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This comprehensive anthology represents the key issues and problems in the field of biomedical ethics through the most up-to-date readings and case studies available. Each of the book's seven parts is prefaced with helpful introductions that raise important questions and skillfully contextualize the positions and main points of the articles that follow. This seventh edition updates and expands parts throughout the text, including the discussions of conflicting roles and responsibilities for medical professionals and justice in health care. A new Part Seven entitled "Emerging Technologies and Perennial Issues," which explores the issues of behavioral genetics and human enhancements.
(* indicates new to 7th edition)
Introduction: Moral Reasoning in the Medical Context
Bioethics: Nature and Scope
Sources of Bioethical Problems and Concerns
Challenges to Ethical Theory
Moral Theories and Perspectives
Modes of Moral Reasoning
PART ONE: Foundations of the Health Professional-Patient Relationship
Section 1: Autonomy, Paternalism, and Medical Models
The Hippocratic Oath
Alan Goldman, "The Refutation of Medical Paternalism"
Beneficience Today, or Autonomy (Maybe) Tomorrow?
Bernice S. Elger, Commentary
Jean-Claude Chevrolet, Commentary
*Terrence F. Ackerman, "Why Doctors Should Intervene"
Ezekiel J. Emanuel and Linda L. Emanuel, "Four Models of the Physician-Patient Relationship"
Section 2: Informed Consent & Truth Telling
John D. Arras, "Antihypertensives and the Risk of Temporary Impotence: A Case Study in Informed Consent"
Jay Katz, "Informed Consent - Must it Remain a Fairy Tale?"
Francoise Baylis, "Error in Medicine: Nurturing Truthfulness"
*Leslie J. Blackhall, Gelya Frank, Sheila Murphy and Vicki Mitchel, "Bioethics In a Different Tongue: The Case of Truth-Telling"
Benjamin Freedman, "Offering Truth"
Section 3: Conflicting Professional Roles and Responsibilities
Tarasoff v. Regents of the University of California
Len Fleck and Marcia Angell, "Please Don't Tell"
Lainie Friedman Ross, "Disclosing Misattributed Paternity"
*Dessmon YH Tai, "SARS Plague: Duty to Care or Medical Heroism"
*Ezekiel J.Emanuel, "The Lessons of SARS"
*Gregory L. Eastwood, Daniel Fu-Chang Tsai, Ding-Shinn Chenn and James Dwyer, "What Should the Dean Do?"
*Julie Cantor and Ken Baum, "The Limits of Conscientious Objections - May Pharmacists Refuse to Fill Prescriptions for Emergency Contraception"
*Atul Gawande, "When Law and Ethics Collide - Why Physicians Participate in Executions"
*Ken Baum, "'To Comfort Always: Physician Participation in Executions"
*Daniel Zupan, Gary Solis, Richard Schoonhoven and George Annas, "Dialysis for a Prisoner of War?"
PART TWO: Allocation, Social Justice, and Health Policy
Section 1: Justice, Health, and Health Care
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, "An Ethical Framework for Securing Access to Health Care"
Norman Daniels, "Equal Opportunity and Health Care"
H. Tristram Engelhardt, Jr., "Freedom and Moral Diversity: The Moral Failures of Health Care in the Welfare State"
*Richard Wilkinson and Michael Marmot, eds. for the World Health Organization, "The Social Determinants of Health: The Solid Facts"
*Ichiro Kawachi, "Why the United States Is Not Number One in Health"
*Norman Daniels, "Justice, Health, and Health Care"
*Gopal Sreenivasan, "Opportunity Is Not the Key"
Section 2: Allocating Scarce Resources
Alex John London, "Bone Marrow Transplants for Advanced Breast Cancer: The Story of Christine deMeurers"
*Ronald Dworkin, "Justice and the High Cost of Health"
*Robert Steinbrook, "Imposing Personal Responsibility for Health"
*Alexander W. Cappellen and Ole Frithjof Norheim, "Responsibility in Health Care: A Liberal Egalitarian Approach"
Norman Daniels and James Sabin, "Last-Chance Therapies and Managed Care: Pluralism, Fair Procedures, and Legitimacy"
*James Dwyer, "Illegal Immigrants, Health Care, and Social Responsibility"
*John D. Arras, "Rationing Vaccine During an Avian Influenza Pandemic: Why It Won't Be Easy"
*Ezekiel J. Emanuel and Alan Wertheimer, "Who Should Get Flu Vaccine When Not All Can?"
Section 3: Organ Transplantation: Gifts vs. Markets
*Janet Radcliffe-Richards, Abdallah S. Daar, Ronald D. Guttman, Raymond Hoffenberg, Ian Kennedy, Margaret Lock, Robert A. Sells, Nicholas L. Tilney, for the International Forum for Transplant Ethics, "The Case for Allowing Kidney Sales"
*Charles A. Erin and John Harris, "An Ethical Market in Human Organs"
*Donald Joralemon and Phil Cox, "Body Values: The Case Against Compensating for Transplant Organs"
Section 4: Poverty, Health, and Justice Beyond National Borders
*Thomas A. Pogge, "Responsibilities for Poverty-Related Ill Health"
*Mathias Risse, "Do We Owe the Global Poor Assistance or Rectification?"
PART THREE: Defining Death, Forgoing Life-Sustaining Treatment, and Euthanasia
Section 1: The Definition of Death
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, "Defining Death"
*James L. Bernat, "The Whole-Brain Concept of Death Remains Optimum Public Policy"
*Jeff McMahan, "An Alternative to Brain Death"
Section 2: Decisional Capacity and the Right to Refuse Treatment
State of Tennessee Department of Human Services v. Mary C. Northern: Transcript of Proceedings, Testimony of Mary C. Northern
Allen Buchanan and Dan W. Brock, "Deciding for Others: Competency"
Keith Burton, "A Chronicle: Dax's Case as it Happened"
Robert B. White, Commentary
H. Tristram Engelhardt, Commentary
Section 3: Advance Directives
George J. Annas, "The Health Care Proxy and the Living Will"
*Angela Fagerlin and Carl E. Schneider, "Enough: The Failure of the Living Will"
Norman L. Cantor, "Testing the Limits of Precedent Autonomy: Five Scenarios"
Section 4: Choosing for the Once-Competent
*Jay Wolfson, "Erring on the Side of Theresa Schiavo: Reflections of the Special Guardian Ad Litem"
*Wesley J. Smith, "'Human Non-Person'Terri Schiavo, Bioethics, and Our Future"
In the Matter of Claire C. Conroy
John D. Arras, "The Severely Demented, Minimally Functional Patient: An Ethical Analysis"
U.S. Bishops Pro-Life Committee, "Nutrition and Hydration: Moral and Pastoral Reflections"
Rebecca S. Dresser and John A. Robertson, "Quality of Life and Non-Treatment Decisions for Incompetent Patients: A Critique of the Orthodox Approach"
Nancy K. Rhoden, "The Limits of Legal Objectivity"
*Section 5: Choosing for the Never-Competent
*Alicia Ouellette, "Termination of Life-Support for a Never-Competent Patient: the Sheila Pouliot Case"
*John Robertson, "Extreme Prematurity and Parental Rights After Baby Doe"
*John Paris, Michael D. Schreiber and Alun Elias-Jones, "Resuscitation of the Preterm Infant Against Parental Wishes"
Section 6: Physician-Assisted Death
Timothy E. Quill, "Death and Dignity: A Case of Individualized Decision Making"
John D. Arras, "Physician-Assisted Suicide: A Tragic View"
Assisted Suicide: an Amicus Curiae Brief
Ronald Dworkin, "Introduction"
Ronald Dworkin, Thomas Nagel, Robert Nozick, John Rawls, Thomas Scanlon, and Judith Jarvis Thomson, "The Philosophers' Brief"
Margaret Battin, "Euthanasia: The Way We Do It, The Way They Do It" (updates for the new edition)
John Hardwig, "Is There A Duty to Die?"
Felicia Nimue Ackerman, "'For Now Have I My Death':the 'Duty to Die' versus the Duty to Help the Ill Stay Alive"
PART FOUR: Reproduction
Section 1: The Morality of Abortion
Pope John Paul II, "The Unspeakable Crime of Abortion"
Don Marquis, "Why Abortion is Immoral"
Bonnie Steinbock, "Why Most Abortions Are Not Wrong"
Judith Jarvis Thomson, "A Defense of Abortion"
Margaret Olivia Little, "The Morality of Abortion"
Section 2: Obligations to the Not-Yet-Born
*Howard Minkoff and Lynn M. Paltrow, "The Rights of 'Unborn Children' and the Value of Pregnant Women"
Allen Buchanan, Dam Brock, Norman Daniels and Daniel Wikler, "Reproductive Freedom and the Prevention of Genetically Transmitted Harmful Conditions"
*Richard J. Hull, "Cheap Listening? - Reflections on the Concept of Wrongful Disability"
Section 3: Assisted Reproduction
John A. Robertson, "The Presumptive Primacy of Procreative Liberty"
Vatican, "Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation"
*Thomas H. Murray, "What are Families for? Getting to an Ethics of Reproductive Technology"
*Jessica Cohen, "Grade A: The Market for a Yale Woman's Eggs"
*Bonnie Steinbock, "Payment for Egg Donation"
Section 4: Reproductive Cloning
*The President's Council on Bioethics, "The Case Against Cloning-to-Produce-Children"
*Bonnie Steinbock, "Reproductive Cloning: Another Look"
Thomas H. Murray, "Even If It Worked, Cloning Wouldn't Bring Her Back"
PART FIVE: Genetics
Section 1: Prenatal Genetic Testing
Adrienne Asch, "Prenatal Diagnosis and Selective Abortion: A Challenge to Practice and Policy"
*Bonnie Steinbock, "Disability, Prenatal Testing and Selective Abortion"
Jeffrey R. Botkin, "Ethical Issues and Practical Problems in Preimplantation Genetic Diagnosis"
Bonnie Steinbock, "Case Study on Molly and Adam Nash"
Section 2: Therapeutic Cloning and Stem Cell Research
*Michael Sandel, "Embryo Ethics - The Moral Logic of Stem-Cell Research"
*Robert George and Patrick Lee, "Acorns and Embryos"
*William FitzPatrick, "Surplus Embryos, Nonreproductive Cloning, and the Intend/Foresee Distinction"
PART SIX: Experimentation on Human Subjects
Section 1: Born in Scandal: The Origins of US Research Ethics
The Nuremburg Code
John D. Arras, "The Jewish Chronic Disease Hospital Case"
David J. Rothman and Sheila M. Rothman, "The Willowbrook Hepatitis Studies"
Allan M. Brandt, "Racism and Research: The Case of the Tuskegee Syphilis Study"
The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, "The Belmont Report"
Section 2: The Ethics of Randomized Clinical Trials
Maurie Markman, "Ethical Difficulties with Randomized Clinical Trials Involving Cancer Patients: Examples from the Field of Gynecologic Oncology"
Samuel Hellman and Deborah S. Hellman, "Of Mice but Not Men: Problems of the Randomized Clinical Trial"
Benjamin Freedman, "A Response to a Purported Ethical Difficulty with Randomized Clinical Trials Involving Cancer Patients"
Section 3: Ethical Issues in International Research
Peter Lurie and Sidney M. Wolfe, "Unethical Trials of Interventions to Reduce Perinatal Transmission of the Human Immunodeficiency Virus in Developing Countries"
Robert A. Crouch and John D. Arras, "AZT Trials and Tribulations"
Alex John London, "The Ambiguity and the Exigency: Clarifying 'Standard of Care' Arguments in International Research"
Leonard H. Glanz, George J. Annas, Michael A Grodin, and Wendy K. Mariner, "Reasearch in Developing Countries: Taking 'Benefit' Seriously"
*Participants in the 2001 Conference on Ethical Aspects of Research in Developing Countries, "Fair Benefits for Research in Developing Countries"
Section 4: Research on Children
Alex John London, "Children and 'Minimal Risk' Research: The Kennedy-Krieger Lead Paint Study"
Thomas H. Murray, "Research on Children and the Scope of Responsible Parenthood"
Benjamin Freedman, Abraham Fuks, and Charles Weijer, "In Loco Parentis: Minimal Risk as an Ethical Threshold for Research upon Children"
PART SEVEN: Emerging Technologies and Perennial Issues
Section 1: Emerging Technologies
*Steven Pinker, "Designer Baby Myth"
*Mark A. Rothstein, "Applications of Behavioral Genetics: Outpacing the Science"
*Walter Glannon, "Neuroethics"
Section 2: Enhancement
*David B. Allen, "Growth Hormone Therapy for the Disability of Short Stature"
Norman Daniels, "The Genome Project, Individual Differences, and Just Health Care"
*Julian Savulescu, "Genetic Interventions and the Ethics of Enhancement of Human Beings"
*Michael Sandel, "The Case Against Perfection: What's Wrong with Designer Children, Bionic Athletes, and Genetic Engineering"
*Ronald Bailey, "Anyone for Tennis, at the Age of 150??"
Section 3: Free Will and Responsibility
*Walter Glannon, "Neurobiology, Neuroimaging, and Free Will"
Appendix: Resources in Bioethics