Euthanasia, Assisted-Suicide, and Palliative Sedation: A Brief Clarification and Reinforcement of the Moral Logic

A persistent misunderstanding of the moral distinctions between the practices of euthanasia, assisted suicide, and palliative sedation suggests a critical need to revisit the relationship each shares with licit medical practice in the context of palliative care. To that end, this essay grounds its arguments in two, straightforward premises: (i) the licitness of medical practice is largely determined by the balance between (a) good ends, (b) proportionate means, (c) appropriate circumstances, and (d) benevolent intentions; and (ii) whereas palliative sedation employs criteria A-D (above), both euthanasia and assisted suicide fail to secure criteria A-C. Drawing from this syllogism, the aim and proposal of this essay is to examine the logic inherent to the practices of euthanasia, assisted suicide, and palliative sedation in the context of palliative care with the intention of positing the argument that while palliative sedation fulfills the requirements of morally licit medical practice – and so successfully executes the tenets of sound ethical logic – both euthanasia and assisted suicide do not

The Ethical Principle of Vulnerability and the Case Against Human Organ Trafficking

An increasingly blurred understanding of the ethical significance of global transplant transactions - a curious combination of altruism and commerce, consent and coercion, gifts and theft, science and sorcery, care and human sacrifice - suggest a critical need to revisit the fundamental moral normlessness of the trafficking enterprise. This essay grounds its arguments in two, straightforward premises: (i) the ethical principle of respect for human vulnerability is an indispensable measure of the licitness of most, if not all, moral actions; and (ii) human organ trafficking violates the ethical principle of respect for human vulnerability. Drawing from this syllogism, the aim and proposal of this essay posits the argument that human organ trafficking cannot, in most, if not all, cases, be morally justified insofar as it violates the ethical principle of respect for human vulnerability

The Truths that Make Us Free: Ethical Reflections on Reproductive Endocrinology

In this essay, the author surveys the concept of therapeutic privilege, and addresses the temptation to respond to biographical questions with biological answers in the context of personal meaning-making

The Bionic Brain: Pragmatic Neuroethics and the Moral Plausibility of Cognitive Enhancement

The seemingly infinite possibilities of contemporary neuroscience span from the augmentation of memory, executive function, appetite, libido, sleep, and mood, to the maturation and development of emotional health and personality. These prospects hint at the capacity to alter neurocognitive conceptions of reality. They also mark the unavoidable inculcation of nuanced individual responses, perhaps radical, to these “tailor- made” perceptions. Hence, there exists certain neuroethical, and even more generally, existential risks within this fascinating and expeditious enterprise. The primary question in the context of present-day neurotechnology is not what can be done, but what should be. To that end, this paper examines the concepts of memory, executive function, and emotional health and personality in the context of neurocognitive enhancement and posits the argument that neurocognitive enhancement can be justified as morally plausible in its potential to edify the caliber of overall cognition, and thus contribute to the ability to make pragmatically, robust moral decisions on the conditions that it (1) promotes general moral character, (2) compliments human nature, and (3) effects a deeper sense of individual and social identity

The False Hope of Deliberate Forgetting: A Critical Response to Proponents of Limited-Use Memory Manipulation

The emergence of manipulation techniques that dampen, disassociate, erase, and replace unsavory episodic memories have given pause to even the most ardent proponents of the practice. Supporters of memory manipulation have since clarified that the interventions should be made available exclusively in extreme and limited-use cases. In light of the narrowing of this approach, the present essay examines the arguments in favor of limited-use memory manipulation (LUMM) for the two most commonly-cited circumstances in which the practice is claimed to be justified: post-traumatic stress disorder (PTSD) and substance addiction. After examining the neuroscience of PTSD and substance addition, the critical concepts of biomedicalization and the codification of new diseases, the myth of global autonomy loss, and the terminal normlessness of LUMM are explored to underscore the false hope of deliberate forgetting

Managing Endings in the Beginning: Ethical Reflections on Neonatal Intensive Care

In this essay, the author examines the difficult task of determining quality of life for seriously-ill newborns, and highlights the narrative vitalism so often characteristic of those forced to make end-of-life decisions on behalf of those whose lives have just begun

The Morality of Medical Miracles: Ethical Reflections on Pediatric Oncology

In this essay, the author investigates the practical ethics of miraculous healings, and proposes a four-step approach for working with parents who, for religious reasons, refuse life-saving treatment for children

The Neuroethical Role of Narrative Identity in Ethical Decision Making

An increasingly blurred understanding of the moral significance of narrative identity for a robust perception of self, other, and community suggests a critical need to explore the inter-relationships shared between autobiographical memory, emotional rationality, and narrative identity, particularly as it bears on decision making. This essay argues that (i) the disintegration of autobiographical memory degenerates emotional rationality; (ii) the degeneration of emotional rationality decays narrative identity; and (iii) the decay of narrative identity disables one to seek, identify, and act on the good. After demonstrating that narrative identity is best understood as the product of autobiographical memory and emotional rationality, which in turn is indispensable to substantive ethical decision making, the essay concludes by suggesting that narrative identity may be successfully employed as a justificatory framework for ethical decision making, providing both education to, and rigor for, substantive moral judgment

Dignity and the Life Worth Living: Ethical Reflections on Pediatric Intensive Care

In this essay, the author navigates the terrain of proxy decision making, and uncovers the hidden tendency of some clinicians to reduce quality of life to physical capability

Living with Productive Discomfort: Ethical Reflections on Critical Care Medicine

In this essay, the author considers the theme of deaths and resurrections in light of uncertain outcomes, and captures the pressure on ethicists to always know “the right thing to do.