Theoretical medicine and bioethics最新文献

If Epicurean arguments for the harmlessness of death are successful, then they also successfully undermine a common justification for physician-assisted suicide, euthanasia, and the termination of hopeless pregnancies that I call the 'Mercy Intuition', according to which, by ending the life of a suffering loved one for whom there is little to no chance of recovery, one is relieving that person of her suffering, and thus providing a great benefit to her. For, if death is not a harm to the person who dies, then it cannot be a benefit to her either, even in cases of intense and prolonged suffering. Along these lines, in this paper, I defend the claim that death cannot provide a benefit to those who are suffering. I begin by highlighting the Epicurean foundations of the argument, focusing on three main Epicurean arguments for the harmlessness of death and their no-benefit analogues. I then move on to explore several important limitations of the argument, which make available a number of strategies for avoiding its conclusion. Along the way, I respond to each of these avoidance strategies. I conclude that even granting several of its limitations, the argument still poses a serious challenge to the Mercy Intuition.

Joona Räsänen argues that vegans ought to be anti-natalists and therefore abstain from having children. More precisely, Räsänen claims that vegans who accept a utilitarian or rights-based argument for veganism, ought to, by parity of reasoning, accept an analogous argument for anti-natalism. In this paper, I argue that the reasons vegans have for refraining from purchasing animal products do not commit them to abstaining from having children. I provide novel arguments to the following conclusion: while there is good reason to believe that factory farming results in a net disutility and involves treating non-human animals as mere means, there is not good reason to believe that having children results in a net disutility or involves treating the children as mere means. Subsequently, I respond to what I take to be Räsänen's underlying reasoning-that vegans are committed to abstaining from other practices which cause unnecessary suffering. I respond by arguing that this is plausibly false as various practices which cause unnecessary suffering are likely permissible, whereas factory farming is not.

Family disputes over the diagnosis of brain death have caused much controversy in the bioethics literature over the conceptual validity of the brain death standard. Given the tenuous status of brain death as death, it is pragmatically fruitful to reframe intractable debates about the metaphysical nature of brain death as metalinguistic disputes about its conceptual deployment. This new framework leaves the metaphysical debate open and brings into focus the social functions that are served by deploying the concept of brain death. In doing so, it highlights the epistemic injustice of medicolegal authorities that force people to uniformly accept brain death as a diagnosis of death based on normative considerations of institutional interests, such as saving hospital resources and organ supplies, rather than empirical evidence of brain death as death, which is insufficient at best and nonexistent at worst. In light of this injustice, I propose the rejection of the uniform standard of brain death in favor of a choice-based system that respects families' individualized views of death.

Virtues commonly associated with physicians and other healthcare professionals include empathy, respect, kindness, compassion, trustworthiness, and many more. Building upon the work of Bortolloti, Murphy-Hollies, and others, I suggest that curiosity as a virtue has an integral role to play in healthcare, namely, in helping to make those who are invisible, visible. Practicing the virtue of curiosity enables one to engage with and explore the experiences of patients and contributes toward building a physician-patient relationship of trust. As the perspectives and experiences of patients can be too often dismissed or lost within medical settings, curiosity can allow physicians to deeply know their patients, and thus provide better care. However, caution must be exercised so as to not to venture into inappropriate curiosity, where questions are asked for improper reasons or to help satisfy the personal interest of physicians. Finally, I sketch out two cases-on chronic pain and on vaccine hesitancy-to illustrate where curiosity can play a valuable role.

Transhumanists and their fellow travelers urge humanity to prioritize the development of biotechnologies that would eliminate aging, delivering 'an endless summer of literally perpetual youth.' Aspiring not to age instantiates what philosopher Martha Nussbaum calls the yearning for 'external transcendence,' or the fundamental surpassing of human bounds due to confidence that life without them would be better. Based on Immanuel Kant's account of the parameters of human understanding, I argue that engineering agelessness could not be a rational priority for humanity on the level of public policy. This stance is complemented by an argument focused on individual decision-making in liberal-democratic milieus, where no governing conception of the good is presumed and the first-personal level matters greatly. Here, drawing on philosopher and cognitive scientist Laurie Ann Paul's concept of 'transformative experience,' I maintain that individuals could not 'rationally,' meaning, here, 'prudentially,' say 'yes' to agelessness. Absorbing the irrationality of human zeal to eliminate aging, based on assurance that an ageless existence would be better, should spur a redoubled dedication to human flourishing.

The COVID-19 pandemic has provoked new interest in the notion of vulnerability and in identifying alternative approaches for responding to vulnerable patients and populations during health emergencies. In this paper, I argue that the autonomy-based approach (the most dominant approach in bioethics) to responding to vulnerability during health emergencies is deficient because it focuses only on the interests, values, and decisions of the individual patient. It overly emphasizes respect for autonomy and not respect for the patient as it does not consider the patient as a social and relational agent. Indeed, relational approaches to autonomy like the feminist and indigenous sub-Saharan African ethical approaches are promising alternatives. In this essay, I use the indigenous African relational approach to autonomy as an example of an alternative method which can be used to respond to vulnerability during a global health emergency like COVID-19.