The third chapter of the sixth edition of Beauchamp and Childress's Principles of Biomedical Ethics tackles the tricky subject of "Moral Status".  In this section the authors describe the five mainstream moral status theories then recommend that bioethicists "appropriate the best from each of the five theories and meld these elements together into a multicriterial, coherent account of moral status."  The B + C strategy is a failure, of course.

B + C divide the mainstream moral status theories into the following five categories: human properties, cognitive properties, moral agency, sentience, and relationships.  The authors do not list a libertarian category of moral status theories.  The purpose of the LIBERTARIAN BIOETHICS BLOG is to correct this injustice.

B + C appropriately note flaws in each of the five mainstream moral status theories.  I will not bore the reader with the details; please read the chapter yourself.  The criticisms in the chapter, interestingly, do not significantly damage the best libertarian bioethics statement regarding moral status, which I previously mentioned in this blog.  The statement is Sigrid Fry-Revere's claim that a being has moral status if the being possesses the minimum mental equipment necessary for reasoning power, regardless of whether the reasoning power is ever utilized.  The definition of reasoning power is of obvious importance for Revere's statement.  I think Revere defines reasoning power as "the capacity for higher brain functions," based on my review of her work.  What are the higher brain functions?  Self-consciousness (awareness), emotion, cognition, motivation (able to give and understand reasons for acting), intention, higher-order volition, ability to engage in purposeful action, ability to communicate with other beings using a language, ability to make moral judgments about the wrongness or rightness of actions, sentience (able to feel pain and pleasure), and the ability of develop relationships involving rules and obligations are the obvious answers. The correct answer to that question is important if non-human beings are created ("living" computers or human/non-human "hybrids") or discovered, for the correct answer will help bioethicists determine, empirically, if the non-human beings have moral status.

The LIBERTARIAN BIOETHICS BLOGger recommends a minor qualification of Revere's moral status statement.  A superior version is as follows: a being has moral status if the being possesses the minimum mental equipment necessary for reasoning power under healthy developmental conditions, regardless of whether the reasoning power is ever utilized.  This adjustment disallows the anencephalic fetus objection (anencephalic fetuses do not have the minimum mental equipment necessary for reasoning power due to unhealthy developmental conditions) and the environmental catastrophe objection (environmental catastrophe could preclude the ability of all members of an advanced species to demonstrate reasoning power leading to beings from other species not accepting the moral status of any of the beings from the damaged species).  Neuroscience advancements, allowing a priori identification of "the minimum mental equipment necessary for reasoning power" would also be helpful for the environmental catastrophe scenario.

A libertarian bioethics blog cannot exist without commentary regarding the Abigail Alliance for Better Access to Developmental Drugs v . Andrew  C. Von Eschenbach case.  My comments shall be brief, however, for I am working on several articles discussing the relevant issues in detail.  Hopefully readers will peruse those essays on other libertarian websites soon.

The absurdly slow progression of the case provides clear evidence of the inertia of state bureaucracy.  In 2003 the Abigail Alliance sued the FDA claiming that terminally ill patients have a constitutional right to access unapproved drugs after they have passed the phase 1 clinical trials process.  In May 2006 a 3-judge panel of the District of Columbia U.S. Court of Appeals ruled in favor of the Abigail Alliance.  In August 2007 the full District of Columbia U.S. Court of Appeals ruled against the Abigail Alliance.  In 2008 the United States Supreme Court declined to hear Abigail Alliance's appeal.

In the final analysis, a State judicial branch confirmed the "right" of a State executive branch to micromanage the chemicals that its slaves (otherwise known as citizens) ingest, which is not a surprising outcome to the LIBERTARIAN BIOETHICS BLOGger.

"The Origins of Altruism" is the title of the first chapter of Peter Singer's The Expanding Circle.  The author details the sociobiological concepts of kin altruism, reciprocal altruism, and group altruism to illuminate animal altruism and the evolution of animal altruism.  These ideas, however, are not the most interesting part of the chapter for the libertarian bioethicist.

The intriguing portions of the first chapter for the libertarian are the paragraphs in which Singer mocks the social contract theory.  Libertarians oppose the social contract theory because statists commonly attempt to legitimize the existence of the state via reference to the false social contract theory.  The author lists the following strong objections to the social contract theory: based on "Rousseau's fantasy of isolation as the original or natural condition of human existence", "ethics probably began in ... pre-human patterns of behavior rather than in the deliberate choices of fully fledged, rational human beings" which directly contradicts the social contract theory which "held that our rules of right and wrong sprang from some distant Foundation Day on which previously independent rational human beings came together to hammer out a basis for setting up the first human society", and human ethics does not rely on "the historical myth of the social contract".   

The LIBERTARIAN BIOETHICS BLOGger continues to enjoy reading The Expanding Circle.    

Declination of the annual influenza vaccination is becoming more difficult every year if one is a practicing physician.  

I recently declined the 2012 annual influenza vaccination when my employer offered to supply the injectable version.  I was given a "Declination of Influenza Vaccine" form to complete.  The first paragraph of this form states the following: "In accordance with CDC recommendations ... requires all its physicians and nurse practitioners to receive annual influenza vaccination unless the care provider has a recognized medical contraindication to receiving the vaccine."  The form then lists the "recognized medical" contraindications. I, fortunately, do not suffer from one of these "recognized medical" contraindications.  However, the form supplies a space to note an alternative "medical reason" to not receive the vaccine.  I wrote as follows: taking adalimumab (Humira) for Crohn's disease.  However, taking Humira for Crohn's disease IS NOT a contraindication to receiving the injectable form of the influenza vacation, but IS a contraindication to receiving the nasal spray version.  I was gambling that the person or persons who would review my completed form would be unaware of this distinction.  I was correct.  

Unfortunately that was not the end of my saga.  My completed form was faxed to all the local hospitals, which also require that physicians receive the annual influenza vaccination.  All local hospitals, except one, accepted the form.  The refusing hospital faxed me a different form demanding that one of my personal physicians, rather than me, verify that I have a "recognized medical contraindication" to the annual influenza vaccination.  Of course, I could not produce such documentation, so I ultimately chose to receive this year's influenza vaccination rather than continue what would have been a futile fight which would have ultimately led to loss of my current job.

The LIBERTARIAN BIOETHICS BLOG opposes mandatory annual influenza vaccination of any person for any reason.