PubMed Health⌕ Search

Biomedical subjects

David DeGrazia

Publications and source records attributed to David DeGrazia.

13 recordsLinked to original sources

Enhancement technologies and human identity.

As the President's Council on Bioethics emphasized in a recent report, rapid growth of biotechnologies creates increasingly many possibilities for enhancing human traits. This article addresses the claim that enhancement via biotechnology is inherently problematic for reasons pertaining to our identity. After clarifying the concept of enhancement, and providing a framework for understanding human identity, I examine the relationship between enhancement and identity. Then I investigate two identity-related challenges to biotechnological enhancements: (1) the charge of inauthenticity and (2) the charge of violating inviolable core characteristics. My thesis is that a lucid, plausible understanding of human identity largely neutralizes these charges, liberating our thinking from some seductive yet unsound objections to enhancement via biotechnology.

Aging↗

Common morality, coherence, and the principles of biomedical ethics.

The fifth edition of Beauchamp and Childress's Principles of Biomedical Ethics is distinguished by its emphatic embrace of common morality as the ultimate source of moral norms. This essay critically evaluates the fifth edition's discussion of common morality and, to a lesser extent, its treatment of coherence (both the model of ethical justification and the associated concept). It is argued that the book is overly accommodating of existing moral beliefs. The paper concludes with three suggestions for improving this leading text.

Beneficence↗

Advance directives, dementia, and 'the someone else problem'

Advance directives permit competent adult patients to provide guidance regarding their care in the event that they lose the capacity to make medical decisions. One concern about the use of advance directives is the possibility that, in certain cases in which a patient undergoes massive psychological change, the individual who exists after such change is literally a (numerically) distinct individual from the person who completed the directive. If this is true, there is good reason to question the authority of the directive -- which is supposed to apply to the individual who completed it, not to someone else. This is 'the someone else problem'. After briefly introducing advance directives as a basis for medical decision-making, this paper elaborates 'the someone else problem' in the context of severe dementia. The paper then reconstructs the reasoning that leads to this putative problem and exposes the important underlying assumption that we are essentially persons. An alternative view of what we are, one that regards personhood as inessential, is then considered, before several arguments are advanced in favor of that alternative view. The paper next explores implications for advance directives: 'The someone else problem' is effectively dissolved, while it is noted that a related problem (one beyond the paper's scope) may persist. A few implications beyond advance directives are also identified.

Advance Directive Adherence↗

Value theory and the best interests standard.

The idea of a patient's best interests raises issues in prudential value theory -- the study of what makes up an individual's ultimate (nonmoral) good or well-being. While this connection may strike a philosopher as obvious, the literature on the best interests standard reveals almost no engagement of recent work in value theory. There seems to be a growing sentiment among bioethicists that their work is independent of philosophical theorizing. Is this sentiment wrong in the present case? Does value theory make a significant difference in interpreting best interests? In pursuing this question, I begin with a quick sketch of broad kinds of value theories, identifying representatives that are plausible enough to count as contenders. I then explore what each account suggests in (1) neonatal treatment decisions, and (2) decisions for patients in persistent vegetative states. I conclude that while these accounts converge somewhat in their interpretations of best interests, they also have importantly different implications.

Adult↗

The moral status of animals and their use in research: a philosophical review.

In this article I offer a philosophical review of (1) leading theories of the moral status of animals, (2) pivotal theoretical issues on which more progress needs to be made, and (3) applications to the setting of animal research. Such an examination demonstrates, I believe, that the practical implications of leading theories converge far more than might be expected. In addition, I hope this review helps to clarify particularly troubling issues that remain so they can be treated adequately.

Animal Experimentation↗