This book articulates an African conception of dignity in light of the salient axiological category of personhood in African cultures. The idea of personhood embodies a moral system for evaluating human lives exuding with virtue or ones that are morally excellent. This book argues that this idea of personhood embodies an under-explored conception of dignity, which accounts for it in terms of our capacity for the virtue of sympathy. It then proceeds to apply this (...) class='Hi'>personhood-based conception of dignity to bioethical questions, specifically, those of abortion and euthanasia. Regarding abortion, it concludes that it is impermissible since foetuses possess partial moral status. Regarding euthanasia, it argues that it is permissible for reasons revolving around avoiding the reversing of personhood. It also, though, minimally, touches on the questions regarding the mentally disabled and animals, to which it assigns lower moral status. (shrink)

This chapter considers the status of metaphysical capacities in the debates on personhood and value theory in African philosophy. Specifically, it considers whether metaphysical capacities are morally neutral, instrumentally good or intrinsically good. The inquiry into the status of metaphysical capacities arises because it is important for the concept of human dignity in African thought. This question emerges because there are scholars that reject capacity-based theories of value and personhood (the minimalist view of personhood) for (...) the performance/merit-based theories of value and personhood (the maximalist view of personhood), which debate has implications for the concept of human dignity in African philosophy. This chapter presents Ikuenobe’s personhood/merit-based theory of human dignity, and it further provides three reasons why we should prefer the metaphysical capacity-based theory of human dignity. The capacity-based theory of value has the theoretical advantages of being more useful in bioethical debates, animal ethics and political theory. The chapter argues that there are good moral-political reasons to attach intrinsic value to the metaphysical capacities of our nature, where intrinsic dignity (minimalist personhood) is primary and achievement dignity (maximalist personhood) is secondary in African moral thought. (shrink)

This chapter, contrary to moderate, radical and limited communitarians’ attempts to include and defend human rights in African political thought, shifts our attention to the primacy of needs in African political thought. It does so by appeal primarily to the ethical concept of personhood in African philosophy. It offers an interpretation of the relationship between ethics and politics inherent in the normative concept of personhood, which has tended to be construed to entail the politics of (...) human rights. To unfold a novel interpretation of politics in relation to the ethical notion of personhood, it relies on Menkiti’s philosophical writings that points us to the politics of duties. It proceeds to explain the importance of duties in the political thought associated with Afro-communitarianism in terms of the primacy of needs. The basic insight that emerges in this chapter is that the provision of basic needs is indispensable for the kind of agency required for the achievement of personhood. (shrink)

Recently, the salient idea of personhood in the tradition of African philosophy has been objected to on various grounds. Two such objections stand out – the book deals with a lot more. The first criticism is that the idea of personhood is patriarchal insofar as it elevates the status of men and marginalises women in society. The second criticism observes that the idea of personhood is characterised by speciesism. The essence of these concerns is that (...) class='Hi'>personhood fails to embody a robust moral-political view. -/- African Personhood and Applied Ethics offers a philosophical explication of the ethics of personhood to give reasons why we should take it seriously as an African moral perspective that can contribute to global moral-political issues. The book points to the two facets that constitute the ethics of personhood – an account of (1) moral perfection and (2) dignity. It then draws on the under-explored view of dignity qua the capacity for sympathy inherent in the moral idea of personhood to offer a unified account of selected themes in applied ethics, specifically women, animal and development. (shrink)

This book explores the salient ethical idea of personhood in African philosophy. It is a philosophical exposition that pursues the ethical and political consequences of the normative idea of personhood as a robust or even foundational ethical category. Personhood refers to the moral achievements of the moral agent usually captured in terms of a virtuous character, which have consequences for both morality and politics. The aim is not to argue for the plausibility of the ethical and (...) political consequences of the idea of personhood. Rather, the book showcases some of the moral-political content and consequences of the account it presents. (shrink)

This article proffers a personhood-based conception of a meaningful life. I look into the ethical structure of the salient idea of personhood in African philosophy to develop an account of a meaningful life. In my view, the ethics of personhood is constituted by three components, namely (1) the fact of being human, which informs (2) a view of moral status qua the capacity for moral virtue, and (3) which specifies the final good of achieving or developing (...) a morally virtuous character. In light of the ethics of personhood, I will propose the view that a meaningful life is a function of achieving moral excellence or perfection. The moral perfection proposed here, to embody a meaningful life, is of a deontological and satisficing kind. The achievement of satisfactory levels of moral excellence, within sociopolitical and moral limits, captures the essence of a meaningful life. I conclude the article by considering objections against the view proposed here. (shrink)

This collection of new essays aims to address some of the most perplexing issues arising from death and dying, as well as the moral status of persons and animals. Leading scholars, including Peter Singer and Gerald Dworkin, investigate diverse topics such as animal rights, vegetarianism, lethal injection, abortion and euthanasia.

Introduction to the study of African Christian ethics -- Foundations of contemporary African ethics -- Foundations of Western ethics -- Foundations of Christian ethics -- Foundations of African Christian ethics -- Applying African Christian ethics -- Church and state -- War and violence -- Strikes -- Poverty -- Corruption -- Fund-raising -- Procreation and infertility -- Reproductive technologies -- Contraception -- Polygamy -- Domestic violence -- Divorce and remarriage -- Widows and orphans -- Rape -- Incest (...) -- Prostitution and sex trafficking -- Female circumcision -- Homosexuality -- HIV/AIDS -- Abortion -- Euthanasia and infanticide -- Strikes and medical services -- Drug and alcohol abuse -- Witchcraft. (shrink)

This article repudiates the dichotomy that African ethics is communitarian (relational) and Western ethics is individualistic. ‘Communitarianism’ is the view that morality is ultimately grounded on some relational properties like love or friendship; and, ‘individualism’ is the view that morality is ultimately a function of some individual property like a soul or welfare. Generally, this article departs from the intuition that all morality including African ethics, philosophically interpreted, is best understood in terms of individualism. But, in this article, (...) I limit myself to the literature in the African moral tradition; and, I argue that it is best construed in terms of individualism contrary to the popular stance of communitarianism. I defend my view by invoking two sorts of evidences. (1) I invoke prima facie evidence, which shows that both secular and religious moral thinkers in the tradition tend to understand it in individualistic terms. And, (2) I invoke concrete evidence, I show that the two terms that can be said to be definitive features of African ethical framework, namely: personhood and dignity, are individualistic. I conclude by considering possible objections against my defense of individualism as a central feature of African ethics. (shrink)

This book is a contribution to African philosophy, by philosophers focusing specifically on the concept of human dignity in ethical theory. The concept of ‘human dignity’ denotes the intrinsic and superlative worth associated with human beings in virtue of which we owe them utmost moral regard. Although dignity is a foundational concept for African philosophy, there remains scant literature in African philosophy dedicated to critical and systematic reflection on the concept of human dignity. This volume responds to (...) this lacuna by bringing together chapters that offer philosophical exposition, defense (or even rejection) and application of the concept of human dignity in light of intellectual resources in African cultures, such as ubuntu, personhood, and serithi. (shrink)

Disputes in Bioethics tackles some of the most debated questions in contemporary scholarship about the beginning and end of life. This collection of essays takes up questions about the dawn of human life, including: Should we make children with three (or more) parents? Is it better never to have been born? and Is the so called 'after-birth' abortion wrong? This volume also asks about the dusk of human life: Is 'death with dignity' a dangerous euphemism? Should euthanasia be permitted for (...) children? and Does assisted suicide harm those who do not choose to die? Still other questions are asked concerning recent views that health care professionals should not have a right to conscientiously object to legal and accepted medical practices. Finally, the book addresses questions about separating conjoined twins as well as the issue of whether the species of an individual makes a difference for the individual's moral status. Christopher Kaczor critiques some of the most recent and influential positions in bioethics, while eschewing both consequentialism and principalism. Rooted in the Catholic principle that faith and reason are harmonious, this book shows how Catholic bioethical teaching is rationally defensible in terms that people of good will, secular or religious, can accept. Proceeding from a natural law perspective, Kaczor defends the inherent dignity of all human beings and argues that they merit the protection of their basic human goods because of that inherent dignity. Philosophers interested in applied ethics, as well as students and professors of law, will profit from reading Disputes in Bioethics. The book aims to be both philosophically sophisticated and accessible for students and experienced researchers alike. (shrink)

African ethicists have so far not agreed on a single, precise, secular and comprehensive basic norm, an Afro-Grundnorm, which captures the core values of Ubuntu sub-Saharan African cosmopolitanism. This article constructs and proffers the ‘double-dignity’ Grundnorm that partly shares with Western stoic cosmopolitans the view that our common human ontological capacity for autonomy identifies us as members of the human species. This capacity grants our first dignity, inherent dignity. Inherent dignity only grants our universal basic (security and subsistence) (...) rights. Our duties to care of each other derive from the second dignity, acquired dignity. Acquired dignity itself derives from our second ontological capacity, our capacity for communion. Unlike inherent dignity, acquired dignity is neither universal nor automatically present in us. It is earned when we commune with others in fostering harmony as we earn ‘full personhood’. Since fostering harmony starts with nurturing communal identities and solidarities, Ubuntu entails efficiency-model moderate cosmopolitanism which permits prioritizing serving our immediate associates or compatriots not because of their special moral worthiness but because we more efficiently serve humanity at large when we do so. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and medicine, (...) truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

_In this article, I look at the African theory that the formation of personhood is relevant to the morality of war. I start by justifying the project of decolonizing the ethics of war. Then I proceed to clarify that some of the African theories that relate to personhood and war should not be taken at face value, but that the concept of personhood does play a role in the morality of war. I then provide examples (...) of how this concept is relevant for jus ad bellum, jus in bello and jus post bellum._ _Keywords:_ African Ethics; Personhood; Just War Theory; _Jus ad Bellum; Jus in Bello; Jus Post Bellum_. (shrink)

Assisted dying and human dignity are two extremely contested topics in Bioethics. This volume offers the first book-length attempt to bring both together. Its authors develop detailed philosophical analyses of dignity, and how it relates to assisted suicide and euthanasia.

The concept of human dignity plays an important role in the public discussion about ethical questions concerning modern medicine and biology. At the same time, there is a widespread skepticism about the possibility to determine the content and the claims of human dignity. The article goes back to Kantian Moral Philosophy, in order to show that human dignity has in fact a determinable content not as a norm in itself, but as the principle and ground of human rights and any (...) deontological norms in biomedical ethics. When it comes to defining the scope of human dignity, i.e., the question which entities are protected by human dignity, Kant clearly can be found on the “pro life”-side of the controversy. This, however, is the result of some specific implications of Kant’s transcendental approach that may be put into question. (shrink)

This article explores the debate between partiality and impartiality from an African perspective. I take one influential instance of a defence of impartiality in the African tradition, ‘sympathetic impartiality’, by Kwasi Wiredu, as a foil to represent African ethics. I argue that impartiality fails to cohere with three centrally defining features of African moral thought: the high regard attributed to the family, the veneration of ancestors and the notion of personhood. I merely highlight the first (...) two aspects of African thought; I base my argument largely on the latter feature. (shrink)

The chapter provides the reader with one way to approach and understand African moral philosophy. It pivots African moral philosophy on the concepts of personhood. It identifies these concepts of personhood in the salient axiological concept of Ubuntu, which is typically explained in terms of the saying “a person is a person through other persons.” In relation to the first two instances of the concepts of personhood in the saying, it identifies three crucial themes of (...) African moral philosophy. First, it identifies foundational issues relating the source and the nature of moral value as secular and construes morality to be derived from human nature. In relation to foundations, it further clarifies that African ethics is a dignity-based ethics. Second, it identifies and elucidates the final good to revolve around the pursuit and acquisition of virtue or excellence. Finally, it considers the robustness of African moral philosophy by considering how it can account for right action, the debate on partiality and impartiality and the status and place of animals in African moral philosophy. (shrink)

Developing World Bioethics, Volume 22, Issue 3, Page 152-161, September 2022.

This paper evaluates Caesar Alimsinya Atuire’s essay “African Perspectives of Moral Status: A Framework for Evaluating Global Bioethical Issues”. Atuire’s essay aims to contribute to global ethical discourse by articulating a systematic account of an African ethical perspective, specifically focusing on the themes of personhood, moral status and the legal question of abortion. We make three objections against Atuire’s essay. Firstly, we argue that a plausible approach to African personhood must consider both its individualistic and (...) relational features, rather than merely emphasize the relational component. The second objection focuses on the theory of moral status, and it has two parts: (a) we insist that a correct understanding of the concept of moral status must construe it as a moral patiency rather than a moral agency term. We believe that Atuire’s view errs in regarding it as the latter. (b) we argue that contrary to Atuire’s assertions, Thaddeus Metz’s friendliness theory of moral status does a better job than Atuire’s object moral status (OMS) and subject moral status (SMS) views of moral status. The final objection is that maybe before we reflect on the legal status of abortion, as ethicists, we should begin by considering the ethical status of abortion in light of African axiological resources. In the final analysis, the paper appreciates Atuire’s contribution to African ethical theory, but it argues that much work still needs to be done before it can be suitable to provide a global framework for evaluating global bioethical issues. (shrink)

In 1996, the 9th Circuit Court of Appeal of United States ruled that a Washington law banning physician-assisted suicide was unconstitutional. In the same year, the 2nd Circuit found a similar law in New York unconstitutional. One year later, the U.S. Supreme Court reversed both rulings, saying that there was no constitutional right to assisted suicide. However, the Court also made plain that they did not reject such a right in principle and that “citizens are free to press for permissive (...) reforms… through legislation or referendums” (Dworkin 1997: 6). (The unanimity of the vote was therefore, as Dworkin notes (1997:1), deceptive.) Oregon chose to do so and legalized physician-assisted suicide in 1997. Oregon’s “Death with Dignity Act” is one of the latest expressions of a medical and legal consensus that has gradually emerged in U.S. and some European countries over the past two decades, that is, the consensus that recognizes the right of terminally ill and competent patients to receive assistance with suicide. (shrink)

The author seeks to respond to the philosophical appeal of W. Norris Clarke, S.J., “to uncover the personalist dimension lying implicit within the fuller understanding of the very meaning and structure of the metaphysics of being itself, not hitherto explicit in either the metaphysical or personalist traditions themselves.” She does this by discussing the distinctions drawn by Karol Wojtyla: (1) between a human being’s personhood and his humanity, and (2) between the ontological dignity and the ethical dignity of the (...) human person. (shrink)

Theoria, Volume 88, Issue 3, Page 666-678, June 2022.

In this book, controversial topics such as the morality of abortion, withdrawing treatment from handicapped newborns, the role of ethics committees, diagnosing death, withdrawing food and fluids and giving lethal injections are discussed. It proposes model legislation to prevent abuse and neglect of the medically vulnerable and dependent, and in a piercing and insightful manner, Fr. Barry critically evaluates many contemporary views on these topics, arguing forcefully for a reappraisal of many popular views on these topics.

A friend once told me I was wasting my time writing about cross-cultural perspectives on the beginnings of life. “Your work is interesting for its curiosity value,” he said, “but fundamentally worthless. What happens in other cultures is totally irrelevant to what is happening here.” Those were discouraging words, but as I followed the American debates about the beginnings and ends of life, it seemed he was right. Anthropologists have written a great deal about birth and death rites in other (...) societies and about non-western notions of personhood, but to date our findings have had little impact on American policy, ethics, or law. The recognized experts on contentious topics such as abortion and euthanasia tend to come from the fields of philosophy, bioethics, theology, law, and biology, but rarely from the social sciences. I was a bit surprised, therefore, to be invited to address the Thomas A. Pitts Memorial Lectureship on “Defining the Beginning and the End of Human Life.”. (shrink)

o ne -taking -Life ana Oavmg .Life The Islamic Context Jonathan E. Brockopp The great ethicists of the western world, Augustine, Aquinas, Kant, and others, ...

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Dignity and Destiny: Humanity in the Image of God by John F. KilnerRichard W. ReichertDignity and Destiny: Humanity in the Image of God John F. Kilner GRAND RAPIDS, MI: EERDMANS, 2015. 414 PP. $35.00There is a problem with locating the imago Dei in a set of unique human attributes that other animals do not possess, such as self-awareness or higher cortical function: persons deficient in these attributes might (...) then be viewed as less complete images of God and therefore be treated as less than fully human. [End Page 209] According to John Kilner, this nonbiblical view contributes support for racism, sexism, and other oppressions. In Dignity and Destiny, Kilner's solution is to realize that the image of God is equally and fully present in every human as a divine blueprint, rooted in God's purpose for humans to reflect the image of God as revealed in Christ. Jesus is the image of God; all humans are created in the image of God.The various imperfect manifestations of God's image among the lives of individuals is due to the corruption of sin, not any diminution of the imago Dei. Here Kilner offers the useful metaphor of a coin. The denarius held up by Jesus when he addressed taxes had the image of Caesar cast on it as evidence of ownership and obligation: "Render to Caesar the things that are Caesar's." Yet even though Caesar's image on some coins was so worn or marred as to be nearly invisible, each coin still had the same monetary value as determined by Caesar's stamp. So, too, humans are stamped by God with the image of Christ, and despite the fact that some people barely manifest Christ's image, all humans still share equal value and dignity based on this divine stamp. Sin corrupts every person's ability to reflect God's image to some extent but does not mar the image of God itself. This concept of the imago Dei secures the full dignity and protection of all humans and opposes all forms of discrimination and oppression. Further, the eschatological destiny of humankind is not merely a return to a state of Edenic innocence but a future destiny toward full conformity to the image of Christ.Dignity and Destiny is a carefully referenced work, and Kilner's argument is clear and well-reasoned. He engages thoughtfully with those who hold alternative views of the image of God, especially with those theologians who argue that the imago Dei entails attributes of reason, righteousness, rulership, or relationship. He offers incisive but limited exegetical support for his view that the Bible does not offer an actual definition of the imago Dei but instead presents a "hermeneutical lens" to understand God's plan for humanity. Kilner's thesis certainly implies a teleological ethic of natural law, but his argument is actually aimed more toward Christ-like virtues and an understated kingdom ethic.The main value of Dignity and Destiny is its cogent evangelical argument against all forms of discrimination, marginalization, and human oppression. This work should appeal to all Christians who value human rights. But Kilner's argument may also provide strong support against many forms of euthanasia and abortion that are frequently justified by applying a qualitative scale of human attributes such as cognition and agency. For this reason, some nonevangelicals might find Kilner's thesis threatening and difficult to accept. In either case, Dignity and Destiny is a provocative and valuable contribution to theological anthropology. [End Page 210]Richard W. ReichertSouthern Baptist Theological SeminaryCopyright © 2017 Society of Christian Ethics... (shrink)

It is generally accepted that the normative idea of personhood is central to African moral thought, but what has not been done in the literature is to explicate its relationship to the Western idea of rights. In this article, I investigate this relationship between rights and an African normative conception of personhood. My aim, ultimately, is to give us a cursory sense why duties engendered by rights and those by the idea of personhood will tend (...) to clash. To facilitate a meaningful philosophical discussion, I locate this engagement in the context of a debate between Ifeanyi Menkiti and Kwame Gyekye about the nature of Afro-communitarianism, whether it will ground rights as primary or secondary. I endorse Menkiti’s stance that duties are primary and rights secondary; and, I also problematize moderate communitarianism for taking a Western stance by employing a naturalist approach to rights. (shrink)

Interaction between Peter Singer and Christian ethics, to the extent that it has happened at all, has been unproductive and often antagonistic. Singer sees himself as leading a 'Copernican Revolution' against a sanctity of life ethic, while many Christians associate his work with a 'culture of death'. Charles Camosy shows that this polarized understanding of the two positions is a mistake. While their conclusions about abortion and euthanasia may differ, there is surprising overlap in Christian and Singerite arguments, and disagreements (...) are interesting and fruitful. Furthermore, it turns out that Christians and Singerites can even make common cause, for instance in matters such as global poverty and the dignity of non-human animals. Peter Singer and Christian ethics are far closer than almost anyone has imagined, and this book is valuable to those who are interested in fresh thinking about the relationship between religious and secular ethics. (shrink)

Theological basis -- Religion and health care -- The dignity of human life -- The integrity of the human person -- Implications for health care -- Theological principles in health care ethics -- Method -- The levels and questions of ethics -- Freedom and the moral agent -- Right and wrong -- Metaethics -- Method in Catholic bioethics -- Catholic method and birth control -- The principle of double effect -- Application -- Forgoing treatment, pillar one: ordinary and extraordinary means (...) -- Forgoing treatment, pillar two: killing and allowing to die -- Forgoing treatment, pillar three: decisions by competent patients -- Forgoing treatment, pillar three: decisions for incompetent patients -- Forgoing treatment, pillar three: advance directives -- Hydration and nutrition -- Physician-assisted suicide and euthanasia -- Medical futility -- Pain and pain management -- Ethics committees -- Embryonic stem cells and the beginning of human personhood -- Genetic engineering -- Allocating health care resources -- The use and misuse of the allocation argument. (shrink)

This article ascertains what philosophical implications can be drawn from the moral idea of personhood dominant in African philosophy. This article aims to go beyond the oft-made submission that this moral idea of personhood is definitive of African moral thought. It does so by advancing discourse with regards to personhood by exploring its relationship with another under-explored idea in African ethics, the idea of partialism. This article ultimately argues that the idea of personhood (...) can be associated with two (related) sorts of partialisms: agent-related and other-centered partialisms. (shrink)

Person, reason, and value -- Moral value, intentionality, and community -- Suicide and the right to die -- Abortion, personhood, and community -- Euthanasia : a reinterpretation -- The death penalty and purposes of punishment -- Privacy, private property, and justice -- The personalist society, community, and justice -- The moral treatment of animals -- Affirmative action and justice -- Community and the environmental crisis.

Machine generated contents note: Table of Cases xi -- Table of legislation xv -- Introduction: Medicine Men, Outlaws and Voluntary Euthanasia 1 -- 1. To Kill or not to Kill; is that the Euthanasia Question? 9 -- Introduction-Why Euthanasia? 9 -- Dead or alive? 16 -- Euthanasia as Homicide 25 -- Euthanasia as Death with Dignity 29 -- 2. Euthanasia and Clinically assisted Death: from Caring to Killing? 35 -- Introduction 35 -- The Indefinite Continuation of Palliative Treatment 38 -- (...) Withholding or Withdrawing Treatment 44 -- The Principle of Double Effect 54 -- Physician Assisted Suicide 60 -- Mercy Killing 64 -- Conclusions 66 -- 3. Consent to Treatment but Not to Death 69 -- Introduction-Why Consent? 69 -- Without Consent 70 -- Killing and Consent 73 -- Valid Consent, Freely Given? 74 -- Old Enough to Consent 80 -- Deciding for Others 82 -- Conclusions-A Consent Too Far? 93 -- 4. Autonomy, Self-determination and Self-destruction 95 -- Introduction-Autonomous Choices 95 -- Choosing to Die-Suicide and Autonomy 100 -- Suicidal Intentions 107 -- Autonomous Clinical Discretion 110 -- Deciding to Live or Die-Whose Decision? 112 -- 5. Living Wills and the Will to Die 115 -- Introduction 115 -- I Know My Will 118 -- This is My Will 121 -- I Will Decide 128 -- Will My Will be Done? 134 -- Where There's a Will 137 -- Conclusions 143 -- 6. Is Euthanasia a Dignified Death? 145 -- Introduction-Why Dignity? 145 -- Needing Dignity 146 -- Finding Dignity 149 -- Achieving Dignity in Dying 151 -- Dignifying Death 157 -- 7. Conclusions: Dignified Life, Dignified Death and Dignified Law 165 -- Select Bibliography 175 -- Index 183. (shrink)

Photo by Hannah Busing on Unsplash INTRODUCTION Religion has long provided guidance that has led to standards reflected in some aspects of medical practices and traditions. The recent bioethical literature addresses numerous new problems posed by advancing medical technology and demonstrates an erosion of standards rooted in religion and long widely accepted as almost axiomatic. In the deep soul-searching that pervades the publications on bioethics, several disturbing and dangerous trends neglect some basic lessons of philosophy, logic, and history. The bioethics (...) discourse on medical aid in dying emphasizes similarity over previously recognized important distinguishing features. For example, it overplays a likeness between assistance in dying and the withdrawal of life-saving technology. In many bioethics’ topics, arguments based on a logical continuum are used to question the lines demarcating important moral differences. l. The Line Between Ethical and Not: Logic Based on Continuum Careful case selection, often either end of a continuum, allows the tearing down or ridiculing of many rules and codes across most professions and fields of interest. This situation holds true for traffic laws as well as medical ethics guidelines. It is relatively simple for those who desire to attack a particular viewpoint by selecting a case that makes that position seem untenable. In the ethics realm, good and bad medicine exist at opposite ends of an ethical continuum, with many practices lying in between. For example, much of medical ethics exists between the Nazi criminal physicians and the most sainted nurse or physician. A gradual progression occurred over less than two decades from a utilitarian position that supported limited euthanasia for those with certain mental illnesses to genocide. German society embraced a utilitarian ethic in which the value of human life no longer was intrinsic but instrumental.[1] Many morally significant points on a continuum were then ignored as the misguided utilitarian policy rampantly continued. A point in the continuum to distinguish between ethically justifiable and that which is not can be difficult to identify compared to the two extremes. This continuum is not unique to ethics but can be applied to almost any other aspect of human life and endeavor. Between a severely ill schizophrenic person and a superbly well-adjusted individual, there is a continuum of mental and psychological function. The existence of a continuum should not paralyze thinking and prevent us from drawing lines and identifying moral differences based on objective criteria as well as moral philosophy. Yet, by focusing on a continuum, many bioethicists use logic to disregard dividing lines between an "ethical" and an "unethical" act. Unfortunately, sometimes bioethicists draw revolutionary conclusions that would change the scope of medical practices which is accepted as ethical. There are many examples of similar shifts on the continuum. Many authors argue for the ethical permissibility of abortion by pointing out that the human fetus is no different in various characteristics, one arguing it is as like an ape or chick as it is like a person,[2] and does not achieve unique human and individual characteristics until well into the first year of life.[3] While human fetuses arguably do not have certain distinctive qualities of personhood, most people shy away from the logical next conclusion: permitting infanticide. For example, Joshua Lederberg condemns infanticide, in the face of biological illogic, because of our emotional commitment to infants, to me, a relatively weak explanation. Sir Francis Crick suggests we might consider birth at two days of life in order to decide whether an infant is a "suitable" member of society.[4] Giublini and Minerva suggest that infanticide should be permissible since late pregnancy abortions are permissible, arguing there is no significant difference between a fetus just before birth and an infant just after birth.[5] Clearly the continuum approach would allow for subjective arguments in favor of later infanticide at other points many days post-birth. Years ago, with a cynical tone, I mentioned infanticide as a further step on the continuum beyond abortion, and I was rightly shouted down as being deliberately provocative to assert the logic would ever stretch so far. While it is not an accepted mainstream position, the movement in academic settings from widespread condemnation to limited possible acceptance of infanticide has taken place in an incredibly short time. Public opinion and medical opinion in these areas have shifted dramatically in a short time. In another area, from a biological and chemical point of view, there is a continuum from man down to a single carbon atom. Yet, it would not seem logical to ignore the emotional differences, the meaning of personhood, or the moral distinction between killing an insect and killing a person. ll. A False Continuum: Medical Aid in Dying I assert that there has been an erosion of ethical guidelines in recent years attributable to using continuums to camouflage important distinctions. James Rachels’ work on active and passive euthanasia, which contends that the two are ethically identical, exemplifies that logic.[6] He illustrates this thesis, using a continuum to compare different scenarios with like consequences as morally equivalent, by comparing the deliberate drowning of a child with a deliberate failure to rescue a drowning child when easily able to do so. The author's comparison proposes that since much of the medical profession has already made peace with withholding treatment in order to hasten death, consistency inexorably demands that we permit active euthanasia as well.[7] When permission for active euthanasia was first introduced, it was limited exclusively to patients suffering severely from an intractable, incurable, and irreversible disease. These guidelines have been continuously eroded. There is now a substantial serious consideration for permitting active euthanasia of healthy elderly individuals who feel that they have completed their lives and are "tired of living."[8] There are many moral and factual differences along the ethical continuum. In human life, there is a difference between a live baby and a fetus, between a viable fetus and one that is not, between a fetus and a zygote, and between a zygote and a sperm cell. Similarly, there is a difference between pulling a trigger to kill someone and not interfering in preventing his death, which is reprehensible though both may be. There is a difference between not resuscitating an 80-year-old man with cancer when his heart stops and injecting him with a fatal dose of potassium chloride. I argue that an overt act of taking life repels civilized human beings is to be commended and encouraged as the reverence for human life or even for just a moment of human life is one of the great contributions of our civilization. CONCLUSION As an orthodox Jew, I feel that divinely inspired guidelines that have stood the test of centuries shape my beliefs, and such guidelines contradict medical aid in dying. I cannot speak to the viewpoint of those who do not access religion in defining their moral stance, nor do I implicate them in the current bioethics' trends, as I am not aware of the personal role of religion in the lives of most such authors. While many nonreligious people have a firm philosophical grounding and oppose medical aid in dying, I suggest that in the absence of any religious or other absolute standards, developing logically defensible ethical guidelines may be challenging. At the least, religion may play a role in defining the points on the continuums that are ethically meaningful and refuting the trending beliefs that if the endpoint is the same, allowing different methods of arriving at that end are somehow ethically equal. The continuum of ways death may result does not negate analysis of whether death is brought about in ways that recognize the importance of life. The German philosopher Hans Jonas said, "It is a question whether without restoring the category of the sacred, the category most thoroughly destroyed by the scientific enlightenment, we can have an ethics able to cope with the extreme powers that we possess today and constantly increase and are compelled to use."[9] While countries vary on the role of religion in policy, with many emphasizing freedoms of religion, a recent position paper released by a group of Jewish, Christian, and Moslem leaders suggested the need for agreement on the unique sanctity of human life.[10] I would recommend that such a document serve as an example of consensus on critical foundational bioethical guidelines for democratic secular societies. - [1] Alexander L Medical science under dictatorship. New England Journal of Medicine, 241, p39-47 DOI10.1056/NEJM194907142410201 [2] Lederberg J. A geneticist looks at contraception and abortion, Annals of Internal Medicine 67, sup 2, 25-27. https:/doi.org/10.7326/0003-4819-67-3-25 [3] Ibid. [4] Editorial, Sociology: Logic of biology. Nature 220, 429 https://www.nature.com/articles/220429b0 [5] Giublini A Minerva F After-birth abortion: why should the baby live. J Med Ethics 39, 261- [6] Rachels J Active and passive euthanasia. New England Journal of Medicine 292, 78-80 [7] Ibid. [8] Cohen-Almagor R Euthanizing people who are "tired of life". in Euthanasia and Assisted Suicide-Lessons from Belgium. Ch 11 of Euthanasia and Assisted Suicide, Cambridge University Press pp173-187. 2017 and DOI; https://doi.org/10.1017/9781108182799.012 [9] Hans Jonas, Technology and Responsibility: Reflections on the New Tasks of Ethics, 1972, found as Chapter IX, Philosophical Essays, 1980. https://inters.org/jonas-technology-responsability [10] A position paper of the Abrahamic Monotheistic religions on matters concerning the end-of-life. Vatican Press 28 October 2019 https://press.vatican.va/content/salastampa/en/bollettino/pubblico/2019/10/28/191028f.html. (shrink)

Ong, Caroline In February 2014, the Belgian parliament passed an amendment to the Belgian Act on Euthanasia of May 28th, 2002 removing the age limit of those requesting euthanasia provided that they have discerning capabilities and their parents approve. After mentioning briefly the arguments against legalising euthanasia, this article questions the ethical validity of removing the age limit, as well as the presumption that ending lives prematurely allows people to die with dignity. Caring for people who are vulnerable in their (...) suffering is the proper goal of the healing professions, not terminating lives. (shrink)

In current Western societies, increasing numbers of people express their desire to choose when to die. Allowing people to choose the moment of their death is an ethical issue that should be embedded in sound clinical and legal frameworks. In the case of persons with dementia, it raises further ethical questions such as: Does the person have the capacity to make the choice? Is the person being coerced? Who should be involved in the decision? Is the person’s suffering untreatable? The (...) use of Advance Euthanasia Directives (AED) is suggested as a way to deal with end-of-life wishes of persons with dementia. However, in the Netherlands—the only country in which this practice is legal—the experiences of patients, doctors, and relatives have been far from satisfactory.Our paper analyses this complex ethical challenge from a Dignity-Enhancing Care approach, starting from the Dutch experiences with AED as a case. We first consider the lived experiences of the different stakeholders, seeking out a dialogical-interpretative understanding of care. We aim to promote human dignity as a normative standard for end-of-life care practices. Three concrete proposals are then presented in which this approach can be operationalised in order to deal respectfully with the end-of-life choices of persons with dementia. (shrink)

Developing World Bioethics, Volume 22, Issue 3, Page 125-125, September 2022.

This is a book about hope in the midst of a polarized culture. Camosy begins with a hopeful starting point in the midst of a crumbling US political culture: two of every three Americans constitute an exhausted majority who reject right/left polarization and are open to alternative viewpoints. Especially at this time of realignment, we have been given a unique moment to put aside the frothy, angsty political debates and think harder about our deepest values. A Consistent Life Ethic, especially (...) one which embraces Pope Francis' challenge to resist throwaway culture, has the capacity to unite people who for the last several decades imagined themselves in a polarized culture war. On issues ranging from hook-up culture, reproductive technology, abortion, euthanasia, poverty, immigration, treatment of animals, and mass incarceration, this book articulates a new moral vision in which a culture of encounter and hospitality replaces a consumer culture in which the most vulnerable get used and discarded as so much trash. At bottom, Camosy offers readers a golden opportunity to dialogue about what kinds of values should serve as the foundation for a new political culture. (shrink)

Appealing to reason rather than religious belief, this book is the most comprehensive case against the choice of abortion yet published. This _Second Edition_ of _The Ethics of Abortion _critically evaluates all the major grounds for denying fetal personhood, including the views of those who defend not only abortion but also post-birth abortion. It also provides several justifications for the conclusion that all human beings, including those in utero, should be respected as persons. This book also critiques the view (...) that abortion is not wrong even if the human fetus is a person. _The Ethics of Abortion _examines hard cases for those who are prolife, such as abortion in cases of rape or in order to save the mother’s life, as well as hard cases for defenders of abortion, such as sex selection abortion and the rationale for being "personally opposed" but publically supportive of abortion. It concludes with a discussion of whether artificial wombs might end the abortion debate. Answering the arguments of defenders of abortion, this book provides reasoned justification for the view that all intentional abortions are ethically wrong and that doctors and nurses who object to abortion should not be forced to act against their consciences. Updates and Revisions to the Second Edition include: -A response to Alberto Giubilini’s and Francesca Minerva’s now famous 2012 article, "After-Birth Abortion" in the _Journal of Medical Ethics _ -Responses to new defenses of Judith Jarvis Thomson’s violinist argument -The addition of a new chapter on gradualist views of fetal moral worth, including Jeff McMahan’s Time-Relative Interest Account -The addition of a new chapter on the conscience protection for health care workers who are opposed to abortion -Responses to many critiques of the first edition, including those made by Donald Marquis, David DeGrazia, and William E. May. (shrink)

Principlism is an ethical framework that has dominated bioethical discourse for the past 50 years. There are differing perspectives on its proper scope and limits. In this article, we consider to what extent principlism provides guidance for the abortion and euthanasia debates. We argue that whilst principlism may be considered a useful framework for structuring bioethical discourse, it does not in itself allow for the resolution of these neuralgic policy discussions. Scholars have attempted to use principlism to analyse the ethics (...) and legality of abortion and euthanasia; but such efforts are methodologically problematic. We close with a consideration of the proper scope of principlism in bioethics–a vision that is more modest than the manner in which principlism is often deployed in contemporary academic bioethics and medical education. (shrink)

Under what circumstances if ever ought we to grant that Artificial Intelligences (AI) are persons? The question of whether AI could have the high degree of moral status that is attributed to human persons has received little attention. What little work there is employs western conceptions of personhood, while non-western approaches are neglected. In this article, I discuss African conceptions of personhood and their implications for the possibility of AI persons. I focus on an African account (...) of personhood that is prima facie inimical to the idea that AI could ever be ‘persons’ in the sense typically attributed to humans. I argue that despite its apparent anthropocentrism, this African account could admit AI as persons. (shrink)

The concepts of personhood and human dignity are widely used in contemporary healthcare ethics. This chapter provides a brief overview of how the concept of human dignity came to be so important in healthcare ethics, and examines how the concept’s widespread use and relationship to the concept of personhood have led to problems regarding its meaning and relevance. A practical solution is then presented. The rise of the concept of human dignity in healthcare ethics The word dignity is (...) derived from the Latin dignus, which means worthy. Since dignity refers to worth, human dignity refers to the worth of the human. What makes the concept of human dignity important for ethics is that, unlike the dignity of a queen or the dignitaries at an awards ceremony, which expresses the worth or status of particular human individuals in relation to others, human dignity is meant to express a worth that is equally shared by all human individuals. It is not meant to be dependent upon their social status, economic wealth, race, gender or anything else. Moreover, it is meant to affirm a worth beyond price. Human individuals are said to be moral goods or ends in themselves, not merely good or useful as means to achieving other ends. (shrink)

Looking Beneath the Surface explores Arab-Islamic and Western perspectives on medical ethical issues: genetic research and treatment, abortion, organ donation, and palliative sedation and euthanasia. The contributions in this volume discuss the state of the art, the role of laws, counseling, and spiritual counseling in the decision-making process. The different approaches to the ethical issues, ways of moral reasoning, become clear in these contributions, especially the role of tradition for Islam and the importance of autonomy for the West. Beneath the (...) differences, however, the reader will also discover common values, such as the role of dignity and the value of life, and similar practices. Some of the main differences are sociocultural in nature, rather than religious as such. Well-known experts in the fields of medicine and ethics have contributed to this volume from different religious and secular backgrounds. The book offers a carefully written introduction and final chapter on intercultural comparisons. Looking Beneath the Surface is more than a collection of writings on issues in medical ethics: it helps the reader to compare different paradigms of accountability and moral reasoning. (shrink)