Bioethical prescriptions

Excerpt

Frances Kamm is one of the most important living philosophers today who are writing on ethics and bioethical issues. The book is a collection of some of her papers written since 1990 and published in different journals and collections. The papers don’t appear here in their original form—in many cases Kamm has excised and substantially rearranged the original articles for this edition. There are 27 chapters and they are arranged in four sections. Part One (Death and Dying) deals with issues around ending life—assisted suicide, euthanasia, advanced directives, brain death. One essay that stands out in this section is Kamm’s meditation on Tolstoy’s classic novella ‘The Death of Ivan Ilyich’ (‘Rescuing Ivan Ilyich: How we Live and How We Die’). Part Two (Early Life) addresses ethical issues around the status of embryos—abortion, using embryos for biomedical research, using of embryonic stem cells. Chapter 12 (‘Creation and Abortion Short) is a summary of Kamm’s ‘Creation and Abortion: A Study in Moral and Legal Philosophy’ (Kamm 1992), a major study of the morality of abortion. In Chapter 11 Kamm engages with Ronald Dworkin’s views on abortion, but Chapter 13 discusses Jeff McMahan’s ethics of killing. This part ends with a rather interesting essay on Munchausen Syndrome (‘Some Conceptual and Ethical Issues in Munchausen Syndrome by Proxy) that doesn’t quite well fits the title of the section (‘Early Life’). Part Three (Genetic and Other Enhancements) contains three essays on topics related to enhancement and cloning, including issues on justice of distribution created by those technologies. This section of the book opens with Kamm’s in-depth discussion of the ‘From Chance to Choice: Genetics and Justice’—a book coauthored by A. Buchanan, D. Brock, N. Daniels, and D. Wikler (Ch. 15) (Buchanan et al. 2000). The next chapter (‘Moral Status, Personal Identity, and Substitubility: Clones, Embryos, and Future Generations’) contains elaborate and very helpful discussion of the concept of moral status and its application to ethics of cloning. The last peace in the section (What Is and Is Not Wrong with Enhancement? Evaluating Sandel’s Views) is considerably elaborated version of Kamm’s rebuttal of Sandel’s attack on biomedical enhancement technologies. Part Four (Allocating Scarce Resources) addresses questions of allocating resources in health care. Chapters 18 (‘Health and Equity’) and 19 (Health and Equality of Opportunity) discuss some general principles of allocation in regard to health. In the later Kamm engages with the views of Norman Daniels. Two chapters (Ch. 21 and 22) in this part are devoted to the questions of rationing against disabled. In Chapter 20 (‘Is it Morally Permissible to discontinue Nonfutile Use of a Scarce Resource?)’ Kamm addresses the issue of discontinuing nonfutile use of scarce resource on the example of clozapine—a drug used to treat schizophrenia. In the last essay of this part (‘Learning from Bioethics: Moral Issues in Rationing Medical and Nonmedical Scarce Resources) Kamm surveys some basic issues of rationing scarce resources in relation to nonmedical resources. Finally, Part Five (Methodology) deals with issues that can be loosely described as methodological. Chapter 24 (‘The Philosopher as Insider and Outsider: How to Advise, Compromise, and Criticize’) is an interesting take on the questions that many philosophers have to face as members of government commissions or as consultants to commissions. In the next essay (‘Theory and Analogy in Law and Philosophy’) Kamm engages with Ronald Dworkin’s views about the role of theory in legal reasoning. Her aim is to defend the role of analogy and case-based reasoning in adjudication—the method that Kamm so skillfully use in her own work. The next essay (Types of Relations between Theory and Practice: High Theory, Low Theory, and Applying Applied Ethics) is an elegant survey of eight different senses of what might be meant by the relation between theory and practice. The main focus of Kamm here is the question of the relation of applied ethics to solution of real world ethical problems. The final essay (‘Understanding, Justifying, and Finding Oneself’) addresses the question of self-knowledge, how we can come to know about what we think. Interestingly, at the same time in this paper Kamm describes her own method of doing moral philosophy—the Method of Hypothetical Cases (I will make some comments on this later). …