Dramatic changes in medical technology challenge mankind’s traditional ways of diagnosing death. Death, Brain Death and Ethics examines the concept of death against the background of these changes, as well as ethical and philosophical issues arising from attempts to redefine the boundaries of life. In this book, David Lamb supports the use of brain-related criteria for the diagnosis of death, and proposes a new clinical definition of death based on both medical and philosophical principles. Death, Brain Death and Ethics articulates (...) the case for a brain death standard, while presenting an informed viewpoint on what constitutes the end points of human life. Although the book is written from a philosophical standpoint, it raises fundamental questions regarding the meaning of life and death, and will interest lay-persons, lawyers, and physicians. Death, Brain Death and Ethics is sure to prompt discussion and reflection on some of the philosophical beliefs which underlie clinical practice. (shrink)
This reply to Martyn Evans's support for a cardiac-centered concept of death attempts to meet some objections to the brainstem definition of death. Evans's appeal to Wittgenstein's philosophy is also criticised.
A `slippery slope' argument in medical ethics is one that opposes itself to a new proposal on the grounds that it is not per se intolerable but will lead to a situation that is. Lamb evaluates such arguments, demonstrating their centrality to the subject.
In this commentary on the recommendations of the Danish Council of Ethics (DCE) concerning criteria for death it is argued that whilst the DCE is correct in stressing the cultural aspects of death, its adoption of cardiac-oriented criteria raises several problems. There are problems with its notion of a 'death process', which purportedly begins with brain death and ends with cessation of cardiac function, and there are serious problems regarding its commitment to a cardiac-oriented definition whilst permitting transplantation when the (...) heart is still beating. (shrink)
This report explores the relationship between philosophy and medicine in the U.K. We note that medical training involves very little formal instruction in philosophy and ethics, and that, with few exceptions, philosophers in the U.K. do not contribute to the instruction of physicians or the philosophy of medicine. However, reviewing the problems arising out of recent developments within scientific medicine we find a pressing need for future philosophical analysis in the following areas: psychiatry, organ transplantation, abortion, euthanasia, experiments on living (...) subjects, consent, confidentiality, the relationship between medicine and political authority, and the provisions for social justice in medicine. (shrink)
This reply to John F Catherwood's criticism of brain-related criteria for death argues that brainstem criteria are neither reductionist nor do they presuppose a materialist theory of mind. Furthermore, it is argued that brain-related criteria are compatible with the majority of religious views concerning death.
l examine Singer’s analogy between human liberation movements and animal liberation movements. Two lines of criticism of animal liberation are rejected: (1) that animal-liberation is not as serious as human liberation since humans have interests which override those of animals; (2) that the concept of animal liberation blurs distinctions between what is appropriate for humans and what is appropriate foranimals. As an alternative I otfer a distinction between reform movements and liberation movements, arguing that while Singer meets the criterion for (...) the former, a higher degree of autonomy and communicative competence is necessary for the latter. In the final section, objections to the possibility of an autonomous animal liberation movement are met by rejecting assumptions concerning the illogicality of interspecies communication. (shrink)
Autonomous decision-making over therapy options is not reducible to the refusal of unwanted medical intervention. This is a myth that has been imported from questionable assumptions in political economy, and is of little benefit to medical practice and the sometimes agonizing decisions which have to be taken by patients and their relatives. An individual's right to therapy abatement can be protected from abuse only in the context of a full understanding of autonomous choice; not merely the right to refuse, but (...) the opportunity to receive assistance and consider alternatives. Limits are also required on the role of the surrogate in the refusal of therapy. Policies endorsing therapy abatement and exercise of the right to forego life-sustaining therapy should carry cast iron guarantees that they will not be disadvantageous to the poor and undereducated members of society. It should also be noted that fears of unlimited life-prolongation have been greatly exaggerated. In an atmosphere of governmental indifference to the plight of the sick, with the notion of welfare tuned to market forces, there is a danger that self-determination can have a restricted meaning; the option of death in the context of an underfunded health service. This may not be the time to campaign for the right to refuse therapy, but rather the time to campaign for improvements to existing therapy. (shrink)
Introducing Applied Ethics Edited by Brenda Almond, Blackwell, 1995. Pp. 375. ISBN 0-631-19389-8. 45.00 (hbk), 14.99 (pbk). Environmental Ethics Edited by Robert Elliot, Oxford University Press, 1995. Pp. 255. ISBN 9-19-875144-3. 9.95 (pbk) Medicine and Moral Reasoning Edited by K.W.M. Fulford, Grant Gillett and Janet Martin Soskice Cambridge University Press, 1994. Pp. 207. ISBN 0-521-45325-9 37.50 (hbk), 12.95 (pbk). Enlightenment and Religion. Rational Dissent in Eighteenth-century Britain Edited by Knud Haakonssen, Cambridge University Press, 1996. Pp. xii + 348. ISBN 0-521-56060-8. (...) 40.00. Dialettica, Arte e Societ : Saggio su Theodor W. Adorno By Giacomo Rinaldi, Quattroventi, Urbino, 1994. Pp. 205. L. 30,000. Relevance: Communication and Cognition, new revised edition, By Dan Sperber and Deirdre Wilson, Blackwell, 1995. Pp. 326. ISBN 0-631-19878-4. 15.99. Autobiographical Reflections By Eric Voegelin (Edited, with Introduction, by Ellis Sandoz), Louisiana State University Press, 1996. Pp. 131. ISBN 0807120766 $10.95. (shrink)
This paper examines the development of the concept of brain death and of the criteria necessary for its recognition. Competing formulations of brain death are assessed and the case for a ‘brainstem’ concept of death is argued. Attention is finally drawn to some of the ethical issues raised by the use of neurological criteria in the diagnosis of human death.
This paper is a reply to proposals to base priority health-care decisions on public opinion surveys. Whilst it is recognised that current practice is less than satisfactory, it is argued here that basing health-care priorities on societal attitudes in this way is not a solution and does not provide a satisfactory basis for bringing democracy to the health service.
This volume is a revised, enlarged, and broadened version of Gert's classic 1970 book, The Moral Rules. Advocating an approach he terms "morality as impartial rationality," Gert here presents a full discussion of his moral theory, adding a wealth of new illuminating detail to his analysis of the concepts--rationality/irrationality, good/evil, and impartiality--by which he defines morality. He constructs a "moral system" that includes rules prohibiting the kinds of actions that cause evil, procedures for determining when violation of the rules is (...) permitted, and ideals which encourage actions that prevent or relieve suffering. To be valid, Gert argues, any such system must be "a public system that applies to all rational persons." The book concludes with a discussion of medical ethics, demonstrating the link between moral theory and its application to real moral problems. (shrink)