Euthanasia and counterfactual consent.

Counterfactuals about what a patient would consent to, if he were able to consent, are often cited as justifications, or partial justifications, for acts of euthanasia. In virtue of this fact, they deserve special scrutiny by moral philosophers. In Chapter I, I examine terminology that is essential to further understanding the relationship between euthanasia and counterfactual consent. I propose a definition of \u27euthanasia\u27, an analysis of \u27consent\u27, and I present a brief description of counterfactuals. In Chapter II, I consider two questions. The first is, When it is appropriate to invoke counterfactual consent in an attempt to justify an act of euthanasia? By making use of an improved version of the voluntary, nonvoluntary, and involuntary distinction among acts of euthanasia, I am able to determine when it is appropriate to cite counterfactuals about consent in an attempt to justify an act of euthanasia. The second is, to what end is counterfactual consent used? I contend that counterfactual consent does morally justify some acts of euthanasia, and defend an argument for this claim. Finally, I look at the role of counterfactual consent as a possible legal justification for acts of euthanasia. In Chapter III, I use possible world semantics to analyze counterfactual consent. Traditional counterfactuals are determined to be true if in the closest world at which their antecedent is true, their consequent is also true. Counterfactuals about consent have a less straightforward reading. I consider and reject several possible ways of reading counterfactuals about consent, before settling on the correct reading of counterfactuals about consent. In Chapter IV, I consider evidence for the truth of claims about counterfactual consent. I consider and reject the claim that no counterfactual is either true or false. I examine both Living Wills and the practice of surrogacy, neither of which offers sufficient evidence for the truth of claims about counterfactual consent. In Chapter V, I contrast counterfactual consent with actual consent. I review and refute the arguments for the claim that actual consent is preferable to counterfactual consent. I conclude by presenting a principle about the relationship between actual and counterfactual consent

Supererogation in Clinical Research

‘Supererogation’ is the notion of going beyond the call of duty. The concept of supererogation has received scrutiny in ethical theory, as well as clinical bioethics. Yet, there has been little attention paid to supererogation in research ethics. Supererogation is examined in this paper from three perspectives: (1) a summary of two analyses of ‘supererogation’ in moral theory, as well as an examination as to whether acts of supererogation exist; (2) a discussion of supererogation in clinical practice, including arguments that both physicians and patients can practice acts of supererogation; (3) a discussion as to why researchers, qua researchers, are not routinely recognized to perform acts of supererogation, while at the same time the very nature of research subject participation involves supererogation. The article concludes by considering three examples of supererogation on the part of researchers, with a plea that researchers’ supererogatory actions be recognized as such.</p