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Bioethics

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Envisioning Health Care 2020

Contrary to popular opinion, one of the main problems in providing uniformly excellent health care is not lack of money but lack of knowledge—on the part of both doctors and patients. The studies in this book show that many doctors and most patients do not understand the available medical evidence. Both patients and doctors are “risk illiterate”—frequently unable to tell the difference between actual risk and relative risk. Further, unwarranted disparity in treatment decisions is the rule rather than the exception in the United States and Europe.

A Life in Bioethics

Daniel Callahan helped invent the field of bioethics more than forty years ago when he decided to use his training in philosophy to grapple with ethical problems in biology and medicine. Disenchanted with academic philosophy because of its analytical bent and distance from the concerns of real life, Callahan found the ethical issues raised by the rapid medical advances of the 1960s—which included the birth control pill, heart transplants, and new capacities to keep very sick people alive—to be philosophical questions with immediate real-world relevance.

Parents routinely turn to prenatal testing to screen for genetic or chromosomal disorders or to learn their child’s sex. What if they could use similar prenatal interventions to learn (or change) their child’s sexual orientation? Bioethicists have debated the moral implications of this still-hypothetical possibility for several decades. Some commentators fear that any scientific efforts to understand the origins of homosexuality could mean the end of gay and lesbian people, if parents shy away from having homosexual children.

Exploring the Controversy

An estimated 100 million nonhuman vertebrates worldwide--including primates, dogs, cats, rabbits, hamsters, birds, rats, and mice--are bred, captured, or otherwise acquired every year for research purposes. Much of this research is seriously detrimental to the welfare of these animals, causing pain, distress, injury, or death. This book explores the ethical controversies that have arisen over animal research, examining closely the complex scientific, philosophical, moral, and legal issues involved.

Why Single Payer Won't Work

In the battle over health care reform we can try to fashion new policies based on old ideas--or we can acknowledge today’s demographic and economic realities. In Health Care Turning Point, health policy expert Roger Battistella argues that the conventional wisdom that dominates health policy debates is out of date. Battistella takes on popular misconceptions about the advantages of single-payer plans, the role of the market, and other health policy issues and outlines a pragmatic new approach.

One of the most daunting challenges facing the new U.S. administration is health care reform. The size of the system, the number of stakeholders, and ever-rising costs make the problem seem almost intractable. But in Chaos and Organization in Health Care, two leading physicians offer an optimistic prognosis. In their frontline work as providers, Thomas Lee and James Mongan see the inefficiency, the missed opportunities, and the occasional harm that can result from the current system. The root cause of these problems, they argue, is chaos in the delivery of care.

Science, Policy, and Politics

Bioethics has become increasingly politicized over the past decade. Conservative voices dominated the debate at first, but the recent resurgence of progressivism and the application of its fundamental values (social justice, critical optimism, practical problem solving) to bioethical issues have helped correct this ideological imbalance. Progress in Bioethics is the first book to debate the meaning of progressive bioethics and to offer perspectives on the topic both from bioethicists who consider themselves progressive and from bioethicists who do not.

Bioconstitutionalism in the Genetic Age
Edited by Sheila Jasanoff

Legal texts have been with us since the dawn of human history. Beginning in 1953, life too became textual. The discovery of the structure of DNA made it possible to represent the basic matter of life with permutations and combinations of four letters of the alphabet, A, T, C, and G. Since then, the biological and legal conceptions of life have been in constant, mutually constitutive interplay--the former focusing on life’s definition, the latter on life’s entitlements.

Autonomy through Psychotherapy

One in six people worldwide will experience depression over the course of a lifetime. Many who seek relief through the healthcare system are treated with antidepressant medication; in the United States, nearly 170 million prescriptions for antidepressants were written in 2005, resulting in more than $12 billion in sales. And yet despite the dominance of antidepressants in the marketplace and the consulting room, another treatment for depression has proven equally effective: psychotherapy--in particular, cognitive behavior therapy (CBT).

A Patient-Centered Approach to Diabetes

The healthcare industry has been slow to join the information technology revolution; handwritten records are still the primary means of organizing patient care. Concerns about patient privacy, the difficulty of developing appropriate computing tools and information technology, high costs, and the resistance of some physicians and nurses have hampered the use of technology in health care. In 2009, the U.S. government committed billions of dollars to health care technology. Many questions remain, however, about how to deploy these resources.

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