Bioethics Principles, Issues, and Cases

by Vaughn, Lewis

• ISBN13: 9780195182828
• ISBN10: 0195182820
• Format: Paperback
• Copyright: 2009-03-13
• Publisher: Oxford University Press

Summary

Vaughn offers a hybrid of text, readings, and cases to fill a need left for a current, accessible introduction to the philosophical, medical, scientific, social, and legal aspects of key bioethics issues. It offers a balance between basic ethical theories and current controversies. Itscase-driven approach and a very robust set of pedagogical features introduce issues in a way that engages students in decision making. Hot topics include paternalism and patient autonomy, truth telling, informed consent, abortion, in vitro fertilization, cloning, impaired infants, embryonicstem-cell dilemmas, genetic engineering, euthanasia, physician-assisted suicide, human and animal research, inequities in access to medical treatment, HIV/AIDS in Africa, and health-care costs.

Author Biography

Lewis Vaughn is the author or coauthor of several books, including: The Power of Critical Thinking, Third Edition (forthcoming from OUP, 9/09); How to Think About Weird Things: Critical Thinking for a New Age, Fifth Edition (2007); Doing Ethics: Moral Reasoning and Contemporary Issues (2007); Doing Philosophy: An Introduction Through Thought Experiments, Third Edition (2006); and Writing Philosophy: A Student's Guide to Writing Philosophy Essays (OUP, 2005).

Table of Contents

Preface	p. ix
Principles and Theories
Moral Reasoning in Bioethics	p. 3
Ethics and Bioethics	p. 3
Ethics and the Moral Life	p. 5
In Depth: Morality and the Law	p. 7
Moral Principles in Bioethics	p. 8
Autonomy	p. 9
Beneficence	p. 10
Utility	p. 11
Justice	p. 12
Ethical Relativism	p. 13
In Depth: Anthropology and Moral Diversity	p. 14
Ethics and Religion	p. 17
Moral Arguments	p. 18
Argument Fundamentals	p. 19
Patterns of Moral Arguments	p. 22
Review: Valid and Invalid Argument Forms	p. 23
In Depth: Fallacies in Moral Reasoning	p. 24
Evaluating Premises	p. 26
Key Terms	p. 28
Summary	p. 28
Further Reading	p. 29
Notes	p. 29
Bioethics And Moral Theories	p. 30
The Nature of Moral Theories	p. 30
Influential Moral Theories	p. 31
Utilitarianism	p. 32
In Depth: Utilitarianism and the Golden Rule	p. 34
Kantian Ethics	p. 34
Natural Law Theory	p. 36
Rawls' Contract Theory	p. 38
Virtue Ethics	p. 39
The Ethics of Care	p. 40
In Depth: Can Virtue Be Taught?	p. 41
Feminist Ethics	p. 42
Criteria for Judging Moral Theories	p. 42
Review: Evaluating Moral Theories: Criteria of Adequacy	p. 44
Applying the Criteria	p. 44
Utilitarianism	p. 45
Kant's Theory	p. 46
Key Terms	p. 46
Summary	p. 47
Further Reading	p. 47
Notes	p. 48
Physician and Patient
Paternalism And Patient Autonomy	p. 51
Shades of Autonomy and Paternalism	p. 51
Refusing Treatment	p. 52
In Depth: The Hippocratic Oath	p. 53
Futile Treatment	p. 54
Legal Brief: Refusing Treatment for Children on Religious Grounds	p. 55
In Depth: CPR and DNR	p. 56
Applying Major Theories	p. 56
Key Terms	p. 57
Summary	p. 57
Classic Case File: Elizabeth Bouvia	p. 58
Cases for Evaluation	p. 60
Further Reading	p. 62
Notes	p. 63
Readings	p. 63
"Paternalism,"	p. 63
"The Refutation of Medical Paternalism,"	p. 73
"Why Doctors Should Intervene,"	p. 79
"Autonomy, Futility, and the Limits of Medicine,"	p. 84
"Whose Body Is It Anyway?"	p. 88
Bouvia v. Superior Court, California Court of Appeal	p. 98
"Fundamental Elements of the Patient-Physician Relationship," AMA Council on Ethical and Judicial Affairs	p. 102
"Code of Ethics for Nurses," American Nurses Association	p. 103
Truth-Telling And Confidentiality	p. 105
Paternalism and Deception	p. 105
In Depth: Do Patients Want the Truth? Do Physicians Tell It?	p. 106
Confidential Truths	p. 108
Legal Brief: Confidentiality and a Duty to Warn	p. 109
Applying Major Theories	p. 110
Classic Case File: Carols R.	p. 111
Key Terms	p. 112
Summary	p. 112
Cases for Evaluation	p. 112
Further Reading	p. 114
Notes	p. 114
Readings	p. 115
"Telling the Truth to Patients: A Clinical Ethics Exploration,"	p. 115
"On Telling Patients the Truth,"	p. 119
"On a Supposed Right to Lie from Altruistic Motives,"	p. 121
"Respect for Patients, Physicians, and the Truth,"	p. 122
"Why Privacy Is Important,"	p. 130
"Confidentiality in Medicine-A Decrepit Concept,"	p. 135
Tarasoff v. Regents of the University of California, Supreme Court of California	p. 138
Informed Consent	p. 144
Autonomy and Consent	p. 144
Conditions of Informed Consent	p. 145
In Depth: Two Views of Informed Consent	p. 147
Legal Brief: Important Informed Consent Cases	p. 148
Applying Major Theories	p. 149
Key Terms	p. 149
Summary	p. 149
Classic Case File: Jerry Canterbury	p. 150
Cases for Evaluation	p. 151
Further Reading	p. 153
Notes	p. 154
Readings	p. 154
"The Concept of Informed Consent,"	p. 154
"Informed Consent-Must It Remain a Fairy Tale?"	p. 159
"Transparency: Informed Consent in Primary Care,"	p. 169
"Should Informed Consent Be Based on Rational Beliefs?"	p. 175
"Informed Consent: Some Challenges to the Universal Validity of the Western Model,"	p. 183
Canterbury v. Spence, United States Court of Appeals	p. 189
Human Research	p. 193
The Science of Clinical Trials	p. 194
In Depth: The Tuskegee Tragedy	p. 195
Beneficence, Science, and Placebos	p. 196
Science and Informed Consent	p. 199
In Depth: Women in Clinical Trials	p. 200
Research on the Vulnerable	p. 201
In Depth: Why Enter a Clinical Trial?	p. 202
Applying Major Theories	p. 205
Key Terms	p. 206
Summary	p. 206
Classic Case File: The UCLA Schizophrenia Study	p. 207
Cases for Evaluation	p. 208
Further Reading	p. 212
Notes	p. 212
Readings	p. 213
The Nuremberg Code	p. 213
Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects, World Medical Association	p. 214
"The Belmont Report," National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research	p. 217
"Final Report: Human Radiation Experiments," Advisory Committee on Human Radiation Experiments	p. 220
"Of Mice but Not Men: Problems of the Randomized Clinical Trial,"	p. 226
"A Response to a Purported Ethical Difficulty with Randomized Clinical Trials Involving Cancer Patients,"	p. 231
"How to Resolve an Ethical Dilemma Concerning Randomized Clinical Trials,"	p. 235
"Clinical Trials: Are They Ethical?"	p. 238
"The Ethics of Clinical Research in the Third World,"	p. 242
"Ethical Issues in Clinical Trials in Developing Countries,"	p. 246
Life and Death
Abortion	p. 253
Starting Point: The Basics	p. 253
Fact File: U.S. Abortions	p. 254
In Depth: Abortion and Public Opinion	p. 256
The Legal Struggle	p. 257
Persons and Rights	p. 257
In Depth: Late-Term Abortion	p. 258
Applying Major Theories	p. 262
Key Terms	p. 263
Summary	p. 263
Classic Case File: Nancy Klein	p. 264
Cases for Evaluation	p. 265
Further Reading	p. 268
Notes	p. 268
Readings	p. 269
"A Defense of Abortion,"	p. 269
"Why Abortion Is Immoral,"	p. 279
"On the Moral and Legal Status of Abortion,"	p. 291
"An Almost Absolute Value in History,"	p. 301
"Abortion Decisions: Personal Morality,"	p. 305
"Abortion and the Concept of a Person,"	p. 310
"In Defense of Abortion and Infanticide,"	p. 316
"Abortion Through a Feminist Ethic Lens,"	p. 333
United States Supreme Court	p. 342
Planned Parenthood of Southeastern Pennsylvania v. Casey, United States Supreme Court	p. 347
Reproductive Technology	p. 354
In Vitro Fertilization	p. 354
Fact File: Assisted Reproduction	p. 355
Surrogacy	p. 360
In Depth: IVF and Children's Future Children	p. 361
Cloning	p. 362
Legal Brief: Surrogacy Contracts and the Law	p. 363
In Depth: Cloning Time Line	p. 365
Applying Major Theories	p. 366
Key Terms	p. 367
Summary	p. 367
Classic Case File: Baby M	p. 368
Cases for Evaluation	p. 369
Further Reading	p. 371
Notes	p. 372
Readings	p. 373
"IVF: The Simple Case,"	p. 373
"IVF and Women's Interests: An Analysis of Feminist Concerns,"	p. 377
"Give Me Children or I Shall Die!" New Reproductive Technologies and Harm to Children,"	p. 389
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation," Congregation for the Doctrine of the Faith	p. 400
"Surrogate Mothering: Exploitation or Empowerment?"	p. 409
"On 'Surrogacy,"	p. 418
"The Wisdom of Repugnance,"	p. 426
"Cloning Human Beings: An Assessment of the Ethical Issues Pro and Con,"	p. 441
Opinion in the Matter of Baby M, New Jersey Supreme Court	p. 452
Genetic Choices	p. 460
Genes and Genomes	p. 460
Genetic Testing	p. 461
In Depth: Direct-to-Consumer Genetic Tests	p. 464
Gene Therapy	p. 468
Fact File: Genetic Tests	p. 469
Stem Cells	p. 471
In Depth: Recent Research in Gene Therapy	p. 472
Applying Major Theories	p. 474
Classic Case File: The Kingsburys	p. 475
Key Terms	p. 476
Summary	p. 476
Cases for Evaluation	p. 477
Further Reading	p. 479
Notes	p. 479
Readings	p. 480
"Implications of Prenatal Diagnosis for the Human Right to Life,"	p. 480
"Genetics and Reproductive Risk: Can Having Children Be Immoral?"	p. 484
"The Morality of Screening for Disability,"	p. 491
"Disowning Knowledge: Issues in Genetic Testing,"	p. 495
"The Non-Identity Problem and Genetic Harms-the Case of Wrongful Handicaps,"	p. 499
"Is Gene Therapy a Form of Eugenics?,"	p. 503
"Genetic Enhancement,"	p. 509
"Germ-Line Gene Therapy,"	p. 514
"What Does 'Respect for Embryos' Mean in the Context of Stem Cell Research?"	p. 521
"Declaration on the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells," Pontifical Academy for Life	p. 524
Euthanasia And Physician-Assisted Suicide	p. 526
Deciding Life and Death	p. 527
Legal Brief: Euthanasia and Assisted Suicide: Major Developments	p. 529
In Depth: Euthanasia and Assisted Suicide: What Doctors Think and Do	p. 530
Autonomy, Mercy, and Harm	p. 530
In Depth: Oregon's Death With Dignity Act	p. 533
Applying Major Theories	p. 534
In Depth: Physician-Assisted Suicide and Public Opinion	p. 535
Key Terms	p. 536
Summary	p. 536
Classic Case File: Nancy Cruzan	p. 537
Cases for Evaluation	p. 538
Further Reading	p. 541
Notes	p. 541
Readings	p. 542
"The Wrongfulness of Euthanasia,"	p. 542
"Voluntary Active Euthanasia,"	p. 545
"When Self-Determination Runs Amok,"	p. 556
"When Abstract Moralizing Runs Amok,"	p. 561
"Physician-Assisted Suicide: A Tragic View,"	p. 565
"Active and Passive Euthanasia,"	p. 580
"The Distinction Between Refusing Medical Treatment and Suicide," New York State Task Force on Life and the Law	p. 584
"The Philosophers' Brief,"	p. 592
Vacco v. Quill, United States Supreme Court	p. 601
Washington v. Glucksberg, United States Supreme Court	p. 604
Justice and Health Care
Dividing Up Health Care Resources	p. 613
Health Care in Trouble	p. 613
In Depth: Unequal Health Care for Minorities	p. 615
Fact File: U.S. Health Care	p. 616
Theories of Justice	p. 616
A Right to Health Care	p. 617
In Depth: Public Opinion: Obtaining Adequate Health Care	p. 618
The Ethics of Rationing	p. 620
Key Terms	p. 622
Summary	p. 622
Classic Case File: Christine deMeurers	p. 623
Cases for Evaluation	p. 624
Further Reading	p. 626
Notes	p. 627
Readings	p. 627
"Is There a Right to Health Care and, if So, What Does It Encompass?"	p. 627
"The Right to a Decent Minimum of Health Care,"	p. 634
"Multiculturalism and Just Health Care: Taking Pluralism Seriously,"	p. 640
"Rights to Health Care, Social Justice, and Fairness in Health Care Allocations: Frustrations in the Face of Finitude,"	p. 652
"Rationing Fairly: Programmatic Considerations,"	p. 661
"The Allocation of Exotic Medical Lifesaving Therapy,"	p. 666
"QALYfying the Value of Life,"	p. 675
Glossary	p. 683
Index	p. 685
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