A Companion to Bioethics by Kuhse, Helga -- Read -- Imperial Library of Trantor

Index

Cover Contents Series Title page Copyright Dedication Contributors Acknowledgments Part I: Introduction

1 What Is Bioethics? A Historical Introduction

Medical Ethics Nursing Ethics Bioethics References

Part II: Questions About Bioethics

2 Ethical Theory and Bioethics

Case Studies and Mid-level Principles Justifying the Choice of an Ethical Theory References Further reading

3 Culture and Bioethics

What Is Culture? Bioethics Today: Present Realities The Universality of Bioethics The Challenge of Transcultural Bioethics Practice Principles and Rules Cultural Imperialism and Value Absolutism Cultural Pluralism and Value Relativism Transculturalism and the Idea of Shared Values References Further reading

4 Gender and Bioethics

Feminism and Gender Gender and Health Care Gender and Ethics Moral Persons and Moral Deliberation Bioethical Self-reflection References Further reading

5 Religion and Bioethics

Problems and Arguments Religion and Bioethics: A Distinctive Contribution? Religion, Bioethics, and Liberal Society References Further reading

6 Law and Bioethics

Law Morality From Morality to Law From Law to Morality Converging Law and Morality Diverging Law and Morality: Beyond the Liberal Model References Further reading

Part III: Ethical Approaches

7 A Principle-based Approach

The Variety of Principle-based Approaches Connecting General Principles to Particular Judgments about Cases Critiques References Further reading

8 Exceptionless Rule Approaches

The Idea of an Exceptionless Moral Norm The Role of Exceptionless Precepts in Moral Thinking Exceptionless Rules and Consequentialism The Casuistry of Exceptionless Rule Approaches References

9 A Utilitarian Approach

References

10 A Virtue Ethics Approach

The Rise of Virtue Ethics Essential Features of Virtue Ethics Virtue Ethics Approaches to Bioethics Criticisms of Virtue Ethics Conclusion References Further reading

11 A Care Approach

One Model of Care Ethics An Overview of Care Ethics Care and Other Moral Perspectives Care and Bioethics Conclusion References Further reading

12 A Case Approach

Top-down vs Bottom-up Core Elements of Casuistical Analysis Advantages of a Casuistical Approach Objections and Replies Conclusion References Further reading

Part IV: Before Birth: Issues Involving Embryos and Fetuses

13 Personhood

Basic Moral Principles and the Concept of a Person Human Persons and Human Organisms The Concept of a Person and the Wrongness of Killing What Makes Something a Person? Is Personhood a Matter of Degree? Is Potential Personhood Morally Significant? Is Species Membership Morally Significant? The Moral Status of Human Embryos, Fetuses, and Newborn Infants Summing Up: Ethics and the Concept of a Person References

14 Abortion

The Arguments for the Freedom to Choose Fetal Life and Humanity The Argument from Fetal Potential Abortion and Fetal Development Making Abortion Difficult to Obtain Ideological Bases of the Abortion Debate Conclusion References

15 Mother–Fetus Conflict

Abortion and Mother–Fetus Conflict Moral Obligations to the Unborn The Obstetrical Cases: Forced Cesareans Fetal Surgery Conclusion References Further Reading

Part V: Issues In Reproduction

16 Population

The Malthusian Warning “Population Control” and its Critics “Leveling Off ”: The Demographic Transition The Ethics of Population Programs Optimal Population Size: Fewer with More, or More with Less? A Thought-Experiment About a Solution to the Population Problem References

17 Assisted Reproduction, Prenatal Testing, and Sex Selection

General Assessments of Assisted Reproduction Pre-birth Testing Conclusion References Further reading

18 Cloning

Cloning and Popular Culture: A Brief History Some Facts About Cloning Exact Copies and Zombies Is Cloning Humans Unnatural? Animal Cloning Originating the First Cloned Baby Preliminary Psychological-Social Objections to Cloning Moral Objections Against Human Embryonic Cloning Conclusions References

Part VI: The New Genetics

19 Gene Therapy

Promise and Disappointment Ethical Issues Resource Allocation References

20 Genetic Enhancement

Possibility, Extent and Significance of Genetic Enhancement Should Human Genetic Enhancement Occur? Conclusion References Further reading

21 Creating and Patenting New Life Forms

Introduction Values Micro-organisms and Plants Animals Humans Patents References Further reading

22 Genetic Counseling, Testing, and Screening

Information Management: Confidentiality, Autonomy and Non-Directiveness Predictive Genetic Testing Childhood Genetic Testing Genetic Screening Informed Consent to Screening Newborn Screening Carrier Screening Prenatal Screening Susceptibility Screening Further Information Management Goals of Genetic Screening: Public Health vs Individual Choice Conclusion References Further reading

Part VII: Life and Death Issues

23 Medical Decisions at the End of Life

An Ethical Framework for Treatment Decision-making Futile Treatment Ordinary and Extraordinary Treatment Killing and Allowing to Die Treating Pain and the Doctrine of Double Effect Conclusion References

24 Severely Disabled Newborns

Introduction Conceptual Issues Decision Issues Conclusion References Further reading

25 Death, Brain Death, and Persistent Vegetative State

The Concept of Brain Death and its Appeal A Critique of Brain Death What Kind of Entity Are We? Persistent Vegetative State References Further reading

26 Advance Directives

What Are Advance Directives and Why Do We Have Them? The Origins, and Limitations, of the “Living Will” Legislatively Authorized “Instruction Directives” Legislatively Authorized “Appointment Directives” Advance Directives Outside the United States Conceptual Problems and Practical Difficulties Barriers Remaining to the Effective Use of Advance Directives References Further reading

27 Voluntary Euthanasia, Suicide, and Physician-assisted Suicide

The Traditional Prejudice Killing Suicide Assisted Suicide and Euthanasia From Morality to Public Policy Conclusion References Further reading

28 The Slippery Slope Argument

An Example The Paradigmatic Form of the Argument The Appeal to a Pernicious Precedent Slopes of Reason Slopes of Unreason Factual and Moral Plausibility Appearance and Reality References

Part VIII: Resource Allocation

29 Deciding Between Patients

What Is “Greater Need” for Health Care? Longevity Should the Health-care System Maximize QALYs? QALYs and Equality The Evidence Base for QALY-informed Decisions Choosing Between Claimants Allocation and Liberation Moral Evaluation of Persons Natural Justice Utility to Society Numbers of Dependents Age and Life Expectancy Fairness and Quality of Life Conclusion References

30 Society’s Allocation of Resources for Health

Determinants of Health Who, If Anyone, Allocates Health Resources? Determining the Share of the Overall Budget To Be Devoted to Health Allocation Within the Budget for Health Health Needs and Benefits Ethical Issues in Measuring Health Benefits: Quantity and Quality of Life Ethical Issues in the Distribution of Health Benefits Other Principles of Allocation Allocation and Social Justice Democratic Choice Conclusion References Further reading

31 Is There a Right to Health Care and, If So, What Does It Encompass?

Is There a Right to Health Care? What Does a Right to Health Care Include? Choice or Consent and the Exercise of our Right to Health Care References

Part IX: Organ Donations

32 A World of Transferable Parts

Introduction Procurement From the Dead Procurement From the Living The Transition from Life to Death Conclusion References

Part X: Global Health-care Issues

33 Global Health Responsibilities

Introduction Doubts About Libertarianism Obligations Conclusions References Further reading

34 Developing World Challenges

Introduction Medical Migration and Moral Responsibility Lending Money to Developing Countries Culture and Religion Health Research and Resources Conclusions References

35 Global Pharmaceutical Markets

Introduction The Shipwreck of the Richmond and the Duty to Rescue The Ethics of Global Access to Essential Medicines Conclusion References

36 Infectious Disease

The Ethical Importance of Infectious Disease The Global Infectious Disease Status Quo: AIDS and TB Drug Resistance Limiting Liberty in Contexts of Contagion Improving Global Health References Further reading

37 AIDS as a Global Health Emergency

HIV Testing HIV Infection: Harm to Self or Harm to Others Access to Experimental Drugs and the Ethics of Research Clinical Trials Developing Preventive Vaccines Affordable Access to Life-preserving Medication HIV Infection in Health-care Professionals and Patients Final Remarks References Further reading

Part XI: Experimentation With Humans and Animals

38 Research Involving Human Beings

Introduction Fundamental Ethical Principles for Research Respect for Persons: Informed Consent Beneficence Justice Vulnerability and Exploitation Research Ethics Committees Conclusion Acknowledgments References

39 Regulating Experimentation in Research and Medical Practice

Introduction History of Experimentation on Human Beings Regulation of Human Experimentation Guidelines, Regulations and Directives to Regulate Human Experimentation Regulation of Experimentation in Surgery and Clinical Medicine Discussion References

40 Research Using Preimplantation Human Embryos

References Further reading

41 The Moral Status of Animals and Their Use As Experimental Subjects

The Moral Critique of Research on Animals The Uses of Animals in Research The Response of the Research Community to the Moral Critique of Animal Research Practical Resolution References Further reading

PART XII: Ethical Issues in the Practice of Health Care

42 Confidentiality

References

43 Truth-telling

The Clinical Encounter Medical Paternalism Re-examined Ethical Frameworks The Temptation to Deceive Different Forms of Deception Communicating Outside Medicine Character, Context, and Care References Further reading

44 Informed Consent and Patient Autonomy

The Moral Foundation The Legal Requirement for Consent in Therapeutic Settings The Exceptions References

45 Patients Doubtfully Capable or Incapable of Consent

The Standard Models of Decision-making Capacity and Surrogate Decision-making References Further reading

46 Ethics in Nursing Practice

Introduction Tracing a History of Nursing Ethics The Sociopolitical Context of Nursing and Nursing Ethics The Renewal of Ethics in Nursing: The Insufficiency of Bioethics Desired Futures Nursing Leadership in Practice and Policy through Attention Ethics Summary References

47 Global Trends in Nursing Ethics

Professional Issues Educational Issues Policy Issues Leadership Issues Specific Issues References

Part XIII: The Teaching and Practice of Bioethics

48 Ethics Committees and Ethics Consultants

Origins and Development The Functions of Ethics Committees and Ethics Consultants The Significance of Ethics Committees and Ethics Consultation for Bioethics Conclusion Acknowledgments References Further reading

49 Teaching Ethics in the Health Professions

Trends in Ethics Teaching in the Health Professions Theoretical Questions Underlying Curriculum Content Ethical Knowledge or Ethical Behavior? The Hidden Curriculum Conclusion References

Index

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