New Perspectives in Healthcare Ethics An

Tong, a well-known biomedical ethicist, combines medical ethics, bioethics, and her own unique insights to provide a comprehensive survey of contemporary health care ethics issues. Among the topics discussed in this book are complementary and alternative medicine; contraception and sterilization; infertility and assisted reproduction; and surrogate motherhood; genetic testing (screening and counseling); genetic therapy; biomedical and behavioral research; and euthanasia and assisted suicide. A useful reference work for those in the health care industry.

Rosemarie Tong is distinguished Professor of Health Care Ethics at the University of North Carolina at Charlotte. She is the author or co-author of Women, Sex, and the Law; Ethics in Policy Analysis; Feminist Thought: A Comprehensive Introduction; Feminine and Feminist Ethics; Controlling Our Reproductive Destiny: A Technological and Philosophical Perspective (with Lawrence Kaplan); Feminist Approaches to Bioethics;and Feminist Thought: A More Comprehensive Introduction. Her edited books include Feminist Philosophy: Essential Readings in Theory, Reinterpretation, and Application (with Nancy Tuana), Globalizing Feminist Bioethics (with Aida Santos and Gwen Anderson), and soon to be published Feminist Bioethics, Human Rights and the Developing World: Integrating Global and Local Perspectives (with Anne Donchin and Susan Dodds).

Preface

xiii

Acknowledgements

xvii

Part One A Conceptual Framework for Health Care Ethics

1

(60)

Introduction

1

(5)

Points of Emphasis

1

(3)

Concluding Thoughts

4

(1)

Endnotes

5

(1)

Ethical Theories and Principles in Health Care

6

(32)

Introduction

6

(1)

Ethical Relativism, Ethical Pluralism, and Ethical Worldviews

6

(3)

Major Ethical Theories in the Western World: Forging a Personal Worldview

9

(15)

Ethical Principles in Health Care

24

(7)

Balancing the Principles of Nonmaleficence, Beneficence, Autonomy and Justice

31

(2)

Conclusion

33

(1)

Discussion Questions

34

(1)

Cases

34

(1)

Endnotes

35

(3)

The Health Care Professional-Patient Relationship

38

(23)

Introduction

38

(1)

The Practice-Institution Relationship in Health Care

38

(2)

Models of the Health Care Professional--Patient Relationship

40

(5)

Meeting the Demands of Competence and Care in the Health Care Professional--Patient Relationship

45

(3)

Respecting the Rights of Patients in the Health Care Professional--Patient Relationship

48

(8)

Conclusion

56

(1)

Discussion Questions

57

(1)

Case Studies

57

(2)

Endnotes

59

(2)

Part Two Health and Disease Issues

61

(48)

Biological Givens Or Social Constructions?

61

(19)

Introduction

61

(1)

Goals of Health Care

61

(4)

The Concepts of Health and Disease

65

(5)

The Concepts of Wellness and Illness

70

(4)

Conclusion

74

(2)

Discussion Questions

76

(1)

Case Studies

76

(2)

Endnotes

78

(2)

Biomedical and Behavioral Research

80

(29)

Introduction

80

(1)

Differences between Biomedical and Behavioral Research

81

(1)

Brief History of Biomedical and Behavioral Research Regulation

81

(2)

Ethical Issues in Biomedical Behavioral Research

83

(2)

Ethical Issues in Behavioral Research

85

(2)

Ethical and Legal Issues in Informed Consent

87

(5)

Protectionism and Accessionism in Biomedical and Behavioral Research

92

(2)

Ongoing and Emerging Debates in Biomedical Research in the United States

94

(7)

Conclusion

101

(2)

Discussion Questions

103

(1)

Case Studies

104

(1)

Endnotes

105

(4)

Part Three Beginning of Life Issues

109

(128)

Abortion

109

(28)

Introduction

109

(1)

Abortion Types and Methods

110

(5)

Ethical Issues in Abortion

115

(6)

Legal Issues in Abortion

121

(8)

Conclusion

129

(2)

Discussion Questions

131

(1)

Case Studies

131

(2)

Endnotes

133

(4)

Reproduction-Assisting Technologies: Donor Insemination, In Vitro Fertilization, and Beyond

137

(40)

Introduction

137

(1)

Treatments for Infertility

138

(1)

Ethical and Legal Dimensions of Donor Insemination (DI)

139

(7)

Ethical and Legal Dimensions of In Vitro Fertilization (IVF)

146

(8)

The Ethical and Legal Dimensions of Surrogate Motherhood

154

(14)

Conclusion

168

(1)

Discussion Questions

168

(1)

Case Studies

169

(2)

Endnotes

171

(6)

Genetic Screening, Counseling, and Therapy

177

(39)

Introduction

177

(1)

Genetic Testing and Screening

178

(19)

Genetic Counseling

197

(1)

Gene Therapy

198

(9)

Conclusion

207

(1)

Discussion Questions

208

(1)

Case Studies

209

(2)

Endnotes

211

(5)

Therapeutic Cloning, Reproductive Cloning, and Ectogenesis

216

(21)

Introduction

216

(1)

Research on Fetuses

217

(2)

Research on Preembryos

219

(5)

Reproductive Cloning

224

(3)

Ectogenesis

227

(4)

Conclusion

231

(1)

Discussion Questions

231

(2)

Case Studies

233

(1)

Endnotes

233

(4)

Part Four End of Life Issues

237

(54)

The Aging Process and Long-Term Health Care

237

(25)

Introduction

237

(1)

The Aging Process

238

(3)

Antiaging Medicine

241

(2)

Aging and the Growing Need for Long-Term Care

243

(11)

Conclusion

254

(2)

Discussion Questions

256

(1)

Case Studies

256

(2)

Endnotes

258

(4)

Euthanasia, Assisted Suicide, and Palliative Care

262

(29)

Introduction

262

(1)

Types of Euthanasia

262

(15)

Physician-Assisted Suicide

277

(4)

Advance Care Directives

281

(2)

Palliative Care and Hospice

283

(2)

Conclusion

285

(1)

Discussion Questions

285

(1)

Case Studies

286

(2)

Endnotes

288

(3)

Part Five Micro- and Macro-Allocation Issues

291

(46)

Organ Transplantation: Individual Allocation Decisions

291

(27)

Introduction

291

(1)

Overview of Organ and Tissue Transplantation

292

(1)

Ethical and Legal Issues Regarding Organ Donors

292

(8)

Ethics of Transplant Teams and End-of-Life Teams

300

(3)

Increasing the Supply of Organs

303

(5)

Allocation of Organs

308

(4)

Conclusion

312

(1)

Discussion Questions and Case Studies

312

(2)

Endnotes

314

(4)

Health Care Reform: Social Distribution Decisions

318

(19)

Introduction

318

(1)

Health Care Costs in the United States

318

(5)

Health Care Insurance Accessibility in the United States

323

(6)

Health Care System Reform Proposals

329

(4)

Conclusion

333

(3)

Discussion Questions

336

(1)

Case Studies

336

(1)

Endnotes

337

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New Perspectives in Healthcare Ethics An Interdisciplinary and Crosscultural Approach

Summary

Author Biography

Table of Contents

Supplemental Materials