Michael Potts

Ben Saunders claims that actual consent is not necessary for organ donation due to ‘normative consent’, a concept he borrows from David Estlund. Combining normative consent with Peter Singer's ‘greater moral evil principle’, Saunders argues that it is immoral for an individual to refuse consent to donate his or her organs. If a presumed consent policy were thus adopted, it would be morally legitimate to remove organs from individuals whose wishes concerning donation are not known. This paper disputes Saunders' arguments. First, if death caused by the absence of organ transplant is the operational premise, then, there is nothing of comparable moral precedence under which a person is not obligated to donate. Saunders' use of Singer's principle produces a duty to donate in almost all circumstances. However, this premise is based on a flawed interpretation of cause and effect between organ availability and death. Second, given growing moral and scientific agreement that the organ donors in heart-beating and non-heart-beating procurement protocols are not dead when their organs are surgically removed, it is not at all clear that people have a duty to consent to their lives being taken for their organs. Third, Saunders' claim that there can be good reasons for refusing consent clashes with his claim that there is a moral obligation for everyone to donate their organs. Saunders' argument is more consistent with a conclusion of ‘mandatory consent’. Finally, it is argued that Saunders' policy, if put into place, would be totalitarian in scope and would therefore be inconsistent with the freedom required for a democratic society

Ethical issues relating to the use of the injectable contraceptive in developed and developing countries alike involve public policy decisions concerning both criteria for testing a new drug and individual choices about using a specific form of contraception approved for national distribution. Drug testing consists of an important but still evolving set of procedures. Depo-Provera is not qualitatively different from any other drug and some unpredictable risks are inevitable, even after extensive animal experiments and clinical trials. In assessing the risks and benefits of Depo-Provera use, epidemiological data from large-scale human use is now beginning to become more important than data from animal experiments and clinical trials. The consumer's best interest is central to any ethically responsible system of drug distribution. Systems of informed choice are needed, even in societies where illiteracy remains common and medical services are weak. In the case of a contraceptive, the risks of non-use leading to unintended pregnancy, which can result in high mortality, are relevant as well as the side-effects of the method. An attempt, therefore, is made here to categorise those issues which are universal and those which are country-specific

The “standard position” on organ donation is that the donor must be dead in order for vital organs to be removed, a position with which we agree. Recently, Robert Truog and Walter Robinson have argued that brain death is not death, and even though “brain dead” patients are not dead, it is morally acceptable to remove vital organs from those patients. We accept and defend their claim that brain death is not death, and we argue against both the US “whole brain” criterion and the UK “brain stem” criterion. Then we answer their arguments in favour of removing vital organs from “brain dead” and other classes of comatose patients. We dispute their claim that the removal of vital organs is morally equivalent to “letting nature take its course”, arguing that, unlike “allowing to die”, it is the removal of vital organs that kills the patient, not his or her disease or injury. Then, we argue that removing vital organs from living patients is immoral and contrary to the nature of medical practice. Finally, we offer practical suggestions for changing public policy on organ transplantation

Individuality has posed difficult problems throughout the history of philosophy. Not only is there the metaphysical difficulty of determining the principle of individuation, but, since our concepts and linguistic structure are based on universals, there is a gap in our knowledge of individuals and in our ability to express knowledge of individuals. God, who in Classical Theism is an individual, poses especially difficult problems. This dissertation proposes one way which may partially close the gap: metaphor. ;I argue that the principle of individuation is what Duns Scotus called haecceitas, which uniquely delimits this particular individual. It is not opposed to form or to universality, but is the ultimate reality of form. I follow Scotus further in holding that the individual qua individual is intrinsically intelligible; our difficulty in understanding individuals is due to the weakness of our intellect, since our thought is through universal concepts. ;Next I defend the interaction theory of metaphor, which holds that the terms of a metaphor interact to form a new meaning which cannot be entirely reduced to the meanings of the terms. I argue further that metaphor can not only give us richer linguistic access to entities, but also give us cognitive insight which cannot be gained in any other way. ;I then defend a form of non-propositional knowing and argue that metaphor is a particularly appropriate way to express this knowledge. I argue that Scotus' theory of individuality, which holds that the individual is intrinsically intelligible, leaves open the possibility of some form of metaphoric cognition of the individual. I present a case study: the poetry of Gerard Manley Hopkins. Hopkins attempted to use metaphor and other devices in his poetry to illuminate individual beings. ;Finally I discuss God, the ultimate instance of the correlation of universality and individuality. God, being the ultimate individual, presents epistemological and linguistic problems similar in some ways to those which accrue to finite individuality. I defend the thesis that metaphorical and modelling language can help us gain insight into God

Based on themes in Aquinas, this paper adds to the defense of the doctrine of an eternal hell, focusing on the state of those in hell after the resurrection. I first summarize the Thomistic doctrine of the human person as a body-soul unity, showing why existence as a separated soul is truncated and unnatural. Next, I discuss the soul-body reunion at the resurrection, which restores an essential aspect of human nature, even for the damned. This reveals the love of God since He gives the damned the best human existence they can possibly have given their disordered wills. Finally, I defend this position against three important objections.

Recently, several articles in the scholarly literature on medical ethics proclaim the need for “responsible scholarship” in the debate over the proper criteria for death, in which “responsible scholarship” is defined in terms of support for current neurological criteria for death. In a recent article, James M. DuBois is concerned that academic critiques of current death criteria create unnecessary doubt about the moral acceptability of organ donation, which may affect the public’s willingness to donate. Thus he calls for a closing of the debate on current death criteria and for journal editors to publish only critiques that “substantially engage and advance the debate.” We argue that such positions as DuBois’ are a threat to responsible scholarship in medical ethics, especially scholarship that opposes popular stances, because it erodes academic freedom and the necessity of debate on an issue that is literally a matter of life and death, no matter what side a person defends

Since the introduction of the concept of brain death by the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death in 1968, the validity of this concept has been challenged by medical scientists, as well as by legal, philosophical, and religious scholars. In light of increased criticism of the concept of brain death, Stephen Napier, a staff ethicist at the National Catholic Bioethics Center, set out to prove that the whole-brain death criterion serves as good evidence for death in the Catholic bioethical framework, on the grounds that when whole-brain death has occurred the soul has already departed from the body. Opponents have argued that (1) brain death does not disrupt the somatic integrative unity and coordinated biological functioning of a living organism and (2) clinical tests outlined in the practice guidelines for determining brain death lack sufficient power to exclude persisting function and fail to detect elements of the brain that, although currently functionless, may retain potential for recovery under conditions of optimal medical care. It is therefore possible that heart-beating organ procurement from patients with impaired consciousness is de facto a concealed practice of active euthanasia and physician-assisted death, both of which, either concealed or overt, the Catholic Church opposes

Alan Shewmons article, The brain and somatic integration: Insights into the standard biological rationale for equating brain death with death (2001), strikes at the heart of the standard justification for whole brain death criteria. The standard justification, which I call the standard paradigm, holds that the permanent loss of the functions of the entire brain marks the end of the integrative unity of the body. In my response to Shewmons article, I first offer a brief summary of the standard paradigm and cite recent work by advocates of whole brain criteria who tenaciously cling to the standard paradigm despite increasing evidence showing that it has significant weaknesses. Second, I address Shewmons case against the standard paradigm, arguing that he is successful in showing that whole brain dead patients have integrated organic unity. Finally, I discuss some minor problems with Shewmons article, along with suggestions for further elaboration.