Bioethics 6e

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