Abstract
Our approach to global bioethics will depend, among other things, on how we answer the questions whether global bioethics is possible and whether it, if it is possible, is desirable. Our approach to global bioethics will also vary depending on whether we believe that the required bioethical deliberation should take as its principal point of departure that which we have in common or that which we have in common and that on which we differ. The aim of this article is to elaborate a theoretical underpinning for a bioethics that acknowledges the diversity of traditions and experiences without leading to relativism. The theoretical underpinning will be elaborated through an exploration of the concepts of sameness, otherness, self and other, and through a discussion of the conditions for understanding and critical reflection. Furthermore, the article discusses whether the principle of respect for the other as both the same and different can function as the normative core of this global bioethics. The article also discusses the New Jersey Death Definition Law and the Japanese Transplantation Law. These laws are helpful in order to highlight possible implications of the principle of respect for the other as both the same and different. Both of these laws open the door to more than one concept of death within one and the same legal system. Both of them relate preference for a particular concept of death to religious and/or cultural beliefs.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
The idea of moral neo-colonialism is described by Widdows (2007, p. 306): “unlike moral colonialism of the past, values are not presented as superior, but as universal, requiring not conversion to an alternative (presumably better) value system, but recognition of universal values.”
Holm and Williams-Jones (2006) both describe and criticise this view.
This is also the case if some will “find their relations defined by similarly socially structured differences of gender, race, class, nation or religion” (Young 1997: 347).This conception of the other is, then, different from the Other in Simone de Beauvoir’s The Second Sex, where the Other is defined as that which the One is not—and where the Other becomes devalued (de Beauvoir 1952).
Young (1997, p. 347) emphasises that the relation between self and other is never or most rarely symmetrical (we need to take into account structured social difference of sex, class, ethnicity, religion etc. And, even if we do so, different persons “bring different life histories, emotional habits and lifeplans to a relationship, which makes their positions irreversible”). Claiming the relation to be symmetrical merely obscures differences.
In this discussion, the other as both the same and different is not only a factual description. The other as same and different is of significance with regard to how we interact and what understanding and critical reflection we can engage in. The other should be respected in both these regards within certain limits.
For this reason, it may seem to be particularly problematic to question and critically examine that which the other says from my own point of view: reflection can destroy understanding. Some have even concluded that the “very attempt to reach a critical perspective would go against the authenticity of the experience of openness as Gadamer has defined it” (Rasmussen 2002, p. 509). This view, I believe, is partly due to a misconception.
This is a questioning where one “does not go about identifying the weakness of what the other person says in order to prove that one is always right, but where one seeks instead as far as possible to strengthen the other’s viewpoint so that what the other person has to say becomes illuminating” (Gadamer 1989, p. 55). This is also what Iris Marion Young (1997) tries to capture with her “respectful stance of wonder” as a basis for ethics. It involves an openness towards the other where she or he is conceived as “irreversible” (not as a mirror of the self); it also involves a response to the other where I neither impose my own views on her or him nor perceive the other as exotic (which either can “turn their transcendence into a human inscrutinability [or] become a prurient curiosity”) (Young 1997, p. 56). The concept of the other as the same and different can be used to highlight this dual concern.
In this sense, reading novels make us meet fictional concrete others. However, the very strength of these others are that they can act in ways that we as readers did not thought they would or could.
Indeed, Gadamer (1989, p. 25) says, “being which can be understood is language,” implying that “that which is can never be completely understood.”
It is important to distinguish between concepts of death, which must involve definitions of death, corresponding criteria for death and tests for death. However, when I discuss death concepts, death definitions, death criteria and tests for death, I will allow myself to refer to this as death concepts and their implications.
According to the heart-lung death definition, death has been assumed to occur at the moment of irreversible cessation of respiration and circulation. If the higher-brain death definition is used, death is defined as the irreversible loss of higher cognitive functions or it is claimed that death takes place when the integration of bodily and (higher) mental functions are irreversibly lost.
The traditional view of Judaism is that death occurs upon the separation of the soul from the body. The question when this takes place is debated. The Babylonic Talmud (tractate Yoma) states that in order to determine whether someone is dead one should examine the person’s respiration (“his nose”). The Babylonic Talmud also adds that examination of cardiac activity may be necessary (“some say: Up to his heart.”) Nowadays, some rabbis accept the whole-brain death definition and the whole-brain death criterion, whereas others hold that death occurs when there is an irreversible cessation of respiration (i.e. they apply a heart-lung death criterion). Still others argue that in Medieval Jewish thought, cessation of respiration was only considered to be indicative of prior cessation of cardiac activity. Indeed, respiration without cardiac activity was thought to be impossible. In line with this reasoning, both the irreversible cessation of cardiac activity and the irreversible cessation of respiration are necessary criteria of death. Rabbis who hold this view do not accept the whole-brain death definition or the whole-brain death criterion. See J.D. Bleich (1999, pp. 372–393), F. Rosner (1999, pp. 210–221).
However, if organ donation is to be allowed to take place, the donor must have expressed which death concept and criteria she or he wanted to be used, the wish to donate organs must have been written beforehand, and the family must agree both on the death concept and organ donation. For a discussion of this law, see Morioka (2001).
References
Ahmed, S. 2006. Queer phenomenology. Durham, London: Duke University Press.
Ahmed, S. 2007. A phenomenology of whiteness. Feminist Theory 8: 149–168.
Bagheri, A. 2005. Organ transplantation laws in Asian countries: A comparative study. Transplantation Proceedings 37: 4159–4162.
Bauer, J.R., and D.A. Bell. 1999. The East Asian challenge for human rights. Cambridge: Cambridge University Press.
Beauchamp, T.L., and J.F. Childress. 2001. Principles of biomedical ethics, 5th ed. Oxford: Oxford University Press.
Beck, U. 2004. The truth of others. A cosmopolitan approach. Common Knowledge 10: 430–449.
Benhabib, S. 1992. Situating the self. Gender, community and postmodernism in contemporary ethics. Cambridge: Polity Press.
Bleich, J.D. 1999. Time of death in Jewish law. New York: Z Berman.
Carsten, J. 2004. After kinship. Cambridge: Cambridge University Press.
Darwall, S. 1977. Two kinds of respect. Ethics 88: 36–49.
de Beauvoir, S. 1952. The second sex. New York: Alfred A. Knopf.
Dillon, R.S. 1992. Care and respect. In Explorations in feminist ethics: Theory and practice, ed. E. Browning Cole, and S. Coultrap-McQuin, Bloomingtown and Indianapolis: Indiana University Press.
Gadamer, H.-G. 1989. Reply to Jacques Derrida. In Dialogue and deconstruction. The Gadamer-Derrida encounter, ed. D.P. Michelfelder, and R.E. Palmer. New York: State University of New York Press.
Gadamer, H.-G. 2004. Truth and method. London, New York: Continuum.
Genesis 7:22. Bible. New international version. 1984. International Bible Society.
Gibson, S. 2006. Respect as esteem: The case of counselling. Res Publica 12: 80.
Engelhardt, H.T. eds. 2007. Global bioethics: The collapse of consensus. Salem, MA, USA: M&M Scrivener Press.
Holm, S., and B. Williams-Jones. 2006. Global bioethics-myth or reality? BMC Medical Ethics 7: 1–10.
Husserl, E. 1989. Ideas pertaining to a pure phenomenology, second book. Dordrecht: Kluwer Academic Publishers.
Irigaray, L. 1974. Speculum of the other woman. Ithaca: Cornell University Press.
John Paul II. 2000. Address to the XVIII International Congress of the Transplantation Society, Aug 29.
Kerridge, I.H., P.P. Saul, M. Lowe, J. McPhee, and D. Williams. 2002. Death, dying and donation: organ transplantation and the diagnosis of death. Journal of Medical Ethics 28: 89–94.
Khushf, G. 2006. Owning up to our agendas: On the role and limits of science in debates about embryos and brain death. Journal of Law, Medicine and Ethics 34: 58–76.
Lock, M. 2002. Twice dead. Organ transplants and the reinvention of death. Berkeley: University of California Press.
Morioka, M. 2001. Reconsidering brain death: A lesson from Japan’s fifteen years of experience. Hastings Center Report 31: 41–46.
New Jersey Statutes. Annotated. 1991. Declaration of death. 26:6A–5. St Louis, MO: West Publishing.
Ohnuki-Tierney, E. 1994. Brain death and organ donation. Cultural. Current Anthropology 35: 233–254.
Olick, R.S. 1991. Brain death, religious freedom, and public policy: New Jersey’s landmark legislative initiative. Kennedy Institute of Ethics Journal 1: 275–288.
President’s Commission for the Study of Ethical Problems in Medicine, Biomedical, Behavioural Research. 1981. Defining death: medical, legal and ethical issues in the definition of death. Washington, DC: U.S. Government Printing Office.
Rasmussen, D.M. 2002. Hermeneutics and public deliberation. Philosophy & Social Criticism 28: 504–511.
Rawlinson, M.C., and A. Donchin. 2005. The quest for universality: reflections on the universal draft declaration on bioethics and human rights. Developing World Bioethics 5: 258–266.
Ricoeur, P. 1981. Hermeneutics and the human sciences. Essays on language, action and interpretation. Cambridge, UK: Cambridge University Press.
Ricoeur, P. 1991. From text to action. London: Athlone.
Rosner, F. 1999. The definition of death in Jewish law. In The definition of death. Contemporary controversies, ed. S.J. Younger, R.M. Arnold, and R. Shapiro. Baltimore, London: The John Hopkins University Press.
Sakamoto, H. 1999. Towards a new “Global Bioethics”. Bioethics 13: 191–197.
Shewmon, A. 2001. The brain and somatic integration: Insights into the standard rationale for equating ‘brain death’ with death. Journal of Medicine and Philosophy 26: 457–478.
Swedish Committee on Defining Death. 1984. The Concept of death. Stockholm: Swedish Ministry of Health and Social Affairs.
Truog, R.D. 1998. Is it time to abandon brain death? In The ethics of organ transplantation, ed. A.L. Caplan, and D.H. Coelho. New York: Prometheus Books.
Uniform Determination of Death Act. 1990. 12 Uniform Laws Annotated 320 (Suppl.).
Veatch, R.M. 1999. The conscious clause: How much individual choice in defining death can our society tolerate? In The definition of death. Contemporary controversies, ed. S.J. Younger, R.M. Arnold, and R. Shapiro. Baltimore, London: The John Hopkins University Press.
Veatch, R.M. 2005. The death of the whole-brain death: The plague of the disaggregators, somaticists and mentalists. Journal of Medicine and Philosophy 30: 353–378.
Widdows, H. 2007. Is global ethics moral neo-colonialism? An investigation of the issue in the context of bioethics. Bioethics 21: 305–315.
Young, I.M. 1997. Assymetrical reciprocity: On moral respect, wonder and enlarged though. Constellations 3: 340–363.
Zeiler, K. 2008. Deadly pluralism? Why death concept, death definition, death criterion and death test pluralism should be allowed, even though it evokes some problems. Bioethics 1–10.
Zoki no Ishoku nikansuru Horitsu [The Law concerning Organ Transplantation]. 1997. Law no. 104 of 1997, July 16.
Acknowledgments
I would like to thank the two anonymous reviewers for their helpful comments on a previous version of this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zeiler, K. Self and other in global bioethics: critical hermeneutics and the example of different death concepts. Med Health Care and Philos 12, 137–145 (2009). https://doi.org/10.1007/s11019-009-9186-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11019-009-9186-y