Transhumanism’s ideology is marked by a commitment to the “progress” or “perfection” of the human species through technological means. What transhumanists are after is not just therapeutic intervention or optimization of current human capabilities, but an ontological change from human to posthuman. In this article, I critique transhumanist ideology on the grounds that it fundamentally misunderstands human moral perfection as resulting from forces acting upon us (i.e., technological interventions), rather than an internal change of character. This misunderstanding reflects an impoverished (...) view of the concept of motion brought about by the rise of modern science, which entails certain ontological commitments that are not Christian in nature. I conclude transhumanism is untenable because it rests on a shaky foundation of Newtonian physics, and reduces the world to mere matter and forces. Furthermore, Christian transhumanism is especially flawed, because it is complicit in this severing of creation from its sacramental ontology, from the Being of God. (shrink)

Recent literature on the ethics of medical error disclosure acknowledges the feelings of injustice, confusion, and grief patients and their families experience as a result of medical error. Substantially less literature acknowledges the emotional and relational discomfort of the physicians responsible or suggests a meaningful way forward. To address these concerns more fully, I propose a model of medical error disclosure that mirrors the theological and sacramental technique of confession. I use Aquinas’ description of moral acts to show that all (...) medical errors are evil, and some accidental medical errors constitute venial sins; all sin and evil should be confessed. As Aquinas urges confession for sins, here I argue that confession is necessary to restore physicians to the community and to provide a sense of absolution. Even mistakes for which physicians are not morally culpable ought to be confessed in order to heal the physician–patient relationship and to address feelings of professional distress. This paper utilizes an Episcopal theology of confession that affirms verbal admission and responsibility-taking as freeing and relationally restoring acts, arguing that a confessional stance toward medical error both leads to better outcomes in physician–patient relationships and is more compassionate toward physicians who err. (shrink)

Honor walks are ceremonies that purportedly honor organ donors as they make their final journey from the ICU to the OR. In this paper, we draw on Ronald Grimes’ work in ritual studies to examine honor walks as ceremonial rituals that display medico-technological power in a symbolic social drama (Grimes, 1982). We argue that while honor walks claim to honor organ donors, ceremonies cannot primarily honor donors, but can only honor donation itself. Honor walks promote the quasi-religious idea of donation (...) as a “good death,” and mask the ambiguity and discomfort inherent in organ donation to promote greater acceptance by the medical community. While some goods may be achieved through honor walks, particularly for donor families, it is still important to examine the negative work done by this practice. (shrink)

In recent years, increasingly advanced artificial intelligence (AI), and in particular machine learning, has shown great promise as a tool in various healthcare contexts. Yet as machine learning in medicine has become more useful and more widely adopted, concerns have arisen about the “black-box” nature of some of these AI models, or the inability to understand—and explain—the inner workings of the technology. Some critics argue that AI algorithms must be explainable to be responsibly used in the clinical encounter, while supporters (...) of AI dismiss the importance of explainability and instead highlight the many benefits the application of this technology could have for medicine. However, this dichotomy fails to consider the particular ways in which machine learning technologies mediate relations in the clinical encounter, and in doing so, makes explainability more of a problem than it actually is. We argue that postphenomenology is a highly useful theoretical lens through which to examine black-box AI, because it helps us better understand the particular mediating effects this type of technology brings to clinical encounters and moves beyond the explainability stalemate. Using a postphenomenological approach, we argue that explainability is more of a concern for physicians than it is for patients, and that a lack of explainability does not introduce a novel concern to the physician–patient encounter. Explainability is just one feature of technological mediation and need not be the central concern on which the use of black-box AI hinges. (shrink)

The push by some bioethicists to excise religion from the clinical ethics consultative process has received institutional support from the American Society for Bioethics and the Humanities. Their certification program, Healthcare Ethics Consultant-Certified, is intended to identify and assess “a national standard for the professional practice of clinical healthcare ethics consulting” devoid of religious content. As Christian ethicists who wish to preserve the morally evaluative nature of healthcare ethics, we must pause and theologically reflect on the meaning of such a (...) program. The five articles in this issue offer rich theological responses to the religion-free standardized methodology endorsed by the ASBH and reified in the HEC-C certification program. They offer a depth of theological reflection we see previously lacking in the literature, attending to the real possibilities of a “terraformed bioethics” effecting metaphysical harm, severing of clinical ethics from its sources, eliminating possibilities for conversion, and confusing the meaning of moral expertise. (shrink)

One must technologize bodies to conceive of organ transplantation. Organs must be envisioned as replaceable parts, serving mechanical functions for the workings of the body. In this way, it becomes possible to imagine exchanging someone’s organs without changing anything essential about the selfhood of the person. But to envision organs as mechanical parts is phenomenologically uncomfortable; thus, the terminology used to describe the practice of organ retrieval seems to attempt other, less technological ways of viewing the human body. In this (...) paper, I analyze three common metaphors that currently contextualize the process of organ retrieval in English-speaking communities: harvesting the agrarian body, procuring the commodified body, and receiving the gifted body. These powerful images constrain the gaze toward the body in important ways. Every gaze both obscures and reveals. While each of these three metaphors makes sense of some aspects of organ retrieval, each of them is ultimately subject to being overtaken by what Jeffrey Bishop calls the technological imaginary. This imaginary deploys a gaze that obscures important elements of what it means to be human and does violence to parts of the phenomenological experience of transplantation and bodily existence. I argue that no matter how hard one tries to avoid the technological aspect of transplantation practices by embracing nonviolent metaphors—even the metaphor of gifting, which seems the most promising—it will never be possible to fully resist organ transplantation’s violence toward our phenomenological sense of embodiment. (shrink)

Clinical ethics consultation (CEC) has become all about right technique. When we encounter a case of conflict or confusion, clinical ethicists are expected to deploy a standardized, repeatable, and rationally defensible method for working toward a recommendation and/or consensus. While it has been noted previously that our techniques of CEC often foreclose on its internal goods, there remains an assumption that we must just find the _right_ efficient technique and the problem would be solved. In this paper, I question that (...) assumption, arguing that any standardized, identically repeatable model of CEC will pull us counterproductively away from ethical reflection, and toward the values of modern _techne_: primarily efficiency, efficacy, and repeatability. This is because standardized techniques of CEC pull the dynamism of being into what Catherine Pickstock calls “identical repetition,” a technologized ontology, which is fundamentally at odds with what being is. And, since ethics is a search for the good of being, avoiding the ontological heart of being severely restricts ethics. (shrink)

In their recent article, Brummett and Muaygil reject Bishop et al.’s framing of the debate over standardization in clinical ethics consultation (CEC) “as one between pro-credentialing procedural and anti-credentialing phenomenological,” claiming that this framing “amounts to a false dichotomy between two extreme approaches to CEC.” Instead of accepting proceduralism and phenomenology as a binary, Brummett and Muaygil propose that these two views should be seen as the extreme ends of a spectrum upon which CEC should be done. However, as evidenced (...) by several inconsistencies within their article, they have failed to fully appreciate the concern animating Bishop et al.’s proposal. Additionally, because of this failure, they do not seem to realize that credentialing ethicists for CEC will only create different problems in Saudi Arabia even as it possibly solves some of the current problems they identify. In this commentary, we highlight and clarify Brummet and Muaygil’s five misunderstandings of Bishop et al. This leads us to conclude that while they claim to be advocating a middle way between proceduralism and phenomenology, in fact they would like for us to standardize another proceduralism, albeit one that incorporates some of the “qualitative” values of American bioethics. (shrink)