Fooling with mother nature.

KIE: Gaylin's cautionary essay discusses the dangers of using modern technologies to condition and modify human behavior. While arguing that the risks of high technology are overstated and the dangers of low technology developments often are overlooked, Gaylin warns against approaches to controlling behavior that reduce heterogeneity and freedom. He sees the mutability of human nature, our freedom from "instinctual fixation," as one of the most valuable facets of human behavior. He argues that the capacity to modify ourselves should be used to effect changes that would encourage and guard the emergence of valued human attributes such as autonomy and a developed conscience.^ieng

Nazi data: dissociation from evil.

KIE: This case study and three commentaries involve a contemporary researcher pondering the moral implications of using Nazi experimental data related to his work. How should Nazi data be regarded? Is it tainted information, or morally neutral? Should researchers today treat this data differently than more conventionally gathered information? Mark Sheldon and William Whitely cite Kristine Moe's four conditions that, if met, may justify the use of Nazi data. They conclude that, while researchers may be obliged to use the data if it can preserve life, by doing so they may be desecrating the memory of Nazi victims unless they can continually and creatively sustain a sense of condemnation. Brian Folker and Arthur Hafner reject the use of Nazi data, but conclude that each researcher must decide out of a concern for him- or herself as a moral being. Willard Gaylin argues that to use Nazi data is to legitimatize it and to become an accomplice.^ieng

'Doctors must not kill'.

KIE: Four physicians respond to "It's over, Debbie," an anonymous resident physician's account of an incident when he or she injected a terminally ill cancer patient with a lethal dose of morphine (JAMA 1988 Jan 8; 259(2): 272). Gaylin and his colleagues condemn both the physician's violation of legal and ethical norms, and the conduct of JAMA's editor in publishing the article without editorial rebuke or comment. They warn that the issue of active euthanasia "touches medicine at its very moral center," and that, as pressure to legalize euthanasia in response to patient demand increases, the medical profession must repudiate direct and intentional killing of patients and discipline doctors who kill.^ieng

In defense of the dignity of being human.

KIE: The concept of human dignity is examined in terms of the religious belief that man is created in God's image and from the Kantian viewpoint that man's autonomy gives special value to our species. The theory of psychic determinism and the prospect of genetic engineering of humans are seen as attacks on self determination. Five additional attributes that make humans "special" are explored: conceptual thought, the capacity for technology, our range of emotions, "Lamarckian" environmental genetics, and the freedom to change and modify ourselves.^ieng

The competence of children: no longer all or none.

KIE: A fixed age of competence at 18 or 21 has been made obsolete by court decisions and new biomedical technologies such as safer abortion procedures. Gaylin discusses the concept of "variable" competence in the context of minors and decision making in medical care or clinical trials, where a child's autonomy is dependent on the amount of risk or gain involved, social benefits and costs, and the nature of the decision itself.^ieng