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Introduction1

1 Posthumous harm, posthumous interests and symbolic existence8

Harm9

General9

Interests9

Posthumous harm: the real puzzles15

The experience problem15

Death as harm17

The Epicurean argument19

Surviving interests20

The problem ofretroactivity22

The moment of harm23

Solving the problem of posthumous （non-）existence25

Existence as a possibility25

Existence in after-life27

Harm and change without existence28

Harm in no particular time31

Persistent existence of the Human Subject34

My proposal34

The nature of the Human Subject36

The relation between the Human Subject and the person37

Strengths of the Human Subject model38

Symbolic existence40

The concept of social self43

Legal support for the interest in symbolic existence45

Conclusion47

2 Posthumous rights49

Specific theories of posthumous rights53

Hillel Steiner53

Annette Baier57

Carl Wellman59

Raymond Belliotti61

General theories of rights63

The choice theory63

Critique of the choice theory64

The exclusion of right-holders67

The dead as right-holders69

The interest theory71

Versions of the interest theory73

The idea of interest76

Applying the interest theory to the dead79

Should the dead be actual right-holders?80

Content of posthumous rights83

Duration of posthumous rights84

Conclusion86

3 Proprietary interest in the body of the deceased88

Is there a proprietary interest in the body of the deceased?89

The ‘no property’ rule89

Haynes’ Case90

Coke’s commentary91

R v.Sharpe92

Exelby v.Handyside93

Common law exceptions to the ‘no property’ rule94

Possession with regard to the duty to bury94

The ‘work and skill’ exception103

The ‘long-dead’ exception107

Undermining the ‘no property’ outcomes110

Undermining the ‘no will’ rule111

Undermining the ‘no theft’ rule113

Should there be a proprietary interest in the body of the deceased?114

Possible theoretical models for acquiring property in the body of the deceased114

Transfer of property114

Property vests in the state115

Abandonment117

Res nullius121

The conceptual meaning of a proprietary interest in the body of the deceased122

Ownership123

Possession126

Use and management127

Disposal127

Transferability and the right to enjoy fruits128

General rationales for a proprietary interest131

Property as a natural right131

Property as the advancement of autonomy and freedom132

Property as constituting personality132

Property as a system of distributive justice134

Property as a form of utilitarianism135

Procedural advantages of a proprietary claim with regard to the human corpse136

Conclusion141

4 Determining the disposal of one’s body after death143

Constraints of autonomy interests145

Legal barriers to enforcing bodily testaments150

Alternatives to the will mechanism154

Human tissue gift laws154

Donor cards155

Living wills156

Trust158

Agency163

Contract164

Alternatives to the property classification criterion165

Substantial limitations of enforcing bodily testaments171

Limitations directly established under legislation172

Limitations directly established under case law173

Clear and convincing demonstration by competent and credible testimony173

Reason, decency and accepted customs of mankind174

Limitations indirectly established under case law174

Timing175

Cost176

Practicability177

Harm to society177

Public mores and vulnerabilities of other groups179

A more general opposition to public policy180

Procedural obstacles181

Protection from harm to third parties181

Quality of familial relationship182

Conditioned bodily testaments183

Quality of relationship to place of disposal183

Conclusion184

5 Medical confidentiality after death186

Introduction186

Post-mortem confidentiality in ethics and law188

Ethics of post-mortem conf identiality188

The legal position189

International law189

Canada190

The USA191

The UK192

General justifications for confidentiality194

Consequentialism194

Rights-based justifications196

Privacy196

Autonomy198

Property200

Fidelity （equity）203

The durability of the obligation to act in confidence204

Survivability of the physician-patient relationship204

An analogy from posthumous attorney—client privilege206

The duty to keep promises: a contractual justification207

Practical solutions to breach of confidentiality212

General solutions to post-mortem confidentiality212

More weight to confidentiality during life212

The ‘no-difference’ approach214

More weight to post-mortem confidentiality214

Casuistical case analysis of post-mortem confidentiality215

Disclosure to protect at-risk third parties215

Disclosure in the best interests of another patient216

Disclosure in death certificates216

Autopsy disclosures219

Disclosure prior to performing an autopsy220

Disclosure from the autopsy procedure itself220

Publication of autopsy reports222

Disclosure to providers of disposal services and organ procurement organizations226

Disclosure of research outcomes concerning dead subjects226

Disclosure for teaching purposes229

Disclosure for contesting a will or supporting an insurance claim230

Disclosure of the medical history of public figures231

Conclusion234

Conclusions236

The application of the interest in the recognition of one’s symbolic existence238

The proprietary interest in the body of the deceased238

The testamentary interest in determining the disposal of one’s body after death241

The interest in post-mortem confidentiality243

Possible objections to the idea of symbolic existence244

Subject of interest244

Duration of symbolic existence245

Balancing the interest in the recognition of one’s symbolic existence with other interests246

A right to the recognition of symbolic existence247

Select bibliography250

Index265