This article explains the problems with Alan Shewmon’s critique of brain death as a valid sign of human death, beginning with a critical examination of his analogy between brain death and severe spinal cord injury. The article then goes on to assess his broader argument against the necessity of the brain for adult human organismal integration, arguing that he fails to translate correctly from biological to metaphysical claims. Finally, on the basis of a deeper metaphysical analysis, I offer a revised (...) rationale for the validity of the neurological criterion of human death. (shrink)

In this paper, I argue that brain death is death because, despite the appearance of genuine integration, the brain-dead body does not in fact possess the unity that is proper to a human organism. A brain-dead body is not a single entity, but a multitude of organs and tissues functioning in a coordinated manner with the help of artificial life support. In order to support this claim, I first lay out Hoffmann and Rosenkrantz’s ontological account of the requirements for organismal (...) unity and summarize an earlier paper in which I apply this account to the brain death debate. I then further support this ontological argument by developing an analogy between the requirements for the unity of an organism and the requirements for the unity of an orchestra. To do so, I begin by examining the role that a conductor plays in unifying a traditional orchestra, and then go on to show that the human organism functions like a traditional orchestra that relies upon a conductor for its unity. Next, I consider the conditions required to achieve orchestral unity in conductorless orchestras and show that, in contrast to simpler organisms like plants, the postnatal human organism lacks those conditions. I argue, in other words, that although conductorless orchestras do exist, the human organism is not one of them. Like a traditional orchestra without a conductor, the brain-dead body is not a unified whole. (shrink)

In this essay, I outline fundamental anthropological and moral principles related to human sexuality and gender identity and then apply these principles to analyze and evaluate the views of several authors who attempt to carve out a “middle way” between liberal and traditionalist approaches to these issues. In doing so, I engage especially with the claim that gender dysphoria, rather than being a psychological issue, is a type of biological intersex condition in which one’s “brain sex” is out of line (...) with one’s genital and chromosomal sex. I argue that understanding the human person as a unity of body and soul and recognizing human sexuality as ordered toward the human good of marriage understood as inseparably unitive and procreative reveals the flaws in this position and helps to show why hormonal or surgical gender reassignment therapy is not a medically or ethically appropriate response to gender dysphoria. I also offer an alternative characterization of gender dysphoria and suggestions for responding with true compassion to those who suffer from it. (shrink)

In this article, I explore difficult and sensitive questions regarding the nature of transgender identity claims and the appropriate medical treatment for those suffering from gender dysphoria. I first analyze conceptions of transgender identity, highlighting the prominence of the wrong-body narrative and its dualist presuppositions. I then briefly argue that dualism is false because our bodily identity is essential and intrinsic to our overall personal identity and explain why a sound, nondualist anthropology implies that gender identity cannot be entirely divorced (...) from sexual identity. Finally, I make the case that arguments in favor of hormonal and surgical treatments for gender dysphoria rest on this mistaken dualist anthropology, and that these treatments therefore give false hope to those suffering from gender dysphoria, while causing irreversible bodily harm and diverting attention from underlying psychological problems that often need to be addressed. I also briefly discuss how these philosophical claims relate to empirical studies on the outcomes of hormonal and surgical treatments for gender dysphoria and to testimonies of transgender individuals who regret having undergone these treatments. (shrink)

As is clear in the 2008 report of the President's Council on Bioethics, the brain death debate is plagued by ambiguity in the use of such key terms as ‘integration’ and ‘wholeness’. Addressing this problem, I offer a plausible ontological account of organismal unity drawing on the work of Hoffman and Rosenkrantz, and then apply that account to the case of brain death, concluding that a brain dead body lacks the unity proper to a human organism, and has therefore undergone (...) a substantial change. I also show how my view can explain hard cases better than one in which biological integration is taken to imply ontological wholeness or unity. (shrink)

Michael Nair-Collins and Franklin Miller are right to emphasise that, in order to deliberate responsibly about ethical and legal questions related to brain death and organ donation, it is crucial to answer the question of whether or not ‘brain death’i does indeed mark the biological death of the organism. Nonetheless, I disagree with the authors’ conclusion that brain death does not indicate the death of the human organism. Death can never be defined in merely biological terms, because any biological conception (...) of death relies on metaphysical presuppositions regarding what it means to be an ‘organism as a whole’, rather than an aggregate of cells and tissues. Death is a change in substance —that is, a change from one type of entity to another — not the cessation of all biological life. Organismal death occurs well before all of the organism’s parts irreversibly cease vital activity and decompose into inorganic matter. Biological life in some form can and usually does continue after organismal death at least for a time, with recent evidence indicating that animal cell networks continue to perform complex functions like stress response, immune response and inflammation response up to several days postmortem.1 With external support, many cells and tissues can continue to perform their functions ex vivo for long periods of time or even indefinitely.2 Henrietta Lax died in 1951, but cells derived from her cancerous cervical cells …. (shrink)

The dominant philosophical view of gamete donation as morally permissible rests on two premises: parental obligations are triggered primarily by playing a causal role in procreation, not by genetic ties, and those obligations are transferable—that is, they are obligations to make adequate provision for the child’s needs, not necessarily to raise the child oneself. Thus while gamete donors are indeed agent causes of the children that their donation helps to bring into existence, most think that donors’ obligations are discharged insofar (...) as they know that competent others intend to care for those children. In this article, I call into question this dominant view by challenging both of its premises. Challenging the first premise, I argue that genetic parenthood is what primarily triggers parental obligations. Challenging the second premise, I claim that those obligations are non-transferable—i.e., that they are obligations not simply to ensure that someone will raise one’s genetic child, but to raise that child oneself . The implication of my argument is that gamete donation is inherently wrong insofar as it involves acquiring non-transferable obligations that one has no intention of fulfilling. (shrink)

This statement summarizes the conclusions of the Symposium on the Definition of Death, held at The Catholic University of America in June 2014. After providing the background and context for contemporary debates about brain death and describing the aims of the symposium, the statement notes points of unanimous and broad agreement among the participants, and highlights areas for further study.

The major difference between “new” and “old” natural law approaches to sexual ethics is that for new natural law theorists the moral evaluation of sex acts is always determined with reference to that basic form of human flourishing which is called marriage; old natural law theorists determine the morality of sex acts also with reference to the natural purpose of the sexual faculties. Ultimately, the old approach relies implicitly on prior value judgments to distinguish biological facts that are axiologically or (...) morally relevant from those that are not. It also appeals to values to ground the wrongness of immoral sex acts. In its pure form, the old natural law approach to sexual ethics lends itself to a misunderstanding of the unitive aspect of marriage. More broadly, an accurate understanding of new natural law does not run afoul of the correct interpretation of “nature” in natural law. (shrink)

In recent years, a number of authors – such as Kershnar and Kelly, Steinhoff, and Scanlon – have criticized the doctrine of double effect (DDE) as incoherent, lacking an underlying rationale, or leading to counterintuitive conclusions. These critiques, however, rest on a failure to understand the DDE’s broader theoretical context and presuppositions. This paper aims to clarify and advance the debate regarding the DDE by, first, outlining a contemporary version of the broader normative theory (i.e. the Aristotelian-Thomistic natural law tradition) (...) within which the DDE finds its proper context, and explaining the rationale for the DDE within this context; second, clarifying the DDE’s proportionality condition to avoid common misinterpretations; and, third, showing how the DDE, when properly formulated and understood within the appropriate theoretical context, can withstand the recent criticisms that have been raised against it. (shrink)

Does the ability of some brain dead bodies to maintain homeostasis with the help of artificial life support actually imply that those bodies are living human organisms? Or might it be possible that a brain dead body on life support is a mere collection of still-living cells, organs and tissues which can coordinate with one another, but which lack the genuine integration that is the hallmark of a unified human organism as a whole? To foster further study of these difficult (...) and timely questions, a Symposium on the Definition of Death was held at The Catholic University of America in June 2014. The Symposium brought together scholars from a variety of disciplines—law, medicine, biology, philosophy and theology—who all share a commitment to the dead donor rule and to a biological definition of death, but who have differing opinions regarding the validity of neurological criteria for human death. The papers found in this special issue are among the fruits of this Symposium. (shrink)

Irene Alexander’s article in last spring’s issue of this journal criticizes the new natural law account of sexual ethics, including Melissa Moschella’s defense of that view in a previous article also in this journal. Alexander claims that the NNL account adopts an empiricist view of nature and that NNL’s rejection of the perverted faculty argument is contrary to the Magisterium. Here Moschella responds to Alexander’s criticisms by clarifying NNL theorists’ understanding of the distinction between speculative and practical reason through an (...) explanation of Aquinas’s account of the four orders, correcting Alexander’s erroneous portrayal of NNL arguments against contraception, and arguing that the NNL account of sexual ethics is not only in line with magisterial teaching, but offers a better philosophical defense of that teaching than the view Alexander proposes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation by Daniel GrollMelissa MoschellaGROLL, Daniel. Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation. New York: Oxford University Press, 2021. 256 pp. Cloth, $74.00In Conceiving People, Daniel Groll argues that, generally speaking, those intending to conceive with the help of donor gametes have a moral obligation to use an open donor rather than (...) an anonymous one. This obligation is grounded on the likelihood that their children will have a significant future interest in acquiring genetic knowledge, defined as "knowledge of who one's genetic progenitors are." Groll labels this view the significant interest view, which he argues for largely on empirical grounds.Before beginning his defense of the significant interest view, Groll dedicates chapter 2 to arguing that parents who conceive with the help of donor gametes should not keep this a secret from their children. His position on this point reflects the current consensus on the subject, but he offers a novel argument for it, based on the claim that keeping "the secret" in itself harms the parent–child relationship by inherently compromising the intimacy proper to that relationship.Chapter 3 presents the significant interest view in greater detail, distinguishing it from two other approaches: (1) the "Profound Prudential Good view," taken from the work of David Velleman, according to which "genetic knowledge is a profound prudential good and people who lack it will have tremendous trouble figuring out who they are," and (2) the view that "people have a right to genetic knowledge." Unlike these competing approaches, Groll's view "does not directly depend on claims about the value of genetic knowledge" but is based primarily on the fact that "many donor-conceived people are subjectively interested in having genetic knowledge," combined with the claim that parents have an obligation to promote their children's well-being by satisfying their worthwhile significant subjective interests. Because Groll's argument depends on the worth and significance of genetic knowledge, it is vulnerable to what he calls the "sideshow objection"—that is, that the significant interest view is just a sideshow, and the worth of genetic knowledge is what actually does the important normative work. At the same time, Groll's view that the interest in genetic knowledge is worthwhile and significant also leaves him open to the "bionormativity objection," according to which the interest in genetic knowledge "is morally problematic in virtue of evincing and entrenching a kind of bionormative prejudice" that sees the biological family as a normative ideal. [End Page 141]Responding to these two objections is the task of chapters 4 and 5. Chapter 4 argues that genetic knowledge is an objective but "prudentially optional good," meaning that "its value is not fungible, but a life that lacks it is not thereby impoverished." This distinguishes Groll's view from the profound prudential good view, which he characterizes as a form of "genetic chauvinism." Groll argues that genetic knowledge is valuable because it can provide insight into personal identity by answering questions about how I came to be and who I am like, but that the genetic knowledge is not the only or best way to answer these questions (thus explaining why it is optional, and why the significant interest view is not just a sideshow).Chapter 5 addresses the "bionormativity objection," which includes both "heteronormativity" (privileging families headed by a mother and father) and "biogenetic normativity" (privileging genetically related families). Groll ultimately responds to this objection by arguing that, even if (as Groll believes) our current society overemphasizes the importance of genetic relationships, "the interest in genetic knowledge is rationally intelligible quite apart from the bionormative social milieu that surrounds it."Chapters 6 through 8 present the implications of the preceding argument. Chapter 6 argues that the reasons to use an open donor are generally conclusive, because most reasons parents might have to use an anonymous donor do not outweigh the child's significant interest in obtaining genetic knowledge. Chapter 7 considers the responsibilities of gamete donors, arguing that gamete donation is not morally objectionable because it is permissible for donors to transfer prospective parenthood responsibilities... (shrink)

Using cell lines like HEK 293 or their products—like many of the COVID-19 vaccines—involves no cooperation with evil strictly speaking, but it does involve appropriation of the benefits of past evil. Applying M. Cathleen Kaveny’s framework for assessing the permissibility of appropriating the benefits of evil, the duty to avoid using cell lines like HEK 293 or their products is weak and defeasible. Proper interpretation of Dignitas personae requires recognizing the crucial moral differences between the use of these cell lines—which (...) does not perpetuate the injustice of abortion, imply approval of abortion, or involve significant risks of corrupting moral character or provoking scandal—and the direct use of fetal tissue or human embryos in research. (shrink)

This article defends the morality of heterologous embryo transfer (HET) against those who claim that HET is wrong because it makes a woman a mother through someone other than her spouse. I contrast genetic parenthood with gestation to show that gestation alone does not make someone a mother in the focal sense. Genetic parenthood gives rise to the full obligations of parenthood—i.e., makes someone a parent in the focal sense—because the child’s relationship to his genetic parents is (1) permanent, (2) (...) identity-defining, and (3) initially (at conception) the child’s closest human relationship. While the gestational relationship importantly influences the child’s identity, it lacks the unique closeness, permanence, and identity-defining nature that characterize the genetic parent-child relationship, and therefore gives rise only to temporary obligations akin to those of a foster parent. Recognizing these crucial differences between gestation and procreation helps to show that HET is not inherently immoral. (shrink)

This article defends the morality of heterologous embryo transfer against those who claim that HET is wrong because it makes a woman a mother through someone other than her spouse. I contrast genetic parenthood with gestation to show that gestation alone does not make someone a mother in the focal sense. Genetic parenthood gives rise to the full obligations of parenthood—i.e., makes someone a parent in the focal sense—because the child’s relationship to his genetic parents is permanent, identity-defining, and initially (...) the child’s closest human relationship. While the gestational relationship importantly influences the child’s identity, it lacks the unique closeness, permanence, and identity-defining nature that characterize the genetic parent-child relationship, and therefore gives rise only to temporary obligations akin to those of a foster parent. Recognizing these crucial differences between gestation and procreation helps to show that HET is not inherently immoral. (shrink)

In this paper I argue that liberal proponents of mandatory autonomy education tend to overlook or underestimate the potential threats that such an education poses to the overall well-being of children (including, ironically, threats to the development of genuine autonomy). They do so by paying insufficient attention to the importance of moral virtue as a constitutive element of and precondition for genuine autonomy, and by failing to recognize how the development and consolidation of moral virtue may be undermined by the (...) sort of autonomy education they recommend. I develop my argument through engagement with the work of Eamonn Callan and Ian MacMullen, drawing on Aristotelian ethics to highlight the shortcomings in their accounts. (shrink)