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Bioethics: Bridging from Morality to Law?

Roger Brownsword

in Law and Bioethics: Current Legal Issues Volume 11

This chapter is divided into four parts. The first part considers the view of ethics presented in the Nuffield Council on Bioethics' report, ‘Critical Care Decisions in Fetal and Neonatal Medicine: ... More

This chapter is divided into four parts. The first part considers the view of ethics presented in the Nuffield Council on Bioethics' report, ‘Critical Care Decisions in Fetal and Neonatal Medicine: Ethical Issues’. According to this view, bioethics has a dual function. On the one hand, it is a critical discipline that ‘investigates the underlying reasons or justifications for specific moral beliefs or moral codes’. On the other hand, bioethics should also seek out platforms and pockets of moral convergence and consensus. The second part sketches the author's view from a particular rights-led legal idealist perspective. The third part considers the nature of the plurality that a critical bioethics will construct, the extent to which that operates against consensus, and the scope for bioethics to play a practically useful role. Finally, some ways in which the critical capacity of bioethics might be further deployed are suggested. It is argued that bioethics needs to transcend the plurality by developing a critical understanding of moral community itself.Less

The Troubled Relationship Between Bioethics and Human Rights

Richard Ashcroft

in Law and Bioethics: Current Legal Issues Volume 11

This chapter examines the relationship between bioethics and humans. The first part of the chapter briefly presents the debate over the value of the UNESCO Universal Declaration on Bioethics and ... More

This chapter examines the relationship between bioethics and humans. The first part of the chapter briefly presents the debate over the value of the UNESCO Universal Declaration on Bioethics and Human Rights. The second part proposes an account of the intellectual, sociological, and institutional differences between advocates of bioethical and human rights approaches to moral and social issues in health, medicine, and the life sciences. The third part discusses recent arguments that bioethics can be subsumed under the human rights umbrella. Finally, the chapter suggests some issues for future work on the relationship between human rights and bioethics.Less

The NBAC Report on Cloning: A Case Study in Religion, Public Policy, and Bioethics

M. Cathleen Kaveny

David E. Guinn (ed.)

in Handbook of Bioethics and Religion

The report produced by the National Bioethics Advisory Commission at the request of President Bill Clinton, titled Cloning Human Beings, provides a good example of the two-pronged approach to ... More

The report produced by the National Bioethics Advisory Commission at the request of President Bill Clinton, titled Cloning Human Beings, provides a good example of the two-pronged approach to religion in bioethics. The report merits careful scrutiny precisely because of the deftness with which it appears to negotiate the thorny questions surrounding the role of religion in public policy. Analysis of the structure, arguments, and rhetoric of the report reveals the theoretical and practical inadequacy of the currently reigning two-pronged approach to the role of religious perspectives in the field of bioethics.Less

The Challenge of Regulatory Legitimacy I

Roger Brownsword

in Rights, Regulation, and the Technological Revolution

This chapter begins with a discussion of the Universal Declaration on Bioethics and Human Rights. It then identifies and maps three leading bioethical positions, each of which is compressed within ... More

This chapter begins with a discussion of the Universal Declaration on Bioethics and Human Rights. It then identifies and maps three leading bioethical positions, each of which is compressed within the declaration. These positions, represented as the ‘bioethical triangle’, generate a background ethical plurality that sets the scene for regulators. The chapter comments on the increasingly important idea of human dignity, an idea which features strongly at two points of the bioethical triangle. Two illustrative applications of the bioethical triangle are discussed: the first concerns the regulation of (human embryonic) stem cell research and therapeutic cloning; the second involves the recognition of proprietary entitlements in relation to human tissue and (detached) body parts.Less

Celebrating Bioethics and Bioethicists

Renée C. Fox and Judith P. Swazey

in Observing Bioethics

Bioethics has found its place in the United States with succeeding events that celebrate its birth, the founding of bioethics institutions, deeper research and development, and prominent figures in ... More

Bioethics has found its place in the United States with succeeding events that celebrate its birth, the founding of bioethics institutions, deeper research and development, and prominent figures in the field. This chapter presents two major achievements in bioethics: the Birth of Bioethics conference and the Belmont Revisited conference, to explore the relation or presence of culture in bioethics.Less

Ethical and Legal Aspects of AIDS Psychiatry

Mary Ann Cohen and Sharon M. Batista

in Handbook of AIDS Psychiatry

From confidentiality, contact notification, and disclosure to decisional capacity, advance directives, and end-of-life care, AIDS presents special bioethical ... More

From confidentiality, contact notification, and disclosure to decisional capacity, advance directives, and end-of-life care, AIDS presents special bioethical challenges to caregivers. Stigma, fear of rejection, and discrimination play significant roles in the bioethical aspects of the care of persons with HIV and AIDS. As a consequence, caregivers are often faced with bioethical dilemmas and conflicts. While many persons with HIV and AIDS are comfortable with disclosure to partners and family members, some persons with HIV refuse to disclose their serostatus even to sexual partners. Many persons with HIV and AIDS are able, especially with support, to come to safer and healthier decisions about disclosure and about their health and medical care. In this chapter, we will explore these dilemmas and provide suggestions on how to deal with them. Strategies for dealing with ethical dilemmas, determining decisional capacity, addressing end-of-life issues, and maintaining confidentiality in the care of persons with HIV and AIDS are also presented. To begin a discussion of ethics as applied to clinical care, it is important to define the terms used in this context. The definitions of the terms used in this chapter are based not only on formal definitions as published in bioethics texts and articles but also their use in common medical practice. Table 13.1 provides definitions of some of the bioethics terms that are relevant to this discussion. Within the doctor–patient relationship, physicians are expected to understand and relate to their patients as their own primary decision-makers. Patients are presumed to be autonomous and to have decisional capacity. However, at times, decisional capacity can be called into question, such as when a medical condition impairs the patient’s capacity to understand the illness or results in impaired judgment. Since autonomy is such a protected right, multiple criteria must be fulfilled in order to substitute another person’s judgment for that of the patient in cases where the patient is unable to make an appropriate decision for him- or herself. This assessment is called an assessment for capacity and is specific for each decision—a separate assessment must be performed for each decision to be made if the patient’s decision-making ability is under question. Less

DistanceXComplicity

Mike Fortun

in Promising Genomics: Iceland and deCODE Genetics in a World of Speculation

In a February 1999 article, Jeffrey Kahn of the University of Minnesota's Center for Bioethics commented that deCODE Genetics negotiated the right to Iceland's genome for $200 million, which seemed, ... More

In a February 1999 article, Jeffrey Kahn of the University of Minnesota's Center for Bioethics commented that deCODE Genetics negotiated the right to Iceland's genome for $200 million, which seemed, thought Kahn, “like a bargain basement price.” But Kahn asked whether a country should sell its people's genetic information. Distance more than complicity makes it necessary to state that in the summer of 1999 the “democratic” government of Iceland abruptly dissolved its National Bioethics Committee—whose members had been nominated by the major Icelandic biomedical institutions and professional associations, and which was advocating widely accepted practices of informed consent that deCODE believed too restrictive—and replaced the committee with a government-appointed set of members who proved more amenable to deCODE's interests.Less

Genetic Engineering: Deconstructing Grown versus Made

Kelly Oliver

in Technologies of Life and Death: From Cloning to Capital Punishment

I use the deconstruction of the nature-culture dichotomy, with its attendant opposition between grown and made, to challenge debates in bioethics over cloning. Indeed, deconstructing the central ... More

I use the deconstruction of the nature-culture dichotomy, with its attendant opposition between grown and made, to challenge debates in bioethics over cloning. Indeed, deconstructing the central terms assumed in these debates can change the very framework of them. These debates are currently dominated by the liberal notion of an autonomous individual with free choice, precisely the notion of the sovereign subject that comes under scrutiny in Derrida's later work. Taking John Harris and Jürgen Habermas as representatives of two sides in debates over genetic engineering and cloning, I show how deconstruction unsettles both. In addition, I consider Derrida's own views on cloning and how they might help us navigate complex ethical issues raised by new technologies of reproduction.Less

Reification of the Human: Global Organ Harvesting and Kazuo Ishiguro’s Never Let Me Go

J. Paul Narkunas

in Reified Life: Speculative Capital and the Ahuman Condition

Kazuo Ishiguro’s 2005 novel Never Let Me Go follows a group of genetic clones who are created as wards of the British health service because they serve a utilitarian function: They are manufactured ... More

Kazuo Ishiguro’s 2005 novel Never Let Me Go follows a group of genetic clones who are created as wards of the British health service because they serve a utilitarian function: They are manufactured for the purpose of having their vital organs harvested until their death. The world he envisions of a grouping of humans reproduced to be a living warehouse of organs while certainly dreadful is nowhere near as horrific as when organ transplantation and global uneven development intersect in our neoliberal present. Ishiguro shows how humans who view their humanity instrumentally expedite a world that is ready to slice them into shares, monetizing all the parts along the way. Through Ishiguro’s text, I diagnose the reification of the body as an aggregation of fungible body parts. Human reification challenges bioethicists and cultural critics alike to reflect on how human dignity and bodily integrity no longer serve as barriers for marking the species-limit due to new advances in biotechnology.Less

Dying, a Lost Art

Lydia S. Dugdale

in Dying in the Twenty-First Century: Toward a New Ethical Framework for the Art of Dying Well

At various points throughout history, for reasons of plague, pestilence, and war, death has dominated human consciousness. This was especially apparent during the Bubonic Plague of the fourteenth ... More

At various points throughout history, for reasons of plague, pestilence, and war, death has dominated human consciousness. This was especially apparent during the Bubonic Plague of the fourteenth century, which claimed the lives of up to two-thirds of Europeans. The Catholic Church responded by issuing texts, collectively known as the Ars moriendi, to guide the laity in its preparation for death. These books circulated widely throughout Europe, and were adopted and modified by both the religious and the non-religious, always with a view to preparing to die well. But as late nineteenth century Western society grew increasingly concerned with the art of living well, practices concerned with dying were largely forgotten or neglected, and death became medicalized. The field of bioethics has, since its earliest days, debated end-of-life issues, but it has not definitively aided the broader public in preparing for death. This book looks to bioethics to frame a modern Ars moriendi – one that can aid an aging, plural population to prepare for death and to support its members through the dying process.Less

Toward a New Ethical Framework for the Art of Dying Well

Lydia S. Dugdale

in Dying in the Twenty-First Century: Toward a New Ethical Framework for the Art of Dying Well

In the concluding chapter, the volume editor Lydia Dugdale collects the themes that emerge from the preceding chapters and shows how together they might contribute to the rediscovery of an art of ... More

In the concluding chapter, the volume editor Lydia Dugdale collects the themes that emerge from the preceding chapters and shows how together they might contribute to the rediscovery of an art of dying. She responds to the concerns raised by Lysaught in chapter 5, and, after reconsidering whether bioethics is in fact suited to the task, concludes that only a very robust bioethics could foster both the contemplation of finitude and the cultivation of community that would be necessary for a present-day Ars moriendi. Returning to the rich complexities of finitude and community, Dugdale outlines the obstacles that impede progress. She concludes by identifying the areas that remain to be explored, recognizing that the contours of this exploration must themselves continue to shift as the needs of dying generations change.Less

Introduction: The Politics of Experiment

J. Benjamin Hurlbut

in Experiments in Democracy: Human Embryo Research and the Politics of Bioethics

The introduction introduces the topic and central argument of the book: that at the heart of the human embryo research debates was the question of how the public should reason together about a domain ... More

The introduction introduces the topic and central argument of the book: that at the heart of the human embryo research debates was the question of how the public should reason together about a domain of science and technology that touches upon the most fundamental dimensions of human life. It introduces the methodological approach and coproductionist theoretical framework of the study. It introduces the idea of the “constitutional position of science” in American democracy, and illustrates the unacknowledged but constitutional position of scientific authority in John Rawls' idea of public reason.Less