Several authors in bioethics literature have expressed the view that a whole brain conception of death is philosophically indefensible. If they are right, what are the alternatives? Some authors have suggested that we should go back to the old cardiopulmonary criterion of death and abandon the so-called Dead Donor Rule. Others argue for a pluralist solution. For example, Robert Veatch has defended a view that competent persons should be free to decide which criterion of death should be used to determine (...) their death. However, there is very little data on people’s preferences about death determination criteria. We conducted online vignette-based survey with Latvian participants (N = 1416). The data suggest that the pluralist solution fits best with the way our study participants think about death determination—widely differing preferences concerning death determination criteria were observed. Namely, most participants choose one of the three criteria discussed in the literature: whole brain, higher brain, and cardiopulmonary. Interestingly, our data also indicate that study participants tend to prefer less restrictive criteria for determination of their own deaths than for determination of deaths of their closest relatives. Finally, the preferences observed in our sample are largely in accord with the Dead Donor Rule for organ procurement for transplantation. (shrink)

A cross-cultural survey experiment revealed a widespread tendency to rely on a rule’s letter over its spirit when deciding which acts violate the rule. This tendency’s strength varied markedly across (k = 15) field sites, owing to cultural variation in the impact of moral appraisals on judgments of rule violation. Compared to laypeople, legal experts were more inclined to disregard their moral evaluations of the acts altogether, and consequently exhibited more pronounced textualist tendencies. Finally, we evaluated a plausible mechanism for (...) the emergence of textualism: In a two-player coordination game, incentives to coordinate in the absence of communication reinforced participants’ adherence to rules’ literal meaning. Together, these studies (Ntotal = 5495) help clarify the origins and allure of textualism, especially in the law. Within heterogeneous communities in which members diverge in their moral appraisals involving a rule’s purpose, the rule’s literal meaning provides a clear focal point—an easily identifiable point of agreement enabling coordinated interpretation among citizens, lawmakers and judges. (shrink)

In her excellent essay, Blumenthal-Barby (2024) argues that it is “time for bioethics to end talk of personhood.” She is concerned, more specifically, with “the philosophical concept of personhood,...

In his paper “The challenge of brain death for the sanctity of life ethic”, Peter Singer advocates two options for dealing with death criteria in a way that is compatible with efficient organ transplantation policy. He suggests that we should either redefine death as cortical death or go back to the old cardiopulmonary criterion and scrap the Dead Donor Rule. We welcome Singer’s line of argument but raise some concerns about the practicability of the two alternatives advocated by him. We (...) propose adding a third alternative that also – as the two previous alternatives – preserves and extends the possibility of organ transplantation without using anyone without their consent. Namely, we would like to draw readers’ attention to a proposal by Robert Veatch, formulated 42 years ago in his 1976 book “Death, dying, and the biological revolution” and developed further in his later publications. Veatch argues for a conscience clause for the definition of death that would permit people to pick from a reasonable range of definitional options. This autonomy-based option, we believe, is more likely to be practicable than the two options advocated by Singer. Furthermore, we present data from a study with Lithuanian participants that suggest that there is quite pronounced variation of preferences concerning death determination. (shrink)

When a terminally ill patient kills herself, using a drug prescribed by a physician for this purpose, in bioethical literature this would be described as a case of physician-assisted suicide. This would also be a case of suicide according to the standard account of suicide in the philosophical literature. However, in recent years, some authors have argued that terminally ill self-killing in fact should not be considered suicide. In this paper, we don’t try to address the philosophical merits of such (...) arguments. Instead, we ask whether these considerations align with the way non-philosophers think about suicide. We present empirical evidence from four studies that address different concerns raised about terminally ill self-killing being a suicide. We conclude that the raised concerns cannot be supported by the folk understanding of suicide. (shrink)

The Human Condition is neither a well-defined nor well-described concept—nevertheless, it is generally agreed that human sexuality is a fundamental and constituent part of it. For most able-bodied persons, accessing and expressing one's sexuality is a (relatively) trouble-free process. However, many disabled persons experience difficulty in accessing their sexuality, while others experience such significant barriers that they are often precluded from sexual citizenship altogether. Recognising the barriers to the sexual citizenship of disabled persons, the concept of a Welfare-Funded Sex Doula (...) Program has been advanced — a program specifically aimed at meeting the various (and often complex) sexual needs of disabled people. Below we show how that program can be justified within at least two different moral frameworks, the capabilities approach and liberal utilitarianism, and consider and repudiate arguments against it. (shrink)

Many prominent bioethicists have recently raised the question of the possibility of moral status enhancement. In this paper I discuss the arguments advanced by Nicholas Agar for the possible existence of the postpersons. I argue that in spite of the many limitations and shortcomings of Agar’s account, there are no conclusive reasons to rule out the possibility of moral status enhancement. However, if post-persons are as they are described by Agar, the fact of their possibility is less interesting and ethically (...) relevant than it might seem. Most importantly, the account of post-persons given by Agar is rather an outcome of some implausible assumptions. I propose that Agar conflates the ethical with the scientific and dismisses the importance of phenomenology in framing our ethical outlook. Also, he seems to follow the assumption made by many utilitarian ethicists that such features as sentience and cognitive capacities have some universal relevance. This accounts for the delusion that we can view our moral attitudes from the point of view of the Universe. (shrink)