Practical Decision Making in Health Care Ethics: Cases and Concepts

Cover......Page 1
Contents......Page 10
Preface to the Third Edition......Page 14
Introduction......Page 16
Defining Ethics......Page 20
Two Kinds of Ethics......Page 26
Historical Versions of the Ethics of Obligation......Page 27
Moral Reasoning and the Theories of Obligation......Page 29
Retrieving the Ethics of the Good......Page 32
Bioethics Today......Page 35
Suggested Readings......Page 36
The Good We Seek......Page 39
Happiness......Page 40
Moral Virtue......Page 47
Prudence......Page 50
Suggested Readings......Page 61
THREE: The Language of Health Care Ethics......Page 66
Distinctions That Can Mislead......Page 67
Helpful Distinctions......Page 80
Suggested Readings......Page 85
Complexity of Health Care Decisions......Page 89
Decision-Making Capacity......Page 91
Informed Consent......Page 94
Advance Directives......Page 106
The Patient Self-Determination Act......Page 110
The Case of Hazel Welch......Page 112
Final Refiections......Page 114
Suggested Readings......Page 115
FIVE: Deciding for Others......Page 118
Becoming a Proxy......Page 119
Standards for Making Proxy Decisions......Page 120
Deciding for Older Children......Page 124
Deciding for the Mentally Ill......Page 130
Final Reflections on Deciding for Others......Page 136
Suggested Readings......Page 138
SIX: Determining Life and Death......Page 140
The Classical Conceptual Framework......Page 141
A New Conceptual Framework......Page 148
When Does One of Us Begin?......Page 150
When Does One of Us Die?......Page 153
Recent Controversies over Determining Death......Page 156
Ethical Refiections......Page 163
Suggested Readings......Page 165
Ventilators......Page 169
The Case of Karen Quinlan......Page 171
The Case of Brother Fox......Page 175
The Case of William Bartling......Page 177
The Case of Helga Wanglie......Page 181
The Case of Barbara Howe......Page 185
The Case of Earle Spring......Page 190
The Case of Rosaria Candura......Page 194
Other Life-Sustaining Treatments......Page 197
Suggested Readings......Page 198
Terminology......Page 200
The Effectiveness of Attempting CPR......Page 201
Learning to Withhold CPR......Page 202
Important Ethical Elements for a DNR Policy......Page 204
Lingering Questions about DNR Orders......Page 206
The Case of Maria M......Page 209
The Case of Shirley Dinnerstein......Page 212
The Case of Catherine Gilgunn......Page 214
Suggested Readings......Page 218
The Techniques and Technologies......Page 221
Conceptualizing Medical Nutrition and Hydration......Page 222
The Case of Clarence Herbert......Page 224
The Case of Claire Conroy......Page 228
The Case of Elizabeth Bouvia......Page 231
The Case of Nancy Cruzan......Page 235
The Case of Terri Schiavo......Page 240
An Emerging Controversy: The Vatican and Feeding Tubes......Page 246
Ethical Reflections......Page 247
Suggested Readings......Page 248
Contraception and Sterilization......Page 251
Artificial Reproductive Techniques......Page 261
Cloning......Page 269
Surrogate Motherhood......Page 272
Ethical Reflections......Page 276
Suggested Readings......Page 278
ELEVEN: Prenatal Life......Page 282
Abortion......Page 283
Moral Issues of Abortion......Page 292
RU-486......Page 295
Maternal-Fetal Treatment Conflicts......Page 297
The Case of Angie......Page 298
Suggested Readings......Page 301
Historical Background......Page 305
A Sampling of Neonatal Abnormalities......Page 307
Special Difficulties in Deciding for Neonates and Small Children......Page 311
The Baby Doe Regulations......Page 312
The Case of Baby Doe......Page 317
The Case of Baby Jane Doe......Page 320
The Case of Danielle......Page 323
The Case of Baby K......Page 328
The Case of Ashley......Page 331
Infant Euthanasia in the Netherlands......Page 336
Suggested Readings......Page 337
Historical Overview......Page 340
Recent Developments......Page 343
Physician-Assisted Suicide and State Laws......Page 345
Physician-Assisted Suicide and the Constitution......Page 346
Relevant Distinctions......Page 348
Moral Reasoning and Euthanasia......Page 352
Reasons for Euthanasia and Physician-Assisted Suicide......Page 353
Reasons against Euthanasia and Physician-Assisted Suicide......Page 355
The Case of Diane......Page 365
Concluding Reflections......Page 370
Suggested Readings......Page 371
FOURTEEN: Medical Research......Page 376
Notorious Examples of Questionable Ethics in Research......Page 377
Reactions to the Questionable Medical Research......Page 381
Research on Embryos......Page 387
Research on Fetuses......Page 394
Research on Minors......Page 397
Research in Developing Countries......Page 398
Two Cases of Controversial HIV/AIDS Research in Developing Countries......Page 399
Other Special Populations in Research......Page 405
Animals and Medical Research......Page 406
Suggested Readings......Page 408
FIFTEEN: Transplantation......Page 413
Transplantation of Organs from Dead Human Donors......Page 414
The Case of Jamie Fiske......Page 421
The Case of Jesse Sepulveda......Page 423
Transplantation of Organs from Living Human Donors......Page 425
Transplantation of Organs from Animals......Page 428
The Case of Baby Fae......Page 429
Implantation of Artificial Hearts......Page 433
Suggested Readings......Page 435
SIXTEEN: Medical Genetics......Page 439
Genetic Testing......Page 442
A Case of Concern about Cancer......Page 444
Genetic Screening......Page 448
Genetic Research on Humans......Page 450
The Case of Jesse Gelsinger......Page 454
Genetic Enhancement......Page 468
Human Genome Project......Page 470
Suggested Readings......Page 472
Paying for Health Care......Page 477
The Case of Sun Hudson......Page 482
The Case of Emilio Gonzales......Page 484
Experimental Drugs for Dying Patients......Page 487
The Case of Abigail Burroughs and the Abigail Alliance......Page 489
Seeding Trials and Ghostwriters......Page 497
Suggested Readings......Page 499
C......Page 504
E......Page 505
I......Page 506
P......Page 507
R......Page 508
V......Page 509
Z......Page 510
Index of Cases......Page 512
A......Page 514
B......Page 515
C......Page 516
D......Page 518
E......Page 519
G......Page 520
H......Page 521
K......Page 522
M......Page 523
P......Page 524
R......Page 526
S......Page 527
U......Page 528
Z......Page 529