Lecture on Death and Abortion Ethics
THE DEFINITION OF DEATH
1. Types of Death
Whole Brain Death: This is defined as "the irreversible loss of functioning of the entire brain (including the brainstem)."
Higher Brain Death: This refers to the irreversible loss of consciousness due to the loss of function of the cerebral cortex.
Persistent Vegetative State (PVS): A condition classified under higher brain death where the entire cortex has been destroyed, leading to the complete absence of consciousness, but the brainstem remains functional. Patients in PVS may exhibit "periods of wakefulness without awareness."
2. Legal Death in the U.S.
According to the Uniform Determination of Death Act (UDDA), a person is legally dead if they meet one of the following two conditions:
There is an irreversible cessation of circulatory or respiratory functions.
There is an irreversible cessation of all functions of the entire brain, including the brainstem.
3. What is the UDDA?
The UDDA was enacted in 1981 to codify the legal definition of death in all 50 states, with minor religious exemptions in New Jersey and New York.
4. Revision of the Definition of Death
Historically, death was defined as the irreversible cessation of heart and lung function. However, the advent of ventilators allowed some patients to retain heartbeats and breathing artificially, complicating the determination of death.
The Dead Donor Rule suggests that organ donations should only be taken from individuals who have been declared dead, hence necessitating a redefinition of death as whole brain death to ensure ethical compliance in organ procurement.
5. Jahi McMath Case
Jahi McMath was a 13-year-old girl who suffered significant brain injury after surgery. She met the criteria for whole-brain death, yet her family asserted that she was still alive. This case prompted discussions regarding:
The equivalence of brain death and biological death.
Observations of racial bias.
The critical issue of public trust in medical practices.
The implications surrounding whether brain-dead individuals can suffer harm, among other topics.
6. Ethical Issues from the Aviv Article
Various ethical quandaries were raised, including:
Metaphysical: At what point do we cease to exist?
Ethical: Should families have the authority to maintain the life of someone who has irreversibly lost consciousness?
Epistemic: How certain must medical professionals be about a diagnosis?
Issues related to race and unequal treatment.
Moral distress experienced by healthcare workers.
The significance of public trust in the medical field.
The question of harm towards those who are dead or irreversibly unconscious.
The role of hope in such scenarios.
7. Marlize Munoz & Adriana Smith
Both women were declared brain dead while pregnant and were kept on life support due to state laws mandating this:
Marlize Munoz: In Texas, state law required the sustenance of her body despite her family's wishes against life support based on her advance directive.
Adriana Smith: In Georgia, a law prohibiting abortion after fetal heartbeat required sustaining her body as well, similarly against the family's wishes.
8. Brain Death Does Not Equal Biological Death (Truog & Miller)
The authors present a three-point argument:
A biological organism is solely considered dead when it irreversibly loses the capability to maintain integrated functioning as a complete entity.
Brain-dead individuals can still manage integrated bodily functions (circulation, metabolism, gestation) while on ventilatory support.
Therefore, brain-dead patients may still be classified as biologically alive.
Counterargument: The claim that needing technological support indicates a lack of life is refuted, as numerous patients rely on machines (e.g., dialysis, pacemakers) yet are considered alive.
9. Legal Status of Brain Death
Despite brain death not being conceptualized as biological death, it serves functional purposes within ethical, legal, and practical frameworks:
The analogy provided is: Legal blindness does not equate to total blindness but rather means being blind for most intents and purposes.
Similarly, establishing brain death means being considered "dead for most intents and purposes."
10. Opinions on the Dead Donor Rule
Truog & Miller dismiss the Dead Donor Rule as an inadequate basis for organ donation practices.
They propose a more suitable rule: "Do not harm or wrong the donor." Since brain-dead individuals cannot be harmed, organ procurement might be acceptable even if these individuals are biologically alive.
11. Ethical Consideration of Organ Procurement from the Biologically Alive
According to Truog & Miller, it is morally permissible to procure organs from an individual deemed brain dead, even if they retain biological life, provided that they cannot be harmed.
THE ETHICS OF ABORTION: THOMSON & MARQUIS
12. Roe v. Wade — Justification & Legal Outcome
Justification: The U.S. Constitution affords a right to privacy that encompasses choices regarding bearing or begetting a child.
Legal Outcomes:
During the first trimester, states are prohibited from regulating abortion.
In the second trimester, states may implement regulations around maternal health.
After viability, states can impose abortion prohibitions, albeit with exceptions.
13. Dobbs v. Jackson
The Dobbs decision reversed the precedents established by Roe and Casey, eliminating federal constitutional protections regarding abortion. States are now permitted to enact bans at any point during pregnancy.
14. Understanding Sentience
Sentience: Defined as "the capacity to have conscious experience."
Examples:
Rocks: Not sentient.
Trees: Not sentient.
Kangaroos: Sentient.
Fetuses: The prevailing medical consensus indicates that sentience does not develop until around 24 to 25 weeks of gestation.
15. Line-Drawing / Sorites Fallacy
A Sorites Fallacy is articulated as follows: "Because we cannot clearly identify the distinct point where X becomes Y, we conclude that there is no difference between X and Y."
Example: The transformation of an acorn into an oak tree lacks an identifiable moment, but this does not justify equating acorns with oak trees.
Thomson's Use: She employs this fallacy to critique arguments asserting that a fetus must be considered a person from the moment of conception due to the inability to pinpoint "personhood".
16. Thomson's Assumption on Fetal Personhood
Thomson assumes the fetus is a person for the purpose of argumentation to demonstrate that even assuming personhood, abortion can still be justified.
Her personal stance is that early fetuses are not persons, while late-term fetuses may arguably attain personhood.
17. The Violinist Thought Experiment
Hypothetical Scenario: You awaken connected to a famous violinist requiring your kidneys for survival over a period of 9 months. Is it ethical to disconnect?
Thomson's Conclusion: Yes, it is permissible to unplug because there was no consent given to utilize one's body.
Implication: This illustrates that even if a fetus is deemed a person, a woman is not necessarily obliged to maintain its life, notably in cases of rape.
18. Is Staying Plugged In Supererogatory?
Thomson denotes that remaining connected to the violinist can be classified as supererogatory, meaning it is morally commendable yet not obligatory.
Examples of Supererogatory Actions: Choosing tea over coffee represents a morally neutral decision.
19. Right to Life Explained
Thomson posits that the right to life does not equate to a right for provision of all necessities required for survival.
20. Comparison of Violinist & Henry Fonda Cases
Violinist Example: Although the violinist requires your kidneys, he possesses no right to them.
Henry Fonda Example: Even if his touch could save your life, he is not obligated to traverse the country to provide assistance. Thus, the right to life does not incorporate the right to use another person's body.
21. The ‘Extreme View’ on Abortion
Defined as the perspective that asserts abortion is impermissible under all circumstances, even to preserve a woman’s life.
22. Refutation of the Extreme View by Thomson
Utilizing the growing baby as a self-defense scenario, Thomson illustrates that if a fetus poses a threat to the mother’s life, the mother is justified in protecting herself.
Therefore, abortion could be justified in scenarios where the mother's life is at risk.
23. Weaker Version of the Extreme View & the Coat Example
Weaker View: Permits a mother to abort for self-preservation but denies the doctor any involvement in the procedure.
Thomson’s Counter: The mother “owns the house” (her body) and thus a third party can help her defend her autonomy, analogous to giving Jones his coat instead of allowing Smith to take it.
24. Right to Life Distinction
Thomson argues that the right to life should be viewed as the right not to be killed unjustly rather than an absolute right not to be killed.
25. People Seeds Analogy
People seeds metaphor represents entities that float around and can take root in a home unless preventive measures (contraceptives) are employed. If a seed takes hold despite precautions, no consent has been given for the use of one's premises for the unintended pregnancy.
Conclusion: This indicates that contraception is a legitimate means to express lack of consent towards pregnancy.
26. Thomson’s Stance on Abortion
Thomson asserts that while some abortions are morally permissible (such as those in cases of rape, life-threatening conditions, or significant burden), others may pose moral issues (e.g., aborting a 7-month fetus just to avoid delaying a trip).
27. Marquis’s Critique of Standard Arguments
Both opposing views commonly hinge on the assertions that:
“Fetuses are human.”
“Fetuses aren’t persons.”
Marquis critiques that these assertions necessitate an underlying moral principle connecting the property to the wrongness of killing, which lacks solid justification from either stance.
28. Why is Killing Considered One of the Worst Crimes?
Killing is viewed as one of the gravest crimes because it deprives the victim of all experiences, activities, projects, and enjoyments of their future.
29. Deprivation Theory of Death
Marquis posits that death is detrimental due to the loss of a potentially valuable future, forming the backbone of his argument on the immorality of killing.
30. Definition of a “Future Like Ours” (FLO)
An FLO is a future encompassing valuable experiences, meaningful relationships, and fulfilling projects.
31. Marquis's Position on Killing and FLO
Marquis clarifies that while depriving someone of a FLO is a sufficient condition for determining wrongness regarding killing, it is not a necessary condition.
32. Does FLO Render Active Euthanasia Incorrect?
No, Marquis asserts that if someone lacks a valuable future (such as in terminal conditions), terminating their life may not result in depriving them of an FLO, thereby not rendering killing unequivocally wrong in such situations.
33. Argument Against Abortion's Immorality
Marquis outlines a structured approach:
Killing is deemed wrong due to its nature of depriving an entity of a FLO.
Fetuses embody an FLO.
Therefore, abortion is fundamentally considered seriously immoral (prima facie).
Prima facie: interpreted as wrong at first glance unless countered by stronger justifications, although Marquis does not deem abortion as impermissible in all scenarios, allowing specific exceptions such as safeguarding the mother's life.
34. Contraception Objection
If the premise is true that killing is wrong because it deprives an individual of an FLO, then it follows that contraception would also be seen as wrong as it obstructs the potential creation of a FLO.
35. Marquis’s Response to the Contraception Objection
Prior to conception, there is no defined individual capable of being deprived of a FLO, thus contraception does not stand as a moral offense because it involves no individual being affected.
36. Possible Stances If Marquis is Incorrect
Rejecting Marquis's argument does not necessitate a pro-choice position; alternative philosophical bases for opposing abortion might be available.
37. Desire for Life and Harm by Death
Marquis does not support the claim that an entity must possess a desire for life in order to be wronged by its death.
He refutes the