Are Brain Dead Individuals Dead? Grounds for Reasonable Doubt.

According to the biological definition of death, a human body that has not lost the capacity to holistically organize itself is the body of a living human individual. Reasonable doubt against the conclusion that it has lost the capacity exists when the body appears to express it and no evidence to the contrary is sufficient to rule out reasonable doubt against the conclusion that the apparent expression is a true expression (i.e., when the conclusion that what appears to be holistic organization is in fact holistic organization remains a reasonable explanatory hypothesis in light of the best evidence to the contrary). This essay argues that the evidence and arguments against the conclusion that the signs of complex bodily integration exhibited in ventilated brain dead bodies are true expressions of somatic integration are unpersuasive; that is, they are not adequate to exclude reasonable doubt against the conclusion that BD bodies are dead. Since we should not treat as corpses what for all we know might be living human beings, it follows that we have an obligation to treat BD individuals as if they were living human beings.

D. Alan Shewmon and the PCBE's White Paper on Brain Death: are brain-dead patients dead?

The December 2008 White Paper (WP) on "Brain Death" published by the President's Council on Bioethics (PCBE) reaffirmed its support for the traditional neurological criteria for human death. It spends considerable time explaining and critiquing what it takes to be the most challenging recent argument opposing the neurological criteria formulated by D. Alan Shewmon, a leading critic of the "whole brain death" standard. The purpose of this essay is to evaluate and critique the PCBE's argument. The essay begins with a brief background on the history of the neurological criteria in the United States and on the preparation of the 2008 WP. After introducing the WP's contents, the essay sets forth Shewmon's challenge to the traditional neurological criteria and the PCBE's reply to Shewmon. The essay concludes by critiquing the WP's novel justification for reaffirming the traditional conclusion, a justification the essay finds wanting.

The problem of fetal pain and abortion: toward an ethical consensus for appropriate behavior.

Debate exists over whether fetuses feel pain, and if so what to do about it. Because they cannot provide self-report, certitude on the question cannot be reached. The essay argues that a presumption of reasonable doubt is adequate to inform moral behavior. It looks at the most recent evidence from fetal anatomical, neurochemical, physiological and behavioral research and concludes that a reasonable doubt exists that fetuses from 20 to 23 weeks do not feel pain. It proposes that where abortion is legal, providers should be legally required both to provide full disclosure of the possibility of fetal pain starting at 20 weeks and to offer pain-relief measures to suppress fetal pain to all women seeking an abortion.

A Critique of the National POLST Paradigm through an Analysis of Colorado's New MOST Legislation.

Colorado recently legalized a new document for use in end-of-life care called a Medical Orders for Scope of Treatment (MOST) form. The legislation exempts from liability to homicide laws caregivers who execute MOST orders for the withdrawing or withholding of life-sustaining procedures. But it drops the requirement that patients be terminally ill before they are free to refuse those procedures. It permits anyone to refuse any medical treatment for any reason; and holds health-care institutions, practitioners, and surrogate decision makers free from liability when they carry out the orders. This essay criticizes the new law together with the view of autonomy implicit within it. The essay proposes six reasons grounded in the requisites of justice and the common good why the new law should be opposed. It recommends that Catholic hospitals refuse to accept MOST-type documents.

"Other selves": moral and legal proposals regarding the personhood of cryopreserved human embryos.

This essay has two purposes. The first is to argue that our moral duties towards human embryos should be assessed in light of the Golden Rule by asking the normative question, "how would I want to be treated if I were an embryo?" Some reject the proposition "I was an embryo" on the basis that embryos should not be recognized as persons. This essay replies to five common arguments denying the personhood of human embryos: (1) that early human embryos lack ontological individuation; (2) that they are members of the species Homo sapiens but not yet human persons; (3) that the argument for personhood commits the "heap argument" fallacy; (4) that since human procreation in nature is inefficient, human embryos cannot be persons; and (5) the "burning building" scenario proves that all arguments for personhood are irrational or inconsistent. The second purpose is to set forth and criticize in light of the normative judgement defended in part one the present legal situation of cryo-preserved embryos in the U.S. The essay ends by proposing legislative reforms to protect ex utero human embryos.