Moral Conflicts of Organ Retrieval

A Case for Constructive Pluralism

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This book addresses ethical conflicts arising from saving the lives of patients who need a transplant while treating living and dead donors, organ sellers, animals, and embryos with proper moral regard. Our challenge is to develop a better world in the light of debatable values and uncertain consequences.

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Charles Hinkley teaches philosophy at Texas State University–San Marcos, Texas in the United States. He took the MA in philosophy from Bowling Green State University and the PhD in the medical humanities from the University of Texas Medical Branch at Galveston, Texas. His current research interests include the sources of moral disagreement, preventive medicine, and moral psychology. Along with his research interests, Dr. Hinkley is committed to increasing his anti-war efforts and his support for those suffering from mental illness.
 Acknowledgments

 Introduction


Part 1: A Philosophical Framework



1 Dilemmas, Conflicts, and Residue
 1 Terminology
 2 Moral Residue
 3 Epistemology and Ontology of Dilemmas
 4 Dilemmas and Deontic Logic
 5 Guilt, Regret, and Remorse
 6 Autonomy and Wrongdoing
 7 Survivor’s Guilt
 8 The Nature of Emotion
 9 Residual Requirements to Act
 10 Can We Do without Residue?
 11 Intuitively Knowing Dilemmas
 12 Conclusion

2 Medical Ethics and Its Limitations
 1 Cliff’s Choice
 2 Beauchamp and Childress’s Principlism
 3 Virtue Ethics
 4 Feminist Bioethics
 5 Case Analysis
 6 Engelhardt’s Postmodern Libertarianism
 7 Gert, Culver, and Clouser on Common Morality
 8 Cliff’s Choice Revisited
 9 Conclusion

3 Pluralism, Incommensurability, and Weighing
 1 Moral Pluralism
 2 Incommensurability
 3 Covering Values
 4 The Plurality of Values
 5 The Calculation of Values
 6 The Irresolvability of Conflict
 7 Education and Skill
 8 Merited Desire Strength
 9 Weighing Our Options
 10 Conclusion


Part 2: Conflicts of Organ Retrieval



4 Transplant Recipients’ Quality of Life
 1 Heart Transplants
 2 Liver Transplants
 3 Kidney Transplants
 4 Conclusion

5 Can We Wrong the Dead?
 1 Bioethics and Patient Autonomy
 2 The Pitcher-Feinberg Thesis
 3 Callahan’s Challenge
 4 Serafini’s Thesis
 5 Symbolic Action and the Preferences of the Living
 6 For the Living
 7 Conclusion

6 Defining Death
 1 Historical Background for the Whole-Brain Definition of Death
 2 Problems with the Whole-Brain Definition of Death
 3 The Higher-Brain Definition
 4 Revisiting the Whole-Brain Definition
 5 The Cardiopulmonary Definition
 6 Renewed Challenges to Whole Brain Death
 7 Is Defining Death a Moral Issue?
 8 Conclusion

7 The Selling of Organs
 1 Models of Organ Vending
 2 Cultural Values and Meaning
 3 Financial Incentives and the Supply of Organs
 4 Commodification
 5 Defenders of Organ Sales and Their Critics
 6 Risks of Living Donation
 7 Respect for Persons
 8 Cadaveric Organ Sales and the Altruistic Tradition
 9 Conclusion

8 Xenografts
 1 Historical Background
 2 Qualitative Distinctions and Human Privilege
 3 Risks to Third Parties
 4 Responding to Risk
 5 The Prospects of Xenografts
 6 Conclusion

 9 Stem Cell Research
 1 United States Policy
 2 The Moral Status of Early Human Life Forms
 3 Property Rights
 4 Adult Stem Cells
 5 iPSCs
 6 Conclusion


Part 3: A Philosophical Response



10 The Regulative Principle
 1 Marcus’s Regulative Principle
 2 Mothersill on the Regulative Principle
 3 The Regulative Principle and Dilemmas
 4 The Regulative Principle and Conflicts
 5 Implications for Prevention
 6 Prevention
 7 Conclusion

11 Constructive Pluralism
 1 Rationality amid Incommensurability
 2 Routine Retrieval, Presumed Consent, and Familial Consent
 3 The Definition of Death
 4 Selling Organs
 5 Xenotransplants
 6 Stem Cell Research
 7 Additional Strategies
 8 Sets of Strategies
 9 Conclusion

 Conclusion

 Bibliography
 Author Index
 subject Index
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