The article argues that altruistic giving based on anonymity, which is expected to promote social solidarity and block trade in human body parts, is conceptually defective and practically unproductive. It needs to be replaced by a more adequate notion which responds to the human practices of giving and receiving. The argument starts with identification of the main characteristics of the anonymous altruistic donation: social separation of the organ donor from the recipient, their mutual replaceability, non-obligatoriness of donation, and non-obligatoriness of (...) reciprocation on the recipient’s part. Since these characteristics are also central to typical market relations, anonymous altruistic donation not only cannot promote solidarity but may encourage proposals for markets of transplantable organs. Thus, transplant ethics needs to be reframed. It needs to be rooted in, rather than promote, the practices of giving and receiving known to human societies. As the basis for such reframing, the idea of sharing in another’s misfortune is proposed. It relies on the human practices of giving and receiving and, with appropriate regulatory safeguards, can provide a better conceptual basis for blocking commercial exchanges of human body parts. (shrink)

Bioethics, Volume 36, Issue 8, Page 821-828, October 2022.

The paper gives an interpretation of Kant's doctrine of the fact of reason against the background of a constructivist reading of his philosophy, which does not allow us to appeal to any indubitable facts. The fact of reason is the object of a philosophical account of the moral law forms the quid juris part of deduction or legitimization of the law. A more intuitive grasp of the fact is the phenomenon of reverence for duty which ordinary people grasp in form (...) of a feeling and emotion. (shrink)

The paper argues that the idea of gift-giving and its associated imagery, which has been founding the ethics of organ transplants since the time of the first successful transplants, should be abandoned because it cannot effectively block arguments for markets in human body parts. The imagery suggests that human bodies or their parts are transferable objects which belong to individuals. Such imagery is, however, neither a self-evident nor anthropologically unproblematic construal of the relation between a human being and their body. (...) The paper proposes an alternative conceptualization of that relation, the identity view according to which a human being is identical with their living body. This view, which offers a new ethical perspective on some central concepts of transplant medicine and its ethical and legal standards and institutions, supports widely shared intuitive ethical judgments. On this proposal, an act of selling a human body or one of its parts is an act of trade in human beings, not in owned objects. Transfers of human body parts for treatment purposes are to be seen as sharing in another human being’s misfortune rather than as giving owned objects. From the perspective of policy-making, the proposal requires, first, that informed consent for removal of transplant material be obtained from the potential benefactor. Secondly, explicit consent by the prospective benefactor is obligatory in the case of removal of transplant material from a living benefactor. Thirdly, in the case of posthumous retrieval, informed consent by the potential benefactor during their life is not ethically indispensable. Additionally, while refusal of posthumous retrieval expressed by a potential benefactor during their life must be respected, such a refusal needs ethical justification and explanation. (shrink)

Supporters of opt‐in organ procurement policies typically claim that the absence of consent to postmortem transplantable organ retrieval is a normative barrier to such retrieval. On this ground, justification of opt‐out policies is demanded. The paper shows that postmortem organ retrieval is normatively different from live organ removal, and so the doctrine of informed consent does not apply to it in the way it does in other types of cases. First, seen as the instrument of protection of autonomy or the (...) right to self‐determination, informed consent cannot be relied on in the case of dead persons; secondly, viewed as an instrument of annulment of harm or wrong to the dead (volenti non fit injuria), informed consent relies on indefensible accounts of posthumous harm or wrong. Postmortem organ retrieval in cases of absence of the decedent's consent and refusal is governed by other norms than those related to consent. Such norms include, among others, respectful treatment of human remains (such as those found in regulations of medicine, law enforcement, and research) and avoidance of inherently wrong contexts and purposes (such as killing for the purpose of organ retrieval or trade in the human body or its parts). It is concluded that the onus probandi is on the supporters of opt‐in, rather than opt‐out, policies of posthumous organ retrieval. (shrink)

Doktryna świadomej zgody jest moralnym fundamentem współczesnej medycyny i jednym z kluczowych zagadnień bioetycznych. Podstawą tej doktryny jest teza głosząca, że świadoma zgoda pacjenta upoważnia lekarza do podjęcia postępowania medycznego. Teza ta nie podlega w zasadzie dyskusji. Poważne wątpliwości pojawiają się, gdy pytamy o potrzebę takiego upoważnienia. Najczęstsza odpowiedź brzmi, iż zabiegając o świadomą zgodę pacjenta, respektujemy jego prawo do decydowania o sobie, czyli jego autonomię. Autonomia uznana jest za centralną wartość moralną. Jakiekolwiek inne wartości mogą być istotne, ale to (...) autonomia jest kluczem do określenia właściwej relacji pacjent - lekarz. Autor niniejszego artykułu poddaje w wątpliwość taki pogląd. Analizuje dwie główne koncepcje pojęcia autonomii: autonomii działania i autonomii osoby, oraz stawia tezę, że żadna z nich nie wyjaśnia, na czym polega wartość autonomii i w związku z tym nie wskazuje, dlaczego lekarze winni zabiegać o zgodę pacjenta. Ideał autonomii, na podstawie którego zbudowana jest doktryna świadomej zgody, został zapożyczony z obszarów w istotny sposób różnych od tego obszaru, w którym znajdujemy relację pacjent - lekarz. Aby uporać się z problemami wynikającymi z powyższego, autor dystansuje się od idei zgody, a skupia się na pojęciu porozumienia. Próba poszukiwania porozumienia między pacjentem a lekarzem nie jest uzasadniona potrzebą ochrony uprzywilejowanych wartości moralnych (czy to autonomii, czy innej wartości), lecz podyktowana jest potrzebą ustalenia, co jest dobre dla pacjenta, będącego w relacji z lekarzem. Dobro pacjenta ma być wyznaczone za pomocą zasad, które określają granice tego, na co można w sposób uprawniony przystać. Obraz porozumienia przedstawiony jest przez autora w duchu myśli kantowskiej. (shrink)

This paper argues that in the case of mental illnesses whose somatic bases are not known or do not exist, a promising route to understand mental illness is to see it as the lack of a patient’s engagement with some moral values that are necessary for a good human life. The paper explains how the first-person perspective, which is constitutive for mental illnesses, makes it impossible to provide an adequate, third-person explanation of the pathological. Because of its irreducible first-personal nature, (...) mental illness must be understood in terms of a moral harm to the patient, and so an integration of ethics and psychiatry is required. This view is further illustrated with A. Kępiński’s idea of psychiatry as therapy with moral values. (shrink)

Artykuł przedstawia interpretację imperatywu kategorycznego podaną przez H. Sidgwicka w The Methods of Ethics i wpływ tej interpretacji na kolejne pokolenia filozofów anglosaskich. Interpretacja ta jest Kantowi całkowicie obca, ponieważ w swojej lekturze Kanta Sidgwick korzystał z zespołu idei, które od dawna były obecne w brytyjskiej filozofii moralnej i znacznie różniły się od idei Kantowskich. Autorytet Sidgwicka spowodował, że jego błędne opinie o imperatywie kategorycznym bezkrytycznie powtarzano bez solidnych badań nad tekstami Kanta. Sidgwickowska interpretacja imperatywu kategorycznego żyje własnym życiem w (...) wielu podręcznikach historii etyki i pośrednio kształtuje myślenie moralne części dzisiejszych etyków. (shrink)

The confrontation of the dominant perspectives on the ethics of the relationship between humans and other animals with the Kantian proposal shows that its situation is not significantly worse than that of its competitors. First, many criticisms of Kant’s ethics are based on a selective reading of his works, and some of those criticisms show little knowledge of Kant’s actual views. Secondly, demands to adapt moral theory to selected moral intuitions uncritically assume that these intuitions are sound. Thirdly, many critics (...) require that the ethics of the relationship between human and non-human animals satisfy theoretical demands which are not the only plausible way of including non-human animals in a human moral perspective. This is particularly true of the question of the directness of obligations to non-human animals. A consideration of the question of the moral significance of non-human animals and of the nature of human obligations to them against the background of Kant’s non-naturalistic approach to the good and of his view of the role of embodiment in the realization of the good shows that Kantian ethics contains theoretical resources which are sufficient for a serious moral treatment of non-human animals and for the articulation of many contemporary moral intuitions concerning those animals. (shrink)

It is sometimes argued that if reproductive human cloning were available to parents who lost a child the possibility of replication of the child would lead to its devaluation. This argument seems to presuppose a view of the relationship between parents and children according to which parental love is loosely linked to children’s identities. The value of a child for a parent, it is assumed, stems from its being a person or genetically linked to its parents. Against this view I (...) offer a more adequate account of parental relationship. It is based on the idea that the value of a child to its parents is grounded in how it shapes their lives and personalities. If reproductive cloning were ever available it would be no viable option for parents who lost a child. Parents who value their child for who it is, and not just for its being a person or a progeny genetically related to them, value the child too much to want to replicate it when it dies. Parents who value their child for reasons other than who it is, value it too little to clone it when it is lost. (shrink)

Equal treatment and sensitivity to differences are often seen as contradictory demands on moral theory. However, they are consistent if moral principles are capable of various degrees of generality. General principles structure moral perception and judgement. When they are in conflict with each other, they give rise to more specific principles. Supplemented with an adequate decision procedure, principles can guide action in a way that avoids uniformity of rigorism and indeterminacy of situationism. Textual analysis shows that, contrary to traditional interpretations, (...) Kantian maxims are good candidates for principles that can be general and specific. (shrink)

Bezprecedensowy rozwój nauk przyrodniczych ostatnich dziesięcioleci może sprawiać wrażenie, że tzw. humanistyka traci na znaczeniu skoro często nie daje ostatecznych odpowiedzi, nie poprawia materialnych warunków życia, nie przyczynia się do innowacyjności gospodarki i nie podnosi produktu krajowego brutto. To częsta opinia. I błędna. Po pierwsze, obiegowy podział na humanistykę i nauki przyrodnicze jest niedoskonały. Nie bardzo wiadomo, gdzie umieścić nauki prawne, społeczne, medyczne czy ekonomiczne, w których wiedza o człowieku łączy się z wiedzą o jego otoczeniu, a jedne i drugie (...) dają nam nie tylko wiedzę, ale i zrozumienie siebie i otoczenia, zaś niektóre z nich są normatywne. Badacze przyrody potrzebują refleksji humanistów tak samo jak humaniści potrzebują wiedzy przyrodników, a domniemany rodzaj naturalny „wiedza ludzka” nie dzieli się na gatunki naturalne: nauki przyrodnicze i humanistyka. Wiedza i zrozumienie świata są nierozłączne. Po drugie, zwolennicy tezy o wyższości nauk przyrodniczych nad humanistyczny- mi zdają się pozostawać pod wrażeniem ogromnego wpływu, jaki za pośrednictwem technologii i przemysłu nauki przyrodnicze wywierają na życie społeczne od nieco więcej niż dwustu lat. To niedługo. Zapominają też, że to przecież niekończące się dys- kusje humanistów wpływają na życie społeczne i miejsce, jakie zajmują w nim nauki przyrodnicze. Z tych dyskusji, a nie z samych odkryć przyrodników, wyłania się kultura, kształtująca oczekiwania jednostek, które z kolei prowadzą do zmian etycznych i prawnych. (shrink)

18 września 2009 roku zmarła w Olsztynie profesor Barbara Skarga, Przewodnicząca Rady Redakcyjnej Etyki, jej redaktor naczelna wlatach 1993–2006. Prof. Skarga była wyjątkową osobą. Po latach spędzonych w sowieckich łagrach, w 1955 roku powróciła do Polski, by kontynuować rozpoczęte jeszcze przed drugą wojną światową studia filozoficzne. W centrum jej zainteresowań zawsze był człowiek, we wszystkich jego wymiarach, złożoności i zdolności do dobra. I do zła. Zawsze pozostawała w kontakcie z otaczającą ją rzeczywistością, dowodząc, że nawet w świecie tak trudnym do (...) ogarnięcia jak dzisiejszy, jest miejsce na filozofię i myślenie o dobru. Z oddaniem pracowała nad kolejnymi tomami „Etyki”, przywracając ją do istnienia w 1993 roku. Bez niej „Etyka” nie przetrwałaby i za to pozostaniemy jej wdzięczni — czytelnicy „Etyki” i jej dzisiejsi redaktorzy. Na niniejszy tom składa się zapis wystąpień uczestników sesji naukowej, jaka odbyła się 16 września 2008 roku w czasie VIII Polskiego Zjazdu Filozoficznego oraz, jak zwykle, przekłady i artykuły nadesłane do redakcji. (shrink)

Conceptualisations of vulnerability of research participants in the international standards of ethics of research involving humans underwent a shift from a group-membership (categorical) to an individual-oriented (analytic) approach to vulnerability. However, the categorical view has not been jettisoned completely, and so its role needs to be examined or explained. It is argued in this chapter that a restricted use of the categorical approach can be justified if protection of vulnerable research participants is seen against the background of the dynamics of (...) study design, review and implementation, and if recognition and protection of participants with vulnerabilities is construed as a process in which researchers and ethics review bodies are involved rather than as a labelling device. From this perspective, the suitability of approach to conceptualisation of vulnerability depends on the kind and scope of the available information on participants. The process of study design, ethics review, and implementation involves different users of the ethics standards at different stages in the lifetime of a project: researchers and members of ethics review bodies. The concepts of individual vulnerability (in the analytic approach) and that of group-membership vulnerability (in the categorical approach) can play their protective roles complementarily in the process of identification of vulnerabilities of participants and protection of participants with vulnerabilities. (shrink)

Traditionally it is believed that there are two requirements which must be met by a plausible normative theory of morality. It is expected to be sensitive to actual moral beliefs and to guide action. However, it is impossible to satisfy them both within the traditional approach to the tasks of moral theorizing. An alternative theory would have to provide intellectual tools for solution of actual moral problems in a way which would rely on judgment and imagination in practical reasoning. Moral (...) theorizing would then be seen as part of moral practice and the philosopher’s role as that of a critical participant in moral practice rather than of a lawgiver with privileged access to moral truths. (shrink)

The paper analyses the application of the best interest standard in the medical care of extremely preterm babies. It proposes that as long as the parents base their decision on a well-founded medical opinion regarding the neonate’s diagnosis and prognosis and are not victims of superstition or prejudice, medical professionals are obligated to respect the parents’ informed consent, even if the professionals disagree with the parents’ opinion. In their assessments of the neonate’s interest, medical professionals can be primarily guided by (...) their judgment regarding its diagnosis and prognosis. By contrast, the personal involvement of the parents in the decision-making process, their values and the family-specific context of the infant’s possible future makes their opinion regarding the infant’s interests significantly more convincing than the opinions of other persons involved. (shrink)

The standard view of the duty to help those in need suggests that it is acceptable to refuse to help others who are known to be in need and who can be assisted. This conclusion can be avoided if helping is seen from the perspective of Kant’s idea of the duty of beneficence. On this view help should not be seen as stemming from the recognition of contingent differences between those who are inclined to help and those who are in (...) need, nor as a one-time response to evil, or as an act close to heroism. Help should be seen as an element of the pursuit of one of the ends which are also duties, i.e. as the promotion of the happiness of others and, at the same time, the self-perfection of the helping person. Helping results from a stable readiness to act for the benefit of others, which stems from one’s recognition of the weakness, limitation, and lack of self-sufficiency which are common to all humans, and so are shared by both the helper and the person in need. (shrink)

I argue in the paper that the problem of freedom has been misconstrued. There is no one problem of freedom but many problems concerning individual agents’ responsiveness to principles and reasons. The problem of free will results from attempts to incorporate the notion of freedom, which belongs to the order of guiding action, into a determinist framework of explanation. My view could be seen as compatibilist because it denies the existence of a fundamental conflict between freedom and determinism. However, since (...) libertarian accounts of local indeterminism are pointless on my view, it cannot be easily place with the compatibilism/libertarianism distinction. Instead of entering the hopelessly unproductive metaphysical debates about freedom and determinism, I propose to turn attention to the domain of ethics. Problems of freedom are questions about the deliberative processes that terminate in action and about reasons and principles on which they are based. To say that an action is free is not to claim that it is independent from causal determination; rather, it is to say that it has been decided upon. (shrink)