In their book Identity, Personhood and the Law,1 authors Charles Foster and Jonathan Herring seek, among other things, to show that the law is based on overly simplistic assumptions about the nature of personal identity. In their Author Meets Critics précis, they summarise the main contentions of the book on this issue. Difficulties in the law’s simplistic approach are, they claim, exposed when we think about people with dementia, ‘where [in advanced cases] I may turn into a person with no (...) apparent continuity at all with my own self’ and where: > X2 will simply inhabit a body composed of some of the same cells as belonged to X1. Deep brain stimulation ‘may similarly transform ‘my’ attributes to such an extent that it seems false to continue to talk about ‘me’ at all.’ Other examples, including cases of patients suffering severe anorexia or who have fallen into a permanent vegetative state, are given. All of them ‘call into question the atomistic, billiard-ball model of identity used by the law and by our uninterrogated intuitions.’ The authors’ approach is to begin with these and a number of other examples and raise several philosophical and ethical issues. They then discuss the issues and develop principles which they apply to the same examples at the end of the book. In this commentary, I cannot do justice to all the claims and challenges to the law the authors make in their rich and highly recommended book. I will focus only on the issue of personal identity and their remarks about the simplistic assumptions made by the courts on this issue. Although my comments will not always be in agreement with theirs, these remarks should be taken …. (shrink)

In their book _Identity, Personhood and the Law_, 1 authors Charles Foster and Jonathan Herring seek, among other things, to show that the law is based on overly simplistic assumptions about the nature of personal identity. In their _Author Meets Critics_ précis, they summarise the main contentions of the book on this issue. Difficulties in the law’s simplistic approach are, they claim, exposed when we think about people with dementia, ‘where [in advanced cases] I may turn into a person with (...) no apparent continuity at all with my own self’ and where: X2 will simply inhabit a body composed of some of the same cells as belonged to X1. Deep brain stimulation ‘may similarly transform ‘my’ attributes to such an extent that it seems false to continue to talk about ‘me’ at all.’ Other examples, including cases of patients suffering severe anorexia or who have fallen into a... (shrink)

This paper provides a new rationale for equating brain death with the death of the human organism, in light of well-known criticisms made by Alan D Shewmon, Franklin Miller and Robert Truog and a number of other writers. We claim that these criticisms can be answered, but only if we accept that we have slightly redefined the concept of death when equating brain death with death simpliciter. Accordingly, much of the paper defends the legitimacy of redefining death against objections, before (...) turning to the specific task of defending a new rationale for equating brain death with death as slightly redefined. (shrink)

Background:Even in countries with an opt-out or presumed consent system, relatives have a considerable influence on the post-mortem organ harvesting decision. However, their reflection capacity may be compromised by grief, and they are, therefore, often prone to choose refusal as default option. Quite often, it results in late remorse and dissatisfaction. So, a high-quality reflection support seems critical to enable them to gain a stable position and a long-term peace of mind, and also avoid undue loss of potential grafts. In (...) practice, recent studies have shown that the ethical aspects of reflection are rarely and often poorly discussed with relatives and that no or incomplete guidance is offered. No review of the literature is available to date, although it could be of value to improve the quality of the daily practice.Objectives:The objective was to review and synthesize the main concepts and approaches, theories and practices of ethical reflection support of the relatives or surrogates of potential post-mortem organ donors.Research design:A narrative review was performed in the medical, psychological and ethical fields using PubMed, PsycArticles and Web of Science databases (1980–2020).Results:Out of 150 papers, 25 were finally retained. Four themes were drawn: the moral status of the potential post-mortem organ donor, the principlistic approach with its limits and critics, the narrative approach and the transcendental approach.Discussion:This review suggests an extension of psychological support towards ethical reflection support. The process of helping relatives in their ethical exploration of post-mortem organ donation is psychologically and morally characterized. The need for specialized professionals educated and experienced both in clinical psychology and in health ethics to carry out this task is discussed.Practical impact:This review could contribute to optimize the quality of the ethical reflection support by initiating an evolution from an empirical, partial and individual-dependent support to a more systematized, professionalized and exhaustive support. (shrink)