Inhalt

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   1. Introduction
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   The notion of well-being is vague
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   The need for a common language
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   1.1. The goal and methodology
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   1.2. The structure of the book
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  2. Paving the way for the analysis ― preliminaries with regard to the concept of well-being
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   2.1. Well-being and related concepts
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   Health and well-being
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   2.2. An initial insight into the character of well-being
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   Hedonism
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   Desire-fulfilment theories
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   Objective list theories
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   Subjective versus objective concepts of well-being
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   3. Well-being in debates concerning the beginning of life: prenatal testing and selection
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   3.1. A short introduction to techniques and practices
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   Prenatal diagnosis and selective abortion
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   Preimplantation genetic diagnosis
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   3.2. The reference to well-being in the debate on prenatal testing and selection
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  3.2.1. The well-being of the prospective parents
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   The desire for a biological child
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   Avoiding the burdens of raising a disabled or an ill child
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   Preventing PND followed by abortion
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   Criticism by the disability rights activists
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   Interim results
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   3.2.2. The well-being of the future child
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   The zero-line stance
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   Procreative perfectionism
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   The non-identity problem and different people choices
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   The disability rights critique
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   The impossibility of anticipating the well-being of a future child
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   The phenomenon of adaptation
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   Interim results
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   3.3. Results arising from the analysis and the issues it raises
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  3.3.1. The presence of well-being in the face of the notion of moral status
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   Three alternative stances with regard to prenatal moral status
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   Classifying the well-being-based lines of reasoning
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   3.3.2. Tension between objectivist and subjectivist concepts of well-being
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   Applying the scheme to the arguments which refer to the well-being of the future child
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   Putting the hypothesis to the test
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   3.4. Findings: well-being in the debates concerning the beginning of life
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   4. The role of well-being in the discussion on enhancement: the case of non therapeutic mood-improvement
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   4.1. The subject of mood enhancement
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   Two alternative definitions of enhancement
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   Characterizing mood enhancement
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   4.2. The role of well-being in the debate on mood enhancement – an analysis
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   4.2.1. Critical attitudes towards mood enhancement
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   Mood enhancement as an alleged ‘shortcut’ to well-being
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   Missing components of well-being where mood enhancement is concerned
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   Mood enhancers and the danger of losing contact to reality
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   Pleasure derived from a false origin
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   The importance of sorrow and sadness
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   Interim results
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   4.2.2. Argumentations in favour of mood enhancement
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   Pleasure as one among other important components of well-being
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   Indirect promotion of well-being through mood enhancement
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   Interim Results
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   4.3. Results arising from the analysis and the issues it raises
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  4.3.1. The value of (human) nature and the notion of well-being
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   Material versus formal sense of the concept
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   The gratitude and the creativity framework
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   The alternative concepts of human nature and their relationship to well-being
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  4.3.2. The prevalence of broad objective conceptions of well-being
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   Bare versus explanatory objectivism
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   Objective concepts of well-being and essentialism
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   Transposing the insights to the case of mood enhancement
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   The prevalence of broad conceptions of well-being
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   4.4. Drawing conclusions with regard to the role of well-being in the debate on mood enhancement
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   5. The reference to well-being in debates on the allocation of scarce goods within medicine: the example of kidney allocation
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   5.1. The quandary of organ allocation
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   5.2. Criteria used in allocation practice: Eurotransplant and United Network of Organ Sharing
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   Eurotransplant International Foundation
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   United Network of Organ Sharing
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   5.3. Well-being as a consideration in debates on organ allocation
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  5.3.1. Quality of life as a rationale for outcome in organ allocation
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   The QALY approach to allocation
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   QALYs and the problem of unjust discrimination
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   Conflicts with the principle of need
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   Life-saving should have priority over life-enhancement
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   The problem of measuring QoL
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   A narrow concept of QoL
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   Interim results
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   5.3.2. Quality of life as a measure for patient need
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   Present need
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   Urgency
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   Need over a lifetime
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   Interim results
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   5.4. Results arising from the analysis and the issues it raises
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  5.4.1. Well-being and the principle(s) of justice
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   Alternative theories of justice
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   Well-being embedded in utilitarian theories of justice
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   Well-being involved in the dispute on maximizing utility versus justice in distribution
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   Well-being within egalitarian lines of reasoning
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  5.4.2. The predominance of a narrow objective concept of well-being
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   Facilitating the operationalizability and the application of standards of well-being
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   Justice leading to the requirement of a narrow objective concept of well-being
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   5.5. Drawing together the main findings concerning the role of well-being in the debate on organ allocation
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   6. Well-being in discussions concerning the end of life: the cases of assistance in dying and foregoing life-sustaining treatment
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   6.1. An introduction to the discussion about euthanasia
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   Common classificatory schemes
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   6.2. Two examples of assistance in dying in practice
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   6.2.1. Physician-assisted dying in the Netherlands
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   6.2.2. Physician-assisted suicide in the U.S. state of Oregon
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   6.3. The role of well-being in the debate on assistance in dying and foregoing life-sustaining treatment
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  6.3.1. Well-being and assistance in dying in the case of competent patients
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   The ‘argument of mercy’137F
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   The relationship of autonomy and well-being within the main argument for AiD
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   Death with Dignity
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   Alleviating pain and suffering
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   The argument of non-necessity144F
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   Reactions to the argument of non-necessity
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   Preliminary results
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   6.3.2. The reference to well-being in the special case of incompetent patients in discussion on forgoing life-sustaining treatment
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   The concept of competence and its gate keeping function
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   Advance directives
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   The substituted judgment standard
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   The alleged shortcomings of advance directives and substituted judgments
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   Best Interest Standard
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   Preliminary results
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   6.4. Results arising from the analysis and the issues it raises
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   6.4.1. The presence of well-being when occurring with autonomy
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   Paternalism: well-being and autonomy in conflict
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   Possible relationships of autonomy and well-being
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   Putting the relationship of autonomy and well-being into concrete terms
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  6.4.2. Predominance of subjective dimensions of well-being
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   Inconsistencies on the conceptual level of well-being
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   The interference of the principle of autonomy with the concept of well-being
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   6.5. Findings in respect of the role of well-being in the discussions concerning the end of life
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   7. Rethinking well-being in biomedical ethics – synopsis of the observations and issues raised by the analysis
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  7.1. The influence of predominant notions on the role of well-being
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  7.1.1. The shifting presence of well-being in biomedical ethics
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   The presence of well-being in the face of other prevalent notions
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   An overt versus a subliminal presence of well-being
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   The subliminal presence of well-being and the ‘triumph of autonomy’
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   7.1.2. The changing character of well-being in the debates
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   Connections between the prevalent notions and the changing character of well-being
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   Well-being – a chameleon in biomedical ethics?
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  7.2. Attempts in revealing the ‘true’ character of well-being in biomedical ethics
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   Ontological, epistemic and evaluative level
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   Broad versus narrow concepts of well-being
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   The restoration, protection and promotion of well-being
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   7.3. Tentative requirements for a concept of well-being in biomedical ethics – an outlook
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   References