Bioethics Principles, Issues, and Cases

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  • Format: Paperback
  • Copyright: 2009-03-13
  • Publisher: Oxford University Press
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Supplemental Materials

What is included with this book?


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

Prefacep. ix
Principles and Theories
Moral Reasoning in Bioethicsp. 3
Ethics and Bioethicsp. 3
Ethics and the Moral Lifep. 5
In Depth: Morality and the Lawp. 7
Moral Principles in Bioethicsp. 8
Autonomyp. 9
Beneficencep. 10
Utilityp. 11
Justicep. 12
Ethical Relativismp. 13
In Depth: Anthropology and Moral Diversityp. 14
Ethics and Religionp. 17
Moral Argumentsp. 18
Argument Fundamentalsp. 19
Patterns of Moral Argumentsp. 22
Review: Valid and Invalid Argument Formsp. 23
In Depth: Fallacies in Moral Reasoningp. 24
Evaluating Premisesp. 26
Key Termsp. 28
Summaryp. 28
Further Readingp. 29
Notesp. 29
Bioethics And Moral Theoriesp. 30
The Nature of Moral Theoriesp. 30
Influential Moral Theoriesp. 31
Utilitarianismp. 32
In Depth: Utilitarianism and the Golden Rulep. 34
Kantian Ethicsp. 34
Natural Law Theoryp. 36
Rawls' Contract Theoryp. 38
Virtue Ethicsp. 39
The Ethics of Carep. 40
In Depth: Can Virtue Be Taught?p. 41
Feminist Ethicsp. 42
Criteria for Judging Moral Theoriesp. 42
Review: Evaluating Moral Theories: Criteria of Adequacyp. 44
Applying the Criteriap. 44
Utilitarianismp. 45
Kant's Theoryp. 46
Key Termsp. 46
Summaryp. 47
Further Readingp. 47
Notesp. 48
Physician and Patient
Paternalism And Patient Autonomyp. 51
Shades of Autonomy and Paternalismp. 51
Refusing Treatmentp. 52
In Depth: The Hippocratic Oathp. 53
Futile Treatmentp. 54
Legal Brief: Refusing Treatment for Children on Religious Groundsp. 55
In Depth: CPR and DNRp. 56
Applying Major Theoriesp. 56
Key Termsp. 57
Summaryp. 57
Classic Case File: Elizabeth Bouviap. 58
Cases for Evaluationp. 60
Further Readingp. 62
Notesp. 63
Readingsp. 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 Appealp. 98
"Fundamental Elements of the Patient-Physician Relationship," AMA Council on Ethical and Judicial Affairsp. 102
"Code of Ethics for Nurses," American Nurses Associationp. 103
Truth-Telling And Confidentialityp. 105
Paternalism and Deceptionp. 105
In Depth: Do Patients Want the Truth? Do Physicians Tell It?p. 106
Confidential Truthsp. 108
Legal Brief: Confidentiality and a Duty to Warnp. 109
Applying Major Theoriesp. 110
Classic Case File: Carols R.p. 111
Key Termsp. 112
Summaryp. 112
Cases for Evaluationp. 112
Further Readingp. 114
Notesp. 114
Readingsp. 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 Californiap. 138
Informed Consentp. 144
Autonomy and Consentp. 144
Conditions of Informed Consentp. 145
In Depth: Two Views of Informed Consentp. 147
Legal Brief: Important Informed Consent Casesp. 148
Applying Major Theoriesp. 149
Key Termsp. 149
Summaryp. 149
Classic Case File: Jerry Canterburyp. 150
Cases for Evaluationp. 151
Further Readingp. 153
Notesp. 154
Readingsp. 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 Appealsp. 189
Human Researchp. 193
The Science of Clinical Trialsp. 194
In Depth: The Tuskegee Tragedyp. 195
Beneficence, Science, and Placebosp. 196
Science and Informed Consentp. 199
In Depth: Women in Clinical Trialsp. 200
Research on the Vulnerablep. 201
In Depth: Why Enter a Clinical Trial?p. 202
Applying Major Theoriesp. 205
Key Termsp. 206
Summaryp. 206
Classic Case File: The UCLA Schizophrenia Studyp. 207
Cases for Evaluationp. 208
Further Readingp. 212
Notesp. 212
Readingsp. 213
The Nuremberg Codep. 213
Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects, World Medical Associationp. 214
"The Belmont Report," National Commission for the Protection of Human Subjects of Biomedical and Behavioral Researchp. 217
"Final Report: Human Radiation Experiments," Advisory Committee on Human Radiation Experimentsp. 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
Abortionp. 253
Starting Point: The Basicsp. 253
Fact File: U.S. Abortionsp. 254
In Depth: Abortion and Public Opinionp. 256
The Legal Strugglep. 257
Persons and Rightsp. 257
In Depth: Late-Term Abortionp. 258
Applying Major Theoriesp. 262
Key Termsp. 263
Summaryp. 263
Classic Case File: Nancy Kleinp. 264
Cases for Evaluationp. 265
Further Readingp. 268
Notesp. 268
Readingsp. 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 Courtp. 342
Planned Parenthood of Southeastern Pennsylvania v. Casey, United States Supreme Courtp. 347
Reproductive Technologyp. 354
In Vitro Fertilizationp. 354
Fact File: Assisted Reproductionp. 355
Surrogacyp. 360
In Depth: IVF and Children's Future Childrenp. 361
Cloningp. 362
Legal Brief: Surrogacy Contracts and the Lawp. 363
In Depth: Cloning Time Linep. 365
Applying Major Theoriesp. 366
Key Termsp. 367
Summaryp. 367
Classic Case File: Baby Mp. 368
Cases for Evaluationp. 369
Further Readingp. 371
Notesp. 372
Readingsp. 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 Faithp. 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 Courtp. 452
Genetic Choicesp. 460
Genes and Genomesp. 460
Genetic Testingp. 461
In Depth: Direct-to-Consumer Genetic Testsp. 464
Gene Therapyp. 468
Fact File: Genetic Testsp. 469
Stem Cellsp. 471
In Depth: Recent Research in Gene Therapyp. 472
Applying Major Theoriesp. 474
Classic Case File: The Kingsburysp. 475
Key Termsp. 476
Summaryp. 476
Cases for Evaluationp. 477
Further Readingp. 479
Notesp. 479
Readingsp. 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 Lifep. 524
Euthanasia And Physician-Assisted Suicidep. 526
Deciding Life and Deathp. 527
Legal Brief: Euthanasia and Assisted Suicide: Major Developmentsp. 529
In Depth: Euthanasia and Assisted Suicide: What Doctors Think and Dop. 530
Autonomy, Mercy, and Harmp. 530
In Depth: Oregon's Death With Dignity Actp. 533
Applying Major Theoriesp. 534
In Depth: Physician-Assisted Suicide and Public Opinionp. 535
Key Termsp. 536
Summaryp. 536
Classic Case File: Nancy Cruzanp. 537
Cases for Evaluationp. 538
Further Readingp. 541
Notesp. 541
Readingsp. 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 Lawp. 584
"The Philosophers' Brief,"p. 592
Vacco v. Quill, United States Supreme Courtp. 601
Washington v. Glucksberg, United States Supreme Courtp. 604
Justice and Health Care
Dividing Up Health Care Resourcesp. 613
Health Care in Troublep. 613
In Depth: Unequal Health Care for Minoritiesp. 615
Fact File: U.S. Health Carep. 616
Theories of Justicep. 616
A Right to Health Carep. 617
In Depth: Public Opinion: Obtaining Adequate Health Carep. 618
The Ethics of Rationingp. 620
Key Termsp. 622
Summaryp. 622
Classic Case File: Christine deMeurersp. 623
Cases for Evaluationp. 624
Further Readingp. 626
Notesp. 627
Readingsp. 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
Glossaryp. 683
Indexp. 685
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