PubMed · 15828147
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Eugene F Diamond. 2004. Further reply to Ford.. https://pubmed.ncbi.nlm.nih.gov/15828147/
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Whereas certain aspects of neonatal resuscitation may benefit from evidence evaluation using standard evaluation techniques, the ethical aspects of non-initiation and discontinuation of resuscitative efforts are more subjective and might certainly be influenced by the biases of the reviewers. The outcome data are relatively straightforward, although survival and morbidity data differ significantly by region and even among hospitals classified at similar levels in the same region. However, the interpretation of that data is necessarily somewhat subjective. Whereas certain aspects of neonatal resuscitation may benefit from evidence evaluation using standard evaluation techniques, the ethical aspects of non-initiation and discontinuation of resuscitative efforts are more subjective and might certainly be influenced by the biases of the reviewers. The outcome data are relatively straightforward, although survival and morbidity data differ significantly by region and even among hospitals classified at similar levels in the same region. However, the interpretation of that data is necessarily somewhat subjective. Does a survival rate of 1% of patients at a certain weight or gestational age warrant full resuscitative efforts? What about 20% or 49%? Similar questions could be posed regarding significant morbidity. However, as the science of neonatal resuscitation advances, it is important to review objective evidence-based outcome data in certain situations in which non-initiation or discontinuation of resuscitative efforts may be appropriate to determine if certain common themes can be elicited.
Neuroscience and technological medicine in general increasingly faces us with the imminent reality of cyborgs-integrated part human and part machine complexes. If my brain functions in a way that is supported by and exploits intelligent technology both external and implantable, then how should I be treated and what is my moral status-am I a machine or am I a person? I explore a number of scenarios where the balance between human and humanoid machine shifts, and ask questions about the moral status of the individuals concerned. The position taken is very much in accordance with the Aristotelian idea that our moral behaviour is of a piece with our social and personal skills and forms a reactive and reflective component of those skills.