Anita L. Allen

Cognitive Enhancement and Beyond: Recommendations from the Bioethics Commission

Media outlets are reporting that cognitive enhancement is reaching epidemic levels, but evidence is lacking and ethical questions remain. The US Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has examined the issue, and we lay out the commissions findings and their relevance for the scientific community.

No Dignity in BODY WORLDS: A Silent Minority Speaks

I applaud Lawrence Burns (2007) for his decision to carefully examine the ethics of Gunther von Hagens’ popular BODY WORLDS shows. These collections of plastinated, dissected human cadavers and body parts have been traveling through Europe, the United States and Canada for several years. Burns (2007) takes up the question whether the shows are an affront to human dignity. He concludes that they are not, if the shows are educational, uniquely educational, and treat the human body in an honorable, dignified way. Although Burns seems to think the shows can be tweaked to meet most of the legitimate “dignity” concerns I disagree. The whole project is a mistake and lacks more than dignity. The dead are dead, but human death and memory merit treatment of a sort that is fundamentally violated by Von Hagen’s plastination project. What Burns (2007) usefully prompts is to think about is, first, the criteria we ought to use within bioethics for determining that an act or practice is a violation of dignity, and, second, the proper interplay in bioethics between considerations of utility and dignity. In 2005, I undertook a study of the BODY WORLDS exhibit then on display at the Franklin Institute in Philadelphia (PA). I went to see the show and spent three hours there. I reviewed the “press kit.” I listened to the audio taped selfguided tour. I spoke to museum and BODY WORLDS officials and also to bioethicists familiar with the show. The exhibit I saw featured dynamically posed and meticulously dissected cadavers. There were gymnasts, a basketball player, an archer, a teacher and a contemplative chess player. One memorable specimen was a baroquely filleted cadaver who sported a comical hat. Another cadaver, expanded to the size of a giant, pedaled an oversized bicycle. Others clutched what appeared to be their own suits of skin, brains or viscera. An exhibit called ”The Family” consists of a man, woman and child. Hidden behind a black curtain reclined the dissected cadaver of a pregnant woman, fetus in situ exposed. She was flanked by two walls of deformed fetuses and newborns that von Hagens says he obtained from ”historic pre-1920s collections” and plastinated after lives in jars of alcohol or formalin.

Is There a Right to Health

Health and Social Justice by Jennifer Prah Ruger is a complex, timely, ambitious reflection on moral and political legitimacy in healthcare. The book presents an original theoretical framework for health ethics, policy, and law. She intends her framework to guide health system development, reform and scarce health resource allocation. Steeped in multiple scholarly literatures, Ruger writes crisply without verbal bric-a-brac for peer audiences. Her tight, analytic approach engages readers familiar with the main debates around domestic healthcare in the United States, but who are hungry for fresh, systematic, forward-looking paradigms that build on relevant philosophical, political and policy scholarship. There is a right to life. Is there a right to health? In Chapter 5, ‘Grounding the Right to Health,’ Ruger lays out the parameters of a philosophical argument for a ‘right to health.’ In her view, we can and must speak of a right to health. The right to health is a positive as opposed to a negative right; a right to a set of conditions and capacities, as opposed to right of mere access to available services; and a right whose correlatives are perfect and imperfect duties of benevolent, rational resource reallocation. To understand and assess Ruger’s effort to defend a right to health, one first needs to understand the book’s larger set of important tasks. Professor Ruger commences with a particular view of the good life. She calls it ‘human flourishing,’ a concept with its deepest roots in Aristotle’s perspective on ethical value, pruned for modern applications by Martha Nussbaum (1990, 2000) and others (Ruger, 2010, p. 45). Under Ruger’s conception of human flourishing, health is an intrinsic good. For Ruger, human health is best understood as a set of physiologic, psychological and social states: functioning optimally without evidence of disease or abnormality; coping optimally with life circumstances; possessing physical and psychological integrity; performing valued roles; dealing with stress; and feeling well and free of undue risk (2010, pp. 85–86). So understood, not only is health an intrinsic good, Ruger urges, but it is and should be more highly valued than other non-intrinsic, instrumental goods, such as wealth or income. The elevated status of human health in the domain of goods gives rise to the urgency of what Ruger refers to as ‘health capability’ or ‘a person’s ability to be healthy’ (2010, p. 3). We all need health capability to have a shot at health, and therefore at flourishing. For each of us, health capability entails Journal of Human Development and Capabilities Vol. 12, No. 4, November 2011

Hijabs and Headwraps: The Case for Tolerance

On March 15, 2006, French President Jacques Chirac signed into law an amendment to his country’s education statute, banning the wearing of conspicuous signs of religious affiliation in public schools. Prohibited items included a large cross, a veil, or skullcap. The ban was expressly introduced by lawmakers as an application of the principle of government neutrality, du principe de laicite. Opponents of the law viewed it primarily as an intolerant assault against the hijab, a head and neck wrap worn by many Muslim women around the world. In Politics of the Veil, Professor Joan Wallach Scott offers an illuminating account of the significance of the hijab in France. Scott’s lucid, compact examination of the hijab complements previous feminist scholarship on veiling with a close look at its role in a particular time and place - contemporary France - where it has been the subject matter of a unique political discourse. How different is America’s political discourse surrounding religious symbols in the schools as compared to the French? I offer a U.S. constitutional perspective on the rights of religious minorities and women in the public schools, and suggest that a ban on the hijab must be considered unconstitutional. A proposal for a national rule against the hijab in public schools or universities would fall flat in the United States. When compared to U.S. approaches to the hijab, the French experience underscores an important point: there is more than one way to be a modern, multicultural western liberal democracy with a Muslim population, and some ways are better than others.