The ongoing evolution of medical care impacts our lives in many ways. One is the continuous change affecting how we cease to exist. Indeed, more and more people cease to exist after spending a long time in conditions that are intermediate between existence and non-existence, and the practical and legal issue of classifying these states is getting more and more pressing. If we want to make rational decisions about where drawing the lines in the grey zone of the continuum – the intermediate area in which survival is controversial – we should explore what are our metaphysical and moral intuitions and which intuitions appear more renounceable in case of conflict between them or their logical consequences. In particular, the ethical problem of organ donation from patients in a permanent vegetative state should be carefully taken apart, the relevant sub-question being: Should we leave people free to determine what happens to their organs after that they have ceased to exist? Should we leave them free to individually decide in which of the intermediate conditions they should be considered as ‘having ceased to exist’ rather than ‘continuing to exist’? Should people be entitled to receive medical aid to cease to exist if this is what they need to save the life of a son, a friend or a handful of strangers? Should an active medical intervention putting an end to the vital processes of the body – rather than merely the withdrawal of life support as provided by Italian law n. 219/2017 – be granted to patients in a permanent vegetative state who have asked for it in their advance directories?
Le condizioni intermedie fra l’esistenza e la cessione dell’esistenza si diffondono sempre di più, e dovremo trovare modi sempre più razionali per tracciare linee divisorie, in parte convenzionali, ai fini legali e pratici. Si propone qui una visione della bioetica come esplorazione delle conseguenze logico-argomentative delle nostre intuizioni morali e metafisiche, allo scopo di individuare le incompatibilità non ovvie fra tali intuizioni e procedere a rinunciare, quindi, alle intuizioni che appaiono più sacrificabili. In questo quadro, si esamina il problema della utilizzabilità degli organi vitali delle persone entrate in una condizione di stato vegetativo permanente, e si mostra come le risposte moralmente corrette dipendano da diverse sottoquestioni: se si debba lasciare alle persone la libertà di decidere come disporre dei propri organi quando abbiano cessato di esistere, se le si debba lasciare anche libere di decidere in quali condizioni intermedie fra l’esistenza e la cessione dell’esistenza esse effettivamente abbiano cessato di esistere e in quali no, se esse abbiano diritto a decidere di cessare di esistere per salvare una persona amata o una o più persone sconosciute, e se possano esigere nelle proprie disposizioni anticipate di trattamento, al verificarsi di certe condizioni, un intervento medico attivo atto a porre fine ai processi vitali del corpo e non solo la sospensione dei trattamenti di supporto vitale come previsto dalla legge 219/2017 attualmente vigente in materia in Italia.
Cessazione di Esistenza, Stato Vegetativo Permanente e Donazione degli Organi / Bacchini, Fabio. - In: BIOETICA. - ISSN 1122-2344. - 3:(2024), pp. 619-637.
Cessazione di Esistenza, Stato Vegetativo Permanente e Donazione degli Organi
Fabio Bacchini
2024-01-01
Abstract
The ongoing evolution of medical care impacts our lives in many ways. One is the continuous change affecting how we cease to exist. Indeed, more and more people cease to exist after spending a long time in conditions that are intermediate between existence and non-existence, and the practical and legal issue of classifying these states is getting more and more pressing. If we want to make rational decisions about where drawing the lines in the grey zone of the continuum – the intermediate area in which survival is controversial – we should explore what are our metaphysical and moral intuitions and which intuitions appear more renounceable in case of conflict between them or their logical consequences. In particular, the ethical problem of organ donation from patients in a permanent vegetative state should be carefully taken apart, the relevant sub-question being: Should we leave people free to determine what happens to their organs after that they have ceased to exist? Should we leave them free to individually decide in which of the intermediate conditions they should be considered as ‘having ceased to exist’ rather than ‘continuing to exist’? Should people be entitled to receive medical aid to cease to exist if this is what they need to save the life of a son, a friend or a handful of strangers? Should an active medical intervention putting an end to the vital processes of the body – rather than merely the withdrawal of life support as provided by Italian law n. 219/2017 – be granted to patients in a permanent vegetative state who have asked for it in their advance directories?I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.