Bioethics

Acknowledgments xii

Introduction 1

Part I Abortion 9

Introduction 11

1 Abortion and Health Care Ethics 15
John Finnis

2 Abortion and Infanticide 23
Michael Tooley

3 A Defense of Abortion 38
Judith Jarvis Thomson

4 Why Abortion Is Immoral 49
Don Marquis

Part II Issues in Reproduction 61

Introduction 63

Assisted Reproduction 69

5 Multiple Gestation and Damaged Babies: God’s Will or Human Choice? 71
Gregory Pence

6 Assisted Reproduction in Same Sex Couples 74
Dorothy A. Greenfeld and Emre Seli

7 Rights, Interests, and Possible People 86
Derek Parfit

8 The Ethics of Uterus Transplantation 91
Ruby Catsanos, Wendy Rogers, and Mianna Lotz

Prenatal Screening, Sex Selection, and Cloning 103

9 Genetics and Reproductive Risk: Can Having Children Be Immoral? 105
Laura M. Purdy

10 Prenatal Diagnosis and Selective Abortion: A Challenge to Practice and Policy 112
Adrienne Asch

11 Genetic Technology: A Threat to Deafness 127
Ruth Chadwick and Mairi Levitt

12 Sex Selection and Preimplantation Genetic Diagnosis

The Ethics Committee of the American Society of Reproductive Medicine 136

13 Sex Selection and Preimplantation Diagnosis: A Response to the Ethics Committee of the American Society of Reproductive Medicine 141
Julian Savulescu and Edgar Dahl

14 Conception to Obtain Hematopoietic Stem Cells 144
John A. Robertson, Jeffrey P. Kahn, and John E. Wagner

15 Why We Should Not Permit Embryos to Be Selected as Tissue Donors 152
David King

16 The Moral Status of the Cloning of Humans 156
Michael Tooley

Part III Genetic Manipulation 173

Introduction 175

17 Questions about Some Uses of Genetic Engineering 177
Jonathan Glover

18 The Moral Significance of the Therapy–Enhancement Distinction in Human Genetics 189
David B. Resnik

19 Should We Undertake Genetic Research on Intelligence? 199
Ainsley Newson and Robert Williamson

20 In Defense of Posthuman Dignity 208
Nick Bostrom

Part IV Life and Death Issues 215

Introduction 217

21 The Sanctity of Life 225
Jonathan Glover

22 Declaration on Euthanasia 235

Sacred Congregation for the Doctrine of the Faith Killing and Letting Die 241

23 The Morality of Killing: A Traditional View 243
Germain Grisez and Joseph M. Boyle, Jr.

24 Active and Passive Euthanasia 248
James Rachels

25 Is Killing No Worse Than Letting Die? 252
Winston Nesbitt

26 Why Killing is Not Always Worse – and Sometimes Better – Than Letting Die 257
Helga Kuhse

27 Moral Fictions and Medical Ethics 261
Franklin G. Miller, Robert D. Truog, and Dan W. Brock

Severely Disabled Newborns 271

28 When Care Cannot Cure: Medical Problems in Seriously Ill Babies 273
Neil Campbell

29 The Abnormal Child: Moral Dilemmas of Doctors and Parents 285
R. M. Hare

30 Right to Life of Handicapped 290
Alison Davis

31 Conjoined Twins, Embodied Personhood, and Surgical Separation 292
Christine Overall

Brain Death 305

32 A Definition of Irreversible Coma 307

Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death

33 Are Recent Defences of the Brain Death Concept Adequate? 312
Ari Joffe

34 Is the Sanctity of Life Ethic Terminally Ill? 321
Peter Singer

Advance Directives 331

35 Life Past Reason 333
Ronald Dworkin

36 Dworkin on Dementia: Elegant Theory, Questionable Policy 341
Rebecca Dresser

Voluntary Euthanasia and Medically Assisted Suicide 351

37 The Note 353
Chris Hill

38 When Self]Determination Runs Amok 357
Daniel Callahan

39 When Abstract Moralizing Runs Amok 362
John Lachs

40 Trends in End]of]Life Practices Before and After the Enactment of the Euthanasia Law in the Netherlands from 1990 to 2010: A Repeated Cross]Sectional Survey 366
Bregje D. Onwuteaka]Philipsen, Arianne Brinkman]Stoppelenburg, Corine Penning, Gwen J. F. de Jong]Krul, Johannes J. M. van Delden, and Agnes van der Heide

41 Euthanasia in the Netherlands: What Lessons for Elsewhere? 377
Bernard Lo

Part V Resource Allocation 381

Introduction 383

42 Rescuing Lives: Can’t We Count? 387
Paul T. Menzel

43 Should Alcoholics Compete Equally for Liver Transplantation? 390
Alvin H. Moss and Mark Siegler

44 The Value of Life 397
John Harris

45 Bubbles under the Wallpaper: Healthcare Rationing and Discrimination 406
Nick Beckstead and Toby Ord

Part VI Obtaining Organs 413

Introduction 415

46 Organ Donation and Retrieval: Whose Body Is It Anyway? 417
Eike]Henner W. Kluge

47 The Case for Allowing Kidney Sales 421
Janet Radcliffe]Richards, A. S. Daar, R. D. Guttmann, R. Hoffenberg, I. Kennedy, M. Lock, R. A. Sells, N. Tilney, and for the International Forum for Transplant Ethics

48 Ethical Issues in the Supply and Demand of Human Kidneys 425
Debra Satz

49 The Survival Lottery 437
John Harris

Part VII Experimentation with Human Participants 443

Introduction 445

Human Participants 449

50 Ethics and Clinical Research 451
Henry K. Beecher

51 Equipoise and the Ethics of Clinical Research 459
Benjamin Freedman

52 The Patient and the Public Good 466
Samuel Hellman

53 Scientific Research Is a Moral Duty 471
John Harris

54 Participation in Biomedical Research Is an Imperfect Moral Duty: A Response to John Harris 483
Sandra Shapshay and Kenneth D. Pimple

55 Unethical Trials of Interventions to Reduce Perinatal Transmission of the Human Immunodeficiency Virus in Developing Countries 489
Peter Lurie and Sidney M. Wolfe

56 We’re Trying to Help Our Sickest People, Not Exploit Them 495
Danstan Bagenda and Philippa Musoke]Mudido

57 Medical Researchers’ Ancillary Clinical Care Responsibilities 497
Leah Belsky and Henry S. Richardson

Human Embryos – Stem Cells 503

58 President Discusses Stem Cell Research 505
George W. Bush

59 Killing Embryos for Stem Cell Research 508
Jeff McMahan

Part VIII Experimentation with Animals 521

Introduction 523

60 Duties towards Animals 527
Immanuel Kant

61 A Utilitarian View 529
Jeremy Bentham

62 All Animals Are Equal 530
Peter Singer

63 Vivisection, Morals and Medicine: An Exchange 540
R. G. Frey and Sir William Paton

Part IX Public Health Issues 551

Introduction 553

64 Ethics and Infectious Disease 555
Michael J. Selgelid

65 Rethinking Mandatory HIV Testing during Pregnancy in Areas with High HIV Prevalence Rates: Ethical and Policy Issues 565
Udo Schuklenk and Anita Kleinsmidt

66 Mandatory HIV Testing in Pregnancy: Is There Ever a Time? 572
Russell Armstrong

67 XDR]TB in South Africa: No Time for Denial or Complacency 582
Jerome Amir Singh, Ross Upshur, and Nesri Padayatchi

Part X Ethical Issues in the Practice of Healthcare 591

Introduction 593

Confidentiality 597

68 Confidentiality in Medicine: A Decrepit Concept 599
Mark Siegler

69 The Duty to Warn and Clinical Ethics: Legal and Ethical Aspects of Confidentiality and HIV/AIDS 603
Christian Saf ken and Andreas Frewer

Truth-Telling 611

70 On a Supposed Right to Lie from Altruistic Motives 613
Immanuel Kant

71 Should Doctors Tell the Truth? 615
Joseph Collins

72 On Telling Patients the Truth 621
Roger Higgs

Informed Consent and Patient Autonomy 629

73 On Liberty 631
John Stuart Mill

74 From Schloendorff v. NewYork Hospital 634
Justice Benjamin N. Cardozo

75 Informed Consent: Its History, Meaning, and Present Challenges 635
Tom L. Beauchamp

76 The Doctor–Patient Relationship in Different Cultures 642
Ruth Macklin

77 Amputees by Choice 654
Carl Elliott

78 Rational Desires and the Limitation of Life]Sustaining Treatment 665
Julian Savulescu

79 The Nocebo Effect of Informed Consent 683
Shlomo Cohen

Part XI Special Issues Facing Nurses 693

Introduction 695

80 The Relation of the Nurse to the Doctor and the Doctor to the Nurse 699
Sarah E. Dock

81 In Defense of the Traditional Nurse 700
Lisa H. Newton

82 Patient Autonomy and Medical Paternity: Can Nurses Help Doctors to Listen to Patients? 708
Sarah Breier

83 Health and Human Rights Advocacy: Perspectives from a Rwandan Refugee Camp 718
Carol Pavlish, Anita Ho, and Ann]Marie Rounkle

Part XII Neuroethics 729

Introduction 731

84 Neuroethics: An Agenda for Neuroscience and Society 733
Jonathan D. Moreno

85 How Electrical Brain Stimulation Can Change the Way We Think 741
Sally Adee

86 Neuroethics: Ethics and the Sciences of the Mind 744
Neil Levy

87 Freedom of Memory Today 749
Adam Kolber

88 Towards Responsible Use of Cognitive]Enhancing Drugs by the Healthy 753
Henry Greely, Barbara Sahakian, John Harris, Ronald C. Kessler, Michael Gazzaniga, Philip Campbell, and Martha J. Farah

89 Engineering Love 760Julian Savulescu and Anders Sandberg

Index 762