Everybody Wants to Go to Heaven but Nobody Wants to Die: Bioethics and the Transformation of Health Care in America

by Amy Gutmann, Jonathan D. Moreno

Overview

NOW FEATURING A NEW AFTERWORD, "PANDEMIC ETHICS"

From two eminent scholars comes a provocative examination of bioethics and our culture’s obsession with having it all without paying the price.

Shockingly, the United States has among the lowest life expectancies and highest infant mortality rates of any high-income nation, yet, as Amy Gutmann and Jonathan D. Moreno show, we spend twice as much per capita on medical care without insuring everyone. A “remarkable, highly readable journey” (Judy Woodruff ) sure to become a classic on bioethics, Everybody Wants to Go to Heaven but Nobody Wants to Die explores the troubling contradictions between expanding medical research and neglecting human rights, from testing anthrax vaccines on children to using brain science for marketing campaigns. Providing “a clear and compassionate presentation” (Library Journal) of such complex topics as radical changes in doctor-patient relations, legal controversies over in vitro babies, experiments on humans, unaffordable new drugs, and limited access to hospice care, this urgent and incisive history is “required reading for anyone with a heartbeat” (Andrea Mitchell).

Product Details

ISBN-13:	9781631498008
Publisher:	Liveright Publishing Corporation
Publication date:	11/10/2020
Pages:	384
Sales rank:	404,876
Product dimensions:	5.40(w) x 8.10(h) x 1.10(d)

About the Author

Amy Gutmann, the eighth president of the University of Pennsylvania, is an award-winning political theorist. She served on President Obama’s bioethics commission.

Jonathan D. Moreno is a Penn Integrates Knowledge University Professor at the University of Pennsylvania. He served on President Obama’s bioethics commission.

Table of Contents

Introduction A Duty to Tell 11

Part 1 New Voices

1 Changing Times 27

2 Bioethics Goes Public 45

3 The Public's Health 67

Part 2 Matters of Life and Death

4 Uneasy Deaths 85

5 The High Price of Unfair Health Care 116

6 Foraging for Ethics 150

Part 3 Moral Science

7 Human Experiments 181

8 Reproductive Technologies 205

9 Opening Cell Doors 226

Epilogue Transforming Minds 251

Afterword Pandemic Ethics 271

Acknowledgments 303

Notes 305

Bibliography 339

Index 363

Editorial Reviews

05/13/2019

Gutmann (The Spirit of Compromise, coauthor) and Moreno (Impromptu Man), who both served on President Obama’s bioethics commission, vividly explore the complexity of the ethical principles underlying scientific advances and emerging medical treatments. The opening chapters lay historic and cultural foundations, showing how debates over medical practices became more contentious as Americans became less automatically trusting of medical practitioners. Gutmann and Moreno then trace the evolving ethical debate by taking on wide-ranging questions, from the concrete—unequal availability of healthcare—to the abstract—the evolving definition of parenthood amid the proliferation of reproductive technologies. They also introduce the different ethical philosophies in play, the best-known of which is utilitarianism, but ensure the discussion remains immediate through real-life examples. These include the case of Brittany Maynard, a 29-year-old terminally ill cancer patient, whose “youth and vigorous advocacy” for her right to a physician-assisted death the authors credit with bringing new attention to the issue. Part cultural history, part philosophical enquiry, and part gentle polemic, this valuable survey should become prescribed reading for America’s healthcare practitioners. (Aug.)

Publishers Weekly

"A remarkable, highly readable journey through the development of modern thinking about bioethics, from syphilis experiments on black men in Tuskegee, and Brittany Maynard’s desire to die rather than live with uncurable cancer, to wondrous medical advances that pose excruciating trade-offs."

Judy Woodruff

"Amy Gutmann and Jonathan Moreno’s groundbreaking Everybody Wants to Go to Heaven But Nobody Wants to Die should be required reading for anyone with a heartbeat who wants to understand the ethical and practical contradictions of our cultural obsession with prolonging life at all costs."

Andrea Mitchell

"Well done."

Booklist

"The age-old debate about health care—what we owe each other as we all become sick—has rarely been able to transcend the superficial and frustratingly binary arguments of the politics that has held a meaningful discussion hostage. This superb book is a refreshing departure."

Ken Burns

"A tour de force. Readable and understandable to lay audiences, sophisticated and comprehensive for all, fair-minded in approach but also taking positions, this book gives a thorough history, with important examples, of all the areas of research and action that raise serious ethical questions. Everybody will face some of the challenges raised in this book. And everyone would benefit immensely from reading it."

Norman Ornstein

2019-05-26
An analysis of how bioethics continue to affect modern American medicine.

"All stages of our lives are caught up in challenging ethical questions raised by modern medicine, health care, public health, and life science research," write University of Pennsylvania president Gutmann (Identity in Democracy, 2003, etc.) and Moreno (Ethics/Univ. of Pennsylvania; Undue Risk: Secret State Experiments on Humans, 2016, etc.) in this astute examination of bioethics as it applies to America's collective health. As a primer to their insightful discussion, the authors share relevant personal stories. Gutmann discusses her beloved grandmother's conundrum involving a crucial medical decision, and Moreno discusses the blatant lack of clinical truth telling and "therapeutic privilege" at work during his mother's ordeal with cancer. These poignant memories illuminate the greater problem of ethics in medicine. The authors' three-part study begins with a comprehensive history of patient care as it progressed from an atmosphere of unquestioned physician opinion to more current viewpoints, where second opinions and collaborative clinical evaluations are more the norm. Gutmann and Moreno lucidly outline the differences between earlier eras in medicine, when a doctor's "implicit permission to mislead, if not to lie outright" was openly accepted, and contemporary medicine, where healthier food "choice architecture" and mental health system reforms are just two examples of the radical shift in perception and patient self-empowerment. The authors are unafraid to address more disputable, "slippery slope" issues, many of which remain targeted by polarized political systems. They also respectfully discuss the idea of universal health care, organ donor matching and transplantation, physician-assisted suicide, the surging interest in genetic manipulation, and the deep ethical issues surrounding the neuroscience field. While the authors agree that great strides have been made through more focused attention on ethical clinical care, America falls critically short on achieving a system that is both affordable and accessible.

An academic, illuminating assessment of the past, present, and future forms of responsible public health care.

Kirkus Reviews