What is harm? I offer an account that involves the victim’s either suffering some adverse intrinsic change or being prevented from enjoying some beneficial intrinsic change. No one is harmed, I claim, in virtue of relational changes alone. Thus (excepting for contrived cases), there are neither posthumous harms nor, in life, harms of the undiscovered betrayal, slander, reputation-damaging variety. Further, two widespread moves in the philosophy of death are rejected. First, death and posthumous are not to be assimilated—death does bring (...) about adverse internal change and harms us straightforwardly. Second, Pitcher-type accounts of posthumous harm are criticized—posthumous events can thwart the satisfaction of my interests, but I am not harmed either just when this occurs or, earlier, when I first acquire or invest in those interests. We have other ways of describing what is going on. (shrink)

This is the first publication of these ideas in book form. 'It is a rare treat--important, original philosophy that is also a pleasure to read.

This latest addition to the Oxford Readings in Philosophy series covers a topic which is one of the focal points of much of the current work in moral and politicaltheory.

Gametes, tissue, and organs can be taken from the dying or dead for reproduction, transplantation, and research. Whole bodies as well as parts can be used for teaching anatomy. While these uses are diverse, they have an ethical consideration in common: the claims of the people whose bodies are used. Is some use permissible only when people have consented to the use, actually wanted the use, would have wanted the use, not opposed the use, or what? The aim of this (...) article is to make progress in answering these questions. Initially I assume knowledge of people’s desires in order to test whether consent is directly required by their rights without worrying about mistaken uses against their wishes. I claim consent is not directly required by people’s rights. If we know people wanted or would want a use, their rights permit the use, but if we know they wanted or would want not to be used, their rights do not permit the use. The knowledge assumption is then dropped and the question becomes how to decide what to do when the wishes of rightholders are not known. I suggest working out what to do when wishes are known and then adjusting, on the basis of whatever evidence there is, for probability and strength of desire. There are other considerations too, for instance about default rules. The key general comment here is that, in setting rules, the costs to rightholders in not getting what they want needs to be taken into account. The final section tries to show that, in setting these rules, mistaken uses are not to be taken as worse than mistaken failure to use. (shrink)

One way of increasing the supply of organs for transplantation is to adopt a policy giving the sick a right to cadaveric organs. Such a right would entail the coercive transfer of organs from the dead without their previous consent. Because this policy would violate individual autonomy and the special relation between humans and their bodies, it would be morally unjustifiable. Although a rights-based non-consensual model of salvaging cadaveric organs would be medically desirable, a communitarian-based consensual model would be a (...) morally justifiable alternative way of addressing the problem of organ scarcity. (shrink)

The purpose of this article is not to affirm or deny particular philosophical positions, but to explore the limits of intelligibility about what post-mortem harm means, especially in the light of improper post-mortem procedures at Bristol and Alder Hey hospitals in the late 1990s. The parental claims of post-mortem harm to dead children at Alder Hey Hospital are reviewed from five different philosophical perspectives, eventually settling on a crucial difference of perspective about how we understand harm to the dead. On (...) the one hand there is the broadly 'analytical' tradition1 of thinking that predicates the notion of harm on the basis of an existing subject. Since the dead are non-existent persons, it makes little sense to view the dead as being harmed. On the other hand, there is a phenomenological perspective, where the dead, in respect to the experience of grief, are existentially absent. This forms the basis that it is possible to harm grieving parent's experiences of how their dead are treated. The article ends with a short examination of what harming the dead implies for traditional bioethical concerns, namely, obtaining informed consent from significant others when planning medical research on the newly dead. (shrink)

What does it mean for someone to have a moral right to something? What kinds of creatures can have rights, and which rights can they have? While rights are indispensable to our moral and political thinking, they are also mysterious and controversial; as long as these controversies remain unsolved, rights will remain vulnerable to skepticism. Here, Sumner constructs both a coherent concept of a moral right and a workable substantive theory of rights to provide the moral foundation necessary to dispel (...) such doubts. (shrink)

The ethics of post-mortem organ retention and use is widely debated in bioethics and law. However, the fundamental ethical issues have often been inadequately treated. According to one argument, dead bodies are no longer “persons”. Given the great benefits dead bodies offer to human kind, they should be automatically treated as public property: when the person dies, the body becomes a public thing . This paper articulates the ethical issues involved in organ and tissue retention and use, both in the (...) case in which the deceased’s wishes are known and in the case in which the wishes are not known. It contends that a dead body is not a republic. The state should maximise availability of organs and tissues by inviting or requiring citizens to make an informed and responsible choice on the matter. (shrink)

Why should we respect the wishes which individuals may have about how their body is treated after death? Reflecting on how and why the law respects the bodies of the living, we argue that we must also respect the ‘dead’. We contest the relevance of the argument ‘the dead have no interests’, rather we think that the pertinent argument is ‘the living have interests in what happens to their dead bodies’. And, we advance arguments why we should also respect the (...) wishes of the relatives of the deceased regarding what happens to the bodies of their loved ones. In our analysis, we use objections to organ and tissue donation for conscientious reasons (often presented as religious reasons) to show why the living can have interests in their dead bodies, and those of their dead relatives, and why these interests should be respected. (shrink)

I argue for the possibility of posthumous harm based on an account of the harm of murder. I start with the deep-seated intuition that when someone is murdered he (or she) is harmed (over and above the pain of injury or dying), and argue that Feinberg's account that assumes that harm is an invasion of an interest cannot plausibly accommodate this intuition. I propose a new account of the harm of murder: it is an irreversible loss of functions necessary for (...) worthwhile existence. I suggest a (partial) loss analysis of harm in general, and then go on to apply it to posthumous harm and defend the idea that there can be posthumous losses. (shrink)

A proposal to allow prisoners to save their lives or to be eligible for commutation of sentence by donating kidneys for transplantation has been a subject of controversy in the Philippines. Notwithstanding the vulnerabilities associated with imprisonment, there are good reasons for allowing organ donations by prisoners. Under certain conditions, such donations can be very beneficial not only to the recipients but to the prisoners themselves. While protection needs to be given to avoid coercion and exploitation, overprotection has to be (...) avoided. The prohibition on the involvement of prisoners in organ transplantation constitutes unjustified overprotection. Under certain conditions, prisoners can make genuinely independent decisions. When it can be reasonably ascertained that they are able to decide freely, society should recognise an obligation to help them implement their decisions, such as when they intend to donate an organ as a way of asserting their religious faith and performing a sacrifice in atonement for their sins. (shrink)

We need to rethink our attitudes to the bodies of the dead in order to increase our willingness to donate organs and tissuesMy father died aged 87 on January 20, 1998. It was the day of his 42nd wedding anniversary. He been admitted to a major teaching hospital with jaundice of unknown origin. He died after a medical procedure and a delay in diagnosis and management of bleeding after the procedure. I believed it was important to understand why he had (...) died and what the underlying cause of his jaundice had been. I requested an autopsy.My father was not only the best father a person could have had, but my closest friend. The circumstances of his death were especially sad for me. I was on a plane while he was allowed to die of blood loss in intensive care over a period of hours, becoming progressively more delirious and experiencing the slow motion throes of death. I was told he had died while I was still in the air. My first thought was that I would never again see him or hear his deep chuckle. I would never again feel the gentle touch of his large hands. He would never see my daughter grow up as he had wanted to, playing, and laughing on the beach.I have witnessed many autopsies. As medical students, we had to attend autopsy each morning at 8.30 am as a part of pathology in fourth year medicine. Before this, we had two years of anatomy dissection, probing every crevice of the formalin fixed human body. I learnt an immense amount from these activities. But I also knew how gruesome the autopsy is. I knew that an autopsy would mean that my father would be dismembered. But I had no hesitation in requesting …. (shrink)

Those who endorse the view that death is in some cases bad for the deceased—a view that, as I shall explain, has considerable bearing on many bioethical issues—need to address the following, Epicurean question: When is death bad for the one who dies? The two most popular answers are "before death" (priorism) and "after death" (subsequentism). Part of the support for these two views consists in the idea that a third answer, "at no time" (atemporalism), makes death unsatisfyingly different from (...) other evils. I argue that this objection is mistaken, and that priorism and subsequentism face problems that atemporalism avoids. Moreover, I argue that if it is nonetheless insisted that we must find a time at which my death is bad for me, we can appeal to periods that begin before my death and end after my death. I end with some implications for posthumous harm. (shrink)

Cadaver organs should be automatically availableThe shortage of donor organs and tissue for transplantation constitutes an acute emergency which demands radical rethinking of our policies and radical measures. While estimates vary and are difficult to arrive at there is no doubt that the donor organ shortage costs literally hundreds of thousands of lives every year. “In the world as a whole there are an estimated 700 000 patients on dialysis . . .. In India alone 100 000 new patients present (...) with kidney failure each year” . Almost “three million Americans suffer from congestive heart failure . . . deaths related to this condition are estimated at 250 000 each year . . . 27 000 patients die annually from liver disease . . .. In Western Europe as a whole 40 000 patients await a kidney but only . . . 10 000 kidneys”1 become available. Nobody knows how many people fail to make it onto the waiting lists and fail to register in the statistics. “As of 24th November 2002 in the United Kingdom 667 people have donated organs, 2055 people have received transplants, and 5615 people are still awaiting transplants.”2Conscious of the terrible and unnecessary tragedy that figures like these represent I have been advocating for more than 20 years now some radical measures to stem this appalling waste of human life. The measure which is the subject of Hamer and Rivlin’s paper 3 concerns the automatic availability of all cadaver organs—a measure, which I first advocated publicly in 1983.4THE AUTOMATIC AVAILABILITY OF DONOR ORGANSWe need to begin by being clear about just what it is I propose and why. At the moment in the United Kingdom we …. (shrink)

No one has the right to say what should be done to their body after deathIn my opinion any concept of property in the human body either during life or after death is biologically inaccurate and morally wrong. The body should be regarded as on loan to the individual from the biomass, to which the cadaver will inevitably return. Development of immunosuppressive drugs has resulted in the cadaver becoming a unique and invaluable resource to those who will benefit from organ (...) donation. Faced with the biological reality, the moral error of any concept of property in the body, and the quantitative failure of voluntary organ donation, I believe that the right of control over the cadaver should be vested in the state as representative of those who may benefit from organ donation.How one regards the dead human body, the cadaver, is in part governed by one’s familiarity with it. At the present time, very few people ever see a cadaver which has not in some way been altered after death, and even fewer touch, handle, deal in any way with the dead human body. In developed countries, death itself most frequently occurs away from the home, in an institution, under the supervision of professional caregivers. For most people, ideas concerning the cadaver, its nature, the proper way to deal with it, are formed under these conditions.As a pathologist specialising in forensic pathology, for 50 years I have been at the other end of the spectrum of experience. In my daily work I have been privileged to examine the cadaver in all its stages after death from the immediate postmortem moments through all the stages of decomposition to bare bones. Working in a relatively small community, I have sometimes been charged with examining the body of someone I …. (shrink)

Epicurus notoriously argued that death at no time is a harm because before death there is no harm and after death there is no victim. The denial that death can be a harm to the one who dies has been challenged by various claims including (1) death is eternally bad for the victim (Feldman), (2) it is before death that it is bad for the victim (Feinberg and Pitcher), (3) death is bad for the victim but at no particular time (...) (Nagel), and (4) it is at the time of death that death is bad for the victim (Lamont). Nagel's account is more plausible and is consistent with the view that the temporal location of the harm of untimely death is best understood as the time when the decedent might otherwise have lived. (edited). (shrink)

This first volume in the four-volume series The Moral Limits of the Criminal Law focuses on the "harm principle," the commonsense view that prevention of harm to persons other than the perpetrator is a legitimate purpose of criminal legislation. Feinberg presents a detailed analysis of the concept and definition of harm and applies it to a host of practical and theoretical issues, showing how the harm principle must be interpreted if it is to be a plausible guide to the lawmaker.

Taking organisational responses to the ?organ retention scandals? in the United Kingdom and Australia as a starting point, this paper considers the role of social welfare workers within the medico-legal system. Official responses to the inquiries of the late 1990s have focused on issues of consent and process-transparency, leaving unaddressed concerns expressed by the bereaved about the impact of organ retention on both their experience of grief and on the deceased themselves. A review of grief and embodiment literature suggests that (...) such concerns are consistent with the significance of relationship, attachment and identity within grief resolution?however that last problematic term is defined. The case example of an Australian coronial jurisdiction which has attempted to deal with some of these issues through mandating the discussion of autopsy and organ retention processes by grief counsellors with bereaved families is then provided. A distinction is drawn between these discussions and the seeking of consent. The discussion concludes by considering the ambiguous nature of the social welfare role within this contested field, suggesting that this ambiguity, while perhaps a source of flexibility in practice, may itself relate to a lack of clear information about the needs of the bereaved. This paper contributes to the development of that knowledge and offers some necessarily tentative recommendations regarding social welfare practice in this challenging arena. (shrink)

The idea that we human beings have souls that can continue to have conscious experiences after the deaths of our bodies is controversial in contemporary academic bioethics; this idea is obviously present whenever questions about harm at the end of life are discussed, but this idea is often ignored or avoided because it is more comfortable to do so. After briefly discussing certain types of experiences that lead some people to believe in souls that can survive the deaths of their (...) bodies, I begin to answer the question, "If personal postmortem survival of some sort is real, then how should this alter the way we approach our bioethical discussions about death, the harm of death, and harming the dead?" The bioethics issues I briefly discuss in the remaining two sections are the debate about defining death and the decision whether to forego life-prolonging treatments. (shrink)