Pediatricians provided expert testimony that, in the case of Baby K, provision of ventilator support goes beyond accepted standards of care for anencephalic infants and so is medically futile. This argument, however reasonable, does not persuade those who believe in the absolute value of even a fraction of human life. In Baby K, court records indicate that Ms. H, Baby K's mother, persistently adheres to the sanctity-of-life principle on religious grounds.While I think that quality-of-life considerations have a role in medical (...) decision making, those who reject such considerations must be respected. This article makes the following claims, on behalf of religious dissenters: the Baby K case should be interpreted in light of the freedom of religion guaranteed in the First Amendment ; religious beliefs should not be trivialized in clinical ethics, even if reason, not belief, is the language of the public forum; the time-honored free exercise clause is essential to the American experiment in liberty and should not be overridden in the name of a concept as vague as futility; and free exercise of religion deserves serious discussion in the futility debate, and significant religious accommodation must be included in any hospital or societal futility policies. In the concluding section, issues are raised regarding the balance between religious consideration and resource allocation. (shrink)

Pediatricians provided expert testimony that, in the case of Baby K, provision of ventilator support goes beyond accepted standards of care for anencephalic infants and so is medically futile. This argument, however reasonable, does not persuade those who believe in the absolute value of even a fraction of human life. In Baby K, court records indicate that Ms. H, Baby K's mother, persistently adheres to the sanctity-of-life principle on religious grounds.While I think that quality-of-life considerations have a role in medical (...) decision making, those who reject such considerations must be respected. This article makes the following claims, on behalf of religious dissenters: the Baby K case should be interpreted in light of the freedom of religion guaranteed in the First Amendment ; religious beliefs should not be trivialized in clinical ethics, even if reason, not belief, is the language of the public forum; the time-honored free exercise clause is essential to the American experiment in liberty and should not be overridden in the name of a concept as vague as futility; and free exercise of religion deserves serious discussion in the futility debate, and significant religious accommodation must be included in any hospital or societal futility policies. In the concluding section, issues are raised regarding the balance between religious consideration and resource allocation. (shrink)

The biophilosophic justification for the idea that “brain death” is death needs to support two claims: that what dies in human death is a human organism, not merely a psychological entity distinct from it; that total brain failure signifies the end of the human organism as a whole. Defenders of brain death typically assume without argument that the first claim is true and argue for the second by defending the “integrative unity” rationale. Yet the integrative unity rationale has fallen on (...) hard times. In this article, I give reasons for why we should think of ourselves as organisms, and why the “fundamental work” rationale put forward by the 2008 President’s Council is better than the integrative unity rationale, despite persistent objections to it. (shrink)

Over the past several decades, geneticists have succeeded in identifying the genetic mutations associated with disease. New strategies for treatment, including gene transfer and gene therapy, are under development. Although genetic science has been welcomed for its potential to predict and treat disease, interventions may become ethically objectionable if they threaten to alter characteristics that are distinctively human. Before we can determine whether or not a genetic technique carries this risk, we must clarify what it means to be “human”. This (...) paper inquires how “humanness” has been defined within various academic fields. The views of several legal theoreists, scientists, bioethicists, psychologists, philosophers and anthropologists whose works seem to best reflect how “humanness” is understood in their respective fields of study are considered. Our survey attempts to chart a path for a more detailed study on the meaning of “humanness” in the future. (shrink)

According to the Thomistic tradition, the Principle of Totality (TPoT) articulates a secondary principle of natural law which guides the exercise of human ownership or dominium over creation. In its general signification, TPoT is a principle of distributive justice determining the right ordering of wholes to their parts. In the medical field it is traditionally understood as entailing an absolute prohibition of bodily mutilation as irrational and immoral, and an imperfect obligation to use the parts of one’s body for the (...) perfection of the bodily whole. TPoT is thus a key element of the system of principles within which an individual exercises her right to life: it helps specify the nature, scope and limits of those actions by which an agent permissibly acts in order to preserve her life. While the Thomistic tradition and the Catholic Church have drawn clear conclusions from the principle regarding, e.g., direct sterilization and non-therapeutic experimentation on human subjects, less attention has been given to the implications of TPoT for non-therapeutic procedures that may positively impact biological functioning or supra-biological goals–that is, for human “enhancement.” We will explore the degree to which TPoT non-univocally guides our use of both artifacts and bodies. We will argue that a careful analysis of these distinct kinds of totalities suggests that the application of TPoT to artifacts and bodies is strongly isomorphic, which is what tempts advocates of the Principle of Autonomy to invalidly infer the absolute dominium of the individual over her body. The inference is invalid because this isomorphism also includes a principle of intrinsic value whose function is to resist the instrumentalization of both artifacts and bodies in some contexts; we are not even related to artifacts as advocates of absolute autonomy believe we are, let alone to our bodies. Rather, the limits of human dominium are determined by the nature and finalities, inherent or acquired, of the objects in question, and it will be argued that articulating these limits raises important, understudied, and fascinating questions about the permissibility of various kinds of human enhancement. (shrink)