
Principles of Health Care Ethics
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Reviews / Votes
"It is probably now the single most comprehensive bioethicstextbook available ... This is a very fine book indeed."(BMA Medical Book Competition - Programme and Award Winners,September 2008) "Serve[s] as a reference text of concise reviews and as amedical ethics sampler. Such approachable original essays byauthors who are experts in their respective fields will serve asexcellent teaching tools, and I anticipate referring house staff,nurses, and therapists to them ... .Serve[s] as a source ofintriguing insights on topics not commonly on the clinical ethicstable. It offers clinicians and medical practitioners a startingplace to understand key concepts and problems in medical ethics. Assuch, it is a valuable reference text." (RespiratoryCare, April 2008) "This is a well though out book covering a wide variety ofethical problems in healthcare. It provides those interested inhealthcare ethics a great resource for starting their inquiry andwould be a valuable inquisition." (Doody's, November2007)More details
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Content
List of Contributors xi
Foreword: Raanan E. Gillon xix
Foreword: Tony Hope xxi
Preface xxiii
PART I: METHODOLOGY AND PERSPECTIVES
Introduction by John R. McMillan 1
1 The 'Four Principles' Approach to Health Care Ethics 3
Tom L. Beauchamp
2 Theories of Autonomy 11
Natalie Stoljar
3 Benefi cence 19
Garrett Cullity
4 Responsibilities for Poverty-Related Ill Health 27
Thomas Pogge
5 Liberalism and Communitarianism 35
Colin Tyler
6 How Many Principles for Bioethics? 43
Robert M. Veatch
7 Casuistical Reasoning in Medical Ethics 51
Albert R. Jonsen
8 Utilitarianism and Bioethics 57
Matti Häyry
9 Deontology 65
David A. McNaughton and J. Piers Rawling
10 Kantian Ethics 73
Onora O'Neill
11 Feminist Approaches to Health Care Ethics 79
Susan Sherwin
12 Virtue Theory 87
Justin Oakley
13 Moral Relativism 93
Mark Sheehan
14 Christian Approaches to Bioethics 99
Heather Widdows
15 Judaism and Medicine: Jewish Medical Ethics 109
Fred Rosner
16 The Search for Islamic Bioethics Principles 117
Abdulaziz Sachedina
17 Buddhist Bioethics 127
James Hughes
18 South Asian Approaches to Health Care Ethics 135
Harold Coward
19 The Specious Idea of an Asian Bioethics: Beyond Dichotomizing East and West 143
Jing-Bao Nie
20 Narrative Ethics 151
Howard Brody
21 Empirical Approaches to Health Care Ethics 159
Jeremy Sugarman, Robert A. Pearlman, Holly A. Taylor
22 Medical Sociology and the Redundancy of Empirical Ethics 167
Adam Hedgecoe
23 The Use of Thought Experiments in Health Care Ethics 177
Adrian Walsh
24 Deliberative Bioethics 185
Michael Parker
25 Law, Ethics and Health Care 193
Sheila A.M. McLean
26 Medical Humanities: An Overview 199
Martyn Evans
27 Reflective Equilibrium as a Method in Health Care Ethics 207
Theo van Willigenburg
28 Hermeneutic Ethics between Practice and Theory 215
Guy A.M. Widdershoven, Tineke A. Abma
29 Paternalism in Health Care and Health Policy 223
James F. Childress
30 Need: An Instrumental View 231
Anthony J. Culyer
31 Rights 239
James G.S. Wilson
32 Exploitation in Health Care 247
Alan Wertheimer
33 Competence to Consent 255
Monique F. Jonas
34 The Doctrine of Double Effect 263
Suzanne Uniacke
35 Ordinary and Extraordinary Means 269
Stephen D. John
36 Acts and Omissions 273
Tuija Takala
37 Personhood and Moral Status 277
Ainsley J. Newson
38 Commodifi cation 285
Stephen Wilkinson
PART II: ISSUES IN HEALTH CARE PRACTICE
Introduction by Heather Draper 293
39 Consent and Informed Consent 297
Neil C. Manson
40 Treatment Decisions for Incapacitated Patients 305
Rebecca S. Dresser
41 Children's Consent to Medical Treatment 311
David W. Archard
42 Patients and Disclosure of Surgical Risk 319
Justin Oakley
43 Confi dentiality 325
Rebecca Bennett
44 Truth Telling, Lying and the Doctor-Patient Relationship 333
Roger Higgs
45 Personal Beliefs and Patient Care 339
Jennifer Jackson
46 Conscience and Health Care Ethics 345
Piers Benn
47 Care in Families 351
Hilde Lindemann
48 The Ethics of Primary Health Care 357
Annettee J. Braunack-Mayer
49 The Nurse-Patient Relationship: A 'Principles plus Care' Account 365
Steven D. Edwards
50 Dual Responsibilities: Do They Raise Any Different Ethical Issues from 'Normal' Therapeutic Relationships? 371
Ann Sommerville and Veronica English
51 Violent and Abusive Patients: An Ethically Informed Response 379
G.M. Behr, J.S. Emmanuel, J.P. Ruddock
52 The Moral Signifi cance of the Human Foetus 387
Norman Ford
53 Will We Need Abortion in Utopia? 393
Adrienne Asch
54 Maternal-Foetal Confl ict 401
Rosamund Scott
55 Limits to Reproductive Liberty 409
Thomas H. Murray
56 Disability without Denial 415
Tom Sorell
57 Disability and Equity: Should Difference Be Welcomed? 421
Tom Shakespeare
58 Genetic Counselling 427
Angus Clarke
59 Ethics and Psychotherapy: An Issue of Trust 435
Tim Bond
60 Mental Illness and Compulsory Treatment 443
John R. McMillan
61 Personality Disorders and Compulsory Detention 449
Matt Matravers
62 Labia mea, Domine: Media, Morality and Eating Disorders 455
Simona Giordano
63 Intellectual Disability 463
Pekka Louhiala
64 Ethical Issues and Health Care for Older People 469
Julian C. Hughes
65 Organs and Tissues for Transplantation and Research 475
David P.T. Price
66 Living Donor Organ Transplantation 483
Timothy M. Wilkinson
67 Euthanasia and Principled Health Care Ethics: From Confl ict to Compromise? 489
Richard Huxtable
68 Understanding and Misunderstanding Death 497
David Lamb
69 Ethics without Boundaries: Medical Tourism 505
Guido Pennings
70 Ethics of Performance Enhancement in Sport: Drugs and Gene Doping 511
Bennett Foddy, Julian Savulescu
71 Training Good Professionals: Ethics and Health Care Education 521
Nafsika Athanassoulis
72 Ethics Consultation and Ethics Committees 527
Anne Slowther
PART III: MEDICINE IN SOCIETY
Introduction by Angus Dawson 535
73 The Concepts of Health and Illness 537
Lennart Y. Nordenfelt
74 Community in Public Health Ethics 543
Bruce Jennings
75 Health Promotion, Society and Health Care Ethics 549
Alan Cribb
76 Preventing Disease 557
Marcel Verweij
77 Quantitative Methods for Priority-Setting in Health: Ethical Issues 563
Daniel Wikler, Dan W. Brock, Sarah Marchand, and Tessa Tan Torres
78 Economics, Political Philosophy and Ethics: The Role of Public Preferences in Health Care Decision-Making 569
Jeff Richardson, John McKie
79 Decision Analysis: The Ethical Approach to Most Health Decision Making 577
Jack Dowie
80 Health Inequities and the Social Determinants of Health 585
Wendy Rogers
81 Organizational Ethics in Health Care 593
Jacob E. Kurlander, Marion Danis
82 Ethical Issues in Epidemiology 601
Steven S. Coughlin
83 Screening: Ethical Aspects 607
Niklas Juth, Christian Munthe
84 Vaccination Ethics 617
Angus Dawson
85 The Patient as Victim and Vector: Bioethics and the Challenge of Infectious Diseases 623
Margaret P. Battin, Linda S. Carr-Lee, Leslie P. Francis, Jay A. Jacobson, Charles B. Smith
86 Bioterrorism, Society and Health Care Ethics 631
Michael J. Selgelid
87 Drug Addiction, Society and Ethics 639
Wayne Hall, Adrian Carter
88 Smoking: Is Acceptance of the Risks Fully Voluntary? 647
Robert E. Goodin
89 Doctors and Human Rights 655
Doris Schroeder
90 Duties to Refugees and Asylum Seekers in Host Countries' Medical Systems 663
Pascale Allotey, Hilary Pickles, Vanessa Johnston
91 Medical Aid in Disaster Relief 671
Soren Holm
PART IV: RESEARCH ETHICS AND ETHICS OF NEW TECHNOLOGIES
Introduction by Richard E. Ashcroft 679
92 The Ethics and Governance of Medical Research 681
Richard E. Ashcroft
93 On The Ethics of Animal Research 689
David DeGrazia
94 The Ethical Requirement for Systematic Reviews for Randomized Trials 697
Mike Clarke
95 Informed Consent for Research 703
James Flory, David Wendler and Ezekiel Emanuel
96 Evaluating Benefi ts and Harms in Clinical Research 711
Paul B. Miller and Charles Weijer
97 Patients' Obligations? 719
Simon Woods
98 Standard of Care Owed to Participants in Clinical Trials: Different Standards in Different Countries? 729
Reidar K. Lie
99 Justice and Priority Setting in International Health Care Research 735
Solomon R. Benatar
100 Obligations of the Pharmaceutical Industry 743
Udo Schuklenk and Jim Gallagher
101 Ethics and Medical Publishing 751
Richard Smith and Iain Chalmers
102 Human Reproductive Cloning 759
D. Gareth Jones and Kerry A. Galvin
103 Obtaining Human Eggs for Stem Cell Research: Ethical Issues 767
Heather Draper
104 The Ethics of Xenotransplantation 775
Jonathan Hughes
105 Pharmacogenomics 783
Ruth Chadwick
106 Ethical Issues in Human Gene Transfer: A Historical Overview 789
Eric T. Juengst and Hannah Grankvist
107 The Ethics of Ageing, Immortality and Genetics 797
Daniela Cutas and John Harris
108 Ethical Issues of Enhancement Technologies 803
Ruud H.J. Ter Meulen, Lisbeth Nielsen, Laurens Landeweerd
109 Psychosurgery and Neuroimplantation: Changing What is Deep Within a Person 811
Grant Gillett
110 Resisting Addiction: Novel Application of Vaccines 819
Andreas Hasman
Index 827
Contributors
TINEKE A. ABMA Professor, Department of Health Ethics and Philosophy, PO Box 616, Faculty of Health Sciences, Universiteit Maastricht, 6200 MD Maastricht, The Netherlands. Email: t.abma@zw.unimaas.nl
PASCALE ALLOTEY Chair in Race and Diversity, School of Health Sciences and Social Care, and, Centre for Public Health Research, Brunel University, Uxbridge UB8 3PH, UK. Email: Pascale.Allotey@brunel.ac.uk
DAVID W. ARCHARD Director, Institute for Philosophy & Public Policy (IPPP), Furness College, Lancaster University, Lancaster LA1 4YG, UK. Email: d.archard@lancaster.ac.uk
ADRIENNE ASCH Edward and Robin Milstein Professor of Bioethics, Wurzweiler School of Social Work, Albert Einstein College of Medicine, Yeshiva University, 2495 Amsterdam Avenue, New York, NY 10033, USA. Email: asch@yu.edu
RICHARD E. ASHCROFT Professor of Biomedical Ethics, Queen Mary University of London, Barts and the London Medical School, Institute of Health Sciences Education, 38-40 New Road, London E1 2AX, UK. Email: r.ashcroft@qmul.ac.uk
NAFSIKA ATHANASSOULIS Lecturer in Ethics, Centre for Professional Ethics, School of Law, Keele University, Staffordshire, ST5 5BG, UK. Email: n.athanassoulis@peak.keele.ac.uk
MARGARET P. BATTIN Distinguished University Professor, Division of Medical Ethics, 260 Central Campus Drive, Room 341, University of Utah, Salt Lake City, UT 84112-9156, USA. Email: battin@utah.edu
TOM L. BEAUCHAMP Professor of Philosophy, Department of Philosophy, Georgetown University, New North 215-37th and O Streets, NW Washington, DC 20057, USA. Email: beauchat@georgetown.edu
GRAHAM M. BEHR Consultant Psychiatrist and Honorary Senior Lecturer in Psychiatry, South Paddington Team, Central and North West London Mental Health NHS Trust, 7A Woodfield Road, London, W9 2NW, UK. Email: graham.behr@nhs.net
SOLOMON R. BENATAR Professor of Medicine, Director Bioethics Centre, Department of Medicine, University of Cape Town, J Floor Old Main Building, Groote Schuur Hospital, Observatory 7925, Western Cape, South Africa. Email: sbenatar@uctgsh1.uct.ac.za or solly.benatar@utoronto.ca
PIERS BENN Lecturer, Division of Epidemiology, Public Health and Primary Care, Imperial College London, Reynolds Building, St Dunstan's Road, London W6 8RP, UK. Email: p.benn@imperial.ac.uk
REBECCA BENNETT Senior Lecturer in Bioethics, The Centre for Social Ethics and Policy, School of Law, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK. Email: rebecca.bennett@manchester.ac.uk
TIM BOND Reader in Counselling and Professional Ethics, Graduate School of Education, University of Bristol, 35 Berkeley Square, Bristol, BS8 1JA. Email: Tim.Bond@bristol.ac.uk
ANNETTEE J. BRAUNACK-MAYER Associate Professor, Discipline of Public Health, The University of Adelaide, Mail Drop 207, Adelaide SA 5005, Australia. Email: annette.braunackmayer@adelaide.edu.au
DAN W. BROCK Frances Glessner Lee Professor of Medical Ethics at Harvard Medical School and Chair of the Division of Medical Ethics, Harvard Program in Ethics and Health, Harvard Medical School, 641 Huntington Avenue, 4th Floor, Boston, MA 02115, USA. Email: dan_brock@hms.harvard.edu
HOWARD BRODY University Distinguished Professor, Family Practice, Philosophy, and Centre for Ethics and Humanities in the Life Sciences, B100 Clinical Center, Michigan State University, East Lansing, MI 48824, USA. Email: Howard.Brody@ht.msu.edu
LINDA S. CARR-LEE Research Associate/Course Coordinator, Division of Medical Ethics, LDS Hospital, 8th Ave and C Street, Salt Lake City, UT 84143, USA. Email: Linda.Carr-Lee@intermountainmail.org
ADRIAN CARTER Office of Public Policy and Ethics, Institute for Molecular Bioscience, and The Queensland Brain Institute, University of Queensland, Ritchie Building (64A) (C Wing), St Lucia, QLD, 4072, Australia. Email: adrian.carter@uq.edu.au
RUTH CHADWICK Professor, CESAGen: ESRC Centre for Economic and Social Aspects of Genomics: a Lancaster-Cardiff collaboration, Cardiff Law School, Cardiff University, Museum Avenue, Cardiff CF10 3XJ, UK. Email: chadwickr1@cardiff.ac.uk
IAIN CHALMERS Editor, James Lind Library, The James Lind Initiative, Summertown Pavillion, Middle Way, Oxford OX2 7LG, UK. Email: Ichalmers@jameslindlibrary.org
JAMES F. CHILDRESS Hollingsworth Professor, Institute for Practical Ethics and Public Life, University of Virginia, PO Box 400800, Charlottesville, VA 22904, USA. Email: jfc7c@virginia.edu
ANGUS CLARKE Department of Medical Genetics, University Hospital of Wales, Health Park, Cardiff CF14 4XN, UK. Email: clarkeaj@cardiff.ac.uk
MIKE CLARKE Professor, Director, UK Cochrane Centre, NHS R&D Programme, Summertown Pavillion, Middle Way, Oxford OX2 7LG, UK. Email: mclarke@cochrane.co.uk, mike.clarke@ctsu.ox.ac.uk
STEVEN S. COUGHLIN Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE (K-55), Atlanta, GA 30341, USA. Email: sic9@cdc.gov
HAROLD COWARD Director, Centre for Studies in Religion and Society, University of Victoria, PO Box 3045, Victoria, BC V8W 3P4 Canada. Email: csrs@uvvm.uvic.ca
ALAN CRIBB Professor of Bioethics and Education, Centre for Public Policy Research, King's College London, Strand, London WC2R 2LS, UK. Email: alan.cribb@kcl.ac.uk
GARRETT CULLITY Associate Professor, Department of Philosophy, The University of Adelaide, Adelaide SA 5005, Australia. Email: garrett.cullity@adelaide.edu.au
ANTHONY J. CULYER Chief Scientist, Institute for Work & Health, 481 University Avenue, Toronto, ON, M5G 2E9, Canada. Email: aculyer@iwh.on.ca
DANIELA CUTAS Research Fellow, CSEP/IMLAB, School of Law, University of Manchester, Williamson Building, Oxford Road, M13 9PL, UK. Email: Daniela.Cutas@manchester.ac.uk
MARION DANIS Head, Section on Ethics and Health Policy, Department of Clinical Bioethics, Warren G. Magnuson Clinical Center, Building 10 Room 1C118, National Institutes of Health, Bethesda, MD 20892-1156, USA. Email: mdanis@nih.gov
ANGUS DAWSON Senior Lecturer in Ethics and Philosophy, Centre for Professional Ethics, School of Law, Keele University, Staffordshire, ST5 5BG, UK. Email: a.j.dawson@keele.ac.uk
DAVID DEGRAZIA Professor of Philosophy, Department of Philosophy, George Washington University, Phillips 525, Washington DC 20052, USA. Email: ddd@gwu.edu
JACK DOWIE Emeritus Professor of Health Impact Analysis, Public Health and Policy Dept, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Email: Jack.Dowie@lshtm.ac.uk
HEATHER DRAPER Reader in Biomedical Ethics, Centre for Biomedical Ethics, Department of General Practice and Primary Care, Primary Care Clinical Sciences Building, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Email: h.draper@bham.ac.uk
REBECCA S. DRESSER Daniel Noyes Kirby Professor of Law and Professor of Ethics in Medicine, School of Law and School of Medicine, Washington University in St Louis, Law School-Box 1120, One Brookings Drive, St Louis, MO 63130, USA. Email: dresser@wulaw.wustl.edu
STEVEN D. EDWARDS Centre for Philosophy, Humanities and Law in Healthcare, School of Health Science, University of Wales, 7th Floor Vivian Building, Swansea SA2 8PP, UK. Email: s.d.edwards@swansea.ac.uk
EZEKIEL EMANUEL Chair, Department of Clinical Bioethics at the Warren G. Magnuson Clinical Center, National Institutes of Health, 10 Center Drive, Building 10, Room 1C118, Bethesda, MD 20892-1156, USA. Email: eemanuel@nih.gov
J.S. EMMANUEL Consultant Psychiatrist and Honorary Senior Lecturer in Psychiatry, Central and North West London Mental Health NHS Trust, 7A Woodfield Road, London, W9 2NW, UK.
VERONICA ENGLISH Deputy Head of Medical Ethics Department, British Medical Association, BMA House, Tavistock Square, London WC1H 9JP, UK. Email: venglish@bma.org.uk
MARTYN EVANS Professor of Humanities in Medicine, Centre for Arts and Humanities in Health and Medicine, University of Durham, Dawson Building, Science Site, South Road, Durham DH1 3HP, UK. Email: h.m.evans@durham.ac.uk
JAMES FLORY MD Student, School of Medicine, University of Pennsylvania, 295 John Morgan Building, 3620 Hamilton Walk, Philadelphia, PA 19104-6055, USA.
BENNETT FODDY Research Student, Centre for Applied Philosophy and Public Ethics, University of Melbourne, Victoria 3010, Australia; and Australian Stem Cell Centre, Monash University, Victoria 3800, Australia. Email: bennett@foddy.net
NORMAN MICHAEL FORD Director, Caroline Chisholm Centre for Health Ethics, East Melbourne; Senior Honorary Research Fellow, Bioethics, Monash University, Melbourne; Lecturer in Bioethics, Melbourne College of Divinity, Australia. Email: nford@mercy.com.au
LESLIE P. FRANCIS Alfred C. Emery Professor of Law, S.J. Quinney College of Law, University of Utah, 332 South 1400 East, Salt Lake City, UT 84112-0730, USA. Email:...
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