Marcus Düwell

In der deutschen medizinethischen Debatte spielen Verweise auf Menschenbilder eine große Rolle. Dabei haben diese Verweise ganz unterschiedliche argumentative Funktionen: Bisweilen sollen mit Bezug auf ein Menschenbild direkt moralische Normen begründet werden, aber Verweise auf Menschenbilder können auch andere Funktionen haben. Problematisch erweist sich jedoch, dass der Verweis auf ein „Bild“ vom Menschen voraussetzt, dass in einem einzigen Bild alle Aspekte, die für das Verständnis des Menschen wesentlich sind, erfasst werden können und damit die Vermittlung zwischen deskriptiven und normativen Dimensionen als unproblematisch angesehen wird. Eine normative Begründungsfunktion des Menschenbildes ist jedoch aus verschiedenen moralphilosophischen Erwägungen heraus problematisch. Dagegen könnte eine Thematisierung eines umfassenden Verständnisses vom Menschen uns in der Tat helfen, metaphysische und ontologische Voraussetzungen moralischer Diskurse sichtbar und diskutierbar zu machen, die Bedingungen des menschlichen Handlungsraumes zu verstehen und das Moralische in einem weiteren Kontext praktischen Selbstverständnisses zu interpretieren. Die Mehrdimensionalität des Begriffs „Menschenbild“ lässt es fraglich erscheinen, ob der Begriff geeignet ist, medizinethische Fragen adäquat zu verstehen; zur Begründung von Handlungsnormen sind Menschenbilder eher ungeeignet.

This paper is written from a perspective that is sympathetic to the basic idea of the capability approach. Our aim is to compare Martha Nussbaum’s capability theory of justice with Alan Gewirth’s moral theory, on two points: the selection and the justification of a list of central capabilities. On both counts, we contend that Nussbaum’s theory suffers from flaws that Gewirth’s theory may help to remedy. First, we argue that her notion of a (dignified) human life cannot fulfill the role of a normative criterion that Nussbaum wants it to play in selecting capabilities for her list. Second, we question whether Nussbaum’s method of justification is adequate, discussing both her earlier self-validating argumentative strategy and her more recent adherence to the device of an overlapping consensus. We conclude that both strategies fail to provide the capabilities theory with the firm foundation it requires. Next, we turn to Gewirth’s normative theory and discuss how it can repair these flaws. We show how his theory starts from a fundamental moral principle according to which all agents have rights to the protection of the necessary preconditions of their agency. Gewirth’s justification of this principle is then presented, using a version of a transcendental argument. Finally, we explicitly compare Nussbaum and Gewirth and briefly demonstrate what it would mean for Nussbaum to incorporate Gewirthian elements into her capabilities theory of justice.

Chervenak and McCullough, authors of the most acknowledged ethical framework for maternal–fetal surgery, rely on the ‘ethical–obstetrical’ concept of the fetus as a patient in order to determine what is morally owed to fetuses by both physicians and the women who gestate them in the context of prenatal surgery. In this article, we reconstruct the argumentative structure of their framework and present an internal criticism. First, we analyse the justificatory arguments put forward by the authors regarding the moral status of the fetus qua patient. Second, we discuss the internal coherence and consistency of the moral obligations those authors derive from that concept. We claim that some of the dilemmas their approach is purported to avoid, such as the debate about the independent moral status of the fetus, and the foundation of the moral obligations of pregnant women (towards the fetuses they gestate) are not, all things considered, avoided. Chervenak and McCullough construct the obligations of physicians as obligations towards entities with equal moral status. But, at the same time, they assume that the woman has an independent moral status while the moral status of the fetus is dependent on the decision of the woman to present it to a physician for care. According to the logic of their own argumentation, Chervenak and McCullough implicitly admit a different moral status of the woman and the fetus, which will lead to different ascription of duties of the physician than those they ascribed

Human beings orient themselves in the world via judgments; factual, moral, prudential, aesthetic, and all kinds of mixed judgments. Particularly for normative orientation in complex and contested contexts of action, it can be challenging to form judgments. This paper explores what one can reasonably expect from a theory of the power of judgment from a Kantian approach to ethics. We reconstruct practical judgments on basis of the self-reflexive capacities of human beings, and argue that for the subject to see himself as committed to prudential goods it is necessarily implied that he understands himself as committed to moral judgment. However, to understand the normativity of understanding oneself as a being with practical commitments at all, the aesthetic judgment is introduced: the power of judgment in its pure form of selfreflexivity. We claim that aesthetic reflection and judgment is conditional on the possibility for human beings to enter the space of reasons, and therewith for practical self-understanding as such. The paper concludes with a preliminary sketch of different conceptual possibilities in fleshing out the role of the power of judgment in its aesthetic employment in developing mixed judgments.

This chapter discusses some philosophical assumptions in the use of transcendental arguments in Alan Gewirth’s method of dialectical necessity. With this method Gewirth aims to show that agents must hold some beliefs in order to understand themselves consistently. Firstly, it is argued that this method is not in the first place used to convince the sceptic, but rather that the aim is gain a reflective understanding of ourselves. Since the methodology investigates ‘judgments’ and their role for the subject, we should see it as part of a hermeneutical enterprise to gain a form of reflected practical self-understanding. Secondly, the paper questions the distinction between ‘dialogical’ and ‘monological’ forms of transcendental justification in ethics. It is argued that the investigation of dialectically necessary judgments of the subject has the aim of showing in which ways the subject must respect the other in order to understand himself consistently. Those normatively committed subjects must be presupposed by discourse ethicists as well, otherwise the dialogue will not reach its goal of generating normatively acceptable outcomes. Finally, the chapter sketches some consequences of seeing the role of transcendental arguments in gaining a reflected form of practical self-understanding. If moral commitments are based in ‘judgment’, the power of judgment is of crucial importance and we must consider how the institutional and individual conditions needed to protect and develop this basic capacity can be protected and increased.

This book is a philosophically-oriented introduction to bioethics. It offers the reader an overview of key debates in bioethics relevant to various areas including; organ retrieval, stem cell research, justice in healthcare and issues in environmental ethics, including issues surrounding food and agriculture. The book also seeks to go beyond simply describing the issues in order to provide the reader with the methodological and theoretical tools for a more comprehensive understanding of current bioethical debates. The aim of the book is to present bioethics as an interdisciplinary field, to explore its close relation to other disciplines (such as law, life sciences, theology and philosophy), and to discuss the conditions under which bioethics can serve as an academically legitimate discipline that is at the same time relevant to society. As a systematic and methodologically rigorous overview, Bioethics: Methods, Theories, Domains will be of particular interest to academics and students in the disciplines of Law, Medicine, Ethics and Philosophy.

This introduction to human dignity explores the history of the notion from antiquity to the nineteenth century, and the way in which dignity is conceptualised in non-Western contexts. Building on this, it addresses a range of systematic conceptualisations, considers the theoretical and legal conditions for human dignity as a useful notion and analyses a number of philosophical and conceptual approaches to dignity. Finally, the book introduces current debates, paying particular attention to the legal implementation, human rights, justice and conflicts, medicine and bioethics, and provides an explicit systematic framework for discussing human dignity. Adopting a wide range of perspectives and taking into account numerous cultures and contexts, this handbook is a valuable resource for students, scholars and professionals working in philosophy, law, history and theology.

This paper analyses the main challenges to the idea that we should and can represent future generations in our present policymaking. It argues that these challenges can and should be approached from the perspective of human rights. To this end it introduces and sketches the main features of a human rights framework derived from the moral theory of Alan Gewirth. It indicates how this framework can be grounded philosophically, sketches the main features and open questions of the framework and its grounding, and shows how it can be used to deal with the challenges to the idea that future generations have rights that can be represented in our policymaking.

The aim of the paper is to examine the possible relationships between the different dimensions of aesthetics on the one hand, and medical practice and medical ethics on the other hand. Firstly, I consider whether the aesthetic perception of the human body is relevant for medical practice. Secondly, a possible analogy between the artistic process and medical action is examined. The third section concerns the comparison between medical ethical judgements and aesthetic judgement of taste. It is concluded that the mutual relevance between the aesthetic sphere, moral judgement and medical practice can be understood only if we recognize these spheres as distinct