•  6
    Arian Lewis provides a comprehensive overview of how the United Kingdom’s medicolegal context manages challenges to determining death by neurologic criteria (DNC) and suggests that a well-crafted s...
  •  5
    Preclinical xenotransplantation research using genetically engineered pigs has begun to show some promising results and could one day offer a scalable means of addressing organ shortage. While it is a fundamental tenet of ethical human subject research that participants have a right to withdraw from research once enrolled, several scholars have argued that the right to withdraw from xenotransplant research should be suspended because of the public health risks posed by xenozoonotic transmission.…Read more
  •  3
    What Is It That You Want Me To Do? Guidance for Ethics Consultants in Complex Discharge Cases
    with Aziz A. Ansari and Kayhan Parsi
    HEC Forum 1-14. forthcoming.
    Some of the most difficult consultations for an ethics consultant to resolve are those in which the patient is ready to leave the acute-care setting, but the patient or family refuses the plan, or the plan is impeded by deficiencies in the healthcare system. Either way, the patient is “stuck” in the hospital and the ethics consultant is called to help get the patient “unstuck.” These encounters, which we call “complex discharges,” are beset with tensions between the interests of the institution …Read more
  •  10
    Shavelson et al., argues that California’s End of Life Option Act (ELOA) violates the Americans with Disabilities Act (ADA), because the ELOA requires the patient to “self-administer” their prescri...
  •  641
    Ontologically Grounded Subordination
    Philosophia Christi 13 (1): 169-180. 2011.
    In a recent article Steven Cowan defended the claim that female subordination and male authority are merely functional differences. Drawing insights from Natural Law, I argue that complementarianism typically speaks of these as proper functions of male and female designs, thus making men and women metaphysically unequal in being. Furthermore, I maintain that the function "serving as a means to an end" is less valuable than the function "having the authority to direct the end." Hence, Cowan fails…Read more
  •  8
    Protecting Life and Ensuring Death—Confounding the Dead Donor Rule
    American Journal of Bioethics 23 (2): 20-22. 2023.
    Nielsen Bush and Mjaaland (“the authors” hereafter) argue that controlled donation after circulatory death (cDCD) protocols that target abdominal organs are consistent with the dead donor rule (DDR...
  •  247
    It is envisioned that one day xenotransplantation will bring about a future where transplantable organs can be safely and efficiently grown in transgenic pigs to help meet the global organ shortage. While recent advances have brought this future closer, worries remain about whether it will be beneficial overall. The unique challenges and risks posed to humans that arise from transplanting across the species barrier, in addition to the costs borne by non-human animals, has led some to question th…Read more
  •  9
    Against abandoning the dead donor rule: reply to Smith
    Journal of Medical Ethics 49 (10): 715-716. 2023.
    Smith argues that death caused by transplant surgery will not harm permanently unconscious patients, because they will not suffer a setback to their interests in the context of donation. Therefore, so the argument goes, the dead donor rule can be abandoned, because requiring a death declaration before procurement does not protect any relevant interest from being thwarted. Smith contends that a virtue of his argument is that it avoids the controversies over defining and determining death. I argue…Read more
  •  281
    Review of When Death Becomes Life: Notes from a Transplant Surgeon (review)
    Kennedy Institute of Ethics Journal 32 (1): 8-12. 2022.
    Joshua Mezrich is a practicing transplant surgeon who draws on his experiences, and those of his patients, to provide a "here's where we're at" moment in the story of transplant medicine. In so doing, he explains what it is like to practice while telling the stories of his patients, donors, and the pioneering surgeons who persisted in the face of failure to make what Mezrich does a work of healing. Written for a popular audience, When Death Becomes Life is perhaps the most accessible work yet on…Read more
  •  350
    The dead donor rule (DDR) prohibits retrieval protocols that would be lethal to the donor. Some argue that compliance with it can be maintained by satisfying the requirements of double‐effect reasoning (DER). If successful, one could support organ donation without reference to the definition of death while being faithful to an ethic that prohibits intentionally killing innocent human life. On the contrary, I argue that DER cannot make lethal organ donation compatible with the DDR, because there …Read more
  •  39
    In ‘Dilemma for Appeals to the Moral Significance of Birth’, we argued that a dilemma is faced by those who believe that birth is the event at which infanticide is ruled out. Those who reject the moral permissibility of infanticide by appeal to the moral significance of birth must either accept the moral permissibility of a late-term abortion for a non-therapeutic reason or not. If they accept it, they need to account for the strong intuition that her decision is wrong as well as deny the underl…Read more
  •  476
    The inviolateness of life and equal protection: a defense of the dead-donor rule
    Theoretical Medicine and Bioethics 43 (1): 1-27. 2022.
    There are increasing calls for rejecting the ‘dead donor’ rule and permitting ‘organ donation euthanasia’ in organ transplantation. I argue that the fundamental problem with this proposal is that it would bestow more worth on the organs than the donor who has them. What is at stake is the basis of human equality, which, I argue, should be based on an ineliminable dignity that each of us has in virtue of having a rational nature. To allow mortal harvesting would be to make our worth contingent up…Read more
  •  479
    Giubilini and Minerva argue that the permissibility of abortion entails the permissibility of infanticide. Proponents of what we refer to as the Birth Strategy claim that there is a morally significant difference brought about at birth that accounts for our strong intuition that killing newborns is morally impermissible. We argue that strategy does not account for the moral intuition that late-term, non-therapeutic abortions are morally impermissible. Advocates of the Birth Strategy must either …Read more
  •  15
    Giving Useful but Not Well-Understood Ideas Their Due
    Journal of Medicine and Philosophy 44 (6): 663-676. 2019.
    In this paper, I introduce the ideas to be discussed in the articles of this journal with reference to an imaginary case involving a pregnant woman declared dead on the basis of neurological criteria. I highlight the fact that although these ideas have proved useful for advancing certain claims in bioethical debates, their implications are not always well understood and may complicate our arguments. The ideas to be discussed are an ethic internal to the profession of medicine; the difference bet…Read more
  •  590
    Brain Death as the End of a Human Organism as a Self-moving Whole
    Journal of Medicine and Philosophy 46 (5): 530-560. 2021.
    The biophilosophic justification for the idea that “brain death” is death needs to support two claims: that what dies in human death is a human organism, not merely a psychological entity distinct from it; that total brain failure signifies the end of the human organism as a whole. Defenders of brain death typically assume without argument that the first claim is true and argue for the second by defending the “integrative unity” rationale. Yet the integrative unity rationale has fallen on hard t…Read more
  •  20
    Inerrancy and Worldview: Answering Modern Challenges to the Bible (review)
    Philosophia Christi 16 (1): 230-233. 2014.
  •  20
    Do You Have a “Syndrome” If You Have a Flat-Shaped Head?
    Journal of Medicine and Philosophy 43 (4): 369-380. 2018.
    The themes of this issue—which include the meaning of our health and disease concepts, the so-called “medical gaze” and its embedded power relations, and the epistemic value of mixing therapy with research—are introduced by reflecting on a case about an infant girl whose head is observed to be somewhat flat.
  •  11
    Free will in philosophical theology (review)
    Philosophia Christi 17 (2): 495-498. 2015.
  •  930
    How (not) to think of the ‘dead-donor’ rule
    Theoretical Medicine and Bioethics 39 (1): 1-25. 2018.
    Although much has been written on the dead-donor rule in the last twenty-five years, scant attention has been paid to how it should be formulated, what its rationale is, and why it was accepted. The DDR can be formulated in terms of either a Don’t Kill rule or a Death Requirement, the former being historically rooted in absolutist ethics and the latter in a prudential policy aimed at securing trust in the transplant enterprise. I contend that the moral core of the rule is the Don’t Kill rule, no…Read more
  •  293
    ‘Total disability’ and the wrongness of killing
    Journal of Medical Ethics 41 (8): 661-662. 2015.
    Walter Sinnott-Armstrong and Franklin G Miller recently argued that the wrongness of killing is best explained by the harm that comes to the victim, and that ‘total disability’ best explains the nature of this harm. Hence, killing patients who are already totally disabled is not wrong. I maintain that their notion of total disability is ambiguous and that they beg the question with respect to whether there are abilities left over that remain relevant for the goods of personhood and human worth.…Read more