Theoretical and clinical concerns about brain death: the debate continues.
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Biomedical subjects
Publications and source records attributed to B A Lustig.
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In response to my earlier critique of recent attempts to rebut principlism as an ethical approach, Green, Gert, and Clouser (GG&C) have in turn offered their own critique of my appraisal. This essay identifies eight major criticisms GG&C raise in their response and offers a rejoinder to each. Among them, three are especially important: (1) that the label of 'deductivism' fails to capture GG&C's ethical method and should be replaced by 'descriptivism'; (2) that pluralistic accounts, including principlism, fail to offer any systematic way to resolve moral conflicts; and (3) that appeals to broader 'moral' principles beyond the moral rules are deceiving, since apparent differences in 'moral' judgment invariably involve disagreement about empirical facts rather than further moral considerations. In response to (1), I defend my earlier label by emphasizing the stipulated and invariant status of the moral rules GG&C invoke, even as I question the adequacy of their putative 'descriptivism'. In response to (2), I suggest the plausibility of pluralist approaches and reiterate the modified just-war criteria that Beauchamp and Childress invoke in situations when principles conflict. In response to (3), I suggest that a 'descriptivism' worthy of the name must systematically accommodate the appeal to moral principles that remains central to metaethical and normative discussions.
This essay analyzes Roman Catholic social teaching on the right to health care and the legitimacy of healthcare rationing. It considers that discussion at two levels: (1) the specific warrants that undergrid key terms; and (2) the accessibility and applicability of those warrants to policy choices in a secular society. The essay concludes with a number of broader reflections meant to reserve an appropriate place for religious voices in the process of policy-making, as distinguished from its justification.
Several scholars have recently criticized the dominant emphasis upon mid-level principles in bioethics best exemplified by Beauchamp and Childress's Principles of Biomedical Ethics. In Part I of this essay, I assess the fairness and cogency of three broad criticisms raised against 'principlism' as an approach: (1) that principlism, as an exercise in applied ethics, is insufficiently attentive to the dialectical relations between ethical theory and mortal practice; (2) that principlism fails to offer a systematic account of the principles of non-maleficence, beneficence, respect for autonomy, and justice; and (3) that principlism, as a version of moral pluralism, is fatally flawed by its theoretical agnosticism. While acknowledging that Beauchamp and Childress's reliance upon Ross's version of intuitionism is problematic, I conclude that the critics of principlism have failed to make a compelling case against its theoretical or practical adequacy as an ethical approach. In Part II, I assess the moral theory developed by Bernard Gert in Mortality: A New Justification of the Moral Rules, because Gert has recommended his approach as a systematic alternative to principlism. I judge Gert's theory to be seriously incomplete and, in contrast to principlism, unable to generate coherent conclusions about cases of active euthanasia and paternalism.