Contemporary Issues in Bioethics

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ISBN: 9780534504762 | 0534504760
Cover: Hardcover
Copyright: 1/19/1999

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This anthology represents all major points of view on the central topics in bioethics. It contains current essays and actual medical and legal cases written by outstanding scholars from around the globe. The book provides readers with diverse views from many standpoints, including medical researchers and practitioners, legal experts, and philosophers.

Preface

PART I Introduction to Ethics

(32)

CHAPTER 1: ETHICAL THEORY AND BIOETHICS

(32)

Fundamental Problems

(9)

The Study of Morality

(2)

Moral Dilemmas and Disagreements

(3)

The Problem of Relativism

(3)

Moral Justification

(1)

Types of Ethical Theory

(8)

Utilitarian Theories

(3)

Kantian Theories

(2)

Contemporary Challenges to the Traditional Theories

(1)

Virtue Ethics

(1)

The Ethics of Care

(1)

Casuistry

(1)

Ethical Principles

(6)

Respect for Autonomy

(1)

Beneficence

(2)

Justice

(2)

Law and Policy

(6)

Ethics and Public Affairs

(1)

Morality and Law

(1)

Legal and Moral Rights

(1)

Law, Authority, and Autonomy

(3)

Suggested Readings

(3)

PART II Patient-Professional Relationships

(156)

CHAPTER 2: RIGHTS AND RESPONSIBILITIES INTRODUCTION

(84)

PROFESSIONAL CODES AND STATEMENTS

(7)

"The Hippocratic Oath" (ca. Fourth Century B.C.)

(1)

American Medical Association, Council on Ethical and Judicial Affairs, "Fundamental Elements of the Patient-Physician Relationship" (1994)

(1)

American Nurses Association, "Code for Nurses" (1985)

(4)

Ralph Crawshaw, et al.

"Patient-Physician Covenant" (1995)

(1)

THE VIRTUES AND OBLIGATIONS OF PROFESSIONALS

(23)

Edmund D. Pellegrino

"The Virtuous Physician and the Ethics of Medicine"

(6)

Nancy S. Jecker

Donnie J. Self

"Separating Care and Cure: An Analysis of Historical and Contemporary Images of Nursing and Medicine"

(11)

Norman Daniels

"The Ideal Advocate and Limited Resources"

(6)

PATIENTS' RIGHTS AND RESPONSIBILITIES

(9)

American Hospital Association, "A Patient's Bill of Rights" (1992)

(3)

President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry, "Consumer Bill of Rights and Responsibilities" (1997)

(2)

Council of Europe, "Convention for Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Biomedicine: Convention on Human Rights and Biomedicine" (1997)

(4)

PROFESSIONALS AND SPECIFIC PATIENT POPULATIONS

(34)

Vanessa Northington Gamble, "Under the Shadow of Tuskegee: African Americans and Health Care"

(6)

American Medical Association, Council on Ethical and Judicial Affairs, "Gender Disparities in Clinical Decision Making"

(5)

Christine K. Cassel

Bernice L. Neugarten

"The Goals of Medicine in an Aging Society"

(9)

Nancy S. Jecker

"Caring for `Socially Undesirable' Patients"

(7)

Paul Chodoff

"The Case for Involuntary Hospitalization of the Mentally Ill"

105

(7)

Suggested Readings

112

(5)

CHAPTER 3: THE MANAGEMENT OF MEDICAL INFORMATION INTRODUCTION

117

(72)

TRUTH TELLING AND THE MANAGEMENT OF BAD NEWS

123

(10)

David C. Thomasma

"Telling the Truth to Patients: A Clinical Ethics Exploration"

123

(4)

Garry S. Sigman

Jerome Kraut

John La Puma

"Disclosure of a Diagnosis to Children and Adolescents When Parents Object"

127

(6)

INFORMED CONSENT

133

(16)

United States Court of Appeals, Canterbury v. Spence

133

(2)

Jay Katz

"Physicians and Patients: A History of Silence"

135

(4)

Ruth R. Faden

Tom L. Beauchamp

"The Concept of Informed Consent"

139

(4)

Robert R. Levine

"Informed Consent: Some Challenges to the Universal Validity of the Western Model"

143

(6)

PATIENT SELF-DETERMINATION AND ADVANCE DIRECTIVES

149

(15)

Susan M. Wolf, et al.

"Sources of Concern about the Patient Self-Determination Act"

149

(7)

Rebecca Dresser

"Confronting the `Near Irrelevance' of Advance Directives"

156

(2)

Linda A. Emanuel

Marion Danis

Robert A. Pearlman

Peter A. Singer

"Advance Care Planning as a Process: Structuring the Discussions in Practice"

158

(6)

THE MANAGEMENT OF CONFIDENTIAL INFORMATION

164

(22)

California Supreme Court, Tarasoff V. Regents of the University of California

164

(5)

Mark Siegler

"Confidentiality in Medicine-A Decrepit Concept"

169

(3)

Sir Douglas Black

"Absolute Confidentiality?"

172

(5)

Lawrence O. Gostin

"Genetic Privacy"

177

(9)

Suggested Readings

186

(3)

PART III The Beginning and End of Life

189

(166)

CHAPTER 4: ABORTION AND MATERNAL-FETAL RELATIONS INTRODUCTION

189

(82)

THE PROBLEM OF MORAL JUSTIFICATION

196

(35)

Don Marquis

"Why Abortion Is Immoral"

196

(6)

Judith Jarvis Thomson

"A Defense of Abortion"

202

(10)

Baruch Brody

"The Morality of Abortion"

212

(10)

Mary Anne Warren

"On the Moral and Legal Status of Abortion"

222

(9)

LEGAL ISSUES OF ABORTION

231

(16)

Susan Dwyer

"A Short Legal History of Abortion in the United States and Canada"

231

(5)

United States Supreme Court, Roe v. Wade: Majority Opinion and Dissent

236

(4)

United States Supreme Court, Planned Parenthood of Southeastern Pennsylvania v. Robert P. Casey, et al., etc.

240

(7)

MATERNAL-FETAL RELATIONSHIPS AND RIGHTS

247

(20)

United States Supreme Court, Automobile Workers v. Johnson Controls, Inc.

247

(2)

District of Columbia Court of Appeals, In Re A.C.

249

(6)

Nancy K. Rhoden

"Cesareans and Samaritans"

255

(6)

John Seymour

"A Pregnant Woman's Decision to Decline Treatment: How Should the Law Respond?"

261

(6)

Suggested Readings

267

(4)

CHAPTER 5: EUTHANASIA AND ASSISTED SUICIDE INTRODUCTION

271

(84)

REFUSAL OF TREATMENT

278

(12)

California Court of Appeals, Second District, Bouvia v. Superior Court

278

(3)

United States Supreme Court, Cruzan v. Director, Missouri Department of Health

281

(5)

Lawrence O. Gostin

"Life and Death Choices after Cruzan"

286

(3)

John A. Robertson

"Cruzan: No Rights Violated"

289

(1)

VOLUNTARY ACTIVE EUTHANASIA

290

(23)

James Rachels

"Active and Passive Euthanasia"

290

(4)

Tom L. Beauchamp

James F. Childress

"Rachels on Active and Passive Euthanasia"

294

(2)

Dan W. Brock

"Voluntary Active Euthanasia"

296

(9)

David C. Thomasma

"When Physicians Choose to Participate in the Death of Their Patients"

305

(8)

PHYSICIAN-ASSISTED SUICIDE

313

(25)

Timothy E. Quill

"Death and Dignity: A Case of Individualized Decision Making"

313

(4)

The Oregon Death with Dignity Act

317

(5)

United States Supreme Court, Vacco v. Quill

322

(2)

United States Supreme Court, Washington v. Glucksberg

324

(5)

American Medical Association, Council on Ethical and Judicial Affairs, "Physician-Assisted Suicide"

329

(3)

James L. Bernat

Bernard Gert

R. Peter Mogielnicki

"Patient Refusal of Hydration and Nutrition: An Alternative to Physician-Assisted Suicide or Voluntary Active Euthanasia"

332

(6)

THE RIGHT TO DIE

338

(14)

F. M. Kamm

"A Right to Choose Death?"

338

(5)

Leon R. Kass

"Is There a Right to Die?"

343

(9)

Suggested Readings

352

(3)

PART IV Access to Health Care

355

(72)

CHAPTER 6: JUSTICE IN THE DISTRIBUTION OF HEALTH CARE INTRODUCTION

355

(72)

JUST HEALTH CARE AND THE RIGHT TO HEALTH CARE

362

(25)

President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, "Securing Access to Health Care"

362

(6)

Robert M. Veatch

"Justice, the Basic Social Contract, and Health Care"

368

(6)

Allen E. Buchanan

"The Right to a Decent Minimum of Health Care"

374

(6)

H. Tristram Engelhardt, Jr.

"Rights to Health Care, Social Justice, and Fairness in Health Care Allocations: Frustrations in the Face of Finitude"

380

(7)

MANAGED CARE AND UNIVERSAL ACCESS

387

(19)

Ezekiel J. Emanuel

Nancy Neveloff Dubler

"Preserving the Physician-Patient Relationship in the Era of Managed Care"

387

(6)

Lawrence O. Gostin

"Securing Health or Just Health Care? The Effect of the Health Care System on the Health of America"

393

(7)

David Orentlicher

"Health Care Reform and the Patient-Physician Relationship"

400

(6)

RATIONING AND THE OREGON PLAN

406

(17)

Norman Daniels

"Rationing Fairly: Programmatic Considerations"

406

(5)

Leonard M. Fleck

"Just Caring: Oregon, Health Care Rationing, and Informed Democratic Deliberation"

411

(7)

Dan W. Brock

"Justice and the ADA: Does Prioritizing and Rationing Health Care Discriminate against the Disabled?"

418

(5)

Suggested Readings

423

(4)

PART V Biomedical Research and Technology

427

(268)

CHAPTER 7: RESEARCH INVOLVING HUMAN AND ANIMAL SUBJECTS INTRODUCTION

427

(84)

CODES AND GUIDELINES

433

(16)

"The Nuremberg Code" (1947)

433

(1)

World Medical Association, "Declaration of Helsinki" (1996)

434

(2)

Council for International Organizations of Medical Sciences in collaboration with the World Health Organization, "International Guiding Principles for Biomedical Research Involving Human Subjects" (1993)

436

(5)

Council for International Organizations of Medical Sciences, "International Guiding Principles for Biomedical Research Involving Animals" (1985)

441

(2)

Baruch A. Brody

"Research Ethics: International Perspectives"

443

(6)

ETHICAL ISSUES IN HUMAN RESEARCH

449

(14)

Leon Eisenberg

"The Social Imperatives of Medical Research"

449

(8)

Benjamin Freedman

"Equipoise and Ethics of Clinical Research"

457

(6)

PAST ABUSES OF HUMAN RESEARCH SUBJECTS

463

(21)

Gregory E. Pence

"The Tuskegee Study"

463

(7)

Sheldon H. Harris

"Factories of Death"

470

(9)

Advisory Committee on Human Radiation Experiments, "Final Report: Executive Summary" (1995)

479

(5)

ETHICAL ISSUES IN ANIMAL RESEARCH

484

(22)

Tom Regan

"The Case against Animal Research"

484

(11)

Carl Cohen

"Do Animals Have Rights?"

495

(7)

Andrew N. Rowan

"Formulation of Ethical Standards for Use of Animals in Medical Research"

502

(4)

Suggested Readings

506

(5)

CHAPTER 8: EUGENICS AND HUMAN GENETICS INTRODUCTION

511

(96)

EUGENICS PROGRAMS IN THE TWENTIETH CENTURY

516

(29)

Philip R. Reilly

"Eugenic Sterilization in the United States"

516

(10)

United States Supreme Court, Buck v. Bell (1927)

526

(2)

Stephen Jay Gould

"Carrie Buck's Daughter"

528

(5)

Robert Jay Lifton

"Sterilization and the Nazi Biomedical Vision"

533

(8)

Veronica Pearson

"Population Policy and Eugenics in China"

541

(4)

THE HUMAN GENOME PROJECT AND GENETIC TESTING

545

(28)

Biological Sciences Curriculum Study, "The Human Genome Project"

545

(2)

Lee Rowen

Gregory Mahairas

Leroy Hood

"Sequencing the Human Genome"

547

(3)

James D. Watson

"Genes and Politics"

550

(5)

United Nations Educational, Scientific, and Cultural Organization, "Universal Declaration on the Human Genome and Human Rights" (December 1997)

555

(4)

Institute of Medicine, Committee on Assessing Genetic Risks, "Assessing Genetic Risks: Implications for Health and Social Policy"

559

(9)

E. Virginia Lapham

Chahira Kozma

Joan O. Weiss

"Genetic Discrimination: Perspectives of Consumers"

568

(5)

HUMAN GENE THERAPY AND GENETIC ENHANCEMENT

573

(29)

LeRoy Walters

Julie Gage Palmer

"The Ethics of Human Gene Therapy"

573

(8)

W. French Anderson

"Human Gene Therapy"

581

(5)

Jonathan Glover

"Questions about Some Uses of Genetic Engineering"

586

(10)

Erik Parens

"The Goodness of Fragility: On the Prospect of Genetic Technologies Aimed at the Enhancement of Human Capabilities"

596

(6)

Suggested Readings

602

(5)

CHAPTER 9: REPRODUCTIVE TECHNOLOGIES AND SURROGATE PARENTING ARRANGEMENTS INTRODUCTION

607

(88)

PARENTING AND THE FAMILY

612

(10)

Ruth Macklin

"Artificial Means of Reproduction and Our Understanding of the Family"

612

(7)

Barbara Katz Rothman

"Motherhood: Beyond Patriarchy"

619

(3)

THE PROBLEM OF INFERTILITY

622

(13)

New York State Task Force on Life and the Law, "The Prevalence of Infertility"

622

(4)

Warnock Committee, "Infertility"

626

(2)

Barbara Katz Rothman

"Infertility as Disability"

628

(5)

United States Supreme Court, "Reproduction as a `Major Life Activity" (Bradgon v. Abbott, 1998)

633

(2)

IN VITRO FERTILIZATION

635

(20)

John A. Robertson

"IVF, Infertility, and the Status of Embryos"

635

(11)

Susan Sherwin

"Feminist Ethics and In Vitro Fertilization"

646

(9)

SURROGATE PARENTING ARRANGEMENTS

655

(19)

Elizabeth S. Anderson

"Is Women's Labor a Commodity?"

655

(19)

Laura M. Purdy

"Surrogate Mothering: Exploitation or Empowerment?"

666

(8)

CLONING

674

(11)

Robert Winston

"The Promise of Cloning for Human Medicine"

674

(2)

National Bioethics Advisory Commission, "Cloning Human Beings: Executive Summary" (1997)

676

(3)

Daniel Callahan

"Cloning: Then and Now"

679

(3)

Lee M. Silver

"Cloning, Ethics, and Religion"

682

(3)

REGULATING ASSISTED REPRODUCTION

685

(6)

Human Fertilisation and Embryology Authority (United Kingdom), "Annual Report" (1997)

685

(3)

ISLAT Working Group, "ART into Science: Regulation of Fertility Techniques"

688

(3)

Suggested Readings

691

(4)

PART VI Public Health

695

CHAPTER 10: THE GLOBAL AIDS EPIDEMIC INTRODUCTION

695

GENERAL ISSUES

701

(26)

Joint United Nations Programme on HIV/AIDS and World Health Organization, "Report on the Global HIV/AIDS Epidemic: June 1998"

701

(7)

LeRoy Walters

"Ethical Issues in the Prevention and Treatment of HIV Infection and AIDS"

708

(11)

National Research Council, Panel on Monitoring the Social Impact of the AIDS Epidemic, "The Social Impact of AIDS in the United States"

719

(4)

Ronald Bayer

Jeff Stryker

"Ethical Challenges Posed by Clinical Progress in AIDS"

723

(4)

THE DUTY TO WARN AND THE DUTY NOT TO HARM

727

(14)

Susan D. Cochran

Vickie M. Mays

"Sex, Lies, and HIV"

727

(2)

Ronald Bayer

"AIDS Prevention--Sexual Ethics and Responsibility"

729

(4)

Ferdinand Schoeman

"AIDS and Privacy"

733

(8)

TESTING AND SCREENING PROGRAMS

741

(25)

James F. Childress

"Mandatory HIV Screening and Testing"

741

(17)

Howard Minkoff

Anne Willoughby

"Pediatric HIV Disease, Zidovudine in Pregnancy, and Unblinding Heelstick Surveys: Reframing the Debate on Prenatal HIV Testing"

758

(5)

Deborah Sontag

"H.I.V. Testing for Newborns Debated Anew"

763

(3)

ISSUES IN CLINICAL RESEARCH ON HIV/AIDS

766

(16)

Peter Lurie

Sidney M. Wolfe

"Unethical Trials of Interventions to Reduce Perinatal Transmission of the Human Immunodeficiency Virus in Developing Countries

766

(4)

Marcia Angell

"The Ethics of Clinical Research in the Third World"

770

(3)

Harold Varmus

David Satcher

"Ethical Complexities of Conducting Research in Developing Countries"

773

(3)

Danstan Bagenda

Philippa Musoke-Mudido

"We're Trying to Help Our Sickest People, Not Exploit Them"

776

(2)

Praphan Phanuphak

"Ethical Issues in Studies in Thailand of the Vertical Transmission of HIV"

778

(2)

P. Vuthipongse, et al.

"Administration of Zidovudine during Late Pregnancy and Delivery to Prevent Perinatal HIV Transmission--Thailand, 1996-1998"

780

(2)

Suggested Readings

782

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Contemporary Issues in Bioethics

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Table of Contents

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