Current medical and legal literature generally favors a definition of death based on total cessation of brain functioning. It does not, however, supply the reasoning for this recommendation. None of the arguments for whole-brain death is convincing; there exists, however, a satisfactory rationale for identifying death with cortical death. Policymakers should refrain from endorsing any of these arguments, focussing instead on the pragmatic tasks involved in guiding medical care at the end of life.
Though the chief responsibility for providing for the health care of older Americans has been (and should remain) society's, there has been increasing interest in private solutions. Individual provision, however, would require not only adequate wealth but prudent planning, demanding in turn more discipline, self-control, and foresightedness than many individuals are normally capable of. One possible corrective is pre-commitment, a strategy of binding oneself to a plan chosen to allocate resources optimally over the life span. Though pre-commitment may have some (...) important uses, however, it is far from clear that people should be encouraged or enabled to rely upon it for old-age health care planning. The present paper examines some of the philosophical and policy concerns attendant to the use of pre-commitment strategies for resource allocation in old age. Keywords: elderly, health care, justice, resource allocation CiteULike Connotea Del.icio.us What's this? (shrink)
"Be All You Can Be," the Army recruiting poster urges young men and women. Many parents share the sentiment. They want their children to be the best they can be. For many parents, their most important project in life is to pursue that goal, and they make sacrifices to see it happen. And why shouldn't parents aim to make their offspring the best they can be?
In From Chance to Choice, Allen Buchanan, Dan Brock, Norman Daniels and DanielWikler propose a new way of defending the moral significance of the distinction between genetic treatments and enhancements. They develop what they call a ‘normal function model’ of equality of opportunity and argue that it offers a ‘limited’ defence of this distinction. In this article, I critically assess their model and the support it (allegedly) provides for the treatment-enhancement distinction. First, I argue that there is (...) a troubling tension in the normal function model. Secondly, I argue that neither of the rationales invoked by Buchanan et al. really serves to justify this model or the results they seek to derive from it with respect to the significance of the distinction between treatments and enhancements. (shrink)
Richard J. Arneson From Choice to Chance: Genes and the Just Society1 intelligently addresses difficult issues at the intersection of medical ethics and the theory of justice. The authors, Dan Brock, Allen Buchanan, Norman Daniels, and DanielWikler, repeatedly emphasize their opinion that advances in genetic technology force upon us entirely new ethical questions which previous moral theories lack the resources to resolve.2 The claims that new scientific discoveries render previous moral theories obsolete should be regarded with suspicion. (...) The reader’s suspicion should be further aroused when she notes another feature of the authors’ theorizing that neatly fits the claim that we stand at the dawn of a new world of ethical theorizing. The authors’ discussion from start to finish stays at a middle level. By this I mean that the authors in each chapter begin with a few moral principles taken to be plausible or possibly plausible and examine their implications for issues raised by new genetic technology.3 This is not an exercise in applied ethics, because the principles initially invoked are subjected to criticism and scrutiny. But in almost every significant case the results are inconclusive. The moral puzzles that are raised are left unsolved, with moral reasons pointing toward opposed conclusions and the.. (shrink)
Among moral philosophers, general disapproval of genetic enhancement has in recent years given way to the view that the permissibility of a eugenic policy depends only on its particular features. Buchanan, Brock, Daniels, and Wikler have extensively defended such a view. However, while these authors go so far as to argue that there are conditions under which parents are not only permitted but also obligated to proeure genetic treatments for their intended child, they stop short of arguing that there (...) are conditions under which parents are required to procure enhancements. By contrast, David Heyd argues that parents are required to proeure treatments or enhancements for their future child, but only. if the intervention would not alter the future child’s personal identity. In this paper I take the case for genetic enhancement a step further by arguing that there are conditions under which parents are morally required to procure genetic interventions for their intended child, regardless of whether the intervention is a treatment or an enhancement, and regardless of whether it would alter the child’s personal identity. (shrink)
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 DanielWikler. 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. Keywords: brain death, definition, criteria, natural vs logical necessity, logical vs natural sufficiency CiteULike Connotea Del.icio.us What's this? (shrink)
In their jointly written book, From Chance to Choice: Genetics and Justice, Allen Buchanan, Dan Brock, Norman Daniels and DanielWikler defend ’the development and deployment of genetic intervention technologies?.?.?.’, including genetic enhancements, against charges that they exacerbate injustice. The present paper examines some of their arguments. The first section shows that the authors confuse real societies with just societies. The second shows that without this confusion, their arguments reveal the enormous justice-impairing potential of deploying genetic enhancements in (...) such societies as the United States. (shrink)
Feminist approaches to bioethics have the striking ability to usefully disrupt conversations otherwise in danger of calcifying into immovable opposing camps. Take, for instance, debates between theorists in disability studies and bioethicists who often take two different approaches to understanding disability. On one side are those such as Buchanan, Brock, Daniels, and Wikler (2000) who seek to locate the apparent functional deficiency of disability in biologically abnormal bodies. Let us call this a normal functioning approach to understanding disability. On (...) the other side are those such as Amundson (2000a; 2005) who argue that to be paraplegic or deaf is not to be inherently deficient but different in .. (shrink)
