Bioethics: principles, issues, and cases

Cover......Page 1
Title Page......Page 2
Copyright......Page 3
BRIEF CONTENTS......Page 4
CONTENTS......Page 6
 SPECIAL FEATURES......Page 12
 ANCILLARIES......Page 13
 ACKNOWLEDGMENTS......Page 14
Part 1: Principles and Theories......Page 18
  ETHICS AND BIOETHICS......Page 20
  ETHICS AND THE MORAL LIFE......Page 22
   IN DEPTH: MORALITY AND THE LAW......Page 24
  MORAL PRINCIPLES IN BIOETHICS......Page 25
   Autonomy......Page 26
   Beneficence......Page 27
   Utility......Page 28
   Justice......Page 29
  ETHICAL RELATIVISM......Page 30
   IN DEPTH: ANTHROPOLOGY AND MORAL DIVERSITY......Page 31
  ETHICS AND RELIGION......Page 34
   Argument Fundamentals......Page 36
   Patterns of Moral Arguments......Page 39
   IN DEPTH: FALLACIES IN MORAL REASONING......Page 41
   Evaluating Premises......Page 43
   Assessing Whole Arguments......Page 45
  SUMMARY......Page 46
  ARGUMENT EXERCISES......Page 47
  FURTHER READING......Page 49
  NOTES......Page 50
  THE NATURE OF MORAL THEORIES......Page 51
  INFLUENTIAL MORAL THEORIES......Page 52
   Utilitarianism......Page 53
   Kantian Ethics......Page 55
   Natural Law Theory......Page 57
   Rawls’ Contract Theory......Page 59
   Virtue Ethics......Page 60
   The Ethics of Care......Page 61
   IN DEPTH: CAN VIRTUE BE TAUGHT?......Page 62
   Feminist Ethics......Page 63
  CRITERIA FOR JUDGING MORAL THEORIES......Page 64
   Utilitarianism......Page 66
   Kant’s Theory......Page 67
  SUMMARY......Page 68
  FURTHER READING......Page 69
   Utilitarianism: JOHN STUART MILL......Page 70
   The Moral Law: IMMANUEL KANT......Page 73
   Virtue and the Moral Life: BERNARD MAYO......Page 79
   The Ethics of Care: VIRGINIA HELD......Page 82
   Moral Saints: SUSAN WOLF......Page 87
Part 2: Medical Professional and Patient......Page 96
  SHADES OF AUTONOMY AND PATERNALISM......Page 98
  REFUSING TREATMENT......Page 99
   IN DEPTH: THE HIPPOCRATIC OATH......Page 100
   IN DEPTH: PHYSICIAN AUTONOMY......Page 101
  FUTILE TREATMENT......Page 102
   LEGAL BRIEF: Refusing Treatment for Childrenon Religious Grounds......Page 103
   IN DEPTH: MORAL CONFLICTS IN NURSING......Page 104
  CLASSIC CASE FILE: Elizabeth Bouvia......Page 105
  APPLYING MAJOR THEORIES......Page 106
  SUMMARY......Page 107
  NOTES......Page 110
   Paternalism: GERALD DWORKIN......Page 111
   The Refutation of Medical Paternalism: ALAN GOLDMAN......Page 121
   Why Doctors Should Intervene: TERRENCE F. ACKERMAN......Page 127
   Autonomy, Futility, and the Limits of Medicine: ROBERT L. SCHWARTZ......Page 132
   Patient Autonomy and Physician Responsibility: COMMENTARIES BY PATRICK C. BEEMAN AND RYAN C. VANWOERKOM......Page 137
   Bouvia v. Superior Court: CALIFORNIA COURT OF APPEAL......Page 140
   Fundamental Elements of the Patient-Physician Relationship: AMA COUNCIL ON ETHICAL AND JUDICIAL AFFAIRS......Page 144
   In Defense of the Traditional Nurse: LISA H. NEWTON......Page 145
   Advocacy or Subservience for the Sake of Patients?: HELGA KUHSE......Page 153
  PATERNALISM AND DECEPTION......Page 161
   IN DEPTH: DO PATIENTS WANT THE TRUTH? DO PHYSICIANS TELL IT?......Page 162
  CONFIDENTIAL TRUTHS......Page 164
   LEGAL BRIEF: Confidentiality and a Duty to Warn......Page 165
   IN DEPTH: TRUTH-TELLING AND CULTURAL DIVERSITY......Page 166
  CLASSIC CASE FILE: Carlos R.......Page 167
  SUMMARY......Page 168
  NOTES......Page 171
   Telling the Truth to Patients:A Clinical Ethics Exploration: DAVID C. THOMASMA......Page 172
   On Telling Patients the Truth: MACK LIPKIN......Page 176
   Is It Ever OK to Lie to Patients?: SHELLY K. SCHWARTZ......Page 178
   Respect for Patients, Physicians, and the Truth: SUSAN CULLEN AND MARGARET KLEIN......Page 181
   Why Privacy Is Important: JAMES RACHELS......Page 189
   Confidentiality in Medicine— A Decrepit Concept: MARK SIEGLER......Page 194
   Ethical Relativism in a Multicultural Society: RUTH MACKLIN......Page 197
   Tarasoff v. Regents of the University of California: SUPREME COURT OF CALIFORNIA......Page 208
  AUTONOMY AND CONSENT......Page 213
  CONDITIONS OF INFORMED CONSENT......Page 214
   IN DEPTH: DECISION-MAKING CAPACITY......Page 216
   IN DEPTH: TWO VIEWS OF INFORMED CONSENT......Page 218
  APPLYING MAJOR THEORIES......Page 220
  CLASSIC CASE FILE: Jerry Canterbury......Page 221
  SUMMARY......Page 222
   The Concept of Informed Consent: RUTH R. FADEN AND TOM L. BEAUCHAMP......Page 225
   Informed Consent— Must It Remain a Fairy Tale?: JAY KATZ......Page 230
   Transparency: Informed Consent in Primary Care: HOWARD BRODY......Page 240
   Informed Consent: Some Challenges to the Universal Validity of the Western Model: ROBERT J. LEVINE......Page 246
   Canterbury v. Spence: UNITED STATES COURT OF APPEALS......Page 252
 CHAPTER 6: Human Research......Page 256
  THE SCIENCE OF CLINICAL TRIALS......Page 257
   IN DEPTH: THE TUSKEGEE TRAGEDY......Page 258
  BENEFICENCE, SCIENCE, AND PLACEBOS......Page 259
  SCIENCE AND INFORMED CONSENT......Page 262
   IN DEPTH: WOMEN IN CLINICAL TRIALS......Page 263
  RESEARCH ON THE VULNERABLE......Page 264
   IN DEPTH: WHY ENTER A CLINICAL TRIAL?......Page 265
  APPLYING MAJOR THEORIES......Page 268
  SUMMARY......Page 269
  CLASSIC CASE FILE: The UCLA Schizophrenia Study......Page 270
  NOTES......Page 275
   The Nuremberg Code......Page 276
   Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects: WORLD MEDICAL ASSOCIATION......Page 277
   The Belmont Report: THE NATIONAL COMMISSION FOR THE PROTECTION OF HUMAN SUBJECTS OF BIOMEDICAL AND BEHAVIORAL RESEARCH......Page 280
   Final Report: Human Radiation Experiments: ADVISORY COMMITTEE ON HUMAN RADIATION EXPERIMENTS......Page 283
   Of Mice but Not Men: Problems of the Randomized Clinical Trial: SAMUEL HELLMAN AND DEBORAH S. HELLMAN......Page 289
   A Response to a Purported Ethical Difficulty with Randomized Clinical Trials Involving Cancer Patients: BENJAMIN FREEDMAN......Page 295
   How to Resolve an Ethical Dilemma Concerning Randomized Clinical Trials: DON MARQUIS......Page 299
   Racism and Research: The Case of the Tuskegee Syphilis Study: ALLAN M. BRANDT......Page 302
   The Ethics of Clinical Research in the Third World: MARCIA ANGELL......Page 314
   Ethical Issues in Clinical Trials in Developing Countries: BARUCH BRODY......Page 318
Part 3: Life and Death......Page 324
  STARTING POINT: THE BASICS......Page 326
   Fact File U. S. Abortions......Page 327
   IN DEPTH: ABORTION AND PUBLIC OPINION......Page 329
  THE LEGAL STRUGGLE......Page 330
  PERSONS AND RIGHTS......Page 331
   IN DEPTH: DOES A FETUS FEEL PAIN?......Page 334
  APPLYING MAJOR THEORIES......Page 336
  SUMMARY......Page 337
  CLASSIC CASE FILE: Nancy Klein......Page 338
  FURTHER READING......Page 341
  NOTES......Page 342
   A Defense of Abortion JUDITH JARVIS THOMSON......Page 343
   Why Abortion Is Immoral: DON MARQUIS......Page 353
   An Almost Absolute Value in History: JOHN T. NOONAN, JR.......Page 365
   On the Moral and Legal Status of Abortion: MARY ANNE WARREN......Page 369
   Virtue Theory and Abortion: ROSALIND HURSTHOUSE......Page 380
   Abortion and the Concept of a Person: JANE ENGLISH......Page 394
   Abortion: MARGARET OLIVIA LITTLE......Page 400
   Abortion Through a Feminist Ethics Lens: SUSAN SHERWIN......Page 405
   Roe v. Wade: UNITED STATES SUPREME COURT......Page 414
   Planned Parenthood of Southeastern Pennsylvania v. Casey: UNITED STATES SUPREME COURT......Page 419
  IN VITRO FERTILIZATION......Page 426
   Fact File Assisted Reproduction......Page 427
  SURROGACY......Page 432
   IN DEPTH: IVF AND CHILDREN’S FUTURE CHILDREN......Page 433
  CLONING......Page 434
   IN DEPTH: CLONING TIME LINE......Page 437
  APPLYING MAJOR THEORIES......Page 438
   IN DEPTH: SHERRI SHEPHERD: HOW SURROGACY CAN GO WRONG......Page 439
  SUMMARY......Page 440
  CLASSIC CASE FILE: Baby M......Page 441
  Cases for Evaluation: CASE 1: The Fate of Frozen Embryos......Page 442
  FURTHER READING......Page 444
  NOTES......Page 445
   IVF: The Simple Case: PETER SINGER......Page 446
   IVF and Women’s Interests: An Analysis of Feminist Concerns: MARY ANNE WARREN......Page 450
   “Give Me Children or I Shall Die!” New Reproductive Technologies and Harm to Children : CYNTHIA B. COHEN......Page 462
   Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation: CONGREGATION FOR THE DOCTRINE OF THE FAITH......Page 473
   The Presumptive Primacy of Procreative Liberty: JOHN A. ROBERTSON......Page 483
   Surrogate Mothering: Exploitation or Empowerment?: LAURA M. PURDY......Page 490
   Is Women’s Labor a Commodity?: ELIZABETH S. ANDERSON......Page 500
   Egg Donation and Commodification: BONNIE STEINBOCK......Page 512
   The Wisdom of Repugnance: LEON R. KASS......Page 521
   Cloning Human Beings: An Assessment of the Ethical Issues Pro and Con: DAN W. BROCK......Page 537
   Opinion in the Matter of Baby M: NEW JERSEY SUPREME COURT......Page 548
  GENES AND GENOMES......Page 556
  GENETIC TESTING......Page 557
   IN DEPTH: DIRECT-TO-CONSUMER GENETIC TESTS......Page 560
  GENE THERAPY......Page 564
   Fact File Available Genetic Tests for Cancer Risk......Page 565
   Fact File Recent Research in Gene Therapy......Page 568
  STEM CELLS......Page 569
  APPLYING MAJOR THEORIES......Page 571
  SUMMARY......Page 573
  FURTHER READING......Page 576
   Implications of Prenatal Diagnosis for the Human Right to Life: LEON R. KASS......Page 577
   Genetics and Reproductive Risk:Can Having Children Be Immoral?: LAURA M. PURDY......Page 581
   The Morality of Screening for Disability: JEFF MCMAHAN......Page 588
   Genetic Dilemmas and the Child’s Right to an Open Future: DENA S. DAVIS......Page 592
   Disowning Knowledge: Issues in Genetic Testing: ROBERT WACHBROIT......Page 602
   The Non-Identity Problem and Genetic Harms—The Case of Wrongful Handicaps: DAN W. BROCK......Page 606
   Is Gene Therapy a Form of Eugenics?: JOHN HARRIS......Page 610
   Genetic Enhancement: WALTER GLANNON......Page 616
   Genetic Interventions and the Ethics of Enhancement of Human Beings: JULIAN SAVULESCU......Page 621
   Germ-Line Gene Therapy: LEROY WALTERS AND JULIE GAGE PALMER......Page 630
   What Does “Respect for Embryos” Mean in the Context of Stem Cell Research?: BONNIE STEINBOCK......Page 637
   Declaration on the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells: PONTIFICAL ACADEMY FOR LIFE......Page 640
 CHAPTER 10: Euthanasia and Physician-Assisted Suicide......Page 642
  DECIDING LIFE AND DEATH......Page 643
   LEGAL BRIEF: Euthanasia and Assisted Suicide: Major Developments......Page 645
   IN DEPTH: EUTHANASIA AND PHYSICIAN-ASSISTED SUICIDE: WHAT DO DOCTORS THINK?......Page 646
  AUTONOMY, MERCY, AND HARM......Page 647
   IN DEPTH: OREGON’S DEATH WITH DIGNITY ACT......Page 649
  APPLYING MAJOR THEORIES......Page 651
   IN DEPTH: PHYSICIAN-ASSISTED SUICIDE AND PUBLIC OPINION......Page 652
  CLASSIC CASE FILE: Nancy Cruzan......Page 653
  SUMMARY......Page 654
  Cases for Evaluation:CASE 1......Page 655
  FURTHER READING......Page 657
  NOTES......Page 658
   Death and Dignity: A Case of Individualized Decision Making: TIMOTHY E. QUILL......Page 659
   Voluntary Active Euthanasia: DAN W. BROCK......Page 663
   When Self-Determination Runs Amok: DANIEL CALLAHAN......Page 675
   Physician-Assisted Suicide: A Tragic View: JOHN D. ARRAS......Page 680
   Active and Passive Euthanasia: JAMES RACHELS......Page 695
   Dying at the Right Time: Reflections on (Un)Assisted Suicide: JOHN HARDWIG......Page 699
   The Philosophers’ Brief: RONALD DWORKIN, THOMAS NAGEL, ROBERT NOZICK, JOHN RAWLS, THOMAS SCANLON, AND JUDITH JARVIS THOMSON......Page 710
   An Alternative to Brain Death: JEFF McMAHAN......Page 718
   Vacco v. Quill: UNITED STATES SUPREME COURT......Page 724
   Washington v. Glucksberg: UNITED STATES SUPREME COURT......Page 727
Part 4: Justice and Health Care......Page 734
  HEALTH CARE IN TROUBLE......Page 736
   IN DEPTH: UNEQUAL HEALTH CARE FOR MINORITIES......Page 738
   Fact File U.S. Health Care......Page 739
  THEORIES OF JUSTICE......Page 740
   IN DEPTH: PUBLIC OPINION: OBTAINING ADEQUATE HEALTH CARE......Page 741
  A RIGHT TO HEALTH CARE......Page 742
  THE ETHICS OF RATIONING......Page 744
  CLASSIC CASE FILE: Christine deMeurers......Page 747
  SUMMARY......Page 748
  NOTES......Page 752
   Is There a Right to Health Care and, if So, What Does It Encompass?: NORMAN DANIELS......Page 753
   The Right to a Decent Minimum of Health Care: ALLEN E. BUCHANAN......Page 760
   Rights to Health Care, Social Justice, and Fairness in Health Care Allocations: Frustrations in the Face of Finitude: H. TRISTRAM ENGELHARDT, JR.......Page 766
   Health Care Reform: Lessons from Canada: RAISA BERLIN DEBER......Page 774
   The Allocation of Exotic Medical Lifesaving Therapy: NICHOLAS RESCHER......Page 782
   QALYfying the Value of Life: JOHN HARRIS......Page 791
   Public Health Ethics: Mapping the Terrain: JAMES F. CHILDRESS, RUTH R. FADEN, RUTH D. GAARE, LAWRENCE O. GOSTIN, JEFFREY KAHN, RICHARD J. BONNIE, NANCY E. KASS, ANNA C. MASTROIANNI, JONATHAN D. MORENO, AND PHILLIP NIEBURG......Page 799
   Human Rights Approach to Public Health Policy: D. TARANTOLA AND S. GRUSKIN......Page 810
 APPENDIX: Answers to Chapter 1 Exercises......Page 822
 GLOSSARY......Page 824
 INDEX......Page 826