Defining DeathDefining Death

Religious Ethics, Feminism, Religious Ethics, Feminism, VirtueVirtue

Whole Brain DeathWhole Brain Death

Zero likelihood of recoveryZero likelihood of recovery Easily used diagnostic criteriaEasily used diagnostic criteria Claim: Not a new idea of death as Claim: Not a new idea of death as

much as a new way to find out when much as a new way to find out when respirator obscures “usual” signsrespirator obscures “usual” signs

Views us as biological organisms not Views us as biological organisms not “persons”-- consistent with standard “persons”-- consistent with standard terminologyterminology

Success of Whole Brain Success of Whole Brain DeathDeath

Adopted as legal standardAdopted as legal standard Widely applied in clinical practiceWidely applied in clinical practice Still misunderstandings over Still misunderstandings over

concept and terminology-- can concept and terminology-- can mislead familiesmislead families– ““Brain dead” vs “dead”Brain dead” vs “dead”– ““Life support machines”Life support machines”– Ask permission to stop respiratorAsk permission to stop respirator

Challenges to Whole BrainChallenges to Whole Brain

Conceptual: We care about the Conceptual: We care about the deaths of persons, not bodies (so deaths of persons, not bodies (so higher brain standard better)higher brain standard better)

Scientific: Whole brain death is a Scientific: Whole brain death is a myth (but: brain has lost its myth (but: brain has lost its coordinating role among body coordinating role among body systems)systems)

Religious exemptionsReligious exemptions

New Jersey lawNew Jersey law Inconsistent?Inconsistent?

– Patients in adjacent ICU beds, same Patients in adjacent ICU beds, same physiological state, one dead and one physiological state, one dead and one alive based on religionalive based on religion

– Resurrection by crossing state line?Resurrection by crossing state line? Value of consistency vs. respect Value of consistency vs. respect

for “minority” religious beliefsfor “minority” religious beliefs

Religious ApproachesReligious Approaches

What is proper role of religious What is proper role of religious arguments in a democratic, liberal, arguments in a democratic, liberal, pluralistic state?pluralistic state?

““Liberal” here means trying to Liberal” here means trying to maximize individual freedom, maximize individual freedom, similar view to what is expressed similar view to what is expressed in Declaration of Independencein Declaration of Independence

One Liberal TheoryOne Liberal Theory

Distinguish private vs. publicDistinguish private vs. public Private practice of religion fully Private practice of religion fully

protected as basic rightprotected as basic right Public appeal to religion as basis for Public appeal to religion as basis for

law, policy is a violation of law, policy is a violation of separation of church and stateseparation of church and state

Therefore, religious arguments out Therefore, religious arguments out of bounds in public arenaof bounds in public arena

ObjectionsObjections

Many (but not all) religious Many (but not all) religious arguments can be reframed or arguments can be reframed or reformulated as secular argumentsreformulated as secular arguments

The more deeply one feels The more deeply one feels committed to a religious source for committed to a religious source for ethics, the more one is forced to ethics, the more one is forced to misrepresent the origins of one’s misrepresent the origins of one’s thought when debating in publicthought when debating in public

Religious Differences as a Religious Differences as a Social GoodSocial Good

If all people thought alike in terms of If all people thought alike in terms of religion, little insight or learning from religion, little insight or learning from give and takegive and take

We all become wiser when more We all become wiser when more different viewpoints are raised in different viewpoints are raised in public discussionpublic discussion

Therefore, narrow liberal theory robs Therefore, narrow liberal theory robs public discourse of a valuable resourcepublic discourse of a valuable resource

A Broader TheoryA Broader Theory

Distinguish two arguments:Distinguish two arguments: ““Let me explain my religious-Let me explain my religious-

ethical conclusions so that you can ethical conclusions so that you can rationally evaluate them and see if rationally evaluate them and see if you can learn from them”you can learn from them”

““My religious-ethical position is My religious-ethical position is right and all others are wrong, so right and all others are wrong, so mine should be the basis for law”mine should be the basis for law”

A Broader TheoryA Broader Theory

First argument totally consistent First argument totally consistent with liberal goalswith liberal goals

Second argument is Second argument is illiberal illiberal (would create state religion)(would create state religion)– Cannot prohibit (free speech)Cannot prohibit (free speech)– Should not be encouragedShould not be encouraged

Feminist EthicsFeminist Ethics

No one unified feminist theoryNo one unified feminist theory A spectrum of feminist positionsA spectrum of feminist positions In popular press “feminism” often In popular press “feminism” often

confused with most extreme confused with most extreme positionspositions

Basic stance: “Exploitation of Basic stance: “Exploitation of women based solely on their women based solely on their gender is wrong”gender is wrong”

Feminist CritiqueFeminist Critique

History of Western thought is largely a History of Western thought is largely a history written by males about maleshistory written by males about males

This history often treats the This history often treats the experiences and lives of women as experiences and lives of women as invisibleinvisible

Thus Western thought is half-thought, Thus Western thought is half-thought, impoverished by elimination of much impoverished by elimination of much valuable human experiencevaluable human experience

Palliative CarePalliative Care

MenMen Cure diseaseCure disease MedicineMedicine ToughTough ScienceScience Highest priority in Highest priority in

today’s medicinetoday’s medicine

WomenWomen Care for symptomsCare for symptoms NursingNursing TenderTender SympathySympathy Much lower Much lower

priority in today’s priority in today’s medicinemedicine

Dilemma Ethics vs. Dilemma Ethics vs. Preventive EthicsPreventive Ethics

Resolve dilemma-- exciting; Resolve dilemma-- exciting; demands action nowdemands action now

Prevent dilemma from arising in Prevent dilemma from arising in first place-- often requires relatively first place-- often requires relatively boring attention to repetitive detail boring attention to repetitive detail such as developing and such as developing and implementing sound hospital implementing sound hospital policies (“women’s work”)policies (“women’s work”)

Justice vs. Care?Justice vs. Care?

Men tend to resolve ethical Men tend to resolve ethical problems in terms of rules and problems in terms of rules and principlesprinciples

Women tend to resolve ethical Women tend to resolve ethical problems in terms of maintaining problems in terms of maintaining important relationshipsimportant relationships

Is this biology or socialization?Is this biology or socialization? Why one or the other?Why one or the other?

Emotion in EthicsEmotion in Ethics

Traditional rationalism: no room for Traditional rationalism: no room for emotion (seeing the world through emotion (seeing the world through a cloudy lens)a cloudy lens)

Lack of emotion as an ethical Lack of emotion as an ethical weakness?weakness?

Emotions as an important ethical Emotions as an important ethical data even if not enough to resolve data even if not enough to resolve issue?issue?

Virtue EthicsVirtue Ethics

Virtues = excellences in human Virtues = excellences in human conductconduct

Virtuous behavior is good in and for Virtuous behavior is good in and for itself, not because it produces other itself, not because it produces other goodsgoods

To be truly virtuous often requires a To be truly virtuous often requires a lifetime of practicelifetime of practice

Virtuous behavior is done for the right Virtuous behavior is done for the right reasons and with the right attitudereasons and with the right attitude

Holier than thou?Holier than thou?

Ideally I am concerned about my own Ideally I am concerned about my own virtue, not pointing fingers at othersvirtue, not pointing fingers at others

Is a scold or petty gossip an example Is a scold or petty gossip an example of “excellence in human conduct”?of “excellence in human conduct”?

The “obituary test” (videotape vs. The “obituary test” (videotape vs. snapshot view of ethics; living a snapshot view of ethics; living a morally good life)morally good life)

Virtuous BehaviorVirtuous Behavior

What would a virtuous person do in this What would a virtuous person do in this situation?situation?

Requires careful inquiry into the detailsRequires careful inquiry into the details Requires application of judgment or Requires application of judgment or

prudential wisdom-- cannot be reduced prudential wisdom-- cannot be reduced to rules or formulato rules or formula

Aristotle: prudential wisdom as “master Aristotle: prudential wisdom as “master virtue”virtue”

Assessing VirtueAssessing Virtue

Sometimes focus on self might Sometimes focus on self might lead to neglect of others’ rightslead to neglect of others’ rights

Best suited to issues of character Best suited to issues of character and integrityand integrity

Important virtues in health careImportant virtues in health care– CompassionCompassion– CourageCourage