Persons and Their Bodies: Rights, Responsibilities, Relationships (Philosophy and Medicine)

409 Pages·1999·1.7 MB·English

by  M.J. Cherry

PERSONS A N D THEIR BODIES:
RIGHTS, RESPONSIBILITIES, RELATIONSHIPS
Philosophy and Medicine
VOLUME60
Editors
H. Tristram Engelhardt, Jr., Center for Medical Ethics and Health Policy,
Baylor College of Medicine and Philosophy Department, Rice University,
Houston, Texas
S. F. Spicker, Massachusetts College of Pharmacy and Allied Health Sciences,
Boston, Mass.
Editorial Board
George J. Agich, Department of Bioethics, The Cleveland Clinic Foundation,
Cleveland, Ohio
Edmund Erde, University of Medicine and Dentistry of New Jersey, Stratford,
New Jersey
E. Haavi Morreim, Department of Human Values and Ethics, College of Medi-
cine, University of Tennessee, Memphis, Tennessee
Becky White, California State University, Chico, California
The titles published in this series are listed at the end of this volume.
PERSONS AND
THEIR BODIES:
RIGHTS, RESPONSIBILITIES,
RELATIONSHIPS
Edited by
MARK J. CHERRY
Saint Edward's University
Austin, Texas, U.S.A.
KLUWER ACADEMIC PUBLISHERS
NEW YORK / BOSTON / DORDRECT / LONDON / MOSCOW
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Print ISBN: 0-792-35701-9
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TABLE OF CONTENTS
PREFACE vii
MARK J. CHERRY / Persons and Their Bodies: Rights, Responsibilities,
and the Sale of Organs 1
SECTION ONE / BODIES AND PERSONS:
ONTOLOGICAL QUESTIONS
R.J. HANKINSON / Body and Soul in Greek Philosophy 35
WENDY DONNER / A Millian Perspective on the Relationship Between
Persons and Their Bodies 57
S. KAY TOOMBS / What Does it Mean to be SomeBody?
Phenomenological Reflections and Ethical Quandaries 73
ALLYNE L. SMITH, JR. / An Orthodox Christian View of Persons
and Bodies 95
SECTION TWO / NATURAL LAW AND
NATURAL RIGHTS
JOSEPH BOYLE / Personal Responsibility and Freedom in Health Care:
A Contemporary Natural Law Perspective 111
ERIC MACK / The Alienability of Lockean Natural Rights 143
GEORGE KHUSHF / Inalienable Rights in the Moral and Political
Philosophy of John Locke: A Reappraisal 177
SECTION THREE / METAPHYSICAL QUANDARIES
AND MORAL QUESTIONS
THOMAS A. POWERS / The Integrity of Body: Kantian Moral
Constraints on the Physical Self 209
vi TABLE OF CONTENTS
DREW LEDER / Whose Body? What Body? The Metaphysics of
Organ Transplantation 233
CHRISTIAN BYK / The Impact of Biomedical Developments
on the Legal Theory of the Mind-Body Relationship 265
SECTION FOUR / THE BODY FOR PROFIT:
ORGAN SALES AND MORAL THEORY
H. TRISTRAM ENGELHARDT, JR. / The Body for Fun, Beneficence,
and Profit: A Variation on a Post-Modern Theme 277
DONNA C. KLINE / Despair, Desire, and Decision: A Fugal Response
to Engelhardt 303
THOMAS J. BOLE, III / The Sale of Organs and Obligations to
One's Body: Inferences from the History of Ethics 331
SECTION FIVE / PERSONS AND THEIR BODIES:
KEY ARGUMENTS AND CONTEMPORARY CRITIQUES
GERALD McKENNY / The Integrity of the Body: Critical Remarks
on a Persistent Theme in Bioethics 353
STEPHEN WEAR, JACK FREER, AND BOGDA KOCZWARA /
The Commercialization of Human Body Parts: Public Policy
Considerations 363
NOTES ON CONTRIBUTORS 385
INDEX 387
PREFACE
This volume is a contribution to the literature of the philosophy of
medicine and bioethics which takes as its heuristic focus the sale of
human organs. The volume seeks insights from the history of philosophy,
including, ancient philosophy, natural law theory, traditional Christianity,
contemporary legal analysis and post-modern critique of moral theory.
The volume’s historical conception was a core set of papers written for a
Liberty Fund Colloquium held in Houston, Texas, directed by Baruch A.
Brody. This conference focused on the freedoms and responsibilities
persons have towards their bodies. What began as the subject for a single
colloquium, however, developed into a sustained philosophical dialogue.
I want to express my thanks to all of those who made the initial
colloquium possible, the Liberty Fund, Inc., Baruch A. Brody, as well
those participants, who though not represented in this volume, contributed
to the intellectual discussion which framed the original set of essays and
thereby indirectly impacted the framing of this volume. I could not have
produced the final version without the support and kindness of the Center
for Medical Ethics and Health Policy. I wish to thank in particular the
Philosophy and Medicine series editors, H. Tristram Engelhardt, Jr. and
Stuart F. Spicker, for their generosity in supporting the publication of this
volume.
This project has benefitted through the kind efforts of many. I am in
the particular debt of Thomas J. Bole, III, who labored with the project
for some time, finding authors and focusing commentaries so that
contributors would address critical perspectives from the history of
philosophy to contemporary concerns in bioethics and health policy. The
project’s final form emerged from discussions with the contributors as
well as with my colleagues H. Tristram Engelhardt, Jr., Ruiping Fan, and
George Khushf. I am much in their debt. Discussions with Laurence
McCullough, Stephen Wear, Nicholas Capaldi, and Joseph Boyle also
helped to shape the character of this volume’s contribution to the debates
surrounding organ sales and health care policy. I wish to acknowledge
also my debt to the authors in this volume for their patient kindness in
revising and rewriting their essays. I have learned a great deal.
M. J. Cherry (ed.), Persons and their Bodies: Rights, Responsibilities, Relationships, vii-viii.
©1 999 Kluwer Academic Publishers. Printed in Great Britain.
vi PREFACE
After numerous revisions a sustained set of analyses has been forged.
During its period of development much has been altered and many
additions have been made. The issues range from ontological questions
regarding mind and body, to the ethical underpinnings of governmental
policy regarding the selling of internal organs. Through the entire
volume, though, the essays focus on the moral permissibility of selling
human organs for transplantation. The volume makes no claim to have
encompassed all of the relevant issues or even all of the relevant
philosophical perspectives. However, it is my hope that the papers
gathered here will assist in clarifying the issues at stake in the medical
and public policy fields, and serve to spur further dialogue. It is a great
pleasure to present this international discussion as part of the Philosophy
and Medicine book series.
Mark J. Cherry
Saint Edward’s University
Austin, Texas August 1999
MARK J. CHERRY
PERSONS AND THEIR BODIES:
RIGHTS, RESPONSIBILITIES, AND THE SALE OF
ORGANS
I. INTRODUCTION:
TAKING THE PHILOSOPHICAL BACKGROUND SERIOUSLY
Contemporary debates about organ sales are largely innocent of the
history of thought on the matter. This volume seeks to remedy this short
coming. Contemporary positions for or against a market in human organs
are nested within moral intuitions, ontological or political theoretical
premises, or understandings of special moral concerns, such as
permissible uses of the body and its parts, which have a long history of
analysis. The essays compass the views of Plato and Aristotle (James
Hankinson), Thomas Aquinas (Thomas Bole), John Locke (Eric Mack
and George Khushf), Immanuel Kant (Tom Powers), G.W.F. Hegel
(Thomas Bole), John Stuart Mill (Wendy Donner), and Christianity
(Allyne Smith and Gerald McKenny). Attention is also given to particular
methodological approaches, such as the phenomenology of the body
(Drew Leder and S. Kay Toombs), natural law theory (Joseph Boyle),
legal theory (Christian Byk, Stephen Wear, and Donna Kline), and
libertarian critique of ethical and legal theory (H. Tristram Engelhardt,
Jr. ) .
These discussions cluster, therefore, a number of conceptually
independent philosophical concerns: (1) What is the appropriate under-
standing of the relationship between persons and their bodies? (2) What
does it mean to “own” an organ? (3) Do governments have moral
authority to regulate how persons use their own body parts? (4) What are
the costs and benefits of a market in human organs? Such questions are
related by an urgent public health challenge: the considerable disparity
between the number of patients who could significantly benefit from
organ transplantation and the number of human organs available for
transplant. In 1996, for example, in the United States, 72,386 patients
waited on the United Network for Organ Sharing lists for transplants
(UNOS, 1998). By August of 1998 the waiting lists included 57,839
patients (UNOS, 1998). Yet, in 1997 only 19,998 organ transplants of all
M. J. Cherry (ed.), Persons and their Bodies: Rights, Responsibilities, Relationships, 1-32.
©1999 Kluwer Academic Publishers. Printed in Great Britain.