The possibility of a human head transplant poses unprecedented philosophical and neuroethical questions. Principal among them are the personal identity of the resultant individual, her metaphysical and social status: Who will she be and how should the “new” person be treated - morally, legally and socially - given that she incorporates characteristics of two distinct, previously unrelated individuals, and possess both old and new physical, psychological, and social experiences that would not have been available without the transplant? We contend (...) that this situation challenges linguistic conventions and conceptual binaries, and calls into question the major philosophical approaches to personal identity: animalism and reductionism. We examine these views critically vis-a-vis head transplantation and conclude that they fail to provide an adequate account of the identity of the resultant individual because both neglect the key role of embodiment for personal identity. We maintain that embodiment is central to personal identity and a radical alteration of the body will also radically alter that person, making her a different person. Consequently, a human head transplant will result in an individual partly continuous with the head/brain, and partly continuous with the body donor. We conclude that the resultant person would be different from both the individual whose head was transplanted and the one to whose body the “new” head is attached. (shrink)

Head transplantation fits within the broader conceptual space occupied by transhumanists and others who seek to extend the lives of human beings indefinitely. It is reasonable to reflect on whether, under what circumstances, and in what ways human immortality would be good. In this paper, I disambiguate the ways in which immortality might be considered a human good and then argue that immortality is neither necessary nor sufficient condition for objective meaning in life. I also argue that mortality (...) is not a necessary condition for objective meaning in life. (shrink)

The principal focus of this paper is to consider the implications of head and neck transplantation surgery on the issue of personal identity. To this end, it is noted that the immune system has not only been established to impose a level of self-identity on bodily cells, it has also been implicated in mental development and the regulation of mental state. In this it serves as a paradigm for the mind as the product of cephalic and extracephalic systems. (...) The importance of bodily systems in identity is then discussed in relation to phantom tissue syndrome. The data strongly indicate that, even if surgically successful, head and neck transplantation will result in the loss of the continuity of personal identity. (shrink)

Head transplantation has ignited intense discussions about whether it should be done scientifically and ethically. This paper examines the ethics of head transplantation from a Confucian perspective and offers arguments against the permissibility of head transplantation. From a Confucian point of view, human beings are the most precious organisms in the world, and ren and li are the basic moral principles of human beings. As long as head transplant technology remains underdeveloped, this procedure (...) should not be done because it will pose a serious risk of harm to humans and thus violate the principles of Confucian ren and li. If head transplant technology matures to the point that it would be safe to try in humans, it still should not be performed because it would change the selfhood or identity of the head donor and the body donor and create a new person. Confucian personal virtues greatly depend on selfhood or personal identity, and selfhood or personal identity depend on one’s body cultivation and mind rectification. Through the hard effort of body cultivation and mind rectification, one transforms one’s selfhood or identity and personality. This selfhood, identity, and personality cannot be separated from one’s body but are embedded in one’s body. Thus, head transplant would destroy two persons’ identities and result in a new person, and the characteristics of this new person’s identity are still unknown. (shrink)

This article consists of four parts. In the first part it briefly describes the history of body‐to‐head transplantation (BHT) and the surgical plan proposed by Drs. Sergio Canavero and Ren Xiaoping on a human subject. In the second part it argues that the BHT procedure that they propose is scientifically invalid and technically infeasible so therefore would end in failure. In the third part it argues that the present conceivable procedure of BHT cannot be ethically justified because it (...) would bring great harm to the human subject, it is uncertain who would be the possible beneficiary, and valid informed consent cannot be obtained. In the fourth part it argues that the action of performing the procedure of BHT might violate China’s current criminal and civil laws. The conclusion that follows from the arguments above is that BHT should be prohibited now and also in the near future. However, this conclusion does not preclude scientists, neurosurgeons and bioethicists doing research into scientific, technical, surgical and ethical issues raised by BHT. (shrink)

Neurosurgeon Sergio Canavero proposed the HEAVEN procedure – i.e. head anastomosis venture – several years ago, and has recently received approval from the relevant regulatory bodies to perform this body-head transplant in China. The BHT procedure involves attaching the donor body to the head of the recipient, and discarding the body of R and head of D. Canavero’s proposed procedure will be incredibly difficult from a medical standpoint. Aside from medical doubt, the BHT has been met (...) with great resistance from many, if not most bio- and neuroethicists.Given both the known challenges and unknown outcomes of HEAVEN, several important neuroethical and legal questions have emerged should Canavero be successful, including: What are the implications for transplantology in the U.S., inclusive of issues of expense, distributive justice, organizational procedures, and the cost of novel insight? How do bioethical and neuroethical principles, and legal regulations of human subject research apply? What are the legal consequences for Canavero performing a BHT? What are the tentative implications for the metaphysical and legal identity of R should they survive post-BHT? These questions are analyzed, issues are identified, and several solutions are proposed in an attempt to re-configure HEAVEN into a safe, clinically effective, and thus realistically viable procedure.Notably, the permissibility of conducting the BHT in China fosters additional, important questions, focal to whether Western ethics and professional norms be used to guide the BHT – or any neuroscientific research and its use - in non-Western countries, such as China; if the models of responsible conduct of research are identical, similar, or applicable to the intent and conduct of research in China; and what economic and political implications are fostered if/when such avant garde techniques are successful.These questions are discussed as a further impetus to develop a globally applicable neuroethical framework that would enable both local articulation and cosmopolitan inquiry and oversight of those methods and approaches deemed problematic, if and when rendered in more international settings. (shrink)

This issue of The Journal of Medicine and Philosophy brings together an international group of scholars from Hong Kong, Mainland China, and North America, critically to explore whole-body/head transplantation. The proposed procedure raises significant philosophical, ethical, and social/political questions. For example, assuming transplant is successful, who survives the surgery? Does personal identity necessarily follow the head? The contributors to this special thematic issue explore the nature and ground of personal identity, what it would mean to preserve personal (...) identity, given such a significant set of physical changes, as well as the morality of such a procedure. As the authors make clear, careful conceptual philosophical analysis is essential for understanding whether whole-body/head transplantation is a life-saving/life-enhancing technological innovation, or a bioethical morass that should not be attempted. How we come to terms with such conceptual and moral concerns will have a significant impact on the future of medicine and medical technological innovation. (shrink)

This essay draws on classical Confucian intellectual resources to argue that the person who emerges from a head transplant would be neither the person who provided the head, nor the person who provided the body, but a new, different person. We construct two types of argument to support this conclusion: one is based on the classical Confucian metaphysics of human life as qi activity; the other is grounded in the Confucian view of personal identity as being inseparable from (...) one’s familial relations. These Confucian ideas provide a reasonable alternative to the currently dominant view that one’s personal identity “follows” one’s head. Together, these arguments imply that head transplantation is ethically inappropriate. (shrink)

Brain transplants have long been no more than the subject of science fiction and engaging thought experiments. That is no longer true. Neuroscientists have announced their intention to transplant the head of a volunteer onto a donated body. Response has been decidedly mixed. How should we think about the moral permissibility of head transplants? Is it a life-saving/life-enhancing opportunity that appropriately expands the boundaries of medical practice? Or, is it a bioethical morass that ought not to be attempted? (...) For the purposes of this paper, I set aside questions regarding the surgical operation’s technological plausibility so as to focus on very basic questions regarding personal identity and the morality of head transplantation. The analysis begins with an exploration of the embodiment of persons. It considers whether persons can be conceptually distinguished from all parts of their body, even if they cannot be physically separated from some parts without loss of personhood. It argues that in most cases replacing body parts with reasonably similar parts will not destroy the conditions for sustaining personhood. However, as I explore, the phenomenology of personhood is such that some physical changes may prove to be too significant to maintain personal identity successfully over time. Given such complexity and the significance of the costs involved, the moral permissibility of head transplantation likely depends on recognizing that persons may give permission to collaborate in common activities, including projects with which others deeply disagree, provided that they only utilize the services and resources of free and consenting others. (shrink)

Plans to attempt what has been called a head transplant, a body transplant, and a head-to-body transplant in human beings raise numerous ethical, social, and legal questions, including the circumstances, if any, under which it would be ethically permissible to attempt whole-body transplantation (WBT) in human beings, the possible effect of WBT on family relationships, and how families should shape WBT decisions. Our assessment of many of these questions depends partially on how we respond to sometimes centuries-old (...) philosophical thought experiments about personal identity. As with so much in bioethics, it is impossible to escape, or at least inadvisable to try to bypass, the relevant foundational philosophical concerns. (shrink)

Response to human head transplant proposal and pertinent personal identity questions.

Canavero and Ren (2017) suggest that both public and bioethical objections to head/body transplantation will subside after patient outcomes prove successful in an analogous way to how similar objec...

A surgical head-transplant technique, HEAVEN, promises to offer significantly improved quality of life for quadriplegics and others whose minds are functional, but whose bodies require artificial support to continue living. HEAVEN putatively actualizes a thought-experiment long debated by philosophers concerning the definition of personhood and criterion of personal identity through time and change. HEAVEN’s advocates presume to preserve the identity of the person whose head is transplanted onto another’s living body, leaving one’s previous body behind as one would (...) their corpse. Various classical and contemporary theories of personhood and personal identity would support this presumption, while others would contest it as providing an accurate or complete view of what is essential for a human person to persist through this procedure. This paper brings such theories to bear in analyzing whether HEAVEN can indeed deliver on its promise of complete ontological survival for the person whose head is transplanted. (shrink)

A dissociated area of medical research warrants bioethical consideration: a proposed transplantation of a donor’s entire body, except head, to a patient with a fatal degenerative disease. The seeming improbability of such an operation can only underscore the need for thorough bioethical assessment: Not assessing a case of such potential ethical import, by showing neglect instead of facing the issue, can only compound the ethical predicament, perhaps eroding public trust in ethical medicine. This article discusses the historical background (...) of full-body transplantation, documents the seriousness of its current pursuit, and builds an argument for why prima facie this type of transplant is bioethically distinct. Certainly, this examination can only be preliminary, indicating what should be a wide and vigorous discussion among practitioners and ethicists. It concludes with practical suggestions for how the medical and bioethics community may proceed with ethical assessment. (shrink)

Richard Swinburne argues that if my cerebral hemispheres were each transplanted into a different head, what would happen to me is not determined by my material parts, and I must therefore have an immaterial part. The paper argues that this argument relies on modal claims that Swinburne has not established. And the means he proposes for establishing such claims cannot succeed.

The ethics committee of the University of São Paulo Medical College Hospital and Clinics has authorized partial liver transplantation from living donors. The request for this type of transplantation was brought to the committee by a team of professors of surgery operating at the university, headed by Dr. Silvano Raia. Their request and justification are presented here, with discussion following.

In this issue of the Journal of Law, Medicine & Ethics Peter Clark provides a comprehensive and sound ethical analysis of clinical trials examining the treatment of advanced Parkinson's disease with fetal tissue transplantation. These studies raise profound questions about how clinical trials of surgical interventions ought to be conducted. At stake is not only the ethical basis of such trials, but differing views as to the proper role of science in medicine and its limitations.Experience with the broader debate (...) on the ethical permissibility of placebo controls has taught us that the choice of control treatment is an aspect of trial design in which ethical and scientific issues overlap. Accordingly, I will highlight, and perhaps expand upon, three issues raised by Clark: What scientific questions ought clinical trials of surgical interventions ask? How should the ethical analysis of risk for such trials be conceived? And, are surgical patients a vulnerable population? (shrink)

The primary intention of Ren and Canavero's article (2017) is to respond to various criticisms raised by their proposal of the head anastomosis venture (HEAVEN) procedure. Before we launch a deeper analysis of Ren and Canavero's article, I would like to draw attention to a sentence, “Unfortunately, humility is not a part of medical lore,” where they refer to the arrogance and unsuccessfulness of medical science to recognize the importance and breakthrough of the HEAVEN procedure. Interestingly, with this repeated (...) citation, they acknowledge a familiar criticism of medical lore, so that we would expect that they provide a good example of the appreciation of humility in their present article. (shrink)

The establishment of research ethics committees (REC) in China’s higher education institutions (HEI) is lagging far behind western developed countries. This has at least partly directly led to anomie in scientific research ethics, as seen in the recent controversies involving a proposed human head transplant and gene-edited babies. At present, the problems for REC in China’s HEI include lack of regulation, informal ethics reviews, lack of supervision and insufficient ethics review capacity. To counteract these problems, suggested measures include mandatory (...) formation of formal ethics committee, administrative support from HEI, ethics approval letter prior to funding application, formulation of regulations and standard operating procedures, selecting and training for members and independent consultants, training for secretaries and staff, ethics training for investigators, and learning from the experience of HEI outside of China, such as the USA and Canada. The establishment of REC in China’s HEI will greatly enhance the overall quality of ethics reviews in China. In addition to better protecting the rights and welfare of human participants, it is also conducive to maintaining the reputation of China’s HEI. (shrink)

LANGUAGE NOTE | Document text in English ; abstract also in Chinese. The cultural differences between East and West, as well as the differences in attitudes on bioethical issues, are hot topics in the international bioethics community. Scandals in biomedical research in recent years have further increased the prominence and importance of these issues. For example, high-profile cases involving head transplant experimentation and gene-edited babies have provoked international outrage, criticism, and condemnation. Among the responses, there have been reflections on (...) the issue of “why China?” Some researchers blame cultural differences, while others argue that there is a lack of rigorous research ethics oversight in the country. In “The Real Problem With Human Head Transplantation,” it is argued that China “is a country that has a history of taking positions on bioethical issues that diverge from most commonly accepted conceptions of medical and research ethics.” (Abstract taken from first paragraph of document) 當下一系列的生物醫學醜聞以及人們對其多元的反應，突顯了更深入的跨文化生命倫理研究的重要性，以加深多元文化和宗教的理解，促進長期共存和繁榮。作為對Tham文章的拓展，本文駁斥了跨文化生命倫理比較研究中將 中國文化和西方文化的簡單二元對立傳統，提出應警惕兩種錯誤傾向：沙文主義和種族中心主義傾向以及不可通約傾向。. (shrink)

Editorial for issue with articles on tranhumanism, principlism, total body transplants and inter-uterine surgery for myelomeningocele.

While dramatic medical "breakthroughs" routinely grab headlines, health-care providers know their daily lives center much more frequently on mundane issues that the media ignore, such as how doctors and their patients can form more trusting relationships. This anthology for health-care providers and ethics committee members focuses on just such questions. Essays are divided under headings including care at the end of life; patients, families, and health-care decisions; health law; care for severely compromised newborns; issues in transplantation, managed care, resource (...) allocation, and genetic testing; and clinical integrity and professionalism. Weinberg is a medical ethicist who teaches at Philadelphia College of Osteopathic Medicine. Annotation copyrighted by Book News Inc., Portland, OR. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Against Their Wishes: The Gift of a GoodbyeAustin MorrisThink back, if you can, to when you were once a 25-year-old young adult. Think back to your hopes, your dreams, your overall plan and expectations for life and where you think you would end up one day. Now imagine facing your own mortality; life as you have known rapidly approaching an end that you were not able to prepare for (...) prior to its arrival. Imagine the fear, the uncertainty; imagine how your family and friends would feel surrounding you on your deathbed.The above was the reality for one of my patients. He was a 25-year-old gentleman rapidly approaching the end of his life. As a physician, it is our duty to do no harm and provide the best standard of care to each patient we see on a day-to-day basis. In some cases, what truly constitutes the best standard of care is uncertain, and oftentimes, we find ourselves stepping out of medicine and into the world of medical ethics. Upon arrival to the hospital, this patient’s initial decision was to be made full “Do Not Resuscitate” and “Do Not Intubate.” This decision was made while the patient was suffering mild symptoms of alcohol withdrawal. He was evaluated by psychiatry, we reviewed every medical note we had to assess for signs of depression, and ultimately he was deemed competent, demonstrating a mental capacity to understand his current healthcare status and the ramifications of the decision he was making.As a 28-year-old resident physician, my experience with medicine may be limited relative to those surrounding me in the profession. My intuition, though, has been sharpened with numerous experiences over the last two years dealing with patients driven into depression following the COVID pandemic, finding solace in the use of hard liquor, and subsequently suffering the side-effects of its toxicity. This 25-year-old patient, upon initial assessment, appeared closer to the age of 40; his eyes were icteric, his skin was profoundly jaundiced, and his abdomen distended visibly underneath his hospital gown and blanket. His mother sat at his bedside, fully unaware of the severity of his condition. The patient was angry, questioning why he was admitted and shouting at his mom for forcing him to be evaluated. My initial review of his chart was as in-depth as it could be for having such a limited health history available. Despite that, I could see the path that this would head down over the next 48 hours. Withdrawal was inevitable. The likelihood of needing intubation within the next 24 hours was extremely high. The only bit of uncertainty I was left with was whether or not this patient would survive following these anticipated life-saving interventions. I had anticipated that this would be a long, tenuous, and challenging admission requiring the highest level of care both for myself as a physician and through the healthcare system within our hospital as a whole. But what I did not anticipate was discussing whether or not a 25-year-old should be a DNR/DNI patient.By day 2 of the patient’s admission, evaluation by hepatology confirmed my suspicions; this patient was suffering from fulminant liver failure, and without a transplant, he would surely die. However, we were not able to have this discussion with the patient, as his withdrawal had progressed to the point of disorientation and agitation. The brief episodes of consciousness were spaced through long [End Page 5] periods of unresponsiveness. Prior to this, as mentioned above, the patient was alert and oriented x3 and had expressed, in no uncertain terms, a DNR/DNI status; the confounding factor, though, was during his time awake, he had not been evaluated by hepatology and had not been diagnosed with fulminant liver failure. As such, the prospect of a liver transplant, which would provide life-saving treatment and potentially a path back to life as this patient knew it, had not existed then. Knowing that my time was limited before the patient would fail to protect his airway and would inevitably die, I reached back out to the patient’s mother... (shrink)

This book is designed primarily to provide readings for a consideration of the moral issues in medicine from a philosophical point of view. There are two basic alternatives in structuring a philosophical course in medical ethics. One is to divide the course according to medically conceived topics such as organ transplantation, genetic engineering, euthanasie, etc. Such an approach is wholly viable, but we have preferred no to adopt it here. Rather, we have organized the book primarily on the basis (...) of more philosophically inspired categories. Thus, our headings invoke such notions of paternalism, truth, social justice, etc. (shrink)

Philosophers often talk as if what it takes for a person to persist through time were up to us, as individuals or as a linguistic community, to decide. In most ordinary situations it might be fully determinate whether someone has survived or perished: barring some unforeseen catastrophe, it is clear enough that you will still exist ten minutes from now, for example. But there is no shortage of actual and imaginary situations where it is not so clear whether one survives. (...) Here reasonable people may disagree. There are "fission" cases where each of one's cerebral hemispheres is transplanted into a different head; Star-Trek-style "teletransportation" stories; actual cases of brain damage so severe that one can never again regain consciousness, even though one's circulation, breathing, digestion, and other "animal" functions continue; and stories where one's brain cells are gradually removed and replaced by cells from someone else, to name only a few favorites. (shrink)

Is the aim of medicine to avert death at all costs? Are doctors there to prescribe cough drops or to clamp wires on our heads? Should there be abortion on demand? What is medicine for? Vitally important decisions are today being left to an exclusive few- the Biocrats. Gerald Leach believes that there is a need now for wider discussion- informed, accurate and sensible discussion. Here he provides a survey, which has been specially updated for this Pelican edition, of such (...) fields as birth and population control, 'test-tube reproduction', eugenics and genetic engineering, mind drugs, transplants, life-propping machines.... all the fantastic realities made possible by modern bio-medicine. The author brings social, personal and legal considerations to his study and concludes by discussing which alternatives we can afford to pursue. (shrink)

An incisive examination of bioethics and American healthcare, and their profound affects on American culture over the last sixty years, from two eminent scholars. An eye-opening look at the inevitable moral choices that come along with tremendous medical progress, Everybody Wants to Go to Heaven but Nobody Wants to Die is a primer for all Americans to talk more honestly about health care. Beginning in the 1950s when doctors still paid house calls but regularly withheld the truth from their patients, (...) Amy Gutmann and Jonathan D. Moreno explore an unprecedented revolution in health care and explain the problem with America’s wanting everything that medical science has to offer without debating its merits and its limits. The result: Americans today pay far more for health care while having among the lowest life expectancies and highest infant mortality of any affluent nation. Gutmann and Moreno—“incisive, influential, and pragmatic thinkers” (Arthur Caplan)—demonstrate that the stakes have never been higher for prolonging and improving life. From health care reform and death-with-dignity to child vaccinations and gene editing, they explain how bioethics came to dominate the national spotlight, leading and responding to a revolution in doctor-patient relations, a burgeoning world of organ transplants, and new reproductive technologies that benefit millions but create a host of legal and ethical challenges. With striking examples, the authors show how breakthroughs in cancer research, infectious disease, and drug development provide Americans with exciting new alternatives, yet often painful choices. They address head-on the most fundamental challenges in American health care: Why do we pay so much for health care while still lacking universal coverage? How can medical studies adequately protect individuals who volunteer for them? What’s fair when it comes to allocating organs for transplants in truly life-and-death situations? A lucid and provocative blend of history and public policy, this urgent work exposes the American paradox of wanting to have it all without paying the price. (shrink)

Animalism is the view that you and I are animals. That is, we are animals in the straightforward sense of having the property of being an animal, or in that each of us is identical to an animal-not merely in the derivative sense of having animal bodies, or of being "constituted by" animals. And by 'animal' I mean an organism of the animal kingdom." Sensible though it may appear, animalism is highly contentious. The most common objection is that it conflicts (...) with widespread and deep beliefs about our identity over time. These beliefs are brought out in reactions to fictional cases. Suppose, for instance, that your brain is transplanted into my head. The being who ends up with that organ, everyone assumes, will remember your life and not mine. More generally, he will have your beliefs, preferences, plans, and other mental properties, for the most part at least. Who would he be-you, me, or someone else? (shrink)

In lieu of an abstract, here is a brief excerpt of the content: -/- I gathered it in my hands as it fell from my hair-brush, too saturated to hold anymore. It felt as if I were inside a movie and waiting for someone to yell “Cut!” but no call came. It continued to fall, feather-like onto the ground, individual strands glinting in the light of the bathroom window. My hair, nearly all of it, was gone. Between the time of (...) my heart transplant and the moment my hair began to fall out, I arguably had suffered enough. Transplant brought four open-heart surgeries, ten days on ECMO, an intra-aortic balloon pump, delirium, necrotizing pneumonia, and so much muscular atrophy that I had to re-learn how to walk. CPR, broken ribs, and the scar of a tricuspid clip from a botched biopsy: it was not the miracle I was hoping for. The internal trauma had certainly taken its toll. I no longer knew how I really felt, thanks to copious pain meds that altered my mind and body. Each limb was foreign as I re-acclimated to how one grabs hold of a cup, signs their name, touches their legs. Externally, I was a mess: covered in deep purple bruises across my torso from the diabetes treatments, dead skin pooling in unwashed pores, my ankles swollen and indiscernible from my legs. But lacking a good mirror (or the desire to find one), I still felt like “myself” during my forty-five day hospital stay. I could feel my cheekbones protruding from thinning skin, saw through unfocused eyes from the tempestuous blood sugars, and my hair sat in a rat’s nest atop my head; but I was still me. -/- Arriving home, I felt like a newborn being brought into the real world for the first time. I needed help with everything—showers, sitting up, putting on shoes, even going to the bathroom. At age twenty-four, I felt I had regressed to the point of no return as I relied on others to do the simplest tasks. In addition, I was quarantined inside for three months, due to the risk of obtaining a fungal infection from the outside. Caged, and alone in my body, I a trapped and wounded tiger: angry, hurting, and scared. [End Page 109]When I had been prepared for transplant—and I use “prepared” loosely because the information packet I was handed was insulting at best—I knew to expect the scars. I had no issue with that, having been cut open at my throat and chest for previous surgeries. I knew to expect a 12-inch line from neck to navel: the most evident sign I would now carry that I was disabled. -/- What I did not expect were the bullet holes— the sealed entrances of thick chest tubes that now dotted my lower torso. I did not anticipate the bruises on my arms and groin from arterial pokes. I felt violated as if I had walked into some kind of abduction and was rolled out, beaten, bruised, and, worst, touched. But it wasn’t the physical trauma that hurt the most. It was that no one seemed surprised. Immediately after transplant, the team’s focus is purely on survival. Survive the 30 days post-surgery. Survive the year. Metrics, uncomfortably tied to transplant center success statistics, funding, and clout have little to do with the patients themselves. What did I care to only survive a year? I wanted years. I wanted decades. It felt I wanted more than anyone was willing to pay attention to. -/- The conversation was narrowed to high-risk issues: infection, rejection, or other life-threatening conditions. While this makes sense on a clinical level, what constitutes a major event for a clinician may not be of the same emotional value to the patient. In my case, I was less occupied by how the steroids were working and more obsessed with their side effects, such as how much weight I was rapidly gaining. I walked into the clinic one day with the beginnings of stretch marks and a week later had claw-like ripples down my sides. My mood swings were explosive... (shrink)

On October 25, 1946, three weeks after the International Military Tribunal at Nuremberg entered its verdicts, the United States established Military Tribunal I for the trial of twenty-three Nazi physicians. The charges, delivered by Brigadier General Telford Taylor on December 9, 1946, form a seminal chapter in the history of medical ethics and, specifically, medical ethics in war. The list of noxious experiments conducted on civilians and prisons of war, and condemned by the Tribunal as war crimes and as crimes (...) against humanity, is by now more or less familiar. That list included: high-altitude experiments; freezing experiments; malaria experiments; sulfanilamide experiments; bone, muscle, and nerve regeneration and bone transplantation experiments; sea water experiments; jaundice and spotted fever experiments; sterilization experiments; experiments with poison and with incendiary bombs. What remains less familiar is the moral mindset of doctors and health care workers who plied their medical skill for morally questionable uses in war. In his 1981 work, The Nazi Doctors, Robert Jay Lifton took up that question, interviewing doctors, many of whom for forty years continued to distance themselves psychologically from their deeds. The questions about moral distancing Lifton raised have immediate urgency for us now. Military medical doctors, psychiatrists and psychologists serve in U.S. military prisons in Guantánamo, Abu Ghraib, Kandahar, and, until very recently, in undisclosed CIA operated facilities around the world where medical ethics are again at issue. Moreover, they serve in top positions in the Pentagon, as civilian and military heads of command, who pass orders and regulations to military doctors in the field, and who are in charge of the health of enemy combatants, as well as U.S. soldiers. Because we recently marked the sixtieth anniversary of the judgment at Nuremberg, I want to awaken our collective memory to the ways in which doctors in war, even in a war very different from the one the Nazis fought, can insulate themselves from their moral and professional consciences. (shrink)

This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: ‘basic elective ventilation’; ‘epistemically complex elective ventilation’; ‘practically complex elective ventilation’; and ‘epistemically and practically complex elective ventilation’. (...) I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation. (shrink)

This book examines the metaphilosophy that underlies the work of Arthur Schopenhauer and discusses important questions concerning the proper nature and aims of philosophy. It sheds vital new light on a thinker whose ideas continue to both provoke and inspire.

This expanded new edition of Law in Perspective focuses on a range of powerful critical thinking tools drawn from logic, science, ethics, and political and social theory. Information on terrorism and refugee law has been fully updated, climate change is discussed throughout, and new chapters have been added on law and Indigenous people, lawyers' ethics and corporate power. The book considers the relationship between legal theory, social theory and empirical research methods, as a guide for students taking on higher degrees (...) in legal research. It also analyzes key theories of the nature and social role of law. (shrink)

This ambitious book examines the notion of legal transparency from a unique cultural and historical perspective. Drawing from their combined academic and practical experience with both Chinese and Western legal traditions, authors John Head and Xing Lijuan explore how an intense debate — pitting legal transparency against legal opaqueness — unfolded in dynastic Chinese law, which began in the dark mists of history and ended formally just over a hundred years ago. They rely on a wide range of both (...) Western and Chinese sources to explain how that great debate was resolved in the early Han Dynasty (around the third century BCE) in a way that molded Chinese law into a sophisticated legal system that for roughly two millennia balanced definitiveness with vagueness, predictability with flexibility, and egalitarianism with privilege — and that reflected cultural values still resonating in China today. Legal Transparency in Dynastic China presents a clear narrative that assumes no prior expertise in Chinese law or history, and it caters to readers interested in issues of good governance, comparative studies, China, history, and law. The book begins by defining “legal transparency” and explaining where it fits into the larger context of the transparency-in-government movement that has gained such momentum in recent years, especially at the urging of Western powers. Then the book explains the fundamentally different values espoused by early Confucianists, for whom society is best governed not through written law but through the exemplary behavior of a highly educated, virtuous, and enlightened elite. After tracing the political and ideological challenges that the Confucianists faced from the Legalists, Head and Xing examine the compromise that resulted in the so-called “Confucianization of the Law” around 200 BCE. They then show how that alloy of competing ideologies characterized Chinese dynastic law for many centuries, resulting in what some would consider the most enduring and effective legal system in human history. (shrink)

. POLITICAL AND INTELLECTUAL BACKGROUND PERSPECTIVES ON TRACY AND THE IDEOLOGUES Tracy and the ideologues have been forgotten and "rediscovered" several ...

This classic anthology offers ancient and modern perspectives on Job's question: 'If a man die, shall he live again?' Spanning over 5,000 years of world thought, the selections invite consideration of an idea that has found hospitality in the greatest minds of history.

First published in 1987. This study describes and analyses the published writings of the French philosopher Antoine Destutt de Tracy. The author focuses on the three decades from the calling of the Etats-généraux to the early years of the Restoration - the period of Tracy's entire literary production, and the period of his greatest influence and reputation. This title will be of great interest to students of history, philosophy and politics.

Introductory chapter, 'Comparing Kant and Sartre' (ed. Baiasu).

ABSTRACTThis paper seeks to shed light on the often-overlooked account of divine and human freedom presented by Anne Conway in her Principles of the Most Ancient Modern Philosophy, partly through a...

This volume collects 12 essays by various contributors on the subject of the importance and influence of Schopenhauer’s doctoral dissertation for both Schopenhauer’s more well-known philosophy and the ongoing discussion of the subject of the principle of sufficient reason. The contributions deal with the historical context of Schopenhauer’s reflections, their relationship to idealism, the insights they hold for Schopenhauer’s views of consciousness and sensation, and how they illuminate Schopenhauer’s theory of action. This is the first full-length, English volume on Schopenhauer’s (...) Fourfold Root and its relevance for Schopenhauer’s philosophy. The thought-provoking essays collected in this volume will undoubtedly enrich the burgeoning field of Schopenhauer-studies. (shrink)