On Replacement Body Parts
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Technological advances are making devices that functionally replace body parts—artificial organs and limbs—more widely used, and more capable of providing patients with lives that are close to “normal.” Some of the ethical issues this is likely to raise relate to how such prostheses are conceptualized. Prostheses are ambiguous between being inanimate objects and sharing in the status of human bodies—which already have an ambiguous status, as both objects and subjects. At the same time, the possibility of replacing body parts with artificial objects puts pressure on the normative status typically accorded to human bodies, seemingly confirming that body parts are replaceable objects. The paper argues that bodies’ normative status relies on the relation of a body to a person and shows that persons could have similar relations to prostheses. This suggests that in approaching ethical issues surrounding prostheses, it is appropriate to regard them as more like body parts than like objects.
KeywordsArtificial organs Prosthetics Embodiment Organ sales
This research was supported by Australian Research Council Centres of Excellence funding scheme (grant ID CE140100012). My thanks to Robert Sparrow for extensive comments on several drafts of the paper. Thanks also to other members of the ethics and policy team at the ARC Centre of Excellence for Electromaterials Science and participants at the 2017 European Society for Philosophy of Medicine and Healthcare Conference, for helpful comments and questions.
- Brown, B. 2013. A farewell to arms (and legs): The legal treatment of artificial limbs. Columbia Journal of Law and Social Problems 47(1): 69–102.Google Scholar
- Food and Drug Administration (FDA). No date. Summary of Safety and Effectiveness Data (CardioWest Total Artificial Heart). https://www.accessdata.fda.gov/cdrh_docs/pdf3/P030011b.pdf. Accessed December 11, 2017a.
- ———. 2014. FDA-approved Cochlear Implants. https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/CochlearImplants/ucm062882.htm. Accessed December 11, 2017.
- ———. 2017. The 670G system—P160017. http://wayback.archive-it.org/7993/20170111141252/http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm522764.htm. Accessed December 11, 2017.
- Garreau, J. 2007. Cold reality of an artificial heart. Seattle Times, August 19. https://www.seattletimes.com/seattle-news/health/cold-reality-of-an-artificial-heart/. Accessed December 11, 2017.
- Glynn, J., H. Song, B. Hull, et al. 2017. The Oregon heart total artificial heart: Design and performance on a mock circulatory loop. Artificial Organs 41(10): 904–910.Google Scholar
- Hume, D. 1969. A treatise of human nature. Edited by E.C. Mossner. London: Penguin.Google Scholar
- International Medical Device Regulators Forum (IMDRF). 2014. Software as a medical device (SaMD): Possible framework for risk categorisation and corresponding considerations. http://www.imdrf.org/workitems/wi-samd.asp. Accessed December 11, 2017.
- Kant, I. 1997. Lectures on Ethics. Edited by P. Heath and J.B. Schneewind. Translated by P. Heath. Cambridge: Cambridge University Press.Google Scholar
- Locke, J. 1975. An essay concerning human understanding. Edited by P.H. Nidditch. Oxford: Oxford University Press.Google Scholar
- Mackenzie, C. 2009. Personal identity, narrative integration, and embodiment. In Embodiment and Agency, edited by S. Campbell, L. Meynell, and S. Sherwin, 100–125. University Park, PA: Penn State University Press.Google Scholar
- ———. 2010. Conceptions of autonomy and conceptions of the body in bioethics. In Feminist Bioethics: At the Centre, on the Margins, edited by J. Leach Scully, L.E. Baldwin-Ragaven, and P. Fitzpatrick, 71–90. Baltimore: John Hopkins University Press.Google Scholar
- ———. 2014. Embodied agents, narrative selves. Philosophical Explorations 17(2): 154–171.Google Scholar
- Martin, R. 1998. Self-Concern: An experiential approach to what matters in survival. Cambridge: Cambridge University Press.Google Scholar
- McDonnell, P.M., R.N. Scott, J. Dickison, R.A. Theriault, B. Wood. 1989. Do artificial limbs become part of the user? New evidence. Journal of Rehabilitation Research and Development 26(2): 17–24.Google Scholar
- MedGadget. 2016. Retina Implant’s higher resolution alpha AMS visual implant cleared in EU. MedGadget, April 1. https://www.medgadget.com/2016/04/retina-implants-higher-resolution-alpha-ams-visual-implant-cleared-in-eu.html. Accessed December 11, 2017.
- Merleau-Ponty, M. 1962. Phenomenology of perception. Abingdon: Routledge.Google Scholar
- Mudry, A., and M. Mills. 2013. The early history of the cochlear implant. JAMA Otalaryngology—Head and Neck Surgery 139(5): 446–453.Google Scholar
- ———. 2008. Embodiment and prosthetics. In Psychoprosthetics, edited by P. Gallagher, D. Desmond, and M. Maclachlan, 119–129. Dordrecht: Springer.Google Scholar
- Ricoeur, P. 1992. Oneself as another. Translated by K. Blamey. Chicago: University of Chicago Press.Google Scholar
- Robson, D. 2014. The mind-bending effects of feeling two hearts. BBC Future, December 5. http://www.bbc.com/future/story/20141205-the-man-with-two-hearts. Accessed December 11, 2017.
- Schechtman, M. 1996. The constitution of selves. Ithaca: Cornell University Press.Google Scholar
- Second Sight. 2017. Frequently asked questions. http://www.secondsight.com/frequently-asked-questions-pf-en.html. Accessed December 11, 2017.
- Tagney, J. 2010. A literature review comparing the experiences and emergent needs of adult patients with permanent pacemakers (PPMs) and implantable cardioverter defibrillators (ICDs). Journal of Clinical Nursing 19(15-16): 2081–2089.Google Scholar
- Wilson, C. 2017. Artificial lungs in a backpack may free people with lung failure. Daily News, March 21. https://www.newscientist.com/article/2125422-artificial-lungs-in-a-backpack-may-free-people-with-lung-failure/. Accessed December 11, 2017.