Contents
Preface
Part 1. Principles and Theories
Chapter 1 Moral Reasoning in Bioethics
I. Ethics and Bioethics
II. Ethics and the Moral Life
In Depth: Morality and the Law
III. Moral Principles in Bioethics
Autonomy
Nonmaleficence
Beneficence
Utility
Justice
IV. Ethical Relativism
In Depth: Anthropology and Moral Diversity
V. Ethics and Religion
VI. Moral Arguments
Argument Fundamentals
Patterns of Moral Arguments
Review: Valid and Invalid Argument Forms
In Depth: Fallacies in Moral Reasoning
Evaluating Premises
Assessing Whole Arguments
VII. Obstacles to Critical Reasoning
Denying Contrary Evidence
Looking for Confirming Evidence
Motivated Reasoning
Preferring Available Evidence
The Dunning-Kruger Effect
VIII. Key Terms
IX. Summary
X. Argument Exercises
XI. Further Reading
XII. Notes
Chapter 2 bioethics and moral theories
I. The Nature of Moral Theories
II. Influential Moral Theories
Utilitarianism
In Depth: Utilitarianism and the Golden Rule
Kantian Ethics
Natural Law Theory
Rawls's Contract Theory
Virtue Ethics
In Depth: Can Virtue Be Taught?
The Ethics of Care
Feminist Ethics
Casuistry
III. Criteria for Judging Moral Theories
Review: Evaluating Moral Theories: Criteria of Adequacy
IV. Applying the Criteria
Utilitarianism
Kant's Theory
V. Principlism: A Framework for Deciding What's Right
Moral Common Sense
Prima Facie Principles
Three Rules
How to Decide
Resolving Cases
VI. Key Terms
VII. Summary
VIII. Further Reading
IX. Notes
Readings
"Utilitarianism," John Stuart Mill
"The Moral Law," Immanuel Kant
Nicomachean Ethics, Aristotle
"The Need for More Than Justice," Annette C. Baier
"Moral Saints," Susan Wolf
"What Makes Right Actions Right?" W.D. Ross
Part 2. Medical Professional and Patient
Chapter 3 paternalism and patient autonomy
I. Shades of Autonomy and Paternalism
II. Refusing Treatment
In Depth: Physician Autonomy
III. Futile Treatment
Legal Brief: Advance Directives
Legal Brief: Refusing Treatment for Children on Religious Grounds
In Depth: CPR and DNR
In Depth: Moral Conflicts in Nursing
Classic Case File: Elizabeth Bouvia
IV. Applying Major Theories
V. Key Terms
VI. Summary
VII. Cases for Evaluation
VIII. Further Reading
IX. Notes
Readings
"Paternalism," Gerald Dworkin
"The Refutation of Medical Paternalism," Alan Goldman
"Why Doctors Should Intervene," Terrence F. Ackerman
"Autonomy, Futility, and the Limits of Medicine," Robert L. Schwartz
"Four Models of the Physician-Patient Relationship," Ezekiel J. Emanuel and Linda L. Emanuel
"Confronting Death: Who Chooses, Who Controls? A Dialogue Between Dax Cowart and Robert Burt," Dax Cowart and Robert Burt
Bouvia v. Superior Court, California Court of Appeal
"Fundamental Elements of the Patient-Physician Relationship," AMA Council on Ethical and Judicial Affairs
Chapter 4 truth-telling and confidentiality
I. Paternalism and Deception
In Depth: Do Patients Want the Truth? Do Physicians Tell It?
II. Confidential Truths
Legal Brief: Confidentiality and a Duty to Warn
In Depth: Truth-Telling and Cultural Diversity
Classic Case File: Carlos R.
III. Applying Major Theories
IV. Key Terms
V. Summary
VI. Cases for Evaluation
VII. Further Reading
VIII. Notes
Readings
"On Telling Patients the Truth," Mack Lipkin
"Is It Ever OK to Lie to Patients?" Shelly K. Schwartz
"Why Privacy Is Important," James Rachels
"Confidentiality in Medicine-A Decrepit Concept," Mark Siegler
Tarasoff v. Regents of the University of California, Supreme Court of California
"Truth-Telling in the Setting of Cultural Differences and Incurable Pediatric Illness," Abby R. Rosenberg, Helene Starks, Yoram Unguru, et al.
Chapter 5 informed consent
I. Autonomy and Consent
II. Conditions of Informed Consent
In Depth: Decision-Making Capacity
In Depth: Two Views of Informed Consent
Legal Brief: Important Informed Consent Cases
III. Applying Major Theories
Classic Case File: Jerry Canterbury
IV. Key Terms
V. Summary
VI. Cases for Evaluation
VII. Further Reading
VIII. Notes
Readings
"The Concept of Informed Consent," Ruth R. Faden and Tom L. Beauchamp
"Informed Consent-Must It Remain a Fairy Tale?" Jay Katz
"Transparency: Informed Consent in Primary Care," Howard Brody
Canterbury v. Spence, United States Court of Appeals
Chapter 6 human research
I. The Science of Clinical Trials
In Depth: The Tuskegee Tragedy
II. Beneficence, Science, and Placebos
III. Science and Informed Consent
In Depth: Women in Clinical Trials
IV. Research on the Vulnerable
In Depth: Why Enter a Clinical Trial?
V. Applying Major Theories
VI. Key Terms
VII. Summary
Classic Case File: The UCLA Schizophrenia Study
VIII. Cases for Evaluation
IX. Further Reading
X. Notes
Readings
The Nuremberg Code
Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects, World Medical Association
"The Belmont Report," The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research
"Final Report: Human Radiation Experiments," Advisory Committee on Human Radiation Experiments
"Of Mice but Not Men: Problems of the Randomized Clinical Trial," Samuel Hellman and Deborah S. Hellman
"A Response to a Purported Ethical Difficulty with Randomized Clinical Trials Involving Cancer Patients," Benjamin Freedman
"Racism and Research: The Case of the Tuskegee Syphilis Study," Allan M. Brandt
"The Ethics of Clinical Research in the Third World," Marcia Angell
"Ethical Issues in Clinical Trials in Developing Countries," Baruch Brody
Part 3. Life and Death
Chapter 7 Abortion
I. Starting Point: The Basics
Fact File: What the Data Say about U.S. Abortions
II. The Legal Struggle
In Depth: Abortions Performed Later in Pregnancy
III. Moral Arguments
In Depth: Does a Fetus Feel Pain?
In Depth: Abortion Law Worldwide
IV. Applying Major Theories
V. Key Terms
VI. Summary
Classic Case File: Nancy Klein
VII. Cases for Evaluation
VIII. Further Reading
IX. Notes
Readings
"A Defense of Abortion," Judith Jarvis Thomson
"Why Abortion Is Immoral," Don Marquis
"On the Moral and Legal Status of Abortion," Mary Anne Warren
"Abortion and the Concept of a Person," Jane English
"Abortion,>" Margaret Olivia Little
"Abortion Through a Feminist Ethics Lens," Susan Sherwin
"Abortion and the 'Interest View',>" Bonnie Steinbock with Lewis Vaughn
"As a Rule, Rape Exceptions for Abortion Don't Work," Samuel Dickman
Chapter 8 Reproductive Technology
I. In Vitro Fertilization
Fact File: Assisted Reproduction
In Depth: "Savior Siblings"
II. Surrogacy
In Depth: IVF and Children's Future Children
III. Cloning
In Depth: Cloning Time Line
IV. Applying Major Theories
V. Key Terms
In Depth: Sherri Shepherd: How Surrogacy Can Go Wrong
VI. Summary
Classic Case File: Baby M
VII. Cases for Evaluation
VIII. Further Reading
IX. Notes
Readings
"IVF: The Simple Case," Peter Singer
"The Presumptive Primacy of Procreative Liberty," John A. Robertson
"Surrogate Mothering: Exploitation or Empowerment?" Laura M. Purdy
"Is Women's Labor a Commodity?" Elizabeth S. Anderson
"Egg Donation and Commodification," Bonnie Steinbock
"Cloning Human Beings: An Assessment of the Ethical Issues Pro and Con," Dan W. Brock
"Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation," Congregation For the Doctrine of the Faith
Chapter 9 genetic choices
I. Genes and Genomes
II. Genetic Testing
III. Gene Therapy
Fact File: Genetic Testing for Cancer Risk
IV. Stem Cells
Fact File: Recent Developments in Gene Therapy
V. Applying Major Theories
Classic Case File: The Kingsburys
VI. Key Terms
VII. Summary
VIII. Cases for Evaluation
IX. Further Reading
X. Notes
Readings
"Genetics and Reproductive Risk: Can Having Children Be Immoral?" Laura M. Purdy
"The Morality of Screening for Disability," Jeff McMahan
"Genetic Dilemmas and the Child's Right to an Open Future," Dena S. Davis
"Disowning Knowledge: Issues in Genetic Testing," Robert Wachbroit
"The Non-Identity Problem and Genetic Harms-The Case of Wrongful Handicaps," Dan W. Brock
"Is Gene Therapy a Form of Eugenics?" John Harris
"Genetic Enhancement," Walter Glannon
"Genetic Interventions and the Ethics of Enhancement of Human Beings," Julian Savulescu
"Germ-Line Gene Therapy," LeRoy Walters and Julie Gage Palmer
"What Does 'Respect for Embryos' Mean in the Context of Stem Cell Research?" Bonnie Steinbock
Declaration on the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells, Pontifical Academy for Life
Chapter 10 euthanasia and physician-assisted suicide
I. Deciding Life and Death
Legal Brief: Euthanasia and Assisted Suicide: Major Developments
In Depth: Assisted Suicide: What Do Doctors Think?
II. Autonomy, Mercy, and Harm
In Depth: Oregon's Death with Dignity Act
In Depth: End-of-Life Decisions in the Netherlands
III. Applying Major Theories
In Depth: Physician-Assisted Suicide and Public Opinion
Classic Case File: Nancy Cruzan
IV. Key Terms
V. Summary
VI. Cases for Evaluation
VII. Further Reading
VIII. Notes
Readings
"Death and Dignity: A Case of Individualized Decision Making," Timothy E. Quill
"Voluntary Active Euthanasia," Dan W. Brock
"When Self-Determination Runs Amok," Daniel Callahan
"Active and Passive Euthanasia," James Rachels
"Dying at the Right Time: Reflections on (Un) Assisted Suicide," John Hardwig
"The Philosophers' Brief,>" Ronald Dworkin, Thomas Nagel, Robert Nozick, John Rawls, Thomas Scanlon, and Judith Jarvis Thomson
"Legalizing Assisted Dying Is Dangerous for Disabled People," Liz Carr
Vacco v. Quill, United States Supreme Court
Part 4. Justice and Health Care
Chapter 11 dividing up health care resources
I. Health Care in Trouble
Fact File: U.S. Health Care
II. Theories of Justice
In Depth: Comparing Health Care Systems: United States, Canada, and Germany
III. A Right to Health Care
In Depth: Public Health and Bioethics
IV. The Ethics of Rationing
Classic Case File: Christine deMeurers
V. Key Terms
VI. Summary
VII. Cases for Evaluation
VIII. Further Reading
IX. Notes
Readings
"Is There a Right to Health Care and, If So, What Does It Encompass?," Norman Daniels
"The Right to a Decent Minimum of Health Care," Allen E. Buchanan
"Rights to Health Care, Social Justice, and Fairness in Health Care Allocations: Frustrations in the Face of Finitude," H. Tristram Engelhardt, Jr.
"Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care," Eric C. Schneider, Dana O. Sarnak, David Squires, et al.
"Public Health Ethics: Mapping the Terrain," James F. Childress, Ruth R. Faden, Ruth D. Gaare, et al.
"Human Rights Approach to Public Health Policy," D. Tarantola and S. Gruskin
Chapter 12 race, racial bias, and health care
I. Race and Racism
Classic Case File: Henrietta Lacks
II. Health Disparities and Race
III. Implicit Bias in Health Care
In Depth: Can Implicit Biases Be Changed?
IV. Racial Profiling in Medicine
V. Key Terms
VI. Summary
VII. Cases for Evaluation
VIII. Further Reading
IX. Notes
READINGS
"Racial Profiling in Medicine," Michael Root
"Clinicians' Racial Bias as Pathways to Iatrogenic Harms for Black People," Keisha Ray
"Algorithms Are Making Decisions About Health Care, Which May Only Worsen Medical Racism," Crystal Grant
Chapter 13 DISABILITY ETHICS
I. Disability Fictions
In Depth: What Do Clinicians Owe Disabled People?
II. What Is Disability?
III. Disability and Justice
IV. Key Terms
V. Summary
VI. Cases for Evaluation
VII. Further Reading
VIII. Notes
Readings
"Disability: Historical Overview," Adam Cureton and David Wasserman
"An Open Letter to Medical Students: Down Syndrome, Paradox, and Medicine," George Estreich
"Disability and Impairment," Jessica Begon
Appendix
Glossary
Index
