions for core areas of human flourishing. Moreover, since the family exists as a nexus of face-to-face relationships, the consent of persons, including adults, to be members of a particular family, subject to its own respective account of family sovereignty, is significantly more amply demonstrated than the consent of citizens to be under the authority of a particular state. As a result, in the face of a general Western bioethical affirmation of the autonomy of individuals, as if adults and children were morally and socially isolated agents, this paper argues that social space must nevertheless be made for families to choose on behalf of their own members. (shrink)

Jerry Fodor is one of the most important philosophers of mind in recent decades. He has done much to set the agenda in this field and has had a significant influence on the development of cognitive science. Fodor's project is that of constructing a physicalist vindication of folk psychology and so paving the way for the development of a scientifically respectable intentional psychology. The centrepiece of his engagement in this project is a theory of the cognitive mind, namely, the computational (...) theory of mind, which postulates the existence of a language of thought. Fodor: Language, Mind and Philosophy is a comprehensive study of Fodor's writings. Individual chapters are devoted to each of the major issues raised by his work and contain extensive discussion of his relationships to key developments in cognitive science and to the views of such philosophical luminaries as Dennett, Davidson and Searle. (shrink)

This essay is concerned with the challenges that moral " blind spots " create for the presence and endurance of democratic virtues under conditions of pluralism. A moral blind spot refers to the occlusions in individual moral perceptions and the limits that circumscribe moral sympathies owing to our ineluctable partialities as socially embedded beings. Blind spots constitute a tragic feature of human perception and moral judgment that facilitate and undermine human agency at once. Yet, far more problematic from the perspective (...) of democratic epistemology and normative ethics is the denial or willful forgetfulness of their place in our individual and collective lives, and the concomitant failure to account for moral blind spots so as to check their most pernicious effects. Accounting for moral blind spots in practice requires actively planning for their presence through the cultivation of the "pathos of distance" towards ourselves and our collective political identities and social institutions. (shrink)

States of character : toward a theory of political vice -- The anti-politics of hubris : vice of sovereignty -- Accounting for moral blindness : vice of wholeness -- Political recalcitrance : vice of exceptionalism -- After vice : the call of accountability.

Organ procurement policy from the recently deceased recasts families into gatekeepers of a scarce medical resource. To the frustration of organ procurement teams, families do not always authorize organ donation. As a result, efforts to increase the number of organs available for transplantation often seek to limit the authority of families to refuse organ retrieval. For example, in some locales if a deceased family member has satisfied the legal conditions for first-person prior assent, a much looser and easier standard to (...) satisfy than informed consent, organ retrieval may proceed despite the family’s objections. Some countries have replaced voluntary consent to organ donation with forms of organ conscription. Often referred to under the misnomer “presumed consent,” such policies legalize the harvesting of organs at death, unless individuals exercise official options to opt out. As this article explores, however, there are good grounds for affirming the authority of the family to consent to or to deny organ donation on behalf of recently deceased family members, as well as to reject first-person assent and “presumed consent” policies of organ procurement. Insofar as individuals have failed clearly and competently to provide informed consent to organ donation, moral authorization for the use of the person and his body ought to be grounded on the foundational authority of the family, rather than the state’s supposed interests in obtaining organs for transplantation. (shrink)

Medicalization was the theme of the 29th European Conference on Philosophy of Medicine and Health Care that included a panel session on the DSM and mental health. Philosophical critiques of the medical model in psychiatry suffer from endemic assumptions that fail to acknowledge the real world challenges of psychiatric nosology. The descriptive model of classification of the DSM 3-5 serves a valid purpose in the absence of known etiologies for the majority of psychiatric conditions. However, a consequence of the “atheoretical” (...) approach of the DSM is rampant epistemological confusion, a shortcoming that can be ameliorated by importing perspectives from the work of Jaspers and McHugh. Finally, contemporary psychiatry’s over-reliance on neuroscience and pharmacotherapy has led to a reductionist agenda that is antagonistic to the inherently pluralistic nature of psychiatry. As a result, the field has suffered a loss of knowledge that may be difficult to recover. (shrink)

Creation of for-profit markets in organs for transplantation ignites in many deep moral repugnance. Proposals to broker organs have been denounced by the US Congress and professional groups alike. Financial incentives are believed to undermine consent, coercing the poor into selling their organs, violating human dignity, and improperly commodifying the human body; such concerns are held to trump the possibility of increasing life-sustaining transplants. While such views summarize the apparent global consensus which marks worldwide prohibition of the sale of human (...) organs, I argue that closer examination reveals significant grounds for concluding that markets would be more successful in preventing exploitation, preserving human dignity, and protecting against improper commodification than governmental bureaucratic procedures for procuring and allocating organs. (shrink)

This study explores the ways in which adolescents, even so-called “mature minors”, lack adequate development of the intellectual, affective, and emotional capacities necessary morally to consent to medical research on their own behalf. The psychological and neurophysiological data regarding brain maturation supports the conclusion that adolescents are qualitatively different types of agents than mature adults. They lack full adult maturity and personal agency. As a result, in addition to the usual requirements for IRB approval, one or both parents, or a (...) legal guardian, should provide informed consent for minor children to participate in medical research. (shrink)

The degree of incoherence, when previsions are not made in accordance with a probability measure, is measured by either of two rates at which an incoherent bookie can be made a sure loser. Each bet is considered as an investment from the points of view of both the bookie and a gambler who takes the bet. From each viewpoint, we define an amount invested (or escrowed) for each bet, and the sure loss of incoherent previsions is divided by the escrow (...) to determine the rate of incoherence. Potential applications include the treatment of arbitrage opportunities in financial markets and the degree of incoherence of classical statistical procedures. We illustrate the latter with the example of hypothesis testing at a fixed size. (shrink)

While many have suggested that to withdraw medical interventions is ethically equivalent to withholding them, the moral complexity of actually withdrawing life supportive interventions from a patient cannot be ignored. Utilizing interplay between expository and narrative styles, and drawing upon our experiences with patients, families, nurses, and physicians when life supports have been withdrawn, we explore the changeable character of boundaries in end-of-life situations. We consider ways in which boundaries imply differences – for example, between cognition and performance – and (...) how the encounter with boundaries can generate altered meanings important for understanding decisions and actions in these contexts. We conclude that the reliance on mere roles to support the moral weight of withdrawing medical interventions is inadequate. Roles that lead us to such moments are exceeded by the responsibility encountered in such moments. And here, we suggest, is the momentous character of withdrawal: it presents the grave astonishment, the trembling awe, in the not-being-there of the other in death. (shrink)

Augustine and William James both argue that religious faith can be both practical and rational even in the absence of knowledge. Augustine argues that religious faith is trust and that trust is a normal, proper, and even necessary way of believing. Beginning with faith, we then work towards knowledge by means of philosophical contemplation. James’ “The Will to Believe” makes pragmatic arguments for the rationality of faith. Although we do not know (yet) whether God exists, faith is a choice between (...) the risk of believing something false and the risk of not believing something true, and in the absence of convincing evidence we may decide for ourselves which risk we prefer. We may be able to experience God in the future and thereby gain knowledge, yet this may be contingent on our willingness to believe. There are key differences, however. Augustine is a Christian with a neo-Platonic bent, James an empiricist defending the religion of your choice. These differences may be less significant than they first appear. After explaining Augustine and then James I draw out the major points of comparison and contrast and suggest a few reasons their insights might be at least partially synthesized. -/- This is the accepted version of the following article: Mark J. Boone, “Augustine and William James on the Rationality of Faith,” The Heythrop Journal (online edition December 2018), which has been published in final form at [See First URL]. This article may be used for non-commercial purposes in accordance with the Wiley Self-Archiving Policy [See Second URL]. (shrink)

Mark J. Cherry; Searching for the Truly Human: Standing at the Precipice of a Post-Christian Age, Christian bioethics: Non-Ecumenical Studies in Medical Moralit.

Mark J. Cherry; The Body for Charity, Profit and Holiness: Commerce in Human Body Parts, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume.

Smith outlines the distinctive features of ecological thought and examines two contentious areas of environmental ethics, the obligations for present generations and the relationship of humans to non-human animals.

Each of the degenerating constitutions in Book VIII of Plato's Republic is the result of the disappearance of one of the four cardinal virtues. The failure of wisdom creates a timocracy; the failure of courage, an oligarchy; the failure of moderation, a democracy; the failure of justice, a tyranny. The degeneration shows that the disunited virtues are imperfect, though they have some power to stave off vice. Thus Book VIII implies a unity of the virtues thesis according to which perfect (...) virtues can only exist in a united state, but imperfect simulacra of virtue can exist in a disunited state. -/- Published 2011 in Apeiron: A Journal for Ancient Philosophy and Science. (Please note that the pagination in the uploaded document is not the same as the pagination in the published edition.). (shrink)

The day-to-day work of clinical ethics consultants and healthcare ethics committees can easily become overly routine. Too much routine, however, comes with a risk that morally important practices will be reduced to mere bureaucratic formalities, while practitioners become desensitized to ethically significant distinctions between cases. Clinical ethics consultation and organizational ethics must be set within the broader social and cultural context of the healthcare environment. This practice requires looking beyond mere legal compliance and the routinely false assumption that there are (...) unambiguous ethical norms that easily govern clinical ethics and hospital policy formation. Together the essays in this issue of HEC Forum challenge readers to rethink taken-for-granted assumptions regarding patient care, physician obligation, clinical ethics consultation, and organizational ethics. (shrink)

The biotechnology industry's intellectual property claims contribute to a subtle but not insignificant encroachment of commodification within health care. Drawing on the conceptual framework of Margaret Jane Radin, I argue that patent claims on human biological materials may commodify that with which our personhood and individuality is intertwined but that such commodification is broad and incomplete. Patents on nonhuman biological organisms contribute to a more materialistic understanding of them but do not significantly change our relationship to them. The systemic effects (...) of biotechnology's commodification within health care are various and may compromise the goal of good health. The morally problematic aspects of patent claims entail certain obligations to inhibit commodification from becoming more egregious, but on balance, those aspects are currently insufficient to justify denying the benefits the patent system promotes. (shrink)

THIS IS A PRE-PUBLICATION VERSION OF THE PAPER. The New Testament speaks of our having faith rather than sight. This distinction is not made to distinguish faith from knowledge. Rather, it is to distinguish one kind of knowledge from another. We may know by trust in reliable authority; this knowledge is necessarily secondhand, but it is knowledge all the same. This, I argue, is the New Testament idea of faith. Another way of knowing is firsthand. Sight in the New Testament, (...) I argue, is a metonym for firsthand knowledge. In this article I consider the meaning of faith and sight in the relevant New Testament passages, with an extended exegesis of 2 Cor. 5:7 and Heb. 11:1. (shrink)

We investigate differences between a simple Dominance Principle applied to sums of fair prices for variables and dominance applied to sums of forecasts for variables scored by proper scoring rules. In particular, we consider differences when fair prices and forecasts correspond to finitely additive expectations and dominance is applied with infinitely many prices and/or forecasts.

With rare exception, Roman Catholic moral theologians condemn the sale of human organs for transplantation. Yet, such criticism, while rhetorically powerful, often over-simplifies complex issues. Arguments for the prohibition of a market in human organs may, therefore, depend on a single premise, or a cluster of dubious and allied premises, which when examined cannot hold. In what follows, I will examine the ways in which such arguments are configured. For example, Thomas Aquinas’(1224-1274) understandings of embodiment and moral uses of the (...) body are usually interpreted as, and cited in support of, foreclosing a market in human organs. Aquinas’ principle of totality requires that one preserve the wholeness of the human body. In approaching Aquinas’ texts, I will assume the role of a revisionist who takes seriously his core commitments, while at the same time indicating that one can further develop his understanding of the body in ways which are supportive of the sale of human organs while remaining in conformity with the author's core concerns. Such considerations will provide significant grounds for concluding that a market in human organs for transplantation appreciates the embodied nature of the human person, respects the body and its parts as personal, rather than as mere things, is consistent with acknowledging God’s dominion over our lives and bodies, and constitutes an appropriate utilization of God's gifts to us. Moreover, such a market would likely create significant opportunities charitably to help others, to enhance human dignity and to protect against the serious dehumanization of current national bureaucratic procedures for organ donation. (shrink)

In recent decades cognitive science has revolutionised our understanding of the workings of the human mind. Philosophy has made a major contribution to cognitive science and has itself been hugely influenced by its development. This dynamic book explores the philosophical significance of cognitive science and examines the central debates that have enlivened its history. In a wide-ranging and comprehensive account of the topic, philosopher M.J. Cain discusses the historical origins of cognitive science and its philosophical underpinnings; the nature and role (...) of representations in cognition; the architecture of the mind and the modularity thesis; the nature of concepts; knowledge of language and its acquisition; perception; and the relationship between the brain and cognition. Cain draws upon an extensive knowledge of empirical developments and their philosophical interpretation. He argues that although the field has generated some challenging new views in recent years, many of the core ideas that initiated its birth are still to be taken seriously. Clearly written and incisively argued, The Philosophy of Cognitive Science will appeal to any student or researcher interested in the workings of the mind. (shrink)

Some important warnings about how we use technology in the philosophies of Plato, Martin Heidegger, Zhuangzi, and C. S. Lewis are relevant to the use of AI in education. Plato cautions us concerning what is lost when we let technology replace some of our own thinking processes. Far from making us more intelligent, the use of AI in writing falls into the mistakes Plato warns us against: We get lazy with learning and remembering, and we substitute a bundle of information (...) for the wisdom and comprehension that constitute genuine knowledge. Heidegger advises against using technology to create more of a product and reducing the role of humanity to merely a part of the system of production. When writing with AI, we abandon our responsibility to shepherd our own work, and we become tools in the machinery of creating a written product, even letting the software guide us rather than the other way around. Zhuangzi teaches us not to follow the patterns set by social convention. Material written by AI is a distillation of conventional word-patterns. Lewis warns us that we abolish part of humanity when we use technology to get what we want without first learning to love what is good. Using AI to get our writing done means sacrificing the essential human love for finding and understanding the truth, instead allowing our own words to be conditioned by unknown authors of algorithms. In this article I explain these matters and close with some helpful suggestions for how we might use AI more constructively—assuming we are going to use it at all. (shrink)

This special thematic issue of The Journal of Medicine and Philosophy brings together a cross-cultural set of scholars from Asia, Europe, and North America critically to explore foundational questions of familial authority and the implications of such findings for organ procurement policies designed to increase access to transplantation. The substantial disparity between the available supply of human organs and demand for organ transplantation creates significant pressure to manipulate public policy to increase organ procurement. As the articles in this issue explore, (...) however, even if well intentioned, the desire to maximize organ procurement does not justify undermining foundational elements of human flourishing, such as the family. While defending at times quite different understandings of autonomy, informed consent, and familial authority, each author makes clear that a principled appreciation of the family is necessary. Otherwise, health care practice will treat the family in a cynical and instrumental fashion unlikely to support social or individual good. (shrink)

Brain transplants have long been no more than the subject of science fiction and engaging thought experiments. That is no longer true. Neuroscientists have announced their intention to transplant the head of a volunteer onto a donated body. Response has been decidedly mixed. How should we think about the moral permissibility of head transplants? Is it a life-saving/life-enhancing opportunity that appropriately expands the boundaries of medical practice? Or, is it a bioethical morass that ought not to be attempted? For the (...) purposes of this paper, I set aside questions regarding the surgical operation’s technological plausibility so as to focus on very basic questions regarding personal identity and the morality of head transplantation. The analysis begins with an exploration of the embodiment of persons. It considers whether persons can be conceptually distinguished from all parts of their body, even if they cannot be physically separated from some parts without loss of personhood. It argues that in most cases replacing body parts with reasonably similar parts will not destroy the conditions for sustaining personhood. However, as I explore, the phenomenology of personhood is such that some physical changes may prove to be too significant to maintain personal identity successfully over time. Given such complexity and the significance of the costs involved, the moral permissibility of head transplantation likely depends on recognizing that persons may give permission to collaborate in common activities, including projects with which others deeply disagree, provided that they only utilize the services and resources of free and consenting others. (shrink)