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In this article, I explore difficult and sensitive questions regarding the nature of transgender identity claims and the appropriate medical treatment for those suffering from gender dysphoria. I first analyze conceptions of transgender identity, highlighting the prominence of the wrong-body narrative and its dualist presuppositions. I then briefly argue that dualism is false because our bodily identity (including our body’s biological organization for sexual reproduction as male or female) is essential and intrinsic to our overall personal identity and explain why a sound, nondualist anthropology implies that gender identity cannot be entirely divorced from sexual identity. Finally, I make the case that arguments in favor of hormonal and surgical treatments for gender dysphoria rest on this mistaken dualist anthropology, and that these treatments therefore give false hope to those suffering from gender dysphoria, while causing irreversible bodily harm and diverting attention from underlying psychological problems that often need to be addressed. I also briefly discuss how these philosophical claims relate to empirical studies on the outcomes of hormonal and surgical treatments for gender dysphoria and to testimonies of transgender individuals who regret having undergone these treatments.

Using cell lines like HEK 293 or their products—like many of the COVID-19 vaccines—involves no cooperation with evil strictly speaking, but it does involve appropriation of the benefits of past evil. Applying M. Cathleen Kaveny’s framework for assessing the permissibility of appropriating the benefits of evil, the duty to avoid using cell lines like HEK 293 or their products is weak and defeasible. Proper interpretation of Dignitas personae requires recognizing the crucial moral differences between the use of these cell lines—which does not perpetuate the injustice of abortion, imply approval of abortion, or involve significant risks of corrupting moral character or provoking scandal—and the direct use of fetal tissue or human embryos in research.

In this essay, I outline fundamental anthropological and moral principles related to human sexuality and gender identity and then apply these principles to analyze and evaluate the views of several authors who attempt to carve out a “middle way” between liberal and traditionalist approaches to these issues. In doing so, I engage especially with the claim that gender dysphoria, rather than being a psychological issue, is a type of biological intersex condition in which one’s “brain sex” is out of line with one’s genital and chromosomal sex. I argue that understanding the human person as a unity of body and soul and recognizing human sexuality as ordered toward the human good of marriage understood as inseparably unitive and procreative reveals the flaws in this position and helps to show why hormonal or surgical gender reassignment therapy is not a medically or ethically appropriate response to gender dysphoria. I also offer an alternative characterization of gender dysphoria and suggestions for responding with true compassion to those who suffer from it.

The major difference between “new” and “old” natural law approaches to sexual ethics is that for new natural law theorists the moral evaluation of sex acts is always determined with reference to that basic form of human flourishing which is called marriage; old natural law theorists determine the morality of sex acts also (or primarily) with reference to the natural purpose of the sexual faculties. Ultimately, the old approach relies implicitly on prior value judgments to distinguish biological facts that are axiologically or morally relevant from those that are not. It also appeals to values to ground the wrongness of immoral sex acts. In its pure form, the old natural law approach to sexual ethics lends itself to a misunderstanding of the unitive aspect of marriage. More broadly, an accurate understanding of new natural law does not run afoul of the correct interpretation of “nature” in natural law.

Ethical issues related to the practice of medicine are typically analyzed using the four principles outlined by Beauchamp and Childress: Autonomy, Beneficence, Non-Maleficence, and Justice. This principlist approach to medical ethics purports to be acceptable to a wide range of people by avoiding contentious foundational issues. Yet, as many critics have pointed out, principlism has significant shortcomings. While it is true that most people can agree on the need to respect the four principles, this superficial agreement masks deep disagreement about their precise meaning, especially when they are in conflict. Melissa Moschella believes that natural law theory has the resources to overcome these difficulties by offering a richer account of the human good that can (1) provide content to the notions of beneficence and non-maleficence, (2) explain how autonomy relates to the human good and therefore how to weigh it against other values in cases of conflict, and (3) offer a conception of justice that is integrated within an account of human flourishing, by contrast with a utilitarian conception that pits the public good against the well-being of the individual. This essay aims to outline and defend a natural law framework to biomedical ethics as a viable alternative to principlism.

In this essay I argue that religion, understood as harmony with the transcendent source of existence and meaning, is a good that practical reason grasps as an objective, distinct, and important aspect of human well-being, one that reasonably takes pride of place among the various aspects of a good human life due to its architectonic role in structuring and adding a transcendent meaning to all of the other goods that we pursue. On the basis of this view of religion, I suggest that religious belief and practice deserve special protection in law, above and beyond mere preferences and even other conscientious commitments. I develop this view through a dialectical engagement with Ronald Dworkin, Brian Barry, and Christopher Eisgruber and Lawrence Sager.

In this paper, I argue that brain death is death because, despite the appearance of genuine integration, the brain-dead body does not in fact possess the unity that is proper to a human organism. A brain-dead body is not a single entity, but a multitude of organs and tissues functioning in a coordinated manner with the help of artificial life support. In order to support this claim, I first lay out Hoffmann and Rosenkrantz’s ontological account of the requirements for organismal unity and summarize an earlier paper in which I apply this account to the brain death debate. I then further support this ontological argument by developing an analogy between the requirements for the unity of an organism and the requirements for the unity of an orchestra. To do so, I begin by examining the role that a conductor plays in unifying a traditional orchestra, and then go on to show that the human organism (at least in postnatal stages) functions like a traditional orchestra that relies upon a conductor (the brain) for its unity. Next, I consider the conditions required to achieve orchestral unity in conductorless orchestras and show that, in contrast to simpler organisms like plants, the postnatal human organism lacks those conditions. I argue, in other words, that although conductorless orchestras do exist, the human organism is not one of them. Like a traditional orchestra without a conductor, the brain-dead body is not a unified whole.

As is clear in the 2008 report of the President's Council on Bioethics, the brain death debate is plagued by ambiguity in the use of such key terms as ‘integration’ and ‘wholeness’. Addressing this problem, I offer a plausible ontological account of organismal unity drawing on the work of Hoffman and Rosenkrantz, and then apply that account to the case of brain death, concluding that a brain dead body lacks the unity proper to a human organism, and has therefore undergone a substantial change. I also show how my view can explain hard cases better than one in which biological integration (as understood by Alan Shewmon and the President's Council) is taken to imply ontological wholeness or unity.

Does the ability of some brain dead bodies to maintain homeostasis with the help of artificial life support actually imply that those bodies are living human organisms? Or might it be possible that a brain dead body on life support is a mere collection of still-living cells, organs and tissues which can coordinate with one another, but which lack the genuine integration that is the hallmark of a unified human organism as a whole? To foster further study of these difficult and timely questions, a Symposium on the Definition of Death was held at The Catholic University of America in June 2014. The Symposium brought together scholars from a variety of disciplines—law, medicine, biology, philosophy and theology—who all share a commitment to the dead donor rule and to a biological definition of death, but who have differing opinions regarding the validity of neurological criteria for human death. The papers found in this special issue are among the fruits of this Symposium.

This statement summarizes the conclusions of the Symposium on the Definition of Death, held at The Catholic University of America in June 2014. After providing the background and context for contemporary debates about brain death and describing the aims of the symposium, the statement notes points of unanimous and broad agreement among the participants, and highlights areas for further study.

This article explains the problems with Alan Shewmon’s critique of brain death as a valid sign of human death, beginning with a critical examination of his analogy between brain death and severe spinal cord injury. The article then goes on to assess his broader argument against the necessity of the brain for adult human organismal integration, arguing that he fails to translate correctly from biological to metaphysical claims. Finally, on the basis of a deeper metaphysical analysis, I offer a revised rationale for the validity of the neurological criterion of human death.

Most people believe that parents have rights to direct their children's education and upbringing. But why? What grounds those rights? How broad is their scope? Can we defend parental rights against those who believe we need more extensive state educational control to protect children's autonomy or prepare them for citizenship in a diverse society? Amid heated debates over issues like sexual education, diversity education and vouchers, Moschella cuts to the heart of the matter, explaining why education is primarily the responsibility of parents, not the state. Rigorously argued yet broadly accessible, the book offers a principled case for expanding school choice and granting exemptions when educational programs or regulations threaten parents' ability to raise their children in line with their values. Philosophical argument is complemented with psychological and social scientific research showing that robust parental rights' protections are crucial for the well-being of parents, children and society as a whole.

The dominant philosophical view of gamete donation as morally permissible (when practiced in the right way) rests on two premises: (1) parental obligations are triggered primarily by playing a causal role (as agent cause) in procreation, not by genetic ties, and (2) those obligations are transferable-that is, they are obligations to make adequate provision for the child's needs, not necessarily to raise the child oneself. Thus while gamete donors are indeed agent causes of the children that their donation helps to bring into existence, most think that donors' obligations are discharged insofar as they know that competent others intend to care for those children. In this article, I call into question this dominant view by challenging both of its premises. Challenging the first premise, I argue that genetic parenthood is what primarily triggers parental obligations. Challenging the second premise, I claim that those obligations are non-transferable-i.e., that they are obligations not simply to ensure that someone will raise one's genetic child, but to raise that child oneself (unless one is incompetent). The implication of my argument is that gamete donation is inherently wrong insofar as it involves acquiring non-transferable obligations that one has no intention of fulfilling.

Proponents of the “ethics of care” frequently pinpoint liberal individualism as one of the roots of contemporary Western culture’s failure to appreciate the profound relationality and interdependence of human beings.1 The ideal of the free and equal individual at the heart of liberal theories masks the reality of human vulnerability—physical, moral, and intellectual—and the centrality to human flourishing of both giving and receiving care. Given the pervasiveness of liberal ideology, and of the resulting exaltation of independence and autonomy as the highest human values, calling attention to interdependence and relationality requires nothing less than a paradigm shift in our way of looking at human nature and of approaching social and political life. To make way for such a shift, it is important to have a thorough understanding of precisely in what ways liberal theory is inadequate and of why it nonetheless has exercised such a strong influence even to the present day.