It Takes Two: Ethical Dualism in the Vegetative State
- PDF / 171,723 Bytes
- 12 Pages / 547.087 x 737.008 pts Page_size
- 23 Downloads / 207 Views
ORIGINAL PAPER
It Takes Two: Ethical Dualism in the Vegetative State Carolyn Suchy-Dicey
Received: 18 October 2008 / Accepted: 18 February 2009 / Published online: 19 May 2009 # Springer Science + Business Media B.V. 2009
Abstract To aid neuroscientists in determining the ethical limits of their work and its applications, neuroethical problems need to be identified, catalogued, and analyzed from the standpoint of an ethical framework. Many hospitals have already established either autonomy or welfare-centered theories as their adopted ethical framework. Unfortunately, the choice of an ethical framework resists resolution: each of these two moral theories claims priority at the exclusion of the other, but for patients with neurological pathologies, concerns about the patient’s welfare are treated as meaningless without consideration of the patient’s expressed wishes, and vice versa. Ethicists have long fought over whether suffering or autonomy should be our primary concern, but in neuroethics a resolution of this question is essential to determine the treatment of patients in
A similar, more established quasi-pluralistic framework could be found in the medical ethics literature under Tom Beauchamp and James Childress’ Principles of Biomedical Ethics. My paper deviates from this text in many ways, but especially in the inclusion of autonomy and happiness as part of ethical theories, rather than guiding principles. C. Suchy-Dicey (*) Boston University, 745 Commonwealth Ave, Boston, MA 02215, USA e-mail: [email protected]
medical and legal limbo. I propose a solution to this problem in the form of ethical dualism. This is a conservative measure in that it retains both sides of the debate: both happiness and autonomy have intrinsic value. However, this move is often met with resistance because of its more complex nature—it is more difficult to make a decision when there are two parallel sets of values that must be considered than when there is just one such set. The monist theories, though, do not provide enough explanatory power: namely, I will present two recently publicized cases where it is clear that neither ethical value on its own (neither welfare nor autonomy) can fully account for how a vegetative patient should be treated. From the neuroethical cases of Terri Schiavo and Lauren Richardson, I will argue that a dualist framework is superior to its monist predecessors, and I will describe the main features of such an account. Keywords Schiavo . Richardson . Vegetative . Laureys . Autonomy . Utilitarianism . Kantianism . Pluralism
Presuppositions In this paper, I will look at two cases concerning neuroscientific practice. In the next section I describe two moral frameworks that are typically used in
126
addressing these problems, referred to here as the autonomy and welfare-centered approaches. Importantly, my argument for dualism rests on the prior acceptance of at least one of these ethical principles. If the reader is not committed to either, I do not here have an argument against competing theories, such as
Data Loading...
