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Erschienen in: Journal of Bioethical Inquiry 1/2019

18.12.2018 | Original Research

On Replacement Body Parts

verfasst von: Mary Jean Walker

Erschienen in: Journal of Bioethical Inquiry | Ausgabe 1/2019

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Abstract

Technological advances are making devices that functionally replace body parts—artificial organs and limbs—more widely used, and more capable of providing patients with lives that are close to “normal.” Some of the ethical issues this is likely to raise relate to how such prostheses are conceptualized. Prostheses are ambiguous between being inanimate objects and sharing in the status of human bodies—which already have an ambiguous status, as both objects and subjects. At the same time, the possibility of replacing body parts with artificial objects puts pressure on the normative status typically accorded to human bodies, seemingly confirming that body parts are replaceable objects. The paper argues that bodies’ normative status relies on the relation of a body to a person and shows that persons could have similar relations to prostheses. This suggests that in approaching ethical issues surrounding prostheses, it is appropriate to regard them as more like body parts than like objects.
Fußnoten
1
For this way of framing the problem I am greatly indebted to Sparrow and Hutchison (unpublished manuscript).
 
2
I leave aside tissue-engineered structures incorporating biological material, as I am specifically interested in objects with a clear artificial status.
 
3
Of course, these practical ethical issues are not entirely resolved by an argument for considering prostheses more like body parts than objects, since they involve a number of complex considerations, and there are of course practical constraints on treating prostheses “like body parts.” My argument below thus will not resolve these practical ethical issues, although it will have implications for their resolution.
 
4
This points to a pre-reflective relationship between a person and their characteristics. Insofar as evaluations of characteristics are reflexive, the person must already recognize that the characteristics are their own. I leave this aside here but discuss an analogous pre-reflective sense of bodily ownership below.
 
5
For detailed elaboration of these and related themes see, e.g., Merleau-Ponty 1962; Atkins 2008; Gallagher 2005.
 
6
An alternative suggestion is made by De Vignemont and Farne (2010) in distinguishing between motor and perceptual embodiment (using that term with a different meaning than I am here) and suggesting that both may occur by degrees. I would further suggest that, however the difference between tools of “completion” and those of “extension” is worked out, there is a need for a more fine-grained approach to understanding what is involved in embodiment—and that our moral intuitions may be an untapped resource for the cognitive sciences in this regard.
 
Literatur
Zurück zum Zitat Alpinar-Sencan, Z. 2016. Reconsidering Kantian arguments against organ selling. Medicine, Health Care and Philosophy 19(1): 21–31.CrossRef Alpinar-Sencan, Z. 2016. Reconsidering Kantian arguments against organ selling. Medicine, Health Care and Philosophy 19(1): 21–31.CrossRef
Zurück zum Zitat Atkins, K. 2008. Narrative identity and embodied continuity. In Practical identity and narrative agency, edited by C. Mackenzie and K. Atkins, 78–98. New York: Routledge.CrossRef Atkins, K. 2008. Narrative identity and embodied continuity. In Practical identity and narrative agency, edited by C. Mackenzie and K. Atkins, 78–98. New York: Routledge.CrossRef
Zurück zum Zitat Baker, L.R. 2000. Persons and bodies: A constitution view. Cambridge: Cambridge University Press.CrossRef Baker, L.R. 2000. Persons and bodies: A constitution view. Cambridge: Cambridge University Press.CrossRef
Zurück zum Zitat Bechara, A., and N. Naqvi. 2004. Listening to your heart: Interoceptive awareness as a gateway to feeling. Nature Neuroscience 7(2): 102–103.CrossRefPubMed Bechara, A., and N. Naqvi. 2004. Listening to your heart: Interoceptive awareness as a gateway to feeling. Nature Neuroscience 7(2): 102–103.CrossRefPubMed
Zurück zum Zitat Brown, B. 2013. A farewell to arms (and legs): The legal treatment of artificial limbs. Columbia Journal of Law and Social Problems 47(1): 69–102. Brown, B. 2013. A farewell to arms (and legs): The legal treatment of artificial limbs. Columbia Journal of Law and Social Problems 47(1): 69–102.
Zurück zum Zitat Calder, G. 2006. Ownership rights and the body. Cambridge Quarterly of Healthcare Ethics 15(1): 89–100.CrossRefPubMed Calder, G. 2006. Ownership rights and the body. Cambridge Quarterly of Healthcare Ethics 15(1): 89–100.CrossRefPubMed
Zurück zum Zitat Chadwick, R.F. 1989. The market for bodily parts: Kant and duties to oneself. Journal of Applied Philosophy 6(2): 129–139.CrossRef Chadwick, R.F. 1989. The market for bodily parts: Kant and duties to oneself. Journal of Applied Philosophy 6(2): 129–139.CrossRef
Zurück zum Zitat Cheng, D.L., P.B. Greenberg, and D.A. Borton. 2017. Advances in retinal prosthetic research: A systematic review of engineering and clinical characteristics of current prosthetic initiatives. Current Eye Research 42(3): 334–7.CrossRefPubMed Cheng, D.L., P.B. Greenberg, and D.A. Borton. 2017. Advances in retinal prosthetic research: A systematic review of engineering and clinical characteristics of current prosthetic initiatives. Current Eye Research 42(3): 334–7.CrossRefPubMed
Zurück zum Zitat Cohrs, N.H., A. Petrou, M. Loepfe, et al. 2017. A soft total artificial heart—first concept evaluation on a hybrid mock circulation. Artificial Organs 41(10): 948–958.CrossRefPubMed Cohrs, N.H., A. Petrou, M. Loepfe, et al. 2017. A soft total artificial heart—first concept evaluation on a hybrid mock circulation. Artificial Organs 41(10): 948–958.CrossRefPubMed
Zurück zum Zitat Cordella, F., A.L. Ciancio, R. Sacchetti, et al. 2016. Literature review on needs of upper limb prosthesis users. Frontiers in Neuroscience 10: 209.CrossRefPubMedPubMedCentral Cordella, F., A.L. Ciancio, R. Sacchetti, et al. 2016. Literature review on needs of upper limb prosthesis users. Frontiers in Neuroscience 10: 209.CrossRefPubMedPubMedCentral
Zurück zum Zitat Couto, B., A. Salles, L. Sedeno, et al. 2014. The man who feels two hearts: The different pathways of interoception. Social Cognitive and Affective Neuroscience 9(9): 1253–1260.CrossRefPubMed Couto, B., A. Salles, L. Sedeno, et al. 2014. The man who feels two hearts: The different pathways of interoception. Social Cognitive and Affective Neuroscience 9(9): 1253–1260.CrossRefPubMed
Zurück zum Zitat de Preester, H., and M. Tsakiris. 2009. Body-extension versus body-incorporation: Is there a need for a body-model? Phenomenology and the Cognitive Sciences 8(3): 307–319.CrossRef de Preester, H., and M. Tsakiris. 2009. Body-extension versus body-incorporation: Is there a need for a body-model? Phenomenology and the Cognitive Sciences 8(3): 307–319.CrossRef
Zurück zum Zitat De Vignemont, F. 2013. The mark of bodily ownership. Analysis 73(4): 643–651.CrossRef De Vignemont, F. 2013. The mark of bodily ownership. Analysis 73(4): 643–651.CrossRef
Zurück zum Zitat De Vignemont, F., and A. Farne. 2010. Widening the body to rubber hands and tools: What’s the difference? Revue de Neuropsychologie 3(2): 203–211.CrossRef De Vignemont, F., and A. Farne. 2010. Widening the body to rubber hands and tools: What’s the difference? Revue de Neuropsychologie 3(2): 203–211.CrossRef
Zurück zum Zitat Finch, J.L., G.H. Heath-, A.R. David, and J. Kulkarni. 2012. Biomechanical assessment of two artificial big toe restorations from Ancient Egypt and their significance to the history of prosthetics. JPO Journal of Prosthetics and Orthotics 24(4): 181–191.CrossRef Finch, J.L., G.H. Heath-, A.R. David, and J. Kulkarni. 2012. Biomechanical assessment of two artificial big toe restorations from Ancient Egypt and their significance to the history of prosthetics. JPO Journal of Prosthetics and Orthotics 24(4): 181–191.CrossRef
Zurück zum Zitat Gallagher, S. 2005. How the body shapes the mind. Oxford: Oxford University Press.CrossRef Gallagher, S. 2005. How the body shapes the mind. Oxford: Oxford University Press.CrossRef
Zurück zum Zitat Gerrand, N. 1999. The misuse of Kant in the debate about a market for human body parts. Journal of Applied Philosophy 16(1): 59–67.CrossRefPubMed Gerrand, N. 1999. The misuse of Kant in the debate about a market for human body parts. Journal of Applied Philosophy 16(1): 59–67.CrossRefPubMed
Zurück zum Zitat Glynn, J., H. Song, B. Hull, et al. 2017. The Oregon heart total artificial heart: Design and performance on a mock circulatory loop. Artificial Organs 41(10): 904–910. Glynn, J., H. Song, B. Hull, et al. 2017. The Oregon heart total artificial heart: Design and performance on a mock circulatory loop. Artificial Organs 41(10): 904–910.
Zurück zum Zitat Hampton T. 2014. Fully automated artificial pancreas finally within reach. JAMA 311(22): 2260–2261.CrossRefPubMed Hampton T. 2014. Fully automated artificial pancreas finally within reach. JAMA 311(22): 2260–2261.CrossRefPubMed
Zurück zum Zitat Heyes, C.J. 2007. Self-transformations: Foucault, ethics, and normalized bodies. Oxford: Oxford University Press.CrossRef Heyes, C.J. 2007. Self-transformations: Foucault, ethics, and normalized bodies. Oxford: Oxford University Press.CrossRef
Zurück zum Zitat Hume, D. 1969. A treatise of human nature. Edited by E.C. Mossner. London: Penguin. Hume, D. 1969. A treatise of human nature. Edited by E.C. Mossner. London: Penguin.
Zurück zum Zitat Hutchison, K., and R. Sparrow. 2016. What pacemakers can teach us about the ethics of maintaining artificial organs. Hastings Center Report 46(6): 14–24.CrossRefPubMed Hutchison, K., and R. Sparrow. 2016. What pacemakers can teach us about the ethics of maintaining artificial organs. Hastings Center Report 46(6): 14–24.CrossRefPubMed
Zurück zum Zitat Hutchison, K., and R. Sparrow. 2017. Ethics and the cardiac pacemaker: More than just end of life issues. Europace 20(5): 739–746.CrossRef Hutchison, K., and R. Sparrow. 2017. Ethics and the cardiac pacemaker: More than just end of life issues. Europace 20(5): 739–746.CrossRef
Zurück zum Zitat Joung, Y-H. 2013. Development of implantable medical devices: From an engineering perspective. International Neurourology Journal 17(3): 98–106.CrossRefPubMedPubMedCentral Joung, Y-H. 2013. Development of implantable medical devices: From an engineering perspective. International Neurourology Journal 17(3): 98–106.CrossRefPubMedPubMedCentral
Zurück zum Zitat Kant, I. 1997. Lectures on Ethics. Edited by P. Heath and J.B. Schneewind. Translated by P. Heath. Cambridge: Cambridge University Press. Kant, I. 1997. Lectures on Ethics. Edited by P. Heath and J.B. Schneewind. Translated by P. Heath. Cambridge: Cambridge University Press.
Zurück zum Zitat Kay, S., and D. Wilks. 2015. Bionic hand transplantation: Linking the cortex to the hand. Lancet 385: 2120–2122.CrossRef Kay, S., and D. Wilks. 2015. Bionic hand transplantation: Linking the cortex to the hand. Lancet 385: 2120–2122.CrossRef
Zurück zum Zitat Locke, J. 1975. An essay concerning human understanding. Edited by P.H. Nidditch. Oxford: Oxford University Press. Locke, J. 1975. An essay concerning human understanding. Edited by P.H. Nidditch. Oxford: Oxford University Press.
Zurück zum Zitat Lundberg, M., K. Hagberg, and J. Bullington. 2011. My prosthesis is a part of me: A qualitative analysis of living with an osseointegrated prosthetic limb. Prosthetics and Orthotics International 35(2): 207–214.CrossRefPubMed Lundberg, M., K. Hagberg, and J. Bullington. 2011. My prosthesis is a part of me: A qualitative analysis of living with an osseointegrated prosthetic limb. Prosthetics and Orthotics International 35(2): 207–214.CrossRefPubMed
Zurück zum Zitat Mackenzie, C. 2009. Personal identity, narrative integration, and embodiment. In Embodiment and Agency, edited by S. Campbell, L. Meynell, and S. Sherwin, 100–125. University Park, PA: Penn State University Press. Mackenzie, C. 2009. Personal identity, narrative integration, and embodiment. In Embodiment and Agency, edited by S. Campbell, L. Meynell, and S. Sherwin, 100–125. University Park, PA: Penn State University Press.
Zurück zum Zitat ———. 2010. Conceptions of autonomy and conceptions of the body in bioethics. In Feminist Bioethics: At the Centre, on the Margins, edited by J. Leach Scully, L.E. Baldwin-Ragaven, and P. Fitzpatrick, 71–90. Baltimore: John Hopkins University Press. ———. 2010. Conceptions of autonomy and conceptions of the body in bioethics. In Feminist Bioethics: At the Centre, on the Margins, edited by J. Leach Scully, L.E. Baldwin-Ragaven, and P. Fitzpatrick, 71–90. Baltimore: John Hopkins University Press.
Zurück zum Zitat ———. 2014. Embodied agents, narrative selves. Philosophical Explorations 17(2): 154–171. ———. 2014. Embodied agents, narrative selves. Philosophical Explorations 17(2): 154–171.
Zurück zum Zitat Martin, R. 1998. Self-Concern: An experiential approach to what matters in survival. Cambridge: Cambridge University Press. Martin, R. 1998. Self-Concern: An experiential approach to what matters in survival. Cambridge: Cambridge University Press.
Zurück zum Zitat McDonnell, P.M., R.N. Scott, J. Dickison, R.A. Theriault, B. Wood. 1989. Do artificial limbs become part of the user? New evidence. Journal of Rehabilitation Research and Development 26(2): 17–24. McDonnell, P.M., R.N. Scott, J. Dickison, R.A. Theriault, B. Wood. 1989. Do artificial limbs become part of the user? New evidence. Journal of Rehabilitation Research and Development 26(2): 17–24.
Zurück zum Zitat Merleau-Ponty, M. 1962. Phenomenology of perception. Abingdon: Routledge. Merleau-Ponty, M. 1962. Phenomenology of perception. Abingdon: Routledge.
Zurück zum Zitat Mudry, A., and M. Mills. 2013. The early history of the cochlear implant. JAMA Otalaryngology—Head and Neck Surgery 139(5): 446–453. Mudry, A., and M. Mills. 2013. The early history of the cochlear implant. JAMA Otalaryngology—Head and Neck Surgery 139(5): 446–453.
Zurück zum Zitat Munzer, S.R. 1993. An uneasy case against property rights in body parts. Canadian Journal of Law and Jurisprudence 6(2): 319–341.CrossRef Munzer, S.R. 1993. An uneasy case against property rights in body parts. Canadian Journal of Law and Jurisprudence 6(2): 319–341.CrossRef
Zurück zum Zitat Murray, C.D. 2004. An interpretative phenomenological analysis of the embodiment of artificial limbs. Disability and Rehabilitation 26(16): 963–973.CrossRefPubMed Murray, C.D. 2004. An interpretative phenomenological analysis of the embodiment of artificial limbs. Disability and Rehabilitation 26(16): 963–973.CrossRefPubMed
Zurück zum Zitat ———. 2008. Embodiment and prosthetics. In Psychoprosthetics, edited by P. Gallagher, D. Desmond, and M. Maclachlan, 119–129. Dordrecht: Springer. ———. 2008. Embodiment and prosthetics. In Psychoprosthetics, edited by P. Gallagher, D. Desmond, and M. Maclachlan, 119–129. Dordrecht: Springer.
Zurück zum Zitat Nghiem, B.T., I.C. Sando, R.B. Gillespie, et al. 2015. Providing a sense of touch to prosthetic hands. Plastic Reconstructive Surgery 135(6): 1652–1663.CrossRefPubMed Nghiem, B.T., I.C. Sando, R.B. Gillespie, et al. 2015. Providing a sense of touch to prosthetic hands. Plastic Reconstructive Surgery 135(6): 1652–1663.CrossRefPubMed
Zurück zum Zitat Nolan, H., D. Wang, and J.B. Zwischenberger. 2011. Artificial lung basics: Fundamental challenges, alternative designs and future innovations. Organogenesis 7(1): 23–27.CrossRefPubMedPubMedCentral Nolan, H., D. Wang, and J.B. Zwischenberger. 2011. Artificial lung basics: Fundamental challenges, alternative designs and future innovations. Organogenesis 7(1): 23–27.CrossRefPubMedPubMedCentral
Zurück zum Zitat Pazzaglia, M., and M. Molinari. 2016. The embodiment of assistive devices—from wheelchair to exoskeleton. Physics of Life Reviews 16: 163–175.CrossRefPubMed Pazzaglia, M., and M. Molinari. 2016. The embodiment of assistive devices—from wheelchair to exoskeleton. Physics of Life Reviews 16: 163–175.CrossRefPubMed
Zurück zum Zitat Ricoeur, P. 1992. Oneself as another. Translated by K. Blamey. Chicago: University of Chicago Press. Ricoeur, P. 1992. Oneself as another. Translated by K. Blamey. Chicago: University of Chicago Press.
Zurück zum Zitat Saal, H.P., and S.J. Bensmaia. 2015. Biomimetic approaches to bionic touch through a peripheral nerve interface. Neuropsychologia 79(B): 344–353.CrossRefPubMed Saal, H.P., and S.J. Bensmaia. 2015. Biomimetic approaches to bionic touch through a peripheral nerve interface. Neuropsychologia 79(B): 344–353.CrossRefPubMed
Zurück zum Zitat Schechtman, M. 1996. The constitution of selves. Ithaca: Cornell University Press. Schechtman, M. 1996. The constitution of selves. Ithaca: Cornell University Press.
Zurück zum Zitat Schofield, J.S., K.R. Evans, J.P. Carey, and J.S. Herbert. 2014. Applications of sensory feedback in motorized upper extremity prosthesis: A review. Expert Review of Medical Devices 11(5): 499–511.CrossRefPubMed Schofield, J.S., K.R. Evans, J.P. Carey, and J.S. Herbert. 2014. Applications of sensory feedback in motorized upper extremity prosthesis: A review. Expert Review of Medical Devices 11(5): 499–511.CrossRefPubMed
Zurück zum Zitat Shoemaker, D. 2007. Personal identity and practical concerns. Mind 116(462): 317–357.CrossRef Shoemaker, D. 2007. Personal identity and practical concerns. Mind 116(462): 317–357.CrossRef
Zurück zum Zitat Sparrow, R. 2015. Enhancement and obsolescence: Avoiding an enhanced “rat race.” Kennedy Institute of Ethics Journal 25(3): 231–260.CrossRefPubMed Sparrow, R. 2015. Enhancement and obsolescence: Avoiding an enhanced “rat race.” Kennedy Institute of Ethics Journal 25(3): 231–260.CrossRefPubMed
Zurück zum Zitat Svenaeus, F. 2010. What is an organ? Heidegger and the phenomenology of organ transplantation. Theoretical Medicine and Bioethics 31(3): 179–196.CrossRefPubMed Svenaeus, F. 2010. What is an organ? Heidegger and the phenomenology of organ transplantation. Theoretical Medicine and Bioethics 31(3): 179–196.CrossRefPubMed
Zurück zum Zitat Tagney, J. 2010. A literature review comparing the experiences and emergent needs of adult patients with permanent pacemakers (PPMs) and implantable cardioverter defibrillators (ICDs). Journal of Clinical Nursing 19(15-16): 2081–2089.PubMed Tagney, J. 2010. A literature review comparing the experiences and emergent needs of adult patients with permanent pacemakers (PPMs) and implantable cardioverter defibrillators (ICDs). Journal of Clinical Nursing 19(15-16): 2081–2089.PubMed
Zurück zum Zitat Toombs, S.K. 2001. Reflections on bodily change: The lived experience of disability. In Handbook of Phenomenology and Medicine, edited by S.K. Toombs, 247–261. Dordrecht: Kluwer Academic Publishers.CrossRef Toombs, S.K. 2001. Reflections on bodily change: The lived experience of disability. In Handbook of Phenomenology and Medicine, edited by S.K. Toombs, 247–261. Dordrecht: Kluwer Academic Publishers.CrossRef
Zurück zum Zitat Velleman, J.D. 1996. Self to self. The Philosophical Review 105(1): 39–76.CrossRef Velleman, J.D. 1996. Self to self. The Philosophical Review 105(1): 39–76.CrossRef
Zurück zum Zitat Wilkinson, S. 2000. Commodification arguments for the legal prohibition of organ sale. Health Care Analysis 8(2): 189–201.CrossRefPubMed Wilkinson, S. 2000. Commodification arguments for the legal prohibition of organ sale. Health Care Analysis 8(2): 189–201.CrossRefPubMed
Metadaten
Titel
On Replacement Body Parts
verfasst von
Mary Jean Walker
Publikationsdatum
18.12.2018
Verlag
Springer Singapore
Erschienen in
Journal of Bioethical Inquiry / Ausgabe 1/2019
Print ISSN: 1176-7529
Elektronische ISSN: 1872-4353
DOI
https://doi.org/10.1007/s11673-018-9889-y

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