Principles of Biomedical Ethics

by Beauchamp, Tom L.; Childress, James F.

• ISBN13: 9780195143324
• ISBN10: 0195143329
• Edition: 5th
• Format: Paperback
• Copyright: 2001-02-15
• Publisher: Oxford University Press

Summary

This edition represents a thorough-going revision of what has become a classic text in biomedical ethics. Major structural changes mark the revision. The authors have added a new concluding chapter on methods that, along with its companion chapter on moral theory, emphasizes convergence across theories, coherence in moral justification, and the common morality. They have simplified the opening chapter on moral norms which introduces the framework of prima facie moral principles and ways to specify and balance them. Together with the shift of advanced material on theory to the back of the book, this heavily revised introductory chapter will make it easier for the wide range of students entering bioethics courses to use this text. Another important change is the increased emphasis on character and moral agency, drawing the distinction between agents and actions. The sections on truth telling, disclosure of bad news, privacy, conflicts of interest, and research on human subjects have also been throughly reworked. The four core chapters on principles (respect for autonomy, nonmaleficence, beneficence, and justice) and the chapter on professional-patient relationships retain their familiar structure, but the authors have completely updated their content to reflect developments in philosophical analysis as well as in research, medicine, and health care. Throughout, they have used a number of actual cases to illuminate and to test their theory, method, and framework of principles.

Table of Contents

PART I
Moral Norms	1	(25)
Ethics and Morality	1	(8)
Moral Dilemmas	9	(3)
A Framework of Moral Principles	12	(2)
The Prima Facie Nature of Moral Norms	14	(1)
Specifying Principles and Rules	15	(3)
Balancing Principles and Rules	18	(5)
Conclusion	23	(3)
Moral Character	26	(31)
Moral Virtues	26	(4)
Virtues in Professional Roles	30	(2)
Five Focal Virtues	32	(7)
The Relationship of Moral Virtues and Moral Principles	39	(1)
Moral Ideals	39	(4)
Moral Excellence	43	(8)
Conclusion	51	(6)
PART II
Respect for Autonomy	57	(56)
The Nature of Autonomy	57	(12)
The Capacity for Autonomous Choice	69	(8)
The Meaning and Justification of Informed Consent	77	(3)
Disclosure	80	(8)
Understanding	88	(5)
Voluntariness	93	(5)
A Framework of Standards for Surrogate Decision-Making	98	(5)
Conclusion	103	(10)
Nonmaleficence	113	(52)
The Concept of Nonmaleficence	114	(5)
Distinctions and Rules Governing Nontreatment	119	(14)
Optional Treatments and Obligatory Treatments	133	(6)
Killing and Letting Die	139	(5)
The Justification of Interntionally Arranged Deaths	144	(8)
Protecting Incompetent Patients	152	(5)
Conclusion	157	(8)
Beneficence	165	(60)
The Concept of Beneficence	166	(1)
Obligatory and Ideal Benefience	167	(9)
Paternalism: Conflicts Between Beneficence and Autonomy	176	(18)
Balancing Benefits, Costs, and Risks	194	(12)
The Value and Quality of Life	206	(8)
Conclusion	214	(11)
Justice	225	(58)
The Concept of Justice	226	(4)
Theories of Justice	230	(5)
Fair Opportunity	235	(4)
The Right to a Decent Minimum of Health Care	239	(11)
The Allocation of Health Care Resources	250	(3)
Rationing and Setting Priorities	253	(11)
Rationing Scarce Treatments to Patients	264	(8)
Conclusion	272	(11)
Professional--Patient Relationships	283	(54)
Veracity	283	(10)
Privacy	293	(10)
Confidentiality	303	(9)
Fidelity	312	(7)
The Dual Roles of Physician and Investigator	319	(8)
Conclusion	327	(10)
PART III
Moral Theories	337	(47)
Criteria for Theory Construction	338	(2)
Utilitarianism: Consequence-Based Theory	340	(8)
Kantianism: Obligation-Based Theory	348	(7)
Liberal Individualism: Rights-Based Theory	355	(7)
Communitarianism: Community-Based Theory	362	(7)
Ethics of Care: Relationship-Based Accounts	369	(7)
Convergence Across Theories	376	(1)
Conclusion	377	(7)
Method and Moral Justification	384	(31)
Justification in Ethics	384	(1)
Top-Down Models: Theory and Application	385	(6)
Bottom-Up Models: Cases and Inductive Generalization	391	(6)
An Integrated Model: Coherence Theory	397	(4)
Common-Morality Theory	401	(7)
Conclusion	408	(7)
Appendix: Cases in Biomedical Ethics	415	(18)
Index	433