Hastings Center Report最新文献

Many participants in bioethical debate believe the long-standing myth about the religiously oriented members of the public—that they disagree with scientific fact claims about the natural world. While there are a few conflicts over such claims for a few religious traditions, largely concerning human origins, these fact claims are not relevant for bioethics. Instead, social science research has shown widespread moral conflict between scientists and the actively religious in the United States. The prevalence of moral conflict and the absence of fact conflict is illustrated by the Covid pandemic, where religious objections to vaccines were moral, not factual, in nature. It is important to accurately represent conflicts so that the public sees bioethical input to policy debates as legitimate.

Much of the debate over whether brain death is death has focused on whether the loss of all brain functions entails the loss of the integration of the human organism as a whole. However, there has been growing recognition that the legal definition of death is not a matter that can be settled by such biological considerations alone and that metaphysical considerations about our nature, along with social and ethical considerations about how brain dead individuals should be treated, are relevant to the choice of criteria for determining death. In this paper, I show how some of the leading proponents and opponents of brain death acknowledge the relevance of metaphysical, social, and ethical considerations and how this may provide some common ground in working toward a consensus on brain death. I also address how in a liberal society disagreement over the criteria for determining death due to disagreement over metaphysical, social, or ethical considerations should be managed in the medical and legal context.

A twenty-three-year-old atheist man was admitted to the intensive care unit after a motor vehicle accident left him terminally unconscious. He was not expected to survive long, so his religious mother asked the attending physician to ask someone from the hospital's spiritual care team to perform an emergent baptism. The physician consulted ethical and spiritual services to determine the best course of action. This essay, which, together with “The Case for Baptizing a Dying, Unconscious Atheist,” by Abram Brummett and Nelson Jones, forms a two-essay case study, argues that the ethicist should recommend against baptism in such a scenario. Without consent, baptism would contradict the patient's self-determined identity and inflict significant dignitary harm. The emotional benefit provided to the mother or other family members, while potentially significant, is insufficient to justify this dignitary harm.

In the essay “‘Please baptize my son’: The Case against Baptizing a Dying, Unconscious Atheist,” in the same issue of this journal, Tate Shepherd and Michael Redinger describe a case in which a clinical ethicist is consulted when a mother requests that someone from the hospital's spiritual care services baptize her dying, unconscious, atheist adult son. The mother's request produces a moral conflict between providing emotional benefits to the patient's mother from seeing her son baptized at the end of his life and a concern about inflicting dignitary harm on the patient by violating a preference related to a deeply held belief. In this essay, we argue that, in these tragic circumstances, some atheists would be agreeable to being baptized to bring some measure of emotional comfort to their family. We suggest that the clinical ethicist should not respond with a categorical rejection of this possibility but take time with the family to reflect on whether there are good reasons to conclude that the patient would have been receptive to his mother's request.

Most medical ethics courses lack a strong emphasis on cultural competency, leaving graduates less prepared to consider how race, culture, and ethnicity influence ethical decision-making for minority patients. Historically Black colleges and universities (HBCUs) play a critical role in training Black physicians and are uniquely positioned to address this gap. Establishing dedicated bioethics and medical humanities departments at HBCU medical schools would integrate cultural competency and attention to the lived experiences of marginalized communities as central components of bioethics education. Faculty and curricula at HBCUs could emphasize how historical injustices, systemic disparities, and culturally specific values shape medical decision-making, preparing future physicians to navigate ethical dilemmas with greater sensitivity and awareness. By embedding cultural competency within a robust bioethics framework, HBCUs can serve as national leaders in producing physicians better prepared to reduce health disparities. Expanding bioethics education at HBCUs would also create more career pathways for minority scholars in bioethics.

On the cover: Dreams, Oracles, Icons, by Mary Husted, 1991, collage

Image: Courtesy The Women's Art Collection, Murray Edwards College, University of Cambridge