Kennedy Institute of Ethics journal
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Kennedy Inst Ethics J · Dec 1995
ReviewPerish and publish: non-heart-beating organ donation and unduly iterative ethical review.
In the expanding repertoire of practices designed to increase the supply of organs for transplantation, non-heart-beating cadaver organ donation has generated an ongoing debate in the literature. The continuing stream of articles is disquieting in part because it documents a troubling "trial-and-error ethics" approach to the formulation of organ procurement policy, and because it raises serious questions about the reasons that the development of this policy is being mediated by published communication. In the light of concerns about the implicit support and credibility that professional publications give to organ procurement policies, restraint in publishing articles about non-heart-beating organ donation as well as in devising such policies is strongly advocated.
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Understanding the philosophical foundations of the principle of respect for autonomy is essential for its proper application within medical ethics. The foundations provided by Immanuel Kant's principle of humanity and John Stuart Mill's principle of liberty share substantial areas of agreement including: the grounding of respect for autonomy in the capacity for rational agency, the restriction of this principle to rational agents, and the important distinction between influence and control. Their work helps to clarify the scope and role of the principle of respect for autonomy in health care delivery; its implications for truth telling, informed consent, and confidentiality; and its relationship to other moral principles, such as beneficence and distributive justice.
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Kennedy Inst Ethics J · Sep 1992
ReviewReligious ethics and active euthanasia in a pluralistic society.
This article sets out a descriptive typology of religious perspectives on legalized euthanasia--political advocacy, individual conscience, silence, embedded opposition, and formal public opposition--and then examines the normative basis for these perspectives through the themes of sovereignty, stewardship, and the self. It also explores the public relevance of these religious perspectives for debates over legalized euthanasia, particularly in the realm of public policy. ⋯ Nonetheless, religious traditions can provide a context of ultimacy and meaning to this debate, which is a condition for genuine pluralism. A table setting out the views of various denominations with regard to euthanasia is included.
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Kennedy Inst Ethics J · Jun 1992
Review Historical ArticleTriage and equality: an historical reassessment of utilitarian analyses of triage.
We distinguish and review aspects of the history of two models of triage: egalitarian and utilitarian. Egalitarian triage is widely and successfully practiced in battlefield medicine, as well as in the emergency room and the ICU. Utilitarian triage has been sporadically practiced and typically collapses under the pressure of public scrutiny. Unfortunately, the two models tend to be conflated, confusing our understanding of the past and confounding our ability to plan for the future.