Biomedical Ethics

by Mappes, Thomas; DeGrazia, David

• ISBN13: 9780072976441
• ISBN10: 0072976446
• Edition: 6th
• Format: Paperback
• Copyright: 2005-08-02
• Publisher: McGraw-Hill Humanities/Social Sciences/Languages

Summary

This best-selling anthology of readings with case studies provides insightful and comprehensive treatment of ethical issues in medicine. Appropriate for courses taught in philosophy departments as well as in schools on medicine and nursing, the collection covers provocative topics such as conflicts of interest in medicine, advance directives, physician-assisted suicide, and the rationing of health care. The effective pedagogical features include chapter introductions, argument sketches, explanations of medical terms, headnotes, and annotated bibliographies.

Table of Contents

Preface	xvii
General Introduction	1	(58)
The Nature of Biomedical Ethics	1	(3)
Recently Dominant Ethical Theories	4	(22)
The Critical Assessment of Competing Ethical Theories	5	(1)
Teleological Versus Deontological Theories	6	(1)
Act-Utilitarianism	7	(6)
Rule-Utilitarianism	13	(4)
Kantian Deontology	17	(6)
W. D. Ross's Theory of Prima Facie Duties	23	(3)
The Principles of Biomedical Ethics	26	(1)
Alternative Directions and Methods	27	(11)
Virtue Ethics	28	(2)
The Ethics of Care and Feminist Ethics	30	(3)
Casuistry: Case-Based Reasoning In Historical Context	33	(3)
Reflective Equilibrium and Appeals to Coherence	36	(2)
Confronting Ethical Relativism	38	(2)
Fundamental Concepts and Principles	40	(13)
Autonomy	40	(6)
Liberty-Limiting Principles	46	(2)
Paternalism	48	(5)
Notes	53	(2)
Annotated Bibliography	55	(2)
Appendix: Selected Reference Sources In Biomedical Ethics	57	(2)
Print Resources	57	(1)
Web Resources	57	(2)
The Physician-Patient Relationship	59	(103)
Introduction	59	(11)
Physicians' Obligations and Virtues	59	(1)
Paternalism and Respect for Patient Autonomy	60	(2)
Truth Telling	62	(2)
Informed Consent	64	(3)
The Practice of Medicine in a Multicultural Society	67	(1)
Contested Therapies Within the Physician-Patient Relationship	67	(2)
Conflicts of Interest, Problems of Conscience, and Managed Care	69	(1)
Notes	70	(1)
Physicians' Obligations and Virtues	70	(6)
The Hippocratic Oath	70	(1)
Council on Ethical and Judicial Affairs, American Medical Association, Fundamental Elements of the Patient-Physician Relationship	71	(1)
The Virtuous Physician and the Ethics of Medicine	72	(4)
Edmund D. Pellegrino
Physician-Patient Models and Patient Autonomy	76	(14)
Metaphors and Models of Doctor-Patient Relationships: Their Implications for Autonomy	76	(9)
James F. Childress
Mark Siegler
Why Doctors Should Intervene	85	(5)
Terrence F. Ackerman
Truth Telling	90	(12)
On Telling Patients the Truth	90	(5)
Roger Higgs
Offering Truth: One Ethical Approach to the Uninformed Cancer Patient	95	(7)
Benjamin Freedman
Informed Consent	102	(16)
Opinion in Canterbury v. Spence	102	(4)
Judge Spotswood W. Robinson III
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, The Values Underlying Informed Consent	106	(6)
Transparency: Informed Consent in Primary Care	112	(6)
Howard Brody
The Practice of Medicine in a Multicultural Society	118	(13)
Ethical Relativism in a Multicultural Society	118	(9)
Ruth Macklin
Quality Care and the Wounds of Diversity	127	(4)
Kenneth Kipnis
Contested Therapies Within the Physician-Patient Relationship	131	(13)
Cosmetic Surgery and the Internal Morality of Medicine	131	(9)
Franklin G. Miller
Howard Brody
Kevin C. Chung
One Pill Makes You Smarter: An Ethical Appraisal of the Rise of Ritalin	140	(4)
Claudia Mills
Conflicts of Interest, Problems of Conscience, and Managed Care	144	(15)
The Doctor as Double Agent	144	(5)
Marcia Angell
Managed Care and the Goals of Medicine	149	(5)
Daniel Callahan
Conscience and Conscientious Actions in the Context of MCOs	154	(5)
James F. Childress
Annotated Bibliography	159	(3)
Hospitals, Nurses, Families, and Medical Confidentiality	162	(62)
Introduction	162	(8)
Professional Statements Regarding Patients' Rights and Professionals' Obligations	162	(1)
The Role and Responsibilities of Nurses	163	(1)
Families and Medical Decision Making	164	(4)
Confidentiality and Conflicting Obligations	168	(1)
Notes	169	(1)
Professional Statements	170	(3)
American Hospital Association, The Patient Care Partnership: Understanding Expectations, Rights and Responsibilities	170	(2)
American Nurses Association, Code of Ethics for Nurses	172	(1)
The Role and Responsibilities of Nurses	173	(19)
In Defense of the Traditional Nurse	173	(7)
Lisa H. Newton
Advocacy or Subservience of the Sake of Patients?	180	(8)
Helga Kuhse
The Nurse/Physician Relationship and Ethical Decision Making	188	(4)
Amy M. Haddad
Families and Medical Decision Making	192	(19)
Patient Choices, Family Interests, and Physician Obligations	192	(9)
Thomas A. Mappes
Jane S. Zembaty
Deaf Culture, Cochlear Implants, and Elective Disability	201	(6)
Bonnie Poitras Tucker
The Hanukkah Bush: Ethical Implications in the Clinical Management of Intersex	207	(4)
Sherri A. Groveman
Confidentiality	211	(11)
Majority Opinion in Tarasoff v. Regents of the University of California	211	(4)
Justice Mathew O. Tobriner
Dissenting Opinion in Tarasoff v. Regents of the University of California	215	(3)
Justice William P. Clark
Please Don't Tell!: A Case About HIV and Confidentiality	218	(4)
Leonard Fleck
Marcia Angell
Annotated Bibliography	222	(2)
Human and Animal Research	224	(78)
Introduction	224	(10)
Conceptual Issues	224	(1)
The Justification of Research Using Human Subjects	225	(2)
The Informed-Consent Requirement	227	(1)
Proxy Consent for Research Subjects Incapable of Informed Consent	228	(2)
Experimental Design and Research in Developing Nations	230	(2)
Animal Research	232	(1)
Notes	233	(1)
Ethical Codes	234	(6)
The Nuremberg Code	234	(1)
World Medical Association, Declaration of Helsinki	235	(4)
Council for International Organizations of Medical Sciences, International Guiding Principles for Biomedical Research Involving Animals	239	(1)
Research Involving ``Vulnerable'' Populations	240	(17)
Proxy Consent for Research on the Incompetent Elderly	240	(7)
Barry F. Brown
The Dangers of Difference	247	(4)
Patricia A. King
Ethical and Human-Rights Issues in Research on Mental Disorders that May Affect Decision-Making Capacity	251	(6)
Alexander Morgan Capron
Experimental Design and Randomized Clinical Trials	257	(9)
Of Mice but Not Men: Problems of the Randomized Clinical Trial	257	(5)
Samuel Hellman
Deborah S. Hellman
How to Resolve an Ethical Dilemma Concerning Randomized Clinical Trials	262	(4)
Don Marquis
Clinical Trials in Developing Countries	266	(10)
Research in Developing Countries: Taking Benefit Seriously	266	(6)
Leonard H. Glantz
George J. Annas
Michael A. Grodin
Wendy K. Mariner
Ethical Issues in Clinical Trials in Developing Countries	272	(4)
Baruch Brody
Animal Research	276	(23)
The Case for the Use of Animals in Biomedical Research	276	(7)
Carl Cohen
The Responsible Use of Animals in Biomedical Research	283	(6)
Edwin Converse Hettinger
The Ethics of Animal Research: What Are the Prospects for Agreement?	289	(10)
David DeGrazia
Annotated Bibliography	299	(3)
Death and Decisions Regarding Life-Sustaining Treatment	302	(75)
Introduction	302	(7)
The Definition and Determination of Death	302	(2)
Competent Adults and the Refusal of Life-Sustaining Treatment	304	(1)
DNR Orders and Medical Futility	305	(1)
Advance Directives and Treatment Decisions for Incompetent Adults	306	(1)
The Treatment of Impaired Infants	307	(1)
Notes	308	(1)
The Definition and Determination of Death	309	(18)
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Why ``Update'' Death?	309	(3)
The Definition and Criterion of Death	312	(7)
Charles M. Culver
Bernard Gert
Pragmatism and the Determination of Death	319	(8)
Martin Benjamin
Competent Adults and the Refusal of Life-Sustaining Treatment	327	(13)
Council on Ethical and Judicial Affairs, American Medical Association, Withholding and Withdrawing Life-Sustaining Treatment	327	(3)
Refusing Life-Sustaining Treatment After Catastrophic Injury: Ethical Implications	330	(5)
Tia Powell
Bruce Lowenstein
Suicide by Persons with Disabilities Disguised as the Refusal of Life-Sustaining Treatment	335	(5)
Vicki Michel
DNR Orders and Medical Futility	340	(10)
Ethics and Communication in Do-Not-Resuscitate Orders	340	(5)
Tom Tomlinson
Howard Brody
Medical Futility: A Conceptual and Ethical Analysis	345	(5)
Mark R. Wicclair
Advance Directives and Treatment Decisions for Incompetent Adults	350	(15)
Some Reflections on Advance Directives	350	(7)
Thomas A. Mappes
My Annotated Living Will	357	(6)
Norman L. Cantor
The Conscious Incompetent Patient	363	(2)
Rebecca Dresser
The Treatment of Impaired Infants	365	(10)
Involuntary Euthanasia of Defective Newborns	365	(6)
John A. Robertson
Members of The Hastings Center Research Project on the Care of Imperiled Newborns, Standards of Judgment for Treatment of Imperiled Newborns	371	(4)
Annotated Bibliography	375	(2)
Suicide, Physician-Assisted Suicide, and Active Euthanasia	377	(71)
Introduction	377	(7)
What Is Suicide?	377	(2)
The Morality of Suicide	379	(1)
The Morality of Active Euthanasia	379	(2)
Physician-Assisted Suicide	381	(1)
Physician-Assisted Suicide, Active Euthanasia, and Social Policy	382	(2)
Notes	384	(1)
The Morality of Suicide	384	(11)
Suicide	384	(4)
Immanuel Kant
The Morality and Rationality of Suicide	388	(7)
R. B. Brandt
The Morality of Active Euthanasia	395	(9)
Active and Passive Euthanasia	395	(4)
James Rachels
Killing and Allowing to Die	399	(2)
Daniel Callahan
Voluntary Active Euthanasia	401	(3)
Dan W. Brock
The Supreme Court, Physician-Assisted Suicide, and Terminal Sedation	404	(13)
Opinion of the Court in Washington v. Glucksberg	404	(5)
Chief Justice William H. Rehnquist
Opinion of the Court in Vacco v. Quill	409	(4)
Chief Justice William H. Rehnquist
Concurring Opinion in Washington v. Glucksberg and Vacco v. Quill	413	(1)
Justice Sandra Day O'Connor
The Supreme Court and Physician-Assisted Suicide: Rejecting Assisted Suicide But Embracing Euthanasia	414	(3)
David Orentlicher
Physician-Assisted Suicide, Active Euthanasia, and Social Policy	417	(28)
Care of the Hopelessly III: Proposed Clinical Criteria for Physician-Assisted Suicide	417	(3)
Timothy E. Quill
Christine K. Cassel
Diane E. Meier
The Oregon Death with Dignity Act	420	(6)
Lawrence O. Gostin. and Diane E. Meier, Regulating Physician-Assisted Death	426	(5)
Franklin G. Miller
Timothy E. Quill
Howard Brody
John C. Fletcher
On the Slippery Slope in the Empire State: The New York State Task Force on Physician-Assisted Death	431	(7)
John D. Arras
Patient Refusal of Hydration and Nutrition: An Alternative to Physician-Assisted Suicide or Voluntary Active Euthanasia	438	(7)
James L. Bernat
Bernard Gert
R. Peter Mogielnicki
Annotated Bibliography	445	(3)
Abortion and Research on Embryonic Stem Cells	448	(63)
Introduction	448	(9)
Abortion: The Ethical Issue	448	(2)
The Conservative View and the Liberal View	450	(1)
Moderate Views	451	(2)
Abortion and Social Policy	453	(2)
Research on Embryonic Stem Cells	455	(1)
Notes	456	(1)
The Morality of Abortion	457	(26)
The Unspeakable Crime of Abortion	457	(2)
Pope John Paul II
On the Moral and Legal Status of Abortion	459	(7)
Mary Anne Warren
Why Abortion is Immoral	466	(5)
Don Marquis
A Defense of Abortion	471	(8)
Judith Jarvis Thomson
The Morality of Abortion	479	(4)
Margaret Olivia Little
Abortion and Social Policy	483	(10)
Majority Opinion in Roe v. Wade	483	(5)
Justice Harry Blackmun
``Partial-Birth Abortion'' and the Supreme Court	488	(5)
George J. Annas
Research on Embryonic Stem Cells	493	(15)
National Institutes of Health, Stem Cells: A Primer	493	(5)
What Does ``Respect for Embryos'' Mean in the Context of Stem Cell Research?	498	(3)
Bonnie Steinbock
President's Council on Bioethics, The Moral Case Against Cloning-for-Biomedical-Research	501	(7)
Annotated Bibliography	508	(3)
Genetics and Human Reproduction	511	(104)
Introduction	511	(10)
Genetic Disease and the Language of Genetics	511	(2)
Prenatal Diagnosis and Selective Abortion	513	(1)
Morality and Reproductive Risk	514	(1)
Reproductive Technologies and the Treatment of Infertility	514	(2)
Reproductive Technologies: Ethical Concerns	516	(1)
Human Cloning	517	(2)
Preimplantation Genetic Diagnosis	519	(1)
Genetic Engineering, Gene Therapy, and Enhancement	519	(1)
Notes	520	(1)
Reproductive Risk, Prenatal Diagnosis, and Selective Abortion	521	(11)
Implications of Prenatal Diagnosis for the Human Right to Life	521	(5)
Leon R. Kass
Genetics and Reproductive Risk: Can Having Children be Immoral?	526	(6)
Laura M. Purdy
Reproductive Technologies	532	(21)
IVF: The Simple Case	532	(4)
Peter Singer
Feminist Ethics and In Vitro Fertilization	536	(5)
Susan Sherwin
The New York State Task Force on Life and the Law, Ethical Debates about Infertility and its Treatment	541	(7)
President's Council on Bioethics, Assisted Reproduction	548	(5)
Gamete Donation and Surrogacy	553	(12)
Families, the Marketplace, and Values: New Ways of Making Babies	553	(8)
Thomas H. Murray
Surrogate Motherhood as Prenatal Adoption	561	(4)
Bonnie Steinbock
Human Cloning	565	(12)
Cloning of Human Beings	565	(3)
Leon R. Kass
Even If It Worked, Cloning Wouldn't Bring Her Back	568	(3)
Thomas H. Murray
Genetic Encores: The Ethics of Human Cloning	571	(6)
Robert Wachbroit
Preimplantation Genetic Diagnosis	577	(9)
Extending Preimplantation Genetic Diagnosis: Medical and Non-Medical Uses	577	(6)
John A. Robertson
President's Council on Bioethics, Selecting Embryos for Desired Traits	583	(3)
Gene Therapy	586	(15)
The Dangerous Promise of Gene Therapy	586	(4)
Sophia Kolehmainen
The Future of Gene Therapy: Balancing the Risks and the Benefits of Clinical Trials	590	(4)
Marina Cavazzana-Calvo
Adrian Thrasher
Fulvio Mavilio
Germ-Line Gene Therapy	594	(7)
LeRoy Walters
Julie Gage Palmer
Genetic Enhancement	601	(11)
Genetic Enhancement	601	(5)
Walter Glannon
Genetic Engineering	606	(6)
Dan W. Brock
Annotated Bibliography	612	(3)
Social Justice and Health-Care Policy	615	(82)
Introduction	615	(13)
Justice, Rights, and Societal Obligations	617	(3)
Rationing, Managed Care, and Health-Care Reform in the United States	620	(4)
Systems of Health-Care Delivery and Finance: Four International Perspectives	624	(3)
Notes	627	(1)
Justice, Rights, and Societal Obligations	628	(17)
Justice: A Philosophical Review	628	(11)
Allen Buchanan
Autonomy, Equality and a Just Health Care System	639	(6)
Kai Nielsen
Rationing, Managed Care, and Health-Care Reform in the United States	645	(27)
Is the Oregon Rationing Plan Fair?	645	(7)
Norman Daniels
Managed Care: Rationing Without Justice, but not Unjustly	652	(8)
Allen Buchanan
Rationing: Don't Give Up	660	(3)
Leonard M. Fleck
Closure, Fair Procedures, and Setting Limits Within Managed Care Organizations	663	(6)
Norman Daniels
James Sabin
Health Care Reform: Still Possible	669	(3)
Ezekiel Emanuel
International Models and Perspectives	672	(22)
Managing Care the Canadian Way	672	(2)
Pat Armstrong
Restoring the Status of an Icon: A Talk with Canada's Minister of Health	674	(7)
John K. Iglehart
The German Health Care System	681	(3)
Gerd Richter
Will the Fudge on Equity Sustain the NHS into the Next Millennium?	684	(5)
Nicholas Mays
Justin Keen
Ethics, Politics, and Priorities in the Italian Health-Care System	689	(5)
Giovanna Ruberto
Annotated Bibliography	694	(3)
Appendix: Case Studies	697	(22)
About the Contributors	719