Bioethics conjures images of dramatic healthcare challenges, yet everyday clinical ethics issues unfold regularly. Without sufficient ethical awareness and a relevant working skillset, clinicians can feel ill-equipped to respond to the ethical dimensions of everyday care. Bioethicists were interviewed to identify the essential skills associated with everyday clinical ethics and to identify educational case scenarios to illustrate everyday clinical ethics. Individual, semi-structured interviews were conducted with a convenience sample of bioethicists. Bioethicists were asked: (1) What are the essential skills required (...) for everyday clinical ethics? And (2) What are potential educational case scenarios to illustrate and teach everyday clinical ethics? Participant interviews were analyzed using qualitative content analysis. Twenty-five (25) bioethicists completed interviews (64% female; mean 14.76 years bioethics experience; 80% white). Five categories of general skills and three categories of ethics-specific skills essential for everyday clinical ethics were identified. General skills included: (1) Awareness of Core Values and Self-Reflective Capacity; (2) Perspective-Taking and Empathic Presence; (3) Communication and Relational Skills; (4) Cultural Humility and Respect; and (5) Organizational Understanding and Know-How. Ethics-specific skills included: (1) Ethical Awareness; (2) Ethical Knowledge and Literacy; and (3) Ethical Analysis and Interaction. Collectively, these skills comprise a Toolbox of Everyday Clinical Ethics Skills. Educational case scenarios were identified to promote everyday ethics. Bioethicists identified skills essential to everyday clinical ethics. Educational case scenarios were identified for the purpose of promoting proficiency in this domain. Future research could explore the impact of integrating educational case scenarios on clinicians’ ethical competencies. (shrink)

The upper time limit on growing embryos in culture for research could be revised, following a new recommendation by the Human Fertilisation and Embryology Authority (HFEA), the regulator of embryo research and fertility treatments in the UK. The recommendation was agreed at a meeting of the HFEA Authority, as part of wider discussions about modernising fertility law in the UK.1 Under the Human Fertilisation and Embryology Act 1990 (as amended), embryos which have been donated or created for research may be (...) grown in culture for up to 14 days or until the appearance of the primitive streak (whichever occurs sooner).2 This rule is widely replicated in other jurisdictions which permit the use of embryos in research.3 When this rule was adopted nearly 35 years ago, there was no prospect of sustaining embryos in vitro for more than a few days, and until recently, it has not posed a significant barrier to research.4 However, pressure to review the limit has grown following the publication of two studies in 2016 which demonstrated the technical feasibility of growing embryos to and potentially beyond the 14-day-limit.5 6 Proponents of changing the limit point to possible benefits of allowing …. (shrink)

Patients and family members (N = 671) were surveyed in five Mid-Atlantic U.S. hospitals to ascertain the number and kinds of ethical concerns they are presently experiencing or have previously experienced while being sick or receiving medical care. Seventy percent of participants had at least one (range 0–14) type of ethical concern or question. The most commonly experienced concerns pertained to being unsure how to plan ahead or complete an advance directive (29.4%), being unsure whether someone in the family was (...) able to make their own decisions (29.2%), deciding about limiting life-sustaining treatments (28.6%), wondering about disclosing personal medical information to others in the family (26.4%) and not being sure whether to undergo treatment because of cost (26.2%). Most were interested to some degree in getting help from ethics consultants in the future (76.6%). Given this prevalence, common concerns might usefully be addressed systematically, rather than exclusively on a case-by-case basis. (shrink)

Research and engineering in the quantum domain involve long chains of activity involving theory development, hypothesis formation, experimentation, device prototyping, device testing, and many more. At each stage multiple paths become possible, and of the paths pursued, the majority will lead nowhere. Our quantum metascience approach provides a strategy which enables all stakeholders to gain an overview of those developments along these tracks, that are relevant to their specific concerns. It provides a controlled vocabulary, built out of terms that are (...) designed to be maximally comprehensible to all groups of stakeholders and across all the sub-fields of the quantum domain. (shrink)

The phone-hacking scandal that led to the closure of the News of the World newspaper in Britain has prompted international debate about media practices and regulation. It is timely to broaden the discussion about journalistic ethics and conduct to include consideration of the impact of media practices upon the population's health. Many commercial organisations cultivate relationships with journalists and news organisations with the aim of influencing the content of health-related news and information communicated through the media. Given the significant influence (...) of the media on the health of individuals and populations, we should be alert to the potential impact of industry–journalist relationships on health care, health policy and public health. The approach taken by the medical profession to its interactions with the pharmaceutical industry provides a useful model for management of industry influence. (shrink)

Explanations of organizational misconduct frequently point to declining firm performance and/or the actions of unethical or suspect leaders. Evidence that high-performing firms act illegally or unethically is an enigma. The purpose of this paper is to address these issues by exploring organizational performance using aspirational rather than absolute measures and examining the effect that suspect leader succession has on the increased probability of organizational misconduct. Our analysis of 128 collegiate football programs competing between 1953 and 2016 reveals an increased likelihood (...) of misconduct among organizations with strong as well as weak performance, most notably in comparison to competitive peer programs. Social- and self-referenced aspirations produced distinct relationships between relative performance and misconduct. The impact of leader succession was conditional. The data revealed an increased likelihood of infraction episodes with the appointment of suspect leaders. In some instances, however, a reduced likelihood of misconduct accompanied succession events involving untainted leaders. (shrink)

Background: In 2006, the Centers for Disease Control and Prevention (CDC) recommended three changes to HIV testing methods in US healthcare settings: (1) an opt-out approach, (2) removal of separate signed consent, and (3) optional HIV prevention counseling. These recommendations led to a public debate about their moral acceptability. Methods: We interviewed 25 members from the fields of US HIV advocacy, care, policy, and research about the ethical merits and demerits of the three changes to HIV testing methods. We performed (...) a qualitative analysis of the participant responses in the interviews and summarized the major themes. Results: In general, arguments in favor of the methods were based upon their ultimate contribution to increasing HIV testing and permitting the consequent benefits of identifying those who are HIV infected and linking them to further care. Conclusions: The prevailing theme of ethical concern focused on suspicions that the methods might not be properly implemented, and that further safeguards might be needed. (shrink)

We extend Tomasello's discussion of children's developing sense of obligation to testimonial learning. First, we review a battery of behaviors in testimonial exchanges that parallel those described by Tomasello. Second, we explore the variable ways in which children hold others accountable, suggestive that children's evaluations of moral and epistemic responsibilities in joint collaborative activities are distinct.

Verifying that conceptualisations of emotions are consistent across languages and cultures is a critical precondition for meaningful cross-cultural research on emotional experience. For achievement...

Reintroduction programs in which captive-bred or reared animals are released into natural habitats are considered a key approach for conservation; however, success rates have generally been low. Accounting for factors that enable individual animals to have a greater chance of survival can not only improve overall conservation outcomes but can also impact the welfare of the individual animals involved. One such factor may be individual personality, and personality research is a growing field. This type of research presents animal welfare scientists (...) with the opportunity to develop behavior profiles that may predict how particular individuals cope with challenges. This has direct implications for both in situ and ex situ populations and can bridge the gap between animal welfare and conservation. We designed a project to ascertain the presence of personality traits in Blanding’s turtles (Emydoidea blandingii), a species of special concern in the state of Michigan, and assess potential links between traits and post-release success. As hypothesized, the Blanding’s turtles in this study displayed behavioral responses to modified open field tests indicative of distinct personality traits: exploration, boldness and aggression. Additionally, the personality traits were correlated differently with survival and behavior patterns when the turtles were released into the Shiawassee National Wildlife Refuge. More exploratory turtles had higher survival rates, while neither boldness nor aggression were related to survival. Exploratory turtles were also more likely to travel longer distances after release. The use of muskrat dens was related to increased survival, and both bolder and more exploratory turtles made higher use of this feature. Exploratory and aggressive turtles were found basking outside of water more often, while bold turtles were more likely to be found at the water surface. Both of these basking behaviors may increase the risk of predation and may be reflective of a trade-off between risk and behaviors related to physiological health. Understanding how personality affects behavior and survival post-release can be a critical tool for improving reintroduction success. Zoo animal welfare scientists and practitioners can implement approaches that improve the welfare of individuals within the context of conservation initiatives. (shrink)

Promoting ethical decisions and behaviors is challenging for any organization. Yet managers are still required to make ethical decisions under conditions which deplete their self-control resources, such as high stress and long hours. This study examines the relationships among symbolic and internal moral identity, self-control, and ethical behavior, and investigates whether self-control acts as the mechanism through which moral identity leads to ethical behavior. Findings indicate that internal moral identity overrides symbolic moral identity in the relationship with self-control and that (...) self-control fully mediates the relationship between internal moral identity and ethical behavior. The implications for organizations is that while rules, procedures, and ethics training are useful, managers with a strong moral compass will be more likely to practice self-control leading to more ethical behaviors. (shrink)

This is the second of the four essays in Part II of the book on liberalism and traditionalist education; all four are by authors who would like to find ways for the liberal state to honour the self-definitions of traditional cultures and to find ways of avoiding a confrontation with differences. Melissa Williams examines citizenship as identity in relation to the project of nation-building, the shifting boundaries of citizenship in relation to globalization, citizenship as shared fate, and the role (...) of multicultural education within the view of citizenship-as-shared-fate. She argues the other side of the same coin to that presented by Shelley Burtt in the previous chapter: according to Williams, the liberal state often demands too much in the way of loyalty from traditional groups, and when it does, it runs a strong risk of becoming oppressive and illiberal. Moreover, she holds that there is no need for a single shared identity among citizens of the liberal state. Her conception of people tied together by a shared fate is to this extent compatible with Burtt’s attempt to make liberalism’s commitment to autonomy more hospitable to groups of individuals encumbered by unchosen attachments, but her notion of citizenship as shared fate also goes further than that, and possibly stands in some tension with, Burtt’s view, since it allows and even encourages people to develop primary affiliation to all kind of groups – traditional as well as global. (shrink)

Political scientist Melissa Orlie asks what it means to live freely and responsibly when advantages are distributed disproportionately according to race, gender ...

In the Doctrine of Virtue Kant stipulates that ‘Love is a matter of feeling, not of willing . . . so a duty to love is an absurdity.’ Nonetheless, in the same work Kant claims that we have duties of love to other human beings. According to Kant, the kind of love which is commanded by duty is practical love. This paper defends the view that the duty of practical love articulated in the Doctrine of Virtue is distinct from the (...) duty of beneficence and best understood as a duty of self-transformation, which agents observe by cultivating a benevolent disposition and practical beneficent desires. (shrink)

Explores the challenges facing democracies in the twenty-first century In Democratic Failure, Melissa Schwartzberg and Daniel Viehoff bring together a distinguished group of interdisciplinary scholars in political science, law, and philosophy to explore the key questions and challenges facing democracies, both in the past and present, around the world. In ten timely essays, contributors examine the fascinating, centuries-old question of whether or not democracy can ever fulfill the promise of its ideals. Together, they explore lessons from the history of (...) democracy, various failures of democratic representation, and more. Ultimately, this latest installment of the NOMOS series provides thought-provoking insights into how we conceptualize, measure, and address democratic erosion in our present-day world. (shrink)

On a version of consent theory that tempts many, predatory sexual relations involving significant power imbalances (e.g. between professors and students, adults and teenagers, or employers and employees) are wrong because they violate consent-centric norms. In particular, the wronged party is said to have been incapable of consenting to the predation, and the sexual wrong is located in the encounter’s nonconsensuality. Although we agree that these are sexual wrongs, we resist the idea that they are always nonconsensual. We argue instead (...) that it is possible for students, teenagers, employees, etc. to fully consent to sexually predatory encounters; denying as much renders survivors of predation vulnerable to compounding harms. Survivors face a dilemma: give up either their understanding of their experience as wrong, or their self-conception as an agent capable of consenting. We call the latter phenomenon agential demotion. (shrink)

In recent essays, Jürgen Habermas endorses an account of political liberalism much like John Rawls'. Like Rawls, he argues that laws and public policies should be justified only in neutral terms, i.e. in terms of reasons that people holding conflicting world-views could accept. Habermas also, much like Rawls, distinguishes reasonable religious citizens, whose views should be included in public discourse, from unreasonable citizens in his expectation that religious citizens self-modernize. But in sharing these Rawlsian features, Habermas is vulnerable to some (...) of the same objections posed to Rawls. In this article I assess Habermas' ability to overcome two objections frequently posed to Rawls: (1) that religious citizens are unfairly expected to split their identities in public discourse, and (2) that the burdens of citizenship are asymmetrically distributed. I conclude that while he may be able to overcome the second, the first remains a problem for him. (shrink)

There can be no doubt that Kant thought we should be reflective: we ought to care to make up our own minds about how things are and what is worth doing. Philosophical objections to the Kantian reflective ideal have centred on concerns about the excessive control that the reflective person is supposed to exert over her own mental life, and Kantians who feel the force of these objections have recently drawn attention to Kant’s conception of moral virtue as it is (...) developed in his later work, chiefly the Metaphysics of Morals. Melissa Merritt’s book is a distinctive contribution to this recent turn to virtue in Kant scholarship. Merritt argues that we need a clearer, and textually more comprehensive, account of what reflection is, in order not only to understand Kant’s account of virtue, but also to appreciate how it effectively rebuts long-standing objections to the Kantian reflective ideal. (shrink)

Scholars exploring the logic of Rousseau's voting rules have typically turned to the connection between Rousseau and the Marquis de Condorcet. Though Condorcet could not have had a direct influence on Rousseau's arguments about the choice of decision rules in "Social Contract," the possibility of a connection has encouraged the view that Rousseau's selection of voting rules was based on epistemic reasons. By turning to alternative sources of influence on Rousseau--the work of Hugo Grotius and particularly that of Samuel Pufendorf--a (...) moral, and not purely epistemic, logic of rules governing collective decision making emerges. For Rousseau, as for Pufendorf, the proper choice of voting rule can elicit the appropriate attitude of an individual with respect to the decision of the whole, and can support the morally significant activity of acknowledging error upon discovering that one has voted against the general will. (shrink)

For nearly thirty years, Melissa Ann Pinney has been photographing girls and women, from infancy to old age, to portray how feminine identity is constructed, taught, and communicated. Pinney’s work depicts not only the rites of American womanhood, but also the informal passages of girlhood and adolescence. With each view—from solitary subjects in pensive moments to complex family and social situations—the audience gains a richer understanding of the connections between a daughter and her parents, grandparents, and the larger world (...) of friends and society. The pictures also reflect the ways in which a girl’s world in 2010 differs from the world Pinney knew growing up in the 1960s, and the ways in which the making of a person can transcend time and place. Girl Ascending is a sequel to Pinney’s widely praised first book, Regarding Emma: Photographs of American Women and Girls. Of that previous book Janina Ciezaldo wrote in Aperture, “Pinney brings compositional integrity, knowledge of color, and a Midwestern richness of light to her inquiries.” This second volume is even more accomplished, mature, and stylistically consistent. As David Travis writes in his introduction, “Pinney has regained that sense of wonder, making her view of girls ascending into young women both believable and enchanting.” Pinney’s photographs are powerful and insightful. As social and artistic documents, they reveal the subtle and bold aspects of feminine identity as it is expressed in American places and spaces, both private and public. (shrink)

This article explains the problems with Alan Shewmon’s critique of brain death as a valid sign of human death, beginning with a critical examination of his analogy between brain death and severe spinal cord injury. The article then goes on to assess his broader argument against the necessity of the brain for adult human organismal integration, arguing that he fails to translate correctly from biological to metaphysical claims. Finally, on the basis of a deeper metaphysical analysis, I offer a revised (...) rationale for the validity of the neurological criterion of human death. (shrink)

Since ancient Athens, democrats have taken pride in their power and inclination to change their laws, yet they have also sought to counter this capacity by creating immutable laws. In Democracy and Legal Change, Melissa Schwartzberg argues that modifying law is a fundamental and attractive democratic activity. Against those who would defend the use of 'entrenchment clauses' to protect key constitutional provisions from revision, Schwartzberg seeks to demonstrate historically the strategic and even unjust purposes unamendable laws have typically served, (...) and to highlight the regrettable consequences that entrenchment may have for democracies today. Drawing on historical evidence, classical political theory, and contemporary constitutional and democratic theory, Democracy and Legal Change reexamines the relationship between democracy and the rule of law from a new, and often surprising, set of vantage points. (shrink)

: Kant’s 1763 essay, Attempt to Introduce the Concept of Negative Magnitudes into Philosophy, is one of the least discussed of all his pre-critical writings. When it is referred to, it is usually just to note a few passages that anticipate Kant’s later, Critical philosophy. I argue that instead of understanding these early anticipations of the Critical philosophy as separable from Kant’s discussion of negative magnitudes, we should take their origin in Kant’s investigation of negative magnitudes to be of central (...) importance, since it can help us to understand aspects of Kant’s Critical view of cognition where negative magnitudes still play a role. I argue that negative magnitudes suggest to Kant a kind of cognitive activity that is neither the spontaneity of discursive thought not the receptivity of the senses. Rather it is an “effort” of the mind, of which we are conscious through a feeling. I show that Kant’s early views about negative magnitudes are retained in his Critical philosophy. (shrink)

Competition among scientists for funding, positions and prestige, among other things, is often seen as a salutary driving force in U.S. science. Its effects on scientists, their work and their relationships are seldom considered. Focus-group discussions with 51 mid- and early-career scientists, on which this study is based, reveal a dark side of competition in science. According to these scientists, competition contributes to strategic game-playing in science, a decline in free and open sharing of information and methods, sabotage of others’ (...) ability to use one’s work, interference with peer-review processes, deformation of relationships, and careless or questionable research conduct. When competition is pervasive, such effects may jeopardize the progress, efficiency and integrity of science. (shrink)

Globalization generates new structures of human interdependence and vulnerability while also posing challenges for models of democracy rooted in territorially bounded states. The diverse phenomena of globalization have stimulated two relatively new branches of political theory: theoretical accounts of the possibilities of democracy beyond the state; and comparative political theory, which aims at bringing non-Western political thought into conversation with the Western traditions that remain dominant in the political theory academy. This article links these two theoretical responses to globalization by (...) showing how comparative political theory can contribute to the emergence of new global “publics” around the common fates that globalization forges across borders. Building on the pragmatist foundations of deliberative democratic theory, it makes a democratic case for comparative political theory as an architecture of translation that helps deliberative publics grow across boundaries of culture. (shrink)

Building trust between academic medical centers and certain communities they depend on in the research process is hard, particularly when those communities consist of minoritized or historically marginalized populations. Some believe that engagement activities like the creation of advisory boards, town halls, or a research workforce that looks more like community members will establish or reestablish trust between academic medical centers and racialized communities. However, without systematic approaches to dismantle racism, those well‐intended actions become public performativity, and trust building will (...) fail. In this essay, we draw upon foundational ethical principles of trust, distrust, and trust building; apply the concept of bounded justice to performative trust acts; and center the works of Black and Indigenous feminist bioethicists to revisit some of the wisdom and valuable lessons they have contributed. Rebuilding trust is hard to do because people and institutions are often not honest about how hard it is and there is no simple box‐checking task that can disentangle our society's injustices, but there are steps to take in this direction. Individuals and institutions can recognize valuable relevant work that has already been written, partake in critical reflection, and then apply insights gained to take both small and sustainable steps toward transformational change and deeper trust. (shrink)

In the Doctrine of Virtue Kant divides duties of love into three categories: beneficent activity , gratitude and Teilnehmung – commonly referred to as the duty of sympathy . In this paper I will argue that the content and scope of the third duty of love has been underestimated by both critics and defenders of Kant's ethical theory. The account which pervades the secondary literature maintains that the third duty of love includes only two components: an obligation to make use (...) of our natural receptivity to sympathetic feelings as a means to fulfilling other duties of love, and an indirect duty to cultivate these feelings. As a result, Kant's duty of sympathy has been widely regarded as a duty whose value is derived from the way in which it serves other duties, in particular, the duty of beneficent activity, which obliges agents ‘to promote according to one's means the happiness of others in need’ . Teilnehmung has thus assumed something of a second-class status among the duties to others. My aim in this paper is to demonstrate that the prevailing account of Kant's third duty of love is incomplete. (shrink)

Researchers are studying how artificial intelligence (AI) can be used to better detect, prognosticate and subgroup diseases. The idea that AI might advance medicine’s understanding of biological categories of psychiatric disorders, as well as provide better treatments, is appealing given the historical challenges with prediction, diagnosis and treatment in psychiatry. Given the power of AI to analyse vast amounts of information, some clinicians may feel obligated to align their clinical judgements with the outputs of the AI system. However, a potential (...) epistemic privileging of AI in clinical judgements may lead to unintended consequences that could negatively affect patient treatment, well-being and rights. The implications are also relevant to precision medicine, digital twin technologies and predictive analytics generally. We propose that a commitment to epistemic humility can help promote judicious clinical decision-making at the interface of big data and AI in psychiatry. (shrink)

This essay seeks a philosophical understanding of the nature of kairos that, in turn, discloses the nature of philosophizing. This essay claims that the kairos of philosophy is dialogue, and that dialogue is kairological in two ways: (1) Dialogue is not just a phenomenon that occurs in chronological time but, rather, imposes its own time in order to see how life (or being) itself is disclosed to us; (2) dialogue is kairological because it denotes a moment in which we are (...) pushed into the open, which demands our receptivity and response. Section I explains kairos as “circumstance” in Aristotle, as a required point of view in Heidegger, and as related to the beginning of creation in Schelling. Section II understands dialogue, as the kairos of philosophy, as a crisis—a breaking away from an ordinary understanding of and experience in the world. This destabilizing experience resonates with the untimeliness of philosophizing. (shrink)

A new reading of Plato’s political thought Plato famously defends the rule of knowledge. Knowledge, for him, is of the good. But what is rule? In this study, Melissa Lane reveals how political office and rule were woven together in Greek vocabulary and practices that both connected and distinguished between rule in general and office as a constitutionally limited kind of rule in particular. In doing so, Lane shows Plato to have been deeply concerned with the roles and relationships (...) between rulers and ruled. Adopting a longstanding Greek expectation that a ruler should serve the good of the ruled, Plato’s major political dialogues—the Republic, the Statesman, and Laws—explore how different kinds of rule might best serve that good. With this book, Lane offers the first account of the clearly marked vocabulary of offices at the heart of all three of these dialogues, explaining how such offices fit within the broader organization and theorizing of rule. Lane argues that taking Plato’s interest in rule and office seriously reveals tyranny as ultimately a kind of anarchy, lacking the order as well as the purpose of rule. When we think of tyranny in this way, we see how Plato invokes rule and office as underpinning freedom and friendship as political values, and how Greek slavery shaped Plato’s account of freedom. Reading Plato both in the Greek context and in dialogue with contemporary thinkers, Lane argues that rule and office belong at the center of Platonic, Greek, and contemporary political thought. (shrink)

Kant's discussion of the feeling of respect presents a puzzle regarding both the precise nature of this feeling and its role in his moral theory as an incentive that motivates us to follow the moral law. If it is a feeling that motivates us to follow the law, this would contradict Kant's view that moral obligation is based on reason alone. I argue that Kant has an account of respect as feeling that is nevertheless not separate from the use of (...) reason, but is intrinsic to willing. I demonstrate this by taking literally Kant's references to force in the second Critique. By referring to Kant's pre-critical essay on Negative Magnitudes (1763), I show that Kant's account of how the moral law effects in us a feeling of respect is underpinned by his view that the will is a kind of negative magnitude, or force. I conclude by noting some of the implications of my discussion for Kant's account of virtue. (shrink)

The android Data from Star Trek admired human emotion whereas Spock viewed emotion as irrational and maladaptive. The theory that emotions fulfil adaptive functions is widely accepted in academic psychology but little is known about laypeople’s theories. The present study assessed the extent to which laypeople share Data’s view of emotion as helpful or Spock’s view of emotion as a hindrance. We also assessed how help and hinder theory endorsement were related to reasoning, emotion regulation, and well-being. Undergraduates completed a (...) stressful timed reasoning task and questionnaires that assessed their theories of emotion, emotion regulation strategies, happiness, and social support. Overall, participants viewed emotion more as a help than a hindrance. The more they endorsed the view that emotion helps, the better their reasoning scores. Endorsing a help theory also predicted the use of reappraisal which, in turn, predicted greater happiness and social support. In contrast, endorsing the view that emotion hinders was associated with emotion suppression and less social support. Thus, people’s theories about the functionality of emotion may have important implications for their reasoning and emotional well-being. (shrink)

In this paper, I argue that brain death is death because, despite the appearance of genuine integration, the brain-dead body does not in fact possess the unity that is proper to a human organism. A brain-dead body is not a single entity, but a multitude of organs and tissues functioning in a coordinated manner with the help of artificial life support. In order to support this claim, I first lay out Hoffmann and Rosenkrantz’s ontological account of the requirements for organismal (...) unity and summarize an earlier paper in which I apply this account to the brain death debate. I then further support this ontological argument by developing an analogy between the requirements for the unity of an organism and the requirements for the unity of an orchestra. To do so, I begin by examining the role that a conductor plays in unifying a traditional orchestra, and then go on to show that the human organism functions like a traditional orchestra that relies upon a conductor for its unity. Next, I consider the conditions required to achieve orchestral unity in conductorless orchestras and show that, in contrast to simpler organisms like plants, the postnatal human organism lacks those conditions. I argue, in other words, that although conductorless orchestras do exist, the human organism is not one of them. Like a traditional orchestra without a conductor, the brain-dead body is not a unified whole. (shrink)