Baruch Brody

(1943 - 2018)

This paper distinguishes four major types of futility (physiological, imminent demise, lethal condition, and qualitative) that have been advocated in the literature either in a patient dependent or a patient independent fashion. It proposes five criteria (precision, prospective, social acceptability, significant number, and non-agreement) that any definition of futility must satisfy if it is to serve as the basis for unilaterally limiting futile care. It then argues that none of the definitions that have been advocated meet the criteria, primarily because their proponents have not paid sufficient attention to the problematic nature of the data supporting the use of their definitions.

There is a growing interest in comparison of international health care data with the hope that such studies will enable individual systems to learn from other systems. Such comparisons, however, presuppose that there exist common criteria for evaluating health care systems. The main thesis of this paper is that these comparative studies are misleading because they employ inappropriate operationalizations of these criteria because the operarionalizations are based upon mistaken global conceptualizations of the criteria in question. The essay provides a methodological critique of what has been done and sets a new agenda for future research.

Until a few years ago, the works of Thomas Reid were known only by specialists in the history of philosophy, and, insofar as people did think at all about Reid and his school of common sense philosophy, it was generally thought that Kant had been right in dismissing them as naive thinkers who did not really understand what philosophical skepticism was all about. This attitude about Reid changed very rapidly in recent years. More and more people now realize that Reid was one of the most important British philosophers, and that his works are full of deep insights that have only recently been rediscovered.

In a recent article (Brody 2010), I analyzed the debates surrounding charges of biopiracy, that is, charges that developed countries use biotechnology patents to expropriate the biological/genetic heritage of less developed countries. Such charges often are accompanied by the additional charge that biotechnology patents are used to expropriate the traditional knowledge about the use of these resources possessed by indigenous communities in less developed countries. It is this second charge that is the focus of this essay, which will develop both narrative and normative claims. The narrative claim is that various context specific principles about justice relating to traditional knowledge were adopted during the..

Empirical research can aid ethical reflection in bioethics by identifying issues, by seeing how they are currently resolved, and by assessing the consequences of these current resolutions. This potential can be misused when the ethical issues in question are fundamentally non-consequentialist or when they are consequentialist but the empirical research fails to address the important consequences. An example of the former problem is some recent studies about bad consequences resulting from commercialized living kidney donor programs. These consequences could be avoided, but the crucial non-consequentialist ethical issues about exploitation and commercialization would still remain. Examples of the latter problem are provided by recent studies of the allocation of ICU beds and of physician deception, where important consequences were not adequately studied.

This essay challenges the view that the provision of health care must take place within a competitive-free system. The author argues that, presuming that there is a requirement to meet the demands of those who cannot pay for health care, a competitive market provides a good way to deal with injustices within the health care system. The author concludes that the demands for justice are best met when indigent individuals use some portion of the funds they receive from the government to purchase one of the many competing forms of health care. This scheme requires a competitive market in the delivery of health care.

Public statements by various international groups emphasize that decisions to undergo genetic screening, either for disease-carrier status or for predisposition-to-disease status, and decisions about the use of the resulting information should be made voluntarily by the party to be screened. For example, the World Medical Association, in its Declaration on the Human Genome Project, says, “One should respect the will of persons screened and their right to decide about participation and about the use of the information obtained.” Giving this principle a name, “voluntarism,” the Council for International Organizations of Medical Sciences, in its Declaration of Inuyama, announced that “voluntarism should be the guiding principle in the provision of genetic services.