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 of 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 text's effective pedagogical features include chapter introductions, argument sketches, explanations of medical terms, headnotes, and annotated bibliographies.
Thomas A. Mappes holds a B.S. in chemistry from the University of Dayton and a Ph.D. in philosophy from Georgetown University. He is professor of philosophy at Frostburg State University, where he has taught since 1973. He is the coeditor (with Jane S. Zembaty) of Social Ethics: Morality and Social Policy (McGraw-Hill, 4/e, 1992) and his published work appears in journals such as American Philosophical Quarterly and Kennedy Institute of Ethics Journal. In 1985, the Frostburg State University Foundation presented him with the Faculty Achievement Award for Teaching. David DeGrazia earned a B.A. from the University of Chicago, an M.St. from Oxford University, and a Ph.D. from Gerogetown University, each in philosophy. He has been teaching philosophy and biomedical ethics at George Washington University since 1989. He is the author of Taking Animals Seriously (Cambridge University Press) and of articles published in such journals as Journal of Medicine and Philosophy, Public Affairs Quarterly, History of Philosophy Quarterly, and Southern Journal of Philosophy.
Chapter 1: GENERAL INTRODUCTION The Nature of Biomedical Ethics Recently Dominant Ethical Theories The Critical Assessment of Competing Ethical Theories Teleological Versus Deontological Theories Act-Utilitarianism Rule-Utilitarianism Kantian Deontology W.D. Ross's Theory of Prima Facie DutiesThe Principles of Biomedical Ethics Alternative Directions and Methods Virtue Ethics The Ethics of Care and Feminist Ethics Casuistry: Case-Based Reasoning in Historical Context Reflective Equilibrium and Appeals to CoherenceConfronting Ethical Relativism Fundamental Concepts and Principles Autonomy Liberty-Limiting Principles PaternalismNotes Annotated Bibliography Appendix: Selected Reference Sources in Biomedical Ethics Print Resources Web Resources
Chapter 2: THE PHYSICIAN-PATIENT RELATIONSHIP Physicians' Obligations and Virtues The Hippocratic Oath Council of Ethical and Judicial Affairs, American Medical Association, Fundamental Elements of the Patient-Physician Relationship Edmund D. Pellegrino, The Virtuous Physician and the Ethics of MedicinePhysician-Patient Models and Patient Autonomy James F. Childress and Mark Siegler, Metaphors and Models of Doctor-Patient Relationships: Their Implications for Autonomy Terrence F. Ackerman, Why Doctors Should InterveneTruth Telling Roger Higgs, On Telling Patients the Truth *Benjamin Freedman, Offering the Truth: One Ethical Approach to the Uninformed Cancer PatientInformed Consent Judge Spotswood W. Robinson III, Opinion in Canterbury v. Spence President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, The Values Underlying Informed Consent Howard Brody, Transparency: Informed Consent in Primary CareThe Practice of Medicine in a Multicultural Society Ruth Macklin, Ethical Relativism in a Multicultural Society Kenneth Kipnis, Quality Care and the Wounds of DiversityContested Therapies within the Physician-Patient Relationship *Franklin G. Miller, Howard Brody, and Kevin C. Chung, Cosmetic Surgery and the Internal Morality of Medicine *Claudia Mills, One Pill Makes You Smarter: An Ethical Appraisal of the Rise of RitalinConflicts of Interest, Problems of Conscience, and Managed Care Marcia Angell, The Doctor as Double Agent Daniel Callahan, Managed Care and the Goals of Medicine *James F. Childress, Conscience and the Conscientious Actions in the Context of MCOsAnnotated Bibliography
Chapter 3: HOSPITALS, NURSES, FAMILIES, AND MEDICAL CONFIDENTIALITY Professional Statements *American Hospital Association, The Patient Care Partnership: Understanding Expectations, Rights and Responsibilities American Nurses' Association, Code of Ethics for NursesThe Role and Responsibilities of Nurses Lisa H. Newton, In Defense of the Traditional Nurse Helga Kuhse, Advocacy or Subservience for the Sake of Patients? Amy H. Haddad, The Nurse/Physician Relationship and Ethical Decision MakingFamilies and Medical Decision Making Thomas A. Mappes and Jane S. Zembaty, Patient Choices, Family Interests, and Physician Obligations *Bonnie Poitras Tucker, Deaf Culture, Cochlear Implants, and Elective Disability *Sherri A. Groveman, The Hanukkah Bush: Ethical Implications in the Clinical Management of IntersexConfidentiality Justice Mathew O. Tobriner, Majority Opinion in Tarasoff v. Regents of the University of California Justice William P. Clar, Dissenting Opinion in Tarasoff v. Regents of the University of California Please Don't Tell!: A Case About HIV and Confidentiality (with commentaries by Leonard Fleck and Marcia Angell)Annotated Bibliography
Chapter 4: HUMAN AND ANIMAL RESEARCH Ethical Codes The Nuremberg Code World Medical Association, Declaration of Helsinki Council for International Organizations of Medical Sciences, International Guiding Principles for Biomedical Research Involving AnimalsResearch Involving "Vulnerable" Populations *Barry F. Brown, Proxy Consent for Research on the Incompetent Elderly Patricia A. King, The Dangers of Difference Alexander Morgan Capron, Ethical and Human-Rights Issues in Research on Mental Disorders That May Affect Decision-Making CapacityExperimental Design and Randomized Clinical Trials Samuel Hellman and Deborah S. Hellman, Of Mice but Not Men: Problems of the Randomized Clinical Trial *Don Marquis, How to Resolve and Ethical Dilemma Concerning Randomized Clinical TrialsClinical Trials in Developing Countries *Leonard H. Glantz, George J. Annas, Michael A. Grodin, and Wendy K. Mariner, Research in Developing Countries: Taking Benefit Seriously *Baruch Brody, Ethical Issues in Clinical Trials in Developing CountriesAnimal Research Carl Cohen, The Case for the Use of Animals in Biomedical Research Edwin Converse Hettinger, The Responsible Use of Animals in Biomedical Research *David DeGrazia, The Ethics of Animal Research: What Are the Prospects for Agreement?Annotated Bibliography
Chapter 5: DEATH AND DECISIONS REGARDING LIFE-SUSTAINING TREATMENT The Definition and Determination of Death President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Why "Update" Death? Charles M. Culver and Bernard Gert, The Definition and Criterion of Death Martin Benjamin, Pragmatism and the Determination of DeathCompetent Adults and the Refusal of Life-Sustaining Treatment Council on Ethical and Judicial Affairs, American Medical Association, Withholding and Withdrawing Life-Sustaining Treatment Tia Powell and Bruce Lowenstein, Refusing Life-Sustaining Treatment After Catastrophic Injury: Ethical Implications *Vicki Michel, Suicide by Persons with Disabilities Disguised as the Refusal of Life-Sustaining TreatmentDNR Orders and Medical Futility Tom Tomlinson and Howard Brody, Ethics and Communication in Do-Not-Resuscitate Orders Mark R. Wicclair, Medical Futility: A Conceptual and Ethical AnalysisAdvance Directives and Treatment Decisions for Incompetent Adults Thomas A. Mappes, Some Reflections on Advance Directives Norman L. Cantor, My Annotated Living Will *Rebecca Dresser, The Conscious Incompetent PatientThe Treatment of Impaired Infants John A. Robertson, Involuntary Euthanasia of Defective Newborns Members of The Hastings Center Research Project on the Care of Imperiled Newborns, Standards of Judgment for Treatment of Imperiled NewbornsAnnotated Bibliography
Chapter 6: SUICIDE, PHYSICIAN-ASSISTED SUICIDE, AND ACTIVE EUTHANASIA The Morality of Suicide Immanuel Kant, Suicide R.B. Brandt, The Morality and Rationality of SuicideThe Morality of Active Euthanasia James Rachels, Active and Passive Euthanasia Daniel Callahan, Killing and Allowing to Die Dan W. Brock, Voluntary Active EuthanasiaThe Supreme Court, Physician-Assisted Suicide, and Terminal Sedation Chief Justice William H. Rehnquist, Opinion of the Court in Washington v. Glucksberg Chief Justice William H. Rehnquist, Opinion of the Court in Vacco v. Quill Justice Sandra Day O'Connor, Concurring Opinion in Washington v. Glucksberg and Vacco v. Quill David Orentlicher, The Supreme Court and Physician-Assisted Suicide: Rejecting Assisted Suicide but Embracing EuthanasiaPhysician-Assisted Suicide, Active Euthanasia, and Social Policy Timothy E. Quill, Christine K. Cassel, and Diane E. Meier, Care of the Hopelessly Ill: Proposed Clinical Criteria for Physician-Assisted Suicide *The Oregon Death with Dignity Act Franklin G. Miller, Timothy E. Quizz, Howard Brody, John C. Fletcher, Lawrence O. Gostin, and Diane E. Meier, Regulating Physician-Assisted Death John D. Arras, On the Slippery Slope in the Empire State: The New York State Task Force on Physician-Assisted Death James L. Bernat, Bernard Gert, and R. Peter Mogielnicki, Patient Refusal of Hydration and Nutrition: An Alternative to Physician-Assisted Suicide or Voluntary Active EuthanasiaAnnotated Bibliography
Chapter 7: ABORTION AND RESEARCH ON EMBRYONIC STEM CELLS The Morality of Abortion Pope John Paul II, The Unspeakable Crime of Abortion Mary Anne Warren, On the Moral and Legal Status of Abortion Don Marquis, Why Abortion Is Immoral Judith Jarvis Thomson, A Defense of Abortion *Margaret Olivia Little, The Morality of AbortionAbortion and Social Policy Justice Harry Blackmun, Majority Opinion in Roe v. Wade *George J. Annas, "Partial-Birth Abortion" and the Supreme CourtResearch on Embryonic Stem Cells *National Institutes of Health, Stem Cells: A Primer *Bonnie Steinbock, What Does "Respect for Embryos" Mean in the Context of Stem Cell Research? *President's Council on Bioethics, The Moral Case against Cloning-for-Biomedical-ResearchAnnotated Bibliography
Chapter 8: GENETICS AND HUMAN REPRODUCTION Reproductive Risk, Prenatal Diagnosis, and Selective Abortion Leon R. Kass, Implications of Prenatal Diagnosis for the Human Right to Life Laura M. Purdy, Genetics and Reproductive Risk: Can Having Children Be Immoral?Reproductive Technologies *Peter Singer, IVF: The Simple Case Susan Sherwin, Feminist Ethics and In Vitro Fertilization The New York State Task Force on Life and the Law, Ethical Debates About Infertility and Its Treatment *President's Council on Bioethics, Assisted ReproductionGamete Donation and Surrogacy Thomas H. Murray, Families, the Marketplace and Values: New Ways of Making Babies Bonnie Steinbock, Surrogate Motherhood as Prenatal AdoptionHuman Cloning Leon R. Kass, Cloning of Human Beings *Thomas H. Murray, Even If It Worked, Cloning Wouldn't Bring Her Back Robert Wachbroit, Genetic Encores: The Ethics of Human CloningPreimplantation Genetic Diagnosis *John A. Robertson, Extending Preimplanation Genetic Diagnosis: Medical and Non-Medical Uses *President's Council on Bioethics, Selecting Embryos for Desired TraitsGene Therapy *Sophia Kolehmainen, The Dangerous Promise of Gene Therapy *Marina Cavazzana-Calvo, Adrian Thrasher, and Fulvio Mavilio, The Future of Gene Therapy: Balancing the Risks and Benefits of Clinical Trials LeRoy Walters and Julie Gage Palmer, Germ-Line Gene TherapyGenetic Enhancement *Walter Glannon, Genetic Enhancement *Dan W. Brock, Genetic EngineeringAnnotated Bibliography
Chapter 9: SOCIAL JUSTICE AND HEALTH-CARE POLICY Justice, Rights and Societal Obligations Allen Buchanan, Justice: A Philosophical Review Kai Nelson, Autonomy, Equality and a Just Health Care SystemRationing, Managed Care, and Health-Care Reform in the United States Norman Daniels, Is the Oregon Rationing Plan Fair? Allen Buchanan, Managed Care: Rationing Without Justice, but Not Unjustly *Leonard M. Fleck, Rationing: Don't Give Up Norman Daniels and James Sabin, Closure, Fair Procedures, and Setting Limits Within Managed Care Organizations *Ezekiel Emanuel, Health Care Reform: Still PossibleInternational Models and Perspectives Pat Armstrong, Managing Care the Canadian Way *John K. Iglehart, Restoring the Status of an Icon: A Talk with Canada's Minister of Health Gerd Richter, The German Health Care System Nicholas Mays and Justin Keen, Will the Fudge on Equity Sustain the NHS into the Next Millennium? *Giovanna Ruberto, Ethics, Politics, and Priorities in the Italian Health-Care SystemAnnotated Bibliography