Whilst I am an advocate for dialogue and mutual understanding and
indeed have written on the possible acceptance of emergency contraception
in instances of rape, I find this article by L. Bovens rather disturbing
and at most insulting to the general Catholic population. Although he uses
the term pro-life, this can only be an emotive attempt, rather than
rational argumentation, since 'pro-lifers' have b...
Whilst I am an advocate for dialogue and mutual understanding and
indeed have written on the possible acceptance of emergency contraception
in instances of rape, I find this article by L. Bovens rather disturbing
and at most insulting to the general Catholic population. Although he uses
the term pro-life, this can only be an emotive attempt, rather than
rational argumentation, since 'pro-lifers' have been associated with hard-
line fundamentalists - which indeed in itself is unfortunate.
Catholics do sometimes complain that using the rhythm method is in a
sense hypocritical and since the intent is the same, then why not use oral
contraception. They do so however in a certain aptitude of ignorance of
the pharmacodynamics and pharmacokinetics of the drug. Oral contraception
is intent merely on stopping the reproductive function, period. It has
also been known to be abortifacient, especially when women are given the
advice to take two pills the next day after a day in which they would have
missed out; and even three pills if they forget taking it for two days.
Perhaps there is an omission of the informed consent process on the part
of the prescribers in this process.
The rhythm method is simply a method by which couples are careful
when the woman is ovulating. This can be used both for the intent of
having babies or for not having them. I will restrict myself to the
Catholic perspective. Being Catholics means being united as a couple. This
unity must be seen in the perspective of trinitarian theology which speaks
of kenosis and perichoresis. The latter is the emptying of oneself; the
former is the making oneself 'one' with the other. This does not translate
that therefore the couple, being one, cannot have a say in God's plan on
planning their family. Where would freedom be if this were not so?
Philosophically however it is even more problematic to think that
people cannot have a say by controlling their reproductive life.
Technically we can spend our whole life in bed trying to have babies,
since every moment that passes is an opportunity 'lost'. Indeed this in
itself is a reductio ad absurdum of Boven's argumentation, I am afraid.
One has also to consider the reasons chosen for family planning. Not
all may be justified and therefore the morality of natural family planning
lies in this non-manifest agenda rather than solely in the act. Besides
this there is the whole concept of one being a natural method which is
inherent in human nature and understanding of its own physiology. The
other is based on a physical barrier, intent on altering one's physiology
and nature. This may be fine for many; it does not translate into being a
moral falsehood for those who believe in the unity and agape of marriage.
This article ignores up to date knowledge of the physiology of
reproduction in its fascination with a mathematical and statistical model
and his illogical assumptions.
The ovum lives for 12-24 hours, and it can only be fertilised within
this short time(1). Outwith the fertile time, the sperm cannot reach the
ovum as the cervical mucus dries and forms a plug(2). The sperm can be
kept waitin...
This article ignores up to date knowledge of the physiology of
reproduction in its fascination with a mathematical and statistical model
and his illogical assumptions.
The ovum lives for 12-24 hours, and it can only be fertilised within
this short time(1). Outwith the fertile time, the sperm cannot reach the
ovum as the cervical mucus dries and forms a plug(2). The sperm can be
kept waiting in the cervical crypts for 4-5 days maximum prior to
ovulation. If a sperm reaches the ovum and fertilises it, it has shown it
has been healthy enough to win the race in the last sprint to the
fallopian tubes!
There is no evidence that there is any variability of viability of
the conceptus with time of fertilisation within this narrow window. The
viability of the new human being is dependent on his or her completely new
and unique genetic make up, which may be defective because of genetic
disease carried by the gametes. It also depends on the health of its
environment rather than the tiredness of the now dispensed propelling
mechanism of the sperm.
Once conception has occurred the next phase kicks into action,
progesterone rises up to about the 7th post-ovulatory day then Human
chorionic gonadotrophin (HCG) produced by the implanting blastocyst,
maintains the corpus luteum(3). Research has revealed variant forms of
ovulation and defects in implantation(4), some due to hormonal problems,
a short post-ovulatory phase or problems with the receptivity of the
endometrium but this is not related to the times of intercourse.
If implantation is faulty in some way, the couple may suffer
recurrent early miscarriages. These couples would therefore be wise to use
the Natural Family Planning in order to achieve, rather than avoid a
pregnancy, in order to increase the probability of fertilisation and
subsequent success. Nature allows wastage, it can be cruel, but as yet, we
have little power over it. NaProTechnology(5), which uses the science
from Natural Family Planning, aims to prevent early miscarriage with
hormone support and to maintain pregnancy to full term.
I was surprised at the out of date science used in this article. We
can only develop our bio-ethics in accord with the best science available
at any point in time, otherwise it would certainly, as in this case, be
reductio ad absurdum.
Dr A M H Williams
GP and Medical Advisor Fertility Care
Glasgow
p.s. I could also add that though many people may use NFP for pro-
life reasons, the overwhelming reason is to not separate the procreative
from the unitive functions of the sexual act, but that may take a bit
longer to explain.
Potts (1) questions the validity of prospective consent to organ
donation as recorded on the organ donor cards in current use in the USA.
The situation is no better in this country. "Consent" as recorded on the
NHS Organ Donor Register is based on nothing more than a ticked box on a
form specifying organs to be taken after death. Such "consent" is surely
invalid, being at the very least far from fu...
Potts (1) questions the validity of prospective consent to organ
donation as recorded on the organ donor cards in current use in the USA.
The situation is no better in this country. "Consent" as recorded on the
NHS Organ Donor Register is based on nothing more than a ticked box on a
form specifying organs to be taken after death. Such "consent" is surely
invalid, being at the very least far from fully informed and arguably
based on misinformation - there being no mention of the fact that death
for transplant purposes will be certified on different, highly
contentious, criteria from those in otherwise universal use.
It may be that a majority of the names on the NHS Organ Donor
Register are there because of failure to appreciate, or even consider,
this vitally important fact. Almost certainly that will be the case where
the names of children are concerned. It may be that the 12 million or so
names on that Register will ultimately be seen as testimony to the power
of official propaganda in the "media" age. It is certainly not a
repository of valid offers of post-mortem organ donation fairly made on a
fully informed and mutually understood premise.
References
1. Potts M. When "consent" is not consent. e-letter to J Med Ethics
(re Bell MDD. J Med Ethics 2006;32:283-6), 18 May 2006.
MDD Bell (1) points out a number of serious ethical problems with
"presumed consent" for organ donation in the UK Human Tissue Act 2004. One
serious problem is that even in a system of voluntary organ donation, such
as the one in the US, true informed consent is not given. Organ donor
cards do not make it clear when claiming that the removal of organs takes
place after the donor is dead, that the poten...
MDD Bell (1) points out a number of serious ethical problems with
"presumed consent" for organ donation in the UK Human Tissue Act 2004. One
serious problem is that even in a system of voluntary organ donation, such
as the one in the US, true informed consent is not given. Organ donor
cards do not make it clear when claiming that the removal of organs takes
place after the donor is dead, that the potential "brain dead" donor is
not dead in the usual sense of the word. Surgery to remove organs begins
with the donor's heart still beating and blood gas exchange continuing in
the cells, tissues, organs, and systems of the body. The patient's being
on a ventilator does not change the fact that he or she is a living human
organism. Families who see their loved ones labeled "dead" when they
appear to be very much alive are wisely reluctant to support the removal
of organs from their loved ones.
Bell also refers to the continuing controversy over the "brainstem
death" criterion in the UK (just as controversy over the "whole brain
death" criterion continues in the US). (2) Beside the fact that brain dead
individuals still have organic unity, it is not clear that their brains
are completely dead. (3) For someone to give consent to organ donation,
one would need to be aware that the issue of the proper criteria for
determining death has not been settled. Potential donors and their
families are not currently informed of these uncertainties. Bell also
rightly mentions the uncertainties, both medical and ethical, surrounding
"non-heartbeating" organ donation, problems which should be revealed to
the families of potential donors.
If there is so much uncertainty over consent in a voluntary system of
donation, a system of "presumed consent" is even more morally problematic.
Such a system presumes that it is clearly rational and ethical for a
person to consent to organ donation, when the evidence indicates that this
may not be the case. An "opt out" system will likely be ineffective,
especially since potential donors will only be presented with a rosy
picture of organ donation. It is almost certain that under "presumed
consent," organs will be taken from donors who oppose organ
transplantation or who believe that removing vital organs from the
"brainstem dead" donor kills the donor. A "presumed consent" system of
organ donation makes a mockery of the term "consent" and should be
rejected.
References
1. Bell MDD. The UK human tissue act and consent: surrendering a
fundamental principle to transplantation needs. J Med Ethics 2006;32:283-
286.
2. Potts M, Byrne PA, Nilges RG, eds. Beyond brain death: the case
against brain-based criteria for human death. Dordrecht, The Netherlands:
Kluwer Academic Publishers, 2000.
3. Potts M, Evans DW. Does it matter that organ donors are not dead?
Ethical and policy implications. J Med Eth 2005;31:406-409.
I very much enjoyed Dr.Bishop paper and I agree on most points, I am
against euthanasia, and do believe that by legalising assisted dying we
place death in a 'metaphysics of efficiency', and that leaving death
'open' would be preferable.
To be sure, making it a law gives death a different status, one of a
medical 'option', and a certain legitimacy as being merely 'an option'.
However, ther...
I very much enjoyed Dr.Bishop paper and I agree on most points, I am
against euthanasia, and do believe that by legalising assisted dying we
place death in a 'metaphysics of efficiency', and that leaving death
'open' would be preferable.
To be sure, making it a law gives death a different status, one of a
medical 'option', and a certain legitimacy as being merely 'an option'.
However, there are already people who wanted to die and wanted physicians
to assist them in that death, prior to any current legal or medical
discourses, such as Lord Joffey's Bill in the UK. Whilst people views are
shaped by medicine, law and popular views of the time, people still have
autonomy. To certain extent we had already placed ourselves in the
metaphysics of efficiency, medicine didn't place us there. DNR, which
Dr.Bishop mentions is a good case point. Medicine may have appropriated
it, but patient groups asked for it. Whilst this does in no way
legitimatize such appropriation, medicine didn't ask for this option to
begin with. That a law might make more people consider death as an
'option' is likely and will enable such a metaphysical 'attitude' to be
all encompassing it was, however, there already.
Competing Interests: None
Reference
1. J P Bishop. Framing euthanasia. J Med Ethics 2006; 32:225-228.
K A Bramstedt maintains in its excellent article that, solely in the
case of transplant between alive, would be acceptable which a transfusion
contract was not signed if both, donor and receiver, are Witnesses of
Jehovah.
Nevertheless, we considered that, even in those cases,
the rejection to the transfusion must be used like exclusion
criterion.
K A Bramstedt maintains in its excellent article that, solely in the
case of transplant between alive, would be acceptable which a transfusion
contract was not signed if both, donor and receiver, are Witnesses of
Jehovah.
Nevertheless, we considered that, even in those cases,
the rejection to the transfusion must be used like exclusion
criterion.
In this case the reason has to be the consumption of
resources,although, more important, it is had to consider that, with our
intervention, in addition to not protecting the health of the ill Witness
of Jehovah, the danger for the health of the healthy Witness of Jehová
would be increased.
We declare that we do not have conflict of interests
Udo Schuklenk wants to denude all physicians of any jewelry,
clothing, or office accouterments that identify them as a member of a
religion, political party, or sexual orientation. (1) Why? Because some
wary patients will see these as barriers between themselves and their
physicians. In consequence, adolescent patients struggling with sexuality
or patients with drug problems may not trust their phy...
Udo Schuklenk wants to denude all physicians of any jewelry,
clothing, or office accouterments that identify them as a member of a
religion, political party, or sexual orientation. (1) Why? Because some
wary patients will see these as barriers between themselves and their
physicians. In consequence, adolescent patients struggling with sexuality
or patients with drug problems may not trust their physicians fully and
withhold information critical to their medical care. This argument is too
clever by half.
In the way he has constructed the argument, all Schuklenk needs to show is
that some patient somewhere is somehow discomfited by his or her
physician’s pro-gay lapel pin, Jewish yarmulke, or Christian cross hung
around the neck. Never mind that for many patients the display of
religious symbols elicits the openness and trust Schuklenk wants to see in
clinical relationships. Never mind that physicians who wear a cross or a
yamulke might also have been sexually confused adolescents or people know
firsthand the difficulties of drug use or an unwanted pregnancy. It
doesn’t matter to Schuklenk that self-identified Christian or Muslim
physicians hold a variety of views when it comes to contraceptives,
abortion, and sexual fidelity. All that matters are patient’s
perceptions, the facts notwithstanding. To be sure, physicians should not
pressure patients toward political and religious views, and any such
actions should be condemned as the unwarranted intrusions that they
are.(2)
But as far as Schuklenk is concerned, passive symbolism is no
less worrisome than active pressure on patients to adopt religious or
political views.
Patients will disclose the truth about their circumstances -- and come to
trust physicians -- if given a reason to do so. Physicians who emphasize
their commitment to patients and the confidentiality of their discussions
provide exactly those reasons, and this is true no matter whether their
clothing identifies them as a member of a religion or not.
References
1. Udo Schuklenk, Medical professionalism and ideological symbols in
doctors’ rooms. Journal of Medical Ethics 2006 (32): 1-2.
P Patel’s article in “Research Ethics: A natural stem cell therapy?
How novel findings and biotechnology clarify the ethics of stem cell
research,” in the April issue of the Journal did not clarify as much as it
could have.
Rather than exploring the “naturalness” of stem cell therapy, a
better understanding would come with examining “destructive” and “non-
destructive” stem cell therapy. Firs...
P Patel’s article in “Research Ethics: A natural stem cell therapy?
How novel findings and biotechnology clarify the ethics of stem cell
research,” in the April issue of the Journal did not clarify as much as it
could have.
Rather than exploring the “naturalness” of stem cell therapy, a
better understanding would come with examining “destructive” and “non-
destructive” stem cell therapy. First of all, however, we must clarify the
definition of the term “embryo.”
The blastocyst, with its inner cell mass, is by definition, an embryo
, without regard to how that organism began. In animals (Dolly the sheep,
Hwang Wu Suk’s “Snuppy,” and the cats, horses, mice, etc.) that have been
cloned by somatic cell nuclear transfer, there is no immediate
fertilization of the oocyte. In nature, the the generation of cell
division is initiated by the penetration of the zona pellucida by the
sperm, in the lab, it may be the electrical stimulation of a “renucleated
oocyte” or even of the oocyte, itself, in some species. Nevertheless, the
donor nucleus did, remotely, result from the fertilization of an oocyte by
a sperm. Science fiction has dealt with the parentage of the clone and the
consensus of these thinkers seems to be that the “parents” of a clone are
both the donor and his/her parents. (Try Lois McMasters Bujold’s
Vorkosigian series.)
As to the determination of the ethics of stem cell research, those of
us who object to the destruction of the embryo by technology and
intentional intervention are concerned with the destruction of a living
human organism, who is developing – as nearly as we can tell – in the same
way that other human organisms do at that stage or age. On the other hand,
there would be no ethical problem if there is no organization and/or no
life.
I’m afraid that the biggest problem is one of time – the time since
the author submitted his article (and possibly, the time since I wrote
these lines.) There is a report of a human embryo that was created from
the replacement of the haploid nucleus of an oocyte by the diploid nucleus
of an embryonic stem cell. In Korea, Hwang Wu Suk able to produce one
very damaged line of stem cells, although there is dispute as to whether
the line came from a human clone or as a result of apparent
parthenogenesis.
Beverly B. Nuckols, MD
Life Ethics.org
New Braunfels, Texas
I would like to thank Professor Häyry for his complimentary remarks
on my
paper, and for his three (characteristically) incisive questions. In what
follows,
I will attempt to answer each of those questions in turn.
(i) Häyry asks how I can consistently maintain the conjunction of the
following
three propositions:
(a) taken together, the external and internal perspectives exhaust...
I would like to thank Professor Häyry for his complimentary remarks
on my
paper, and for his three (characteristically) incisive questions. In what
follows,
I will attempt to answer each of those questions in turn.
(i) Häyry asks how I can consistently maintain the conjunction of the
following
three propositions:
(a) taken together, the external and internal perspectives exhaust
the
standpoints available to a prospective parent in thinking about the lives
of
her possible future children;
(b) it is morally inapproriate for a prospective parent to take up the
external
perspective; but
(c) it is not obligatory for a prospective parent to take up the internal
perspective.
Häyry's thought here is that, if it is morally inappropriate for a
prospective
parent to take up the external perspective, and if the internal
perspective is
the only other available, then it must surely be obligatory for her to
take up
the internal. Häyry has clearly detected that I simultaneously feel both
tempted and reluctant to take the hard-line position that adoption of the
internal perspective is a strict duty for prospective parents! But while I
admit
that my intuitions pull me in two directions here, I am not convinced that
this
causes me to fudge the issue.
That is, the opposite of "morally inappropriate" does not seem to me
to be
"obligatory", but rather "morally appropriate". In saying that a
prospective
parent does something morally inappropriate in adoting the external
perspective, I am not suggesting that she is thereby contravening a duty.
Rather, I am saying that she is not, as it were, being the prospective
parent
she might be, since she is not taking up the perspective that is
appropriate
for her qua prospective parent. Now, doubtless it is trivially true that
we
should do what it is morally appropriate for us to do, but it seems to me
that
this claim makes use of a weaker sense of "should" than attaches to
statements of strict obligation. Importantly for my argument in the paper,
however, what does follow from the claim that the external perspective is
morally inappropriate for prospective parents, is that prospective parents
cannot be obliged to follow any principle (such as that of procreative
beneficence) that is rooted in that perspective.
(ii) As Häyry goes on to note, I state in my paper that the external
perspective
is the proper one for political decision makers to adopt, when choosing
policies that will affect which people are born, and the expected quality
of the
lives those people will lead (as in Parfit's conservation/depletion
example,
cited in my paper). Given this, Häyry asks what is to be done about the
apparent clash between the perspectives fitting for parents and for policy
makers, and between the actions that will result from the adoption of
those
perspectives. My answer is that political decision makers will be obliged
not
to interfere with decisions that ought to be the sole preserve of
prospective
parents. I take it that the choice of a conservation or a depletion policy
is not
such a decision, whereas whether to choose a better life embryo or a worse
life embryo is. Häyry's point does me the service of drawing my attention
to
the fact that I ought not to have said that "adoption of the external
perspective ... is obligatory for political decision makers ...", but
rather that it
is prima facie obligatory. I am grateful to him for this.
(iii) Towards the end of my paper, I introduce a principle of
acceptable
outlook (PAO), which I maintain ought to guide prospective parents'
decisions
about which children to produce, in place of Savulescu's principle of
procreative beneficence (PPB). PAO, I say, will take a form similar to "'I
will not
allow any child of mine to have a quality of life below L', where L is a
level of
acceptable outlook ... PAO will typically find expression in such
attitudes as 'I
do not want any child of mine to suffer unacceptably' ...". I also claim
that no
definite answer can be given to the question of where exactly L (the level
of
acceptable outlook) should be fixed, and rather imply that it may differ
from
prospective parent to prospective parent (although I do say that a life
not
worth living will fall below any plausible candidate for L).
Now, given this last point, Häyry asks what is stop a proponent of
PPB from
setting L at "the standard suggested by procreative beneficence", and
holding
that prospective parents either could or should hold a principle of the
form "I
do not want any child of mine to have a life that is worse than the best
life a
child of mine could have had". This, as Häyry notes, would involve the
collapse of the distinction between PAO and PPB.
But that such a collapse would occur ought to give us pause. That is,
if any
prospective parent employed PAO in this fashion, she would, in doing so,
be
making an external perspective judgement about the lives of her possible
future children. Such a judgement is, my paper argues, morally
inappropriate
for a prospective parent, and it is precisely this fact that prevents our
being
able legitimately to flesh out PAO in the way Häyry mentions.
Of course, it may be that a prospective parent locates L at a
standard that, so
to speak, just turns out to equal that of the best life a child of hers
could
have. This might seem a curiously high standard to set, but so long as it
is
not chosen just because it is the level of the best life a child of hers
could
have, it would involve no external perspective judgement, and so no
illegitimate
application of PAO.
Peter Herissone-Kelly[1] makes the case that it would be morally
inappropriate for prospective parents to select their children based on
comparative judgments about their life quality. This view is in stark
contradiction with the view, advanced by Julian Savulescu [2], that
parents have a moral obligation to select the best possible children they
can have.
Peter Herissone-Kelly[1] makes the case that it would be morally
inappropriate for prospective parents to select their children based on
comparative judgments about their life quality. This view is in stark
contradiction with the view, advanced by Julian Savulescu [2], that
parents have a moral obligation to select the best possible children they
can have.
Herissone-Kelly argues that future lives can be assessed from two
mutually exclusive viewpoints: the external and the internal. The external
perspective, assumed by Savulescu in his Principle of Procreative
Beneficence, is according to Herissone-Kelly (pp. 167-168), "obligatory
for political decision makers selecting social policies that will
indirectly affect both who will come into existence in the future, and the
quality of those future persons' lives." It would, however, be (p. 168),
"unfitting ... for prospective parents to take up the external
perspective", indeed, "it would be morally inappropriate for them to do
so."
The use of the internal perspective in parental decision making
leads, Herissone-Kelly maintains, to the rejection of the Principle of
Procreative Beneficence, and to the assumption of an alternative axiom,
the Principle of Acceptable Outlook. This stipulates that possible
children are not compared with one another – the fact that child A could
have a better life than child B is not a fitting (or at least not a
binding) parental reason for choosing A. It also stipulates that parents
are not obliged to have children whose life quality would be at a level
that the parents deem to be unacceptably low.
Herissone-Kelly's principle is in many respects intuitively more
acceptable than Savulescu's. It states that as long as all our potential
children would have a reasonably good life, we may choose any one of them.
(Savulescu would insist that the best must be selected.) It also allows us
not to have children at all, if none of our potential offspring can be
expected to have an acceptable life quality. (Savulescu's principle would
morally oblige us to have a child with a truly miserable life, if there
are no better options).
The claim is interesting and skilfully defended, and the author has
made a considerable contribution to the current discussion on the use of
technology in reproduction. I have three questions concerning the
Principle of Acceptable Outcome, its implications, and its applications.
(i) Herissone-Kelly hovers in the paper between the view that it is
prima facie obligatory for parents to adopt his principle and the view
that it is merely admirable and permissible for them to do so. He is
explicitly (p. 168) "inclined to say that it is not" obligatory, but he
also says that "it would be morally inappropriate" for the parents to take
up the external perspective.
My question is this. If the external and internal perspectives are
the only options available, and if it is morally inappropriate to assume
the external perspective, how can it not be obligatory to take up the
internal view? The logic of moral sentences seems to be that if one of
only two alternatives is wrong, then the one remaining is right in the
strong sense of being a moral duty.
(ii) If what I have said is correct, what are the social and
political implications? Herissone-Kelly states that political decision
makers have an obligation to take up the external view, and in the present
context this means that they should aim for the "best" future population
they can, probably by using all available genetic and medical technologies
in the choice of prospective citizens. The parents, on the other hand,
have an obligation to adopt the internal view, which implies that they
should resist at least some of the authorities' attempts to influence
their reproductive choices. How can this potential tension be handled?
(iii) In the internal assessment of the life quality of possible
children, Herissone-Kelly allows the parents to consider whether their
offspring would suffer unacceptably. He goes on to say that (p. 169) "what
counts as unacceptable suffering, or precisely where the level of
acceptable outlook ought to be fixed, are not questions to which any very
definite answer can be supplied."
If this is so, what prevents a proponent of Savulescu's principle
from arguing that the acceptable level should be set higher, to the
standard suggested by procreative beneficence? Parents could (or should?)
arguably have the attitude that "I do not want any child of mine to have a
life that is worse than the best life a child of mine could have had". In
this case, the difference between the principles would seem to evaporate.
References
[1] Herissone-Kelly P. Procreative beneficence and the prospective
parent. J Med Ethics 2006;32:166-169.
[2] Savulescu J. Procreative beneficence: why we should select the best
children. Bioethics 2001;15:413-426.
Dear Editor,
Whilst I am an advocate for dialogue and mutual understanding and indeed have written on the possible acceptance of emergency contraception in instances of rape, I find this article by L. Bovens rather disturbing and at most insulting to the general Catholic population. Although he uses the term pro-life, this can only be an emotive attempt, rather than rational argumentation, since 'pro-lifers' have b...
Dear Editor,
This article ignores up to date knowledge of the physiology of reproduction in its fascination with a mathematical and statistical model and his illogical assumptions.
The ovum lives for 12-24 hours, and it can only be fertilised within this short time(1). Outwith the fertile time, the sperm cannot reach the ovum as the cervical mucus dries and forms a plug(2). The sperm can be kept waitin...
Dear Editor,
Potts (1) questions the validity of prospective consent to organ donation as recorded on the organ donor cards in current use in the USA. The situation is no better in this country. "Consent" as recorded on the NHS Organ Donor Register is based on nothing more than a ticked box on a form specifying organs to be taken after death. Such "consent" is surely invalid, being at the very least far from fu...
Dear Editor,
MDD Bell (1) points out a number of serious ethical problems with "presumed consent" for organ donation in the UK Human Tissue Act 2004. One serious problem is that even in a system of voluntary organ donation, such as the one in the US, true informed consent is not given. Organ donor cards do not make it clear when claiming that the removal of organs takes place after the donor is dead, that the poten...
Dear Editor,
I very much enjoyed Dr.Bishop paper and I agree on most points, I am against euthanasia, and do believe that by legalising assisted dying we place death in a 'metaphysics of efficiency', and that leaving death 'open' would be preferable.
To be sure, making it a law gives death a different status, one of a medical 'option', and a certain legitimacy as being merely 'an option'. However, ther...
Dear Editor,
K A Bramstedt maintains in its excellent article that, solely in the case of transplant between alive, would be acceptable which a transfusion contract was not signed if both, donor and receiver, are Witnesses of Jehovah.
Nevertheless, we considered that, even in those cases, the rejection to the transfusion must be used like exclusion criterion.
In this case the reason has to be...
Dear Editor,
Udo Schuklenk wants to denude all physicians of any jewelry, clothing, or office accouterments that identify them as a member of a religion, political party, or sexual orientation. (1) Why? Because some wary patients will see these as barriers between themselves and their physicians. In consequence, adolescent patients struggling with sexuality or patients with drug problems may not trust their phy...
Dear Editor,
P Patel’s article in “Research Ethics: A natural stem cell therapy? How novel findings and biotechnology clarify the ethics of stem cell research,” in the April issue of the Journal did not clarify as much as it could have.
Rather than exploring the “naturalness” of stem cell therapy, a better understanding would come with examining “destructive” and “non- destructive” stem cell therapy. Firs...
Dear Editor,
I would like to thank Professor Häyry for his complimentary remarks on my paper, and for his three (characteristically) incisive questions. In what follows, I will attempt to answer each of those questions in turn.
(i) Häyry asks how I can consistently maintain the conjunction of the following three propositions:
(a) taken together, the external and internal perspectives exhaust...
Dear Editor,
Peter Herissone-Kelly[1] makes the case that it would be morally inappropriate for prospective parents to select their children based on comparative judgments about their life quality. This view is in stark contradiction with the view, advanced by Julian Savulescu [2], that parents have a moral obligation to select the best possible children they can have.
Herissone-Kelly argues that futu...
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