Document Detail


Response to Erich Loewy: commentary.
MedLine Citation:
PMID:  11642928     Owner:  KIE     Status:  MEDLINE    
Abstract/OtherAbstract:
The capacity to suffer, the vulnerability with respect to suffering, confers on all animals with that capacity (not just human beings) a prima facie right not to be caused suffering. Nurturing in order to stave off such suffering is the first act of the community toward the individual, primarily in infancy. Hence for Loewy, autonomy, the gradual growth of self-determination in individuals, is grounded in a broader moral commitment of the community, that of beneficence. This is the critical point in his argument, for it represents a wholesale critique of modern libertarianism. Libertarians, in contrast to Loewy's argument, seem to ground the nature of the community in the prima facie right of autonomy. For Loewy, the community not only has an obligation to refrain from harming individuals (nonmaleficence), but it also has an active duty to ameliorate and prevent, as far as possible, the suffering of its members. Thus, if there is a social contract, it is one of nurturing one another to overcome the vulnerability of suffering, not primarily one of protecting autonomy. This is most significant for clinical ethics as well. Once the primary obligation to ameliorate suffering is no longer necessary, when the individual loses or does not have the primary moral worth prompted by the capacity to suffer, then secondary and symbolic obligations emerge. Loewy is thereby able to suggest a "calculus" of moral worth, wherein our obligations to individuals in a permanent vegetative state or to anencephalics (almost always the individual will have lost the capacity to suffer through some cerebral event) must be weighed against other primary obligations. Although Loewy admits that grounding clinical ethics in the capacity to suffer might be "thin," it nevertheless prompts serious discussion about the nature of the "good" in good clinical ethics decisions.
Authors:
David C Thomasma
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of clinical ethics     Volume:  2     ISSN:  1046-7890     ISO Abbreviation:  J Clin Ethics     Publication Date:  1991  
Date Detail:
Created Date:  1992-02-19     Completed Date:  1992-02-19     Revised Date:  2004-11-18    
Medline Journal Info:
Nlm Unique ID:  9114645     Medline TA:  J Clin Ethics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  90-1     Citation Subset:  E    
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MeSH Terms
Descriptor/Qualifier:
Altruism*
Animal Rights
Animals
Beneficence*
Bioethics*
Decision Making
Empathy
Ethical Analysis*
Ethics*
Ethics, Clinical
Ethics, Medical
Freedom
Human Rights
Humans
Individuality
Interpersonal Relations
Moral Obligations*
Patient Care
Patients
Personal Autonomy
Personhood
Physician-Patient Relations*
Social Justice
Social Responsibility*
Stress, Psychological*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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