This chapter explains the principle of equivalence in medical rights between prisoners and the free public and argues that MAID will be authorized for prisoners on the grounds that depriving them of this option is unconstitutional.

Providing care in the perinatal period brings medical practice to the essence of what it means to be human: fertility, birth, death, dignity, personhood, parenthood, and beyond. Such a shifting technological and moral landscape necessitates practitioners to develop an adaptable ethical framework to address complex, emotionally charged, value-laden decisions. As the border of viability is pushed earlier in gestational life and we improve treatment of conditions that were once considered untreatable, areas for ethical inquiry and potential moral distress grow. Our ethical examinations of such advances often lag, evolving as the shortcomings of those leaps become apparent. Projected neurologic function often lies at the heart of ethical questions that emerge in the neonatal period. Despite rigorous efforts in research, reliable, evidence-based guidance is lacking. We must investigate many elements of the decision-making process concerning medical practitioners, families, and the courts. We must balance the rights of the patient and surrogate decision-makers, the duties of the physician and care team, legal precedent, and questions revolving around quality and quantity of life. Recent controversies highlight the challenge of communicating with desperate parents, the delicate balance involved in respecting family preferences today, and research that yields valuable evidence for superior care tomorrow.

Lane argues that Charles Peirce’s philosophy can contribute to contemporary debates about the metaphysical and moral status of prenatal humans. Some participants in those debates view an early embryo as numerically identical to, and as having the same moral status as, the adult to which it gives rise; bioethicists in this camp tend to maintain that our metaphysical and moral judgments about prenatal humans are capable of objective truth. Others argue from the continuity of prenatal development to the view that metaphysical judgments about when beings like us begin to exist and moral judgments about when beings like us attain moral status cannot be objective. Lane argues that Peirce provides the resources for developing alternative positions. Those resources are Peirce’s synechism, according to which continuity is of central importance in philosophy, his scholastic realism, according to which there are real kinds, his basic realism, according to which there is a world that is the way it is apart from how anyone represents it to be, and his pragmatic clarifications of the concepts of reality and truth.

Abstract: In this chapter, Taye explores Dewey’s pragmatist ethics in Human Nature and Conduct (1922) showing how it assists in addressing daunting challenges of healthcare allocation in sub-Saharan Africa. Given resource scarcity, economic dependency, and externally imposed policies in sub-Saharan nations, Dewey’s approach provides a context-sensitive, deliberative, and participatory model for decision-making. Traditional bioethical models, such as principlism, are often criticized for their Western-centric assumptions and rigid deductive logic. Pragmatism, by contrast, emphasizes empirical inquiry, interdisciplinarity, and social engagement. Dewey’s ethics reject fixed principles, favoring adaptive problem-solving that responds to local contexts. Sub-Saharan Africa’s healthcare systems struggle under colonial legacies and international interventions, with policies imposed top-down. Global allocation models, including cost-effectiveness metrics and donor-driven frameworks, often fail to align with local needs. A more suitable approach must incorporate community participation and indigenous health perspectives. Dewey’s alternative emphasizes public deliberation, ensuring stakeholder engagement at all levels. Education plays a foundational role in fostering collective problem-solving and rebuilding institutions. Rather than relying on externally imposed ethical frameworks, African healthcare systems must develop their own allocation models through participatory governance. Taye concludes that a Deweyan pragmatist approach offers a promising path toward ethical and effective healthcare distribution in the region.

Before examining how the regulation of bioethical matters impacts the equal right to live in the world for people with impairments, Chapter 1 elaborates on key concepts relevant for the book’s later chapters: disability, eugenics, ableism, and neoliberalism. It begins with a critical discussion of the medical and social models of disability, the two dominant approaches to understanding disability in disability studies. The chapter also highlights the troubled recent history of eugenics, the concept of ableism and the persistence of ableist policies and practices, as well as the importance and shortcomings of disability rights laws in furthering disability justice and equality.

The introductory chapter outlines the book’s central premise: disabled people have as much right to live in the world as the non-disabled. It introduces the human rights and critical disability studies methods used to interrogate the problem of disability discrimination throughout the life cycle, especially at the beginning and end of life. Along with providing an overview, the introductory chapter argues that the book is particularly needed because disability equal rights struggles remain marginal in mainstream bioethics and law.

The concluding chapter summarises the book’s central argument that laws, policies, and practices which privilege the birth and survival of the non-disabled fundamentally challenge the notion that people with impairments have an equal right to live in the world. It also discusses avenues for further research, before closing with some final remarks.

We describe our personal and professional struggles with an organizational ethics consultation involving thoracoabdominal normothermic regional perfusion (TA-NRP), an organ procurement technique used after circulatory death. We ultimately concluded that TA-NRP is ethically permissible (with caveats), yet we are haunted. Our advice was taken seriously, but was it the right advice? Our recommendations might have let us off the hook.

This chapter begins by returning to a key moment for conceptions of medical progress in the context of civil rights movements when a new awareness of the insufficiencies of medical progress as “merely” scientific knowledge gains led to a sustained interest in knowledge that was empowering for patients. Amid the growing numbers of people who challenged the focus on scientific progress, many turned to freedom as a new concept for grounding progress in medicine. At times, this went together with more holistic views of personhood and health and the desire to put self-determination at the heart of theories of progress. Other, related trends acknowledged the potential contradictions between freedom and progress head-on and argued that taking individual freedom seriously implied challenging traditional, scientific/technological forms of medical progress. The chapter concludes with a detailed examination of several recent instances, including personalized medicine, in which technological progress is presented as being highly compatible with individual empowerment and liberation.