Sterilizations reconsidered?

Cowdin and Tuohey argue for a rethinking of Catholic bioethical principles and the Church's moral authority. Citing the Second Vatican Council for support, they argue that if the Church were to respect the proper autonomy of medicine, it would allow sterilizations. In this essay I argue against Cowdin and Tuohey's understanding that the Church has derived its moral laws independent of consultation with medicine and that it treats medicine simply as a source of technical expertise. I also argue that they misunderstand that nature of autonomy as well as the Church's position regarding the type of autonomy they request for medicine. I will especially argue against their understanding of the principles of totality and double effect as "dispensations" from the moral order. I conclude that they have provided no grounds to cause the Church to reconsider its condemnation of all sterilizations.     

Moral knowledge: some reflections on moral controversies, incompatible moral epistemologies, and the culture wars.

An authentic Christian bioethical account of abortion must take into consideration the conflicting epistemologies that separate Christian moral theology from secular moral philosophy. Moral epistemologies directed to the issue of abortion that fail to appreciate the orientation of morality to God will also fail adequately to appreciate the moral issues at stake. Christian accounts of the bioethics of abortion that reduce moral-theological considerations to moral-philosophical considerations will not only fail to appreciate fully the offense of abortion, but morally mislead. This article locates the bioethics of abortion within the theology of the Church of the first millennium, emphasizing that abortion was prohibited, whether or not one considered the embryo or fetus to be ensouled.     

Health, fortune, and moral authority in medicine.

The Christian conviction about Divine Providence encourages a novel account of the moral content of health and authority in the health care context. While health can be understood as the disposition of a living body to be able to proceed in the world well, as a species of freedom it is informed by the particular projects and concerns that Christians hold deepest. This is due to the fact that health acquires content, and thus becomes desirable as a particular type of good, only in relation to judgments about the good life. Aquinas' reflections concerning the good of health and its partial slavery to fortune reveal a Christian past that dwelt on the intrinsic and instrumental good of health. A rich Christian tradition in which health as intrinsically good, a good of the body, is ordained to the interests of right Christian virtue. Each of these factors affects the character of the health to be pursued and the authority of the physician as determining the ends and means of medicine.     

A Bad Disease, a Fatal Cure: Why Sterilization is Permissible and the Autonomy of Medicine is Not

The debate in this issue regarding the Roman Catholic condemnationof the morality of sterilization is puzzling for Protestants.As I will argue the puzzlement arises on two grounds. First,why would anyone object to direct sterilization for the cureor prevention of disease? Second, if one wanted to challengesuch an objection on moral grounds why would one turn to medicineto do so? For Christian ethics there is nothing wrong in principlewith direct sterilization when there are good reasons for precludingthe possibility of an additional pregnancy; and it is a serioustheological mistake to treat medicine as an independent moralauthority.     

The moral status of a human fetus: a response to Lee.

It is an undeniable empirical fact that a human fetus is a member of the species homo sapiens from the moment of conception. There is thus an important sense in which it is a human being in itself, and not simply part of a pregnant woman's body, despite what defenders of abortion on demand might want us to think. It is also reasonable to suppose that all human beings, and thus human fetuses, are persons, with all that entails, but this is a metaphysical presupposition as opposed to an empirical fact, and is thus contentious. It is argued, however, that this should be of little comfort to the defenders of abortion, because the mere fact that human fetuses have an inherent tendency to become persons is sufficient reason to confer a moral status upon them, which renders abortion morally problematic at best.     

Maturity is explicit: Self-importance of traits in humanitarian moral identity

Development of humanitarian moral identity may correspond with the growing self-importance of moral traits. This study considered the extent to which moral traits become explicit in novice and expert humanitarian moral identity narratives. Eighty humanitarian caregivers from L’Arche communities were given self-understanding interview prompts to assess temporal (i.e., past, present, and future) and relational expectations. Humanitarian responses were compared to four paragraphs comprised of moral traits (i.e., just, brave, caring, and religious) using a computational knowledge representation model known as latent semantic analysis (Landauer, T., McNamara, D., Dennis, S., & Kintsch, W. (Eds.). (2007). Handbook of latent semantic analysis (University of Colorado Institute of Cognitive Science). Mahwah, NJ: Erlbaum). Consistent with predictions, humanitarian experts displayed more explicitly self-important moral traits than novices on future and romantic partner expectations. Findings suggest that humanitarian development is associated with simulation related to future goal achievement and moral action modeled by close intimates.     

Knowledge,Authority and Identity: A Prolegomenon to an Epistemology of the Clinic

Disputes about theory in bioethics almost invariablyrevolve around different understandings of morality or practicalreasoning; I here suggest that the field would do well to becomemore explicitly contentious about knowledge, and start the taskof putting together a clinical epistemology. By way of providingsome motivation for such a discussion, I consider two cases ofresistance to shifts in clinical practice that are, by and large,not ethically controversial, highlighting how differentconceptions of epistemic authority may contribute to clinicians'unwillingness to adopt these changes, and sketching out someinitial suggestions for epistemic analysis of clinical practice.     

Stopping nutrition and hydration technologies: a conflict between traditional Catholic ethics and church authority.

This article focuses on the troubling effects of the secular values of individual freedom and autonomy and their impact on laws regarding suicide and euthanasia. The author argues that in an increasingly secularized culture, death and dying are losing their meaning and are not thought of within a moral framework. The debate regarding the provision of artificial nutrition and hydration is critically considered in light of the history of Catholic morality as well as within the modern healthcare context, and finally with new insight from the recent statements made by the late pope. Drane argues that the pope's insistence on providing artificial nutrition and hydration despite irreversible persistent vegetative states in unconvincing.     

Maturity is coherent: Structural and content-specific coherence in adolescent moral identity

Identity narrative may involve considerable variations in structural and content-specific coherence. These variations are potentially relevant to the development of moral commitment in adolescence. The present study analyzed coherence in moral identity narratives for a matched comparison sample of urban adolescents. Thirty nominated adolescent moral exemplars and 30 everyday comparators were given interview prompts designed to tap identity narrative. Structural and content-specific coherence dimensions were assessed with a palette of computational techniques known as coh-metrix. Consistent with study hypotheses, exemplar adolescent moral identity narratives generally evinced greater structural and content-specific coherence than everyday comparators, particularly on causality and agentic intentionality dimensions. Findings suggest that moral identity coherence is a kind of expertise fixed in developmental processes and associated with real-world action.     

要告诉孩子:世界上根本就没有鬼神

有一天,我六岁的儿子问了我一个问题:爸爸,世界上到底有没有鬼.我没有立即告诉他,反问了他一句:你说呢?儿子摇了摇头,说:不知道.我立刻觉得这是个十分严肃的问题,使我不得不说说这个话题.……     

全球生命伦理学:共识的瓦解(上)——对全球性道德的探求:生命伦理学,文化战争和道德多样性

探究道德差异的核心问题以及哪种道德意见被我们采纳,比如为了建立医疗保健伦理模式与决策方法比较传统与后传统、家族本位与个人本位之间的关系。考虑到以道德多元化定义当代人类处境,关于卫生保健政策和生命法则的反思是明智的。这个反思强调了俗世伦理学的道德多元化和为对自由和责任进行俗世化思考的结论之间分歧的意义。     

Interests and Neonates: There Is More to the Story than We Explicitly Acknowledge

Although there are many different moral arguments concerning the use of Best Interests in neonatal decision-making, there seems in practice a firm commitment to application of the concept. And yet, there is still little reflection given by practitioners about what employing a Best Interest determination means in infant care. The following lays out a comprehensive taxonomy of interest-sources in order to provide for more robust considerations of what constitutes best interests of/for neonates.     

Publicly Accessible Intuitions: "Neutral Reasons" and Bioethics

This article examines Leon Kass's contention that a choice forphysician-assisted suicide is "undignified." Although Kass isJewish rather than Christian, he argues for positions that mostChristians share, and he argues for these positions withoutpresupposing the truth of specific religious claims. I arguethat although Kass has some important intuitions, he too readilyassumes that these intuitions will be shared by his audience,and that this assumption diminishes the force of his argument.An examination of the limitations of Kass's argument is helpfulinsofar as it illustrates the real challenge faced by religiousbelievers who wish to defend their beliefs in the "public forum."For it illustrates that what needs to be made "accessible" isthe Judeo-Christian understanding of man and his place in theworld. While I do not wish to claim that this task is impossible,I do think that it is far more difficult than most realize.Like all important tasks, however, unless we wrestle with thedifficulties it raises, our arguments will strike many as unconvincing.     

Sterilization, Catholic health care, and the legitimate autonomy of culture.

Disagreement over the legitimacy of direct sterilization continues within Catholic moral debate, with painful and at times confusing ramifications for Catholic healthcare systems. This paper argues that the medical profession should be construed as a key moral authority in this debate, on two grounds. First, the recent revival of neo-Aristotelianism in moral philosophy as applied to medical ethics has brought out the inherently moral dimensions of the history and current practice of medicine. Second, this recognition can be linked to Catholic morality through Vatican II's affirmation of the legitimate autonomy of culture, including the sciences. A partial precedent for understanding the moral authority of medicine can be found in the recent history of Catholic medical morality, and we further argue that a full contemporary recognition of that authority would weigh against an absolute prohibition of direct sterilizations. Institutionally, we propose the allowance of direct sterilizations in cases where the clinically perceived biomedical good of the patient is at stake.     

When ignorance is no excuse: Different roles for intent across moral domains

A key factor in legal and moral judgments is intent. Intent differentiates, for instance, murder from manslaughter. Is this true for all moral judgments? People deliver moral judgments of many kinds of actions, including harmful actions (e.g., assault) and purity violations (e.g., incest, consuming taboo substances). We show that intent is a key factor for moral judgments of harm, but less of a factor for purity violations. Based on the agent’s innocent intent, participants judged accidental harms less morally wrong than accidental incest; based on the agent’s guilty intent, participants judged failed attempts to harm more morally wrong than failed attempts to commit incest. These patterns were specific to moral judgments versus judgments of the agent’s control, knowledge, or intent, the action’s overall emotional salience, or participants’ ratings of disgust. The current results therefore reveal distinct cognitive signatures of distinct moral domains, and may inform the distinct functional roles of moral norms.     

Human moral responsibility is moral responsibility enough: A reply to F. Allan Hanson

Hanson claims that moral responsibility should be distributed among both the humans and artifacts comprising complex wholes that produce morally relevant outcomes in the world. I argue that this claim is not sufficiently supported. In particular, adopting a consequentialist understanding of morality does not by itself support the view that the existence of a causally necessary object in such a complex whole is sufficient for assigning moral responsibility to that object. Moreover, there are good reasons, both evolutionary and contemporary, for not adopting this stance.     

Eudaimonia and well-being: questioning the moral authority of advance directives in dementia

Theoretical Medicine and Bioethics - This paper revisits Ronald Dworkin’s influential position that a person’s advance directive for future health care and medical treatment retains its...     

There is no clam with coats in the calm coast: Delimiting the transposed-letter priming effect

In this article, we explore the transposed-letter priming effect (e.g., jugde–JUDGE vs. jupte–JUDGE), a phenomenon that taps into some key issues on how the brain encodes letter positions and has favoured the creation of new input coding schemes. However, almost all the empirical evidence from transposed-letter priming experiments comes from nonword primes (e.g., jugde–JUDGE). Indeed, previous evidence when using word–word pairs (e.g., causal–CASUAL) is not conclusive. Here, we conducted five masked priming lexical decision experiments that examined the relationship between pairs of real words that differed only in the transposition of two of their letters (e.g., CASUAL vs. CAUSAL). Results showed that, unlike transposed-letter nonwords, transposed-letter words do not seem to affect the identification time of their transposed-letter mates. Thus, prime lexicality is a key factor that modulates the magnitude of transposed-letter priming effects. These results are interpreted under the assumption of the existence of lateral inhibition processes occurring within the lexical level—which cancels out any orthographic facilitation due to the overlapping letters. We examine the implications of these findings for models of visual-word recognition.     

Societal rule evaluations: Adolescent offenders' reasoning about moral,conventional, and personal rules

This study investigated adolescent offenders' (81 felons and 83 misdemeanants) evaluations of three types of societal rules (moral, conventional, and personal) on dimensions pertaining to importance, sanctions, authority, and individual choice. In addition, participants selected the acts which should be under personal jurisdiction. Participants provided reasons (i.e., justifications) to support their evaluations. The judgment evidence suggests that the moral rules were considered the most important, the transgressions the most wrong, the violators the most deserving of punishment, and the acts the least acceptable when permitted by an authority. With regard to these same dimensions, conventional rules and violations were ranked second; whereas, the personal rules were ranked third. Offender status differences were obtained for importance ratings and for deservedness of punishment. Justifications for moral events reflected reasoning from both the moral (e.g., other's welfare) and conventional (e.g., social order) domains. Reasoning about conventions involved both conventional and personal concerns; whereas, justifications about personal issues focused on individual prerogatives. The implications of these data are discussed. © 1996 Wiley-Liss, Inc.