Governments, health professionals, patients, research institutions, and research subjects look to bioethicists for guidance in making important decisions about medical treatment and research. And yet, argues Jonathan Baron in Against Bioethics, applied bioethics lacks the authority of a coherent guiding theory and is based largely on intuitive judgments. Baron proposes an alternative, arguing that bioethics could have a coherent theory based on utilitarianism and decision analysis. Utilitarianism holds that the best option is the one that does the most expected good.
The principle of patient autonomy dominates the contemporary debate over medical ethics. In this examination of the doctor-patient relationship, physician and philosopher Alfred Tauber argues that the idea of patient autonomy—which was inspired by other rights-based movements of the 1960s—was an extrapolation from political and social philosophy that fails to ground medicine's moral philosophy. He proposes instead a reconfiguration of personal autonomy and a renewed commitment to an ethics of care.
The provocative contention of the postmodernist and feminist essays in Ethics of the Body is that conventional bioethics is out of touch, despite its growing profile. It is out of touch with an ongoing phenomenological sense of bodies themselves; with the impact of postmodernist theory as it problematizes the certainties of binary thinking; and with a postmodern culture in which bioscientific developments force us to question what is meant by the notion of the human self.
In this book, Norman Cantor analyzes the legal and moral status of people with profound mental disabilities—those with extreme cognitive impairments that prevent their exercise of medical self-determination. He proposes a legal and moral framework for surrogate medical decision making on their behalf. The issues Cantor explores will be of interest to professionals in law, medicine, psychology, philosophy, and ethics, as well as to parents, guardians, and health care providers who face perplexing issues in the context of surrogate medical decision making.
This examination of end-of-life decision making offers a broader perspective than that found in the extensive existing literature on this topic by offering a cross-national comparison. Experts from twelve countries analyze death-related issues and policies in their respective nations, discussing such topics as health care costs, advance directives or wills, pain management, and cultural, social, and religious factors.
Is DNA technology the ultimate diviner of guilt or the ultimate threat to civil liberties? Over the past decade, DNA has been used to exonerate hundreds and to convict thousands. Its expanded use over the coming decade promises to recalibrate significantly the balance between collective security and individual freedom. For example, it is possible that law enforcement DNA databases will expand to include millions of individuals not convicted of any crime.
As our scientific and technical abilities expand at breathtaking speeds, concern that modern genetics and bioengineering are leading us to a posthuman future is growing. Is Human Nature Obsolete? poses the overarching question of what it is to be human against the background of these current advances in biotechnology. Its perspective is philosophical and interdisciplinary rather than technical; the focus is on questions of fundamental ontological importance rather than the specifics of medical or scientific practice.
Definitions of health and disease are of more than theoretical interest. Understanding what it means to be healthy has implications for choices in medical treatment, for ethically sound informed consent, and for accurate assessment of policies or programs. This deeper understanding can help us create more effective public policy for health and medicine. It is notable that such contentious legal initiatives as the Americans with Disability Act and the Patients' Bill of Rights fail to define adequately the medical terms on which their effectiveness depends.
Insurance companies routinely use an individual's medical history and family medical history in determining eligibility for life insurance; this is part of the process of medical underwriting. Insurers have also long used genetic information, often derived from family history, in underwriting. But rapid advances in gene identification and genetic testing are changing the way we look at genetic information. Should the results of genetic testing (which might identify a predisposition toward disease not related to medical history) be available to life insurance medical underwriters?
This textbook for instruction in biomedical research ethics can also serve as a valuable reference for professionals in the field of bioethics. The 149 cases included in the book are grouped in nine chapters, each of which covers a key area of debate in the field. Some of the case studies are classics, including the famous cases of the Tuskegee Syphilis Study (in which subjects with syphilis were not given treatment) and the Willowbrook hepatitis studies (in which institutionalized subjects were intentionally exposed to hepatitis).