I. Membership in the Community
1. Every system of ethics defines not only rights and obligations but the community which will protect those rights and obligations. We extend ethical recognition to those in our community; thus, the way in which we define our community is essential to the study of bioethics. Every society defines its community in some way.
2. John Rawls, Justice as Fairness (p. 2)
a. Rawls provides us with a single statement on the comprehensive system of ethics, analyzing the interrelationship of society and the individual, working out rights and responsibilities.
b. The fundamental idea in the concept of justice is fairness.
c. Rawls rejects utilitarianism.
d. Two principles of justice:
i. Each person participating in a practice, or affected by it, has an equal right to the most extensive liberty compatible with the like liberty for all.
(A) There must be a justification for departing from the initial position of equal liberty defined by practice (burden of proof on person departing so often is justification).
ii. Inequalities are arbitrary unless it is reasonable to expect that they will work out to everyone’s advantage, and provided the positions and offices to which they attach, or from which they may be gained, are open to all.
(A) Social and economic inequalities are to be to the greatest benefit of the least advantaged members of society.
e. Rawls is basically arguing that we should put all of our effort into seeing that the “rules of the game” are fair. Once society has been organized around a set of fair rules, people can freely “play the game” without interference.
f. A person should never be used as a means to an end.
g. The touchstone of Rawls’ argument is the emphasis on the agreement of parties to an arrangement.
h. Rawls would find the rationing of health care problematic, and concepts such as substituted judgment or community need in organ donations would be difficult to defend.
order to be a person.
vi. Sense of the Past: Memory.
vii. Capability to Relate to Others: Interpersonal relationships.
viii. Concern for Others: The absence of a conscious extra-ego orientation is a clinical indication of psychopathology.
ix. Communication: Completely and finally isolated individuals are not persons.
x. Control of Existence
xi. Curiosity: Indifference is inhuman.
xii. Change and Changeability
xiii. Balance of Rationality and Feeling
xiv. Idiosyncrasy: Individual identity.
xv. Neocortical Function: The definitive determination of death is the loss of cerebration, not just of any or all brain function. The moral worth of an action is determined solely by its contribution to overall utility in maximizing happiness or pleasure in the greatest number of people).