Principles of Biomedical Ethics

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

• ISBN13: 9780195335705
• ISBN10: 0195335708
• Edition: 6th
• Format: Paperback
• Copyright: 2008-05-23
• Publisher: Oxford University Press

Summary

Building on the best-selling tradition of previous editions, Principles ofBiomedical Ethics, Sixth Edition, provides a highly original, practical, andinsightful guide to morality in the health professions. Acclaimed authors Tom L.Beauchamp and James F. Childress thoroughly develop and advocate for fourprinciples that lie at the core of moral reasoning in health care: respect forautonomy, nonmaleficence, beneficence, and justice. Drawing from contemporaryresearch--and integrating detailed case studies and vivid real-life examples andscenarios--they demonstrate how these prima facie principles can be expanded toapply to various conflicts and dilemmas, from how to deliver bad news to whetheror not to withhold or withdraw life-sustaining treatments. Illuminating both theory and method throughout, Principles of BiomedicalEthics, Sixth Edition, considers what constitutes moral character and addressesthe problem of moral status: what rights are due to people and animals, andwhen. It also examines the professional-patient relationship, surveys majorphilosophical theories--including utilitarianism, Kantianism, rights theory, andCommunitarianism--and describes methods of moral justification in bioethics.Ideal for courses in biomedical ethics, bioethics, and health care ethics, thetext is enhanced by hundreds of annotated citations and a substantialintroduction that clarifies key terms and concepts. Features of the Sixth Edition: * Integrates case studies throughout the text, rather than presenting them inan appendix as in previous editions * A new chapter on moral status (Chapter 3) * Extensively revised and expanded material on the theory of the commonmorality (Chapters 1 and 10) * A reworked discussion of the ethics of care as a form of virtue ethics(Chapter 2) * Revised and updated treatments of nonmaleficence and beneficence, which takeinto account recent legal and philosophical literature and discussions (Chapters5 and 6) * A new section on vulnerability and exploitation as it applies to justice(Chapter 7) * A more concise treatment of the principles of biomedical ethics throughoutthe text, featuring developed, refined, and modified perspectives

Table of Contents

Moral Foundations
Moral Norms	p. 1
Normative and Nonnormative Ethics	p. 1
The Common Morality as Universal Morality	p. 2
Particular Moralities as Nonuniversal	p. 5
Moral Dilemmas	p. 10
A Framework of Moral Norms	p. 12
Conflicting Moral Norms	p. 14
Conclusion	p. 25
Moral Character	p. 30
Moral Virtues	p. 30
Virtues in Professional Roles	p. 33
The Virtue of Caring	p. 36
Five Focal Virtues	p. 38
Moral Virtues and Action Guides	p. 45
Moral Ideals	p. 47
Moral Excellence	p. 51
Conclusion	p. 57
Moral Status	p. 64
The Problem of Moral Status	p. 64
Theories of Moral Status	p. 66
From Theories to Practical Guidelines	p. 81
Vulnerable Populations	p. 89
Conclusion	p. 93
Moral Principles
Respect for Autonomy	p. 99
The Nature of Autonomy	p. 99
The Capacity for Autonomous Choice	p. 111
The Meaning and Justification of Informed Consent	p. 117
Disclosure	p. 121
Understanding	p. 127
Voluntariness	p. 132
A Framework of Standards for Surrogate Decision Making	p. 135
Conclusion	p. 140
Nonmaleficence	p. 149
The Concept of Nonmaleficence	p. 149
Distinctions and Rules Governing Nontreatment	p. 155
Optional Treatments and Obligatory Treatments	p. 166
Killing and Letting Die	p. 172
The Justification of Intentionally Arranged Deaths	p. 176
Protecting Incompetent Patients	p. 185
Conclusion	p. 190
Beneficence	p. 197
The Concept of Beneficence	p. 197
Obligatory Beneficence and Ideal Beneficence	p. 198
Paternalism: Conflicts between Beneficence and Autonomy	p. 206
Balancing Benefits, Costs, and Risks	p. 221
The Value and Quality of Life	p. 230
Conclusion	p. 233
Justice	p. 240
The Concept of Justice	p. 241
Theories of Justice	p. 244
Fair Opportunity and Unfair Discrimination	p. 248
Vulnerability and Exploitation	p. 253
National Health Policy and the Right to Health Care	p. 258
Global Health Policy and the Right to Health	p. 264
Allocating, Setting Priorities, and Rationing	p. 267
Conclusion	p. 280
Professional-Patient Relationships	p. 288
Veracity	p. 288
Privacy	p. 296
Confidentiality	p. 302
Fidelity	p. 311
The Dual Roles of Clinician and Investigator	p. 317
Conclusion	p. 324
Theory and Method
Moral Theories	p. 333
Criteria for Theory Construction	p. 334
Utilitarianism	p. 336
Kantianism	p. 343
Rights Theory	p. 350
Communitarianism	p. 356
Convergence of Theories	p. 361
Conclusion	p. 363
Method and Moral	p. 368
Justification	p. 368
Justification in Ethics	p. 368
Top-Down Models: Theory and Application	p. 369
Bottom-Up Models: Cases and Analogy	p. 375
An Integrated Model Using Reflective Equilibrium	p. 381
Common-Morality Theory	p. 387
Conclusion	p. 397
Index	p. 403
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