Medical Ethics

by Veatch, Robert M.

• ISBN13: 9780867209747
• ISBN10: 0867209747
• Edition: 2nd
• Format: Hardcover
• Copyright: 1997-01-01
• Publisher: Jones & Bartlett

Summary

Fourteen leading authorities in their respective fields provide the most comprehensive and current survey of issues in medical ethics ever written. Each author is given the opportunity to write a chapter surveying a critical issue in one of the major subject areas in medical ethics. Within each chapter, the author develops a discussion of the critical concepts, arguments and positions in a particular facet of medical ethics, without arguing for one position or another. Since the first edition of Medical Ethics in 1989, important changes have occurred that affect every chapter in this book. To address these changes, Robert Veatch has asked the original contributors to address the developments of the past six years. Additionally, Ronald Bayer has contributed a new chapter on AIDS and ethics. Norman Daniels, former member of the ethics advisory group for President Clinton's Health Care Task Force, provides a framework for understanding the ethical dimension of the health care policy debate. This collection of readings is a valuable resource for participants in the current debate, practitioners and students of medical ethics.

Table of Contents

Contributors	xi
Preface	xiii
Preface to the First Edition	xv
Medical Ethics: An Introduction	1	(28)
Robert M. Veatch
The History of Medical Ethical Systems	6	(12)
The Role of Codes	18	(4)
Choosing Among Professional and Other Codifications	22	(2)
Discussion Questions	24	(1)
References	25	(4)
The Normative Principles of Medical Ethics	29	(28)
James F. Childress
Moral Justification and Moral Theories	30	(3)
Moral Principles and Rules	33	(2)
The Meaning and Weight of Principles and Rules	35	(2)
Connecting General Principles to Particular Judgments About Cases	37	(8)
Criticisms of Principles	45	(3)
Interactions Among Strangers or Among Friends and Intimates?	48	(5)
Discussion Questions	53	(1)
References	53	(4)
The Concepts of Health, Illness, and Disease	57	(18)
Arthur L. Caplan
Why Are Health and Disease So Important in Contemporary Society?	58	(3)
Health, Disease, and the Scope of Medicine	61	(2)
The Relationship Between the Concepts of Health, Illness, and Disease	63	(1)
Normativism versus Nonnormativism in the Definition of Disease	64	(3)
Health as Normality, Disease as Abnormality	67	(1)
Proponents of Normativism	68	(2)
Normativism versus Nonnormativism---What is Really at Issue?	70	(2)
Discussion Questions	72	(1)
For Further Reading	73	(2)
The Physician--Patient Relationship	75	(28)
Howard Brody
Paternalism and Contractual Models	77	(2)
Criticisms of Contractual Models	79	(4)
Contract versus Virtue	83	(2)
Truthful Disclosure	85	(4)
Confidentiality	89	(4)
The Physician as Gatekeeper	93	(2)
Conclusion	95	(1)
Discussion Questions	96	(3)
References	99	(4)
Limiting Procreation	103	(32)
Judith Areen
Contraception, Voluntary Sterilization, and the Duty to Procreate	105	(10)
Mandatory Sterilization for Eugenic Purposes	115	(2)
Abortion, Fetal Rights, and the Right of Privacy	117	(8)
The Rights of Fathers	125	(1)
The Rights of Minors	126	(1)
Public Funding	127	(2)
Medical Interventions for Fetuses	129	(1)
Conclusion	130	(1)
Discussion Questions	131	(1)
References	131	(4)
Human Experimentation	135	(50)
A. M. Capron
A Historical Comparison	136	(4)
Definitions	140	(5)
Justifications and Principles	145	(10)
Ethical Review Procedures	155	(4)
Current Issues	159	(11)
A Final Word	170	(1)
Discussion Questions	171	(1)
References	171	(14)
Appendix 1: The Nuremberg Code	176	(1)
Appendix 2: Department of Health and Human Services, Basic HHS Policy for Protection of Human Research Subjects	177	(8)
Informed Consent	185	(24)
Tom L. Beauchamp
Historical Background	186	(4)
The Concept and Elements of Informed Consent	190	(6)
The Law and Its Limits	196	(2)
The Quality of Consent	198	(1)
Vulnerable Subjects and Compliant Patients	199	(3)
Competence to Consent	202	(1)
Justifications for Not Obtaining Consent	203	(2)
Conclusion	205	(1)
Discussion Questions	205	(1)
References	206	(3)
Reproductive Technologies and Genetics	209	(30)
LeRoy Walters
Reproductive Technologies	210	(9)
Genetic Testing and Screening	219	(9)
Human Gene Therapy and Genetic Engineering	228	(5)
Discussion Questions	233	(1)
References	234	(5)
Ethical Issues in Organ Transplantation	239	(36)
Albert R. Jonsen
The Intrinsic Morality of Organ Transplantation	242	(2)
The Determination of Death	244	(3)
The Supply of Organs	247	(8)
The Experimental Frontier	255	(3)
Selection of Patients for a Scarce Resource	258	(5)
Allocation of Scarce Resources	263	(5)
Conclusion	268	(1)
Discussion Questions	269	(1)
References	270	(5)
Moral Problems in Psychiatry: The Role of Value Judgments in Psychiatric Practice	275	(46)
Loretta M. Kopelman
Moral and Nonmoral Value Judgments	276	(2)
Distinguishing Moral and Scientific Judgments	278	(3)
The Moral Basis of Psychiatric Diagnosis	281	(7)
Duties in Diagnoses	288	(2)
Duties Regarding Confidentiality	290	(2)
Judging Competency	292	(5)
Balancing Paternalism with Freedom	297	(2)
Liberty-Limiting Principles	299	(3)
Deciding for Incompetent People	302	(2)
Standards for Decision Making	304	(1)
Involuntary Commitment	305	(3)
Informed Consent	308	(2)
Research	310	(3)
Discrimination	313	(3)
Discussion Questions	316	(1)
References	317	(4)
Health-Care Delivery and Resource Allocation	321	(42)
Allen Buchanan
Preliminary Analysis of Key Concepts	322	(1)
Types of Allocations	323	(1)
Criteria for Evaluating Allocations	324	(7)
Ethical Criteria	331	(6)
Rights to Health Care	337	(18)
Beneficence Rather Than Justice: Obligations Without Rights	355	(4)
Conclusion	359	(1)
Discussion Questions	359	(1)
References	360	(3)
Death and Dying	363	(32)
Dan W. Brock
The Definition of Death	364	(2)
An Ethical Framework for Life Support Decisions	366	(4)
The Incompetent Patient	370	(2)
Some Additional Controversial Moral Constraints on Forgoing Life Support	372	(14)
Some Cases of Special Policy Concern	386	(5)
Conclusion	391	(1)
Discussion Questions	392	(1)
References	392	(3)
AIDS and Ethics	395	(20)
Ronald Bayer
The Ethics of Prevention and Protection	396	(9)
The Ethics of Research	405	(2)
The Ethics of Care	407	(2)
AIDS and the World	409	(1)
Conclusion	410	(1)
Discussion Questions	411	(1)
References	411	(4)
National Health-Care Reform	415	(28)
Norman Daniels
Introducing Design Principles	417	(1)
The Leading Reform Proposals	418	(2)
Applying Design Principles to National Health-Care Reform Proposals	420	(19)
Conclusion	439	(1)
Discussion Questions	440	(1)
References	441	(2)
Glossary	443	(4)
Index	447