Developing a Living Donor Ethics Framework

This chapter advances an ethical framework for living donor transplantation. Given the analogies between living donor transplantation and human subjects research, the three principles enumerated in the National Commission’s Belmont Report are adopted as the starting point: respect for persons, beneficence, and justice. Two additional principles are also adopted: the principle of vulnerability and the principle that special relationships create special obligations. Whereas the Belmont Report discussed vulnerable groups, vulnerability is more aptly understood as an assortment of vulnerabilities that may apply to different people in different circumstances at different times of their lives. Eight distinct but overlapping vulnerabilities are described: capacitational, juridic, deferential, social, medical, situational, allocational, and infrastructural. The living donor advocate team (LDAT) stands in special relationship with the potential living donor and supports living organ donation provided that the living donor successfully addresses the challenges to autonomy and voluntariness that these vulnerabilities pose.

The Living Organ Donor as Patient

This is a book about living solid organ donors as patients in their own right. This book is premised on the supposition that the field of living donor organ transplantation is ethical, even if some specific applications are not, eg, pre-mortem organ procurement of an imminently dying patient. When Joseph Murray performed the first successful living kidney donor transplant in 1954, he thought this would be a temporary stopgap. Today, however, the goal of adequate organ supply without living donors remains elusive. If anything, the supply:demand ratio is worse. In this book, a five-principle living donor ethics framework is developed and used to examine the ethical issues raised by living donor selection demographics, innovative attempts to increase living organ donation, and living donor decision-making and risk thresholds. This ethics framework uses the three principles of the Belmont Report modified to organ transplantation (respect for persons, beneficence, and justice) supplemented by the principles of vulnerability and of special relationships creating special obligations. The approach requires that the transplant community fully embraces living organ donors (and prospective living organ donors) as patients to whom special obligations are owed. Only when living organ donors are regarded as patients in their own right and have a living donor advocate team dedicated to their well-being can the moral boundaries of living solid organ donation be determined and realized. This book provides theoretical arguments and practice guidelines, complemented by case studies, to ensure that living donors are given the full respect and care they deserve.

Welcoming, Wild Animals, and Obligations to Assist

What we could call ‘relational non-interventionism’ holds that we have no general obligation to alleviate animal suffering, and that we do not typically have special obligations to alleviate wild animals’ suffering. Therefore, we do not usually have a duty to intervene in nature to alleviate wild animal suffering. However, there are a range of relationships that we may have with wild animals that do generate special obligations to aid—and the consequences of these obligations can be surprising. In this paper, it is argued that we have special obligations to those animals we have historically welcomed or encouraged into our spaces. This includes many wild animals. One of the consequences of this is that we may sometimes possess obligations to actively prevent rewilding—or even to dewild—for the sake of welcomed animals who thrive in human-controlled spaces.

An Interest-Based Model of Moral Status

This chapter briefly defends each of the following theses, which together comprise an interest-based model of moral status: (1) Being human is neither necessary nor sufficient for moral status; (2) The capacity for consciousness is necessary but not sufficient; (3) Sentience is necessary and sufficient; (4) Social relations are not a basis for moral status but may ground special obligations to those with moral status; (5) The concept of personhood is unhelpful in modeling moral status, unless a non-vague conception is identified and its moral relevance clarified; (6) Sentient beings are entitled to equal consequentialist consideration; and (7) Sentient beings with substantial temporal self-awareness have special interests that justify the added protection of rights. This model will be engaged in illuminating the moral status of ordinary, self-aware human beings, non-paradigm humans, animals, robots and AI systems, brain organoids, and post-humans with superior self-awareness.

Populism, localism and democratic citizenship

This article articulates and explores a localist conception of citizenship that stands in contrast to more liberal, neoliberal and cosmopolitan conceptions. A localist orientation, and some real sympathy, is evident in specifically ethnographic accounts of voters who supported Trump, Brexit and populism more broadly, including such accounts by Arlie Hochschild, Robert Wuthnow, Kathy Cramer and Justin Gest. This localist orientation echoes the Antifederalist opponents of the American Constitution, Jacksonian Democrats, Tocqueville’s account of American democracy and the American populists. I consider both the virtues and vices of localism. The possible benefits include local practices of nested reciprocity, special obligations, specifically local ‘social bases of selfrespect’ – in the terminology of John Rawls – and feelings of belonging and home (what the Germans call Heimat). However, localism also has its downsides: its resources can empower prejudice and exclusion. I end with a reflection on localism and exclusion in Lorraine Hasberry’s A Raisin in the Sun.

Cybersecurity als Unternehmensleitungsaufgabe

Cybersecurity is a central challenge for many companies. On the one hand, companies have to protect themselves against cyberattacks; on the other hand, they have special obligations towards third parties and the state in critical infrastructures or when dealing with personal data. These responsibilities converge with company management. This volume examines the duties and liability risks of management in connection with cyber security from the perspective of corporate, constitutional and labour law. The volume is based on a conference of the same name, which took place in cooperation with the Friedrich Naumann Stiftung für die Freiheit on 23 and 24 October 2020 at Bucerius Law School in Hamburg. With contributions by Andreas Beyer, Marc Bittner, Alexander Brüggemeier, Anabel Guntermann, Katrin Haußmann, Dennis-Kenji Kipker, Christoph Benedikt Müller, Isabella Risini, Darius Rostam, Sarah Schmidt-Versteyl and Gerald Spindler.

Love thy neighbour? Allocating vaccines in a world of competing obligations

Although a safe, effective, and licensed coronavirus vaccine does not yet exist, there is already controversy over how it ought to be allocated. Justice is clearly at stake, but it is unclear what justice requires in the international distribution of a scarce vaccine during a pandemic. Many are condemning ‘vaccine nationalism’ as an obstacle to equitable global distribution. We argue that limited national partiality in allocating vaccines will be a component of justice rather than an obstacle to it. For there are role-based and community-embedded responsibilities to take care of one’s own, which constitute legitimate moral reasons for some identity-related prioritisation. Furthermore, a good form of vaccine nationalism prioritises one’s own without denying or ignoring duties derived from a principle of equal worth, according to which all persons, regardless of citizenship or identity, equally deserve vaccine-induced protection from COVID-19. Rather than dismissing nationalism as a tragic obstacle, it is necessary to acknowledge that a limited form of it is valuable and expresses moral commitments. Only then can one understand our world of competing obligations, a world where cosmopolitan duties of benevolence sometimes conflict with special obligations of community membership. Once these competing obligations are recognised as such, we can begin the work of designing sound ethical frameworks for achieving justice in the global distribution of a coronavirus vaccine and developing practical strategies for avoiding, mitigating or resolving conflicts of duty.

The Idea of Moral Duties to History

History is, indeed, little more than the register of the crimes, follies, and misfortunes of mankind. Edward Gibbon, The Decline and Fall of the Roman Empire I argue that there are duties that can be called ‘Moral duties due to history’ or, in short, ‘Duties to History’ (DTH). My claim is not the familiar thought that we need to learn from history on how to live better in the present and going forward, but that history itself creates moral duties. In addition to those obligations we currently recognise in response to the present and the future, there also exist special obligations in response to the past. If convincing, this means that our lives ought to be guided, in part, not only by our obligations to the living but by our DTH. This is a surprising result, with significant and sometimes perplexing implications. My focus is on the obligations of individuals in the light of history rather than on collective duties. I argue that there are duties that can be called ‘Moral duties due to history’ or, in short, ‘Duties to History’ (DTH). My claim is not the familiar thought that we need to learn from history on how to live better in the present and going forward, but that history itself creates moral duties. In addition to those obligations we currently recognise in response to the present and the future, there also exist special obligations in response to the past; such as obligations to good people in the past, but going beyond them. If convincing, this means that our lives ought to be guided, in part, not only by our obligations to the living but by our DTH. This is a surprising result, with significant and sometimes perplexing implications. My focus is on the obligations of individuals in the light of history rather than on collective duties.

Do You Have to Reply to This Paper?

I explore the question of whether one has to reply to a paper such as this, and consider what a positive answer (in any respect) would teach us. I argue for a qualified Yes. By “reply” I refer to an attempt to write a paper responding to the original one, which addresses (some of) the major claims made in it. I first ask what philosophical papers are for, and note the important role played by replies to them. I consider special obligations to reply to philosophical papers; and the weaker pro tanto obligations that might exist for most professional philosophers. Finally, I consider objections to my claims; and the broader implications if my case is plausible.

No Utilitarians in a Pandemic? Shifts in Moral Reasoning during the COVID-19 Global Health Crisis

The COVID-19 pandemic poses many real-world moral dilemmas, which can pit the needs and rights of the many against the needs and rights of the few. We investigated the influence of this contemporary global crisis on moral judgments in older adults, who are at greatest personal risk from the pandemic. We hypothesized that during this pandemic, individuals would give fewer utilitarian responses to hypothetical dilemmas, accompanied by higher levels of confidence and emotion elicitation. Our pre-registered analysis (https://osf.io/g2wtp) involved two waves of data collection, before (2014) and during (2020) the COVID-19 pandemic, regarding three categories of moral dilemmas (personal rights, agent-centered permissions, and special obligations). While utilitarian responses considered across all categories of dilemma did not differ, participants during the 2020 wave gave fewer utilitarian responses to dilemmas involving personal rights; that is, they were less willing to violate the personal rights of others to produce the best overall outcomes.