Bioethics: Principles, Issues, and Cases / Edition 3

by Lewis Vaughn

Overview

Bioethics: Principles, Issues, and Cases, Fourth Edition, explores the philosophical, medical, social, and legal aspects of key bioethical issues. Opening with a thorough introduction to ethics, bioethics, and moral reasoning, it then covers influential moral theories and the criteria for evaluating them. Integrating eighty-seven readings—ten of them new to this edition—substantive introductions to each issue, numerous classic bioethical cases, and abundant pedagogical tools, this text addresses the most provocative and controversial topics in bioethics.

Product Details

ISBN-13:	9780190250102
Publisher:	Oxford University Press
Publication date:	07/15/2016
Edition description:	Older Edition
Pages:	832
Product dimensions:	7.50(w) x 9.10(h) x 1.20(d)

About the Author

Lewis Vaughn is the author or coauthor of several textbooks, including The Power of Critical Thinking, Sixth Edition (2018), Philosophy Here and Now, Third Edition (2018), Writing Philosophy, Second Edition (2018), and Living Philosophy, Second Edition (2017).

Table of Contents

Preface xii

Part I Principles and Theories 1

Chapter 1 Moral Reasoning in Bioethics 3

Ethics and Bioethics 3

Ethics and the Moral Life 5

In Depth: Morality and the Law 7

Moral Principles in Bioethics 8

Autonomy 9

Nonmaleficence 10

Beneficence 10

Utility 11

Justice 12

Ethical Relativism 13

In Depth: Anthropology and Moral Diversity 14

Ethics and Religion 17

Moral Arguments 19

Argument Fundamentals 19

Patterns of Moral Arguments 22

Review: Valid and Invalid Argument Forms 23

In Depth: Fallacies in Moral Reasoning 24

Evaluating Premises 26

Assessing Whole Arguments 28

Obstacles to Critical Reasoning 29

Denying Contrary Evidence 30

Looking for Confirming Evidence 30

Motivated Reasoning 31

Preferring Available Evidence 32

The Dunning-Kruger Effect 33

Key Terms 34

Summary 34

Argument Exercises 35

Further Reading 36

Notes 37

Chapter 2 Bioethics and Moral Theories 38

The Nature of Moral Theories 38

Influential Moral Theories 39

Utilitarianism 40

In Depth: Utilitarianism and the Golden Rule 42

Kantian Ethics 42

Principlism 44

Natural Law Theory 45

Rawls's Contract Theory 47

Virtue Ethics 49

In Depth: Can Virtue Be Taught? 50

The Ethics of Care 50

Feminist Ethics 51

Casuistry 52

Criteria for Judging Moral Theories 53

Review: Evaluating Moral Theories: Criteria of Adequacy 54

Applying the Criteria 54

Utilitarianism 55

Kant's Theory 56

Key Terms 57

Summary 57

Further Reading 58

Notes 58

Readings 59

"Utilitarianism," John Stuart Mill 59

"The Moral Law," Immanuel Kant 62

Nicomachean Ethics Aristotle 67

"The Need for More Than Justice," Annette C. Baier 78

"Moral Saints," Susan Wolf 86

Part 2 Medical Professional and Patient 95

Chapter 3 Paternalism and Patient Autonomy 97

Shades of Autonomy and Paternalism 97

Refusing Treatment 98

In Depth: Physician Autonomy 100

Futile Treatment 100

Legal Brief: Advance Directives 101

Legal Brief: Refusing Treatment for Children on Religious Grounds 102

In Depth: CPR and DNR 103

In Depth: Moral Conflicts in Nursing 103

Classic Case File: Elizabeth Bouvia 104

Applying Major Theories 105

Key Terms 106

Summary 106

Cases for Evaluation 107

Further Reading 109

Notes 110

Readings 110

"Paternalism," Gerald Dworkin 110

"The Refutation of Medical Paternalism," Alan Goldman 120

"Why Doctors Should Intervene," Terrence F. Ackerman 126

"Autonomy, Futility, and the Limits of Medicine," Robert L. Schwartz 131

"Four Models of the Physician-Patient Relationship," Ezekiel J. Emanuel Linda L. Emanuel 136

"Confronting Death: Who Chooses, Who Controls? A Dialogue Between Dax Cowart and Robert Burt," Dax Cowart Robert Burt 146

Bouvia v. Superior Court, California Court of Appeal 156

"Fundamental Elements of the Patient-Physician Relationship," AMA Council on Ethical and Judicial Affairs 161

"Advocacy or Subservience for the Sake of Patients?" Helga Kuhse 162

Chapter 4 Truth-Telling and Confidentiality 170

Paternalism and Deception 170

In Depth: Do Patients Want the Truth? Do Physicians Tell It? 171

Confidential Truths 173

Legal Brief: Confidentiality and a Duty to Warn 174

In Depth: Truth-Telling and Cultural Diversity 175

Classic Case File: Carlos R. 176

Applying Major Theories 177

Key Terms 178

Summary 178

Cases for Evaluation 178

Further Reading 180

Notes 180

Readings 181

"On Telling Patients the Truth," Mack Lipkin 181

"Is It Ever Ok to Lie to Patients?" Shelly K. Schwartz 183

"Why Privacy Is Important," James Rachels 186

"Confidentiality in Medicine-A Decrepit Concept," Mark Siegler 192

Tarasoff v. Regents of the University of California, Supreme Court of California 195

Chapter 5 Informed Consent 200

Autonomy and Consent 200

Conditions of Informed Consent 201

In Depth; Decision-Making Capacity 203

In Depth: Two Views of Informed Consent 205

Legal Brief: Important Informed Consent Cases 206

Applying Major Theories 207

Classic Case File: Jerry Canterbury 208

Key Terms 209

Summary 209

Cases for Evaluation 210

Further Reading 212

Notes 212

Readings 212

"The Concept of Informed Consent," Ruth R. Faden Tom L. Beauchamp 212

"Informed Consent-Must It Remain a Fairy Tale?" Jay Katz 217

"Transparency: Informed Consent in Primary Care," Howard Brady 227

Canterbury v. Spence, United States Court of Appeals 234

Chapter 6 Human Research 238

The Science of Clinical Trials 239

In Depth: The Tuskegee Tragedy 240

Beneficence, Science, and Placebos 241

Science and Informed Consent 244

In Depth: Women in Clinical Trials 245

Research on the Vulnerable 246

In Depth: Why Enter a Clinical Trial? 247

Applying Major Theories 250

Key Terms 251

Summary 251

Classic Case File: The UCLA Schizophrenia Study 252

Cases for Evaluation 253

Further Reading 257

Notes 257

Readings 258

The Nuremberg Code 258

Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects, World Medical Association 259

"The Belmont Report," The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research 262

"Final Report: Human Radiation Experiments," Advisory Committee, on Human Radiation Experiments 265

"Of Mice but Not Men: Problems of the Randomized Clinical Trial," Samuel Hellman Deborah S. Hellman 271

"A Response to a Purported Ethical Difficulty with Randomized Clinical Trials Involving Cancer Patients," Benjamin Freedman 277

"Racism and Research: The Case of the Tuskegee Syphilis Study," Allan M. Brandt 281

"The Ethics of Clinical Research in the Third World," Marcia Angell 293

"Ethical Issues in Clinical Trials in Developing Countries," Baruch Brody 297

Part 3 Life and Death 303

Chapter 7 Abortion 305

Starting Point: The Basics 305

Fact File: U.S. Abortions 306

In Depth: Abortion and Public Opinion 2021 309

The Legal Struggle 310

In Depth: Abortions Performed Later in Pregnancy 311

Persons and Rights 312

In Depth: Does a Fetus Feel Pain? 315

Applying Major Theories 316

Key Terms 317

Summary 317

Classic Case File: Nancy Klein 318

Cases for Evaluation 319

Further Reading 322

Notes 322

Readings 323

"A Defense of Abortion," Judith Jarvis Thomson 323

"Why Abortion Is Immoral," Don Marquis 334

"On the Moral and Legal Status of Abortion," Mary Anne Warren 346

"Abortion and the Concept of a Person," Jane English 357

"Abortion," Margaret Olivia Little 364

"Abortion Through a Feminist Ethics Lens," Susan Sherwin 369

Roe v. Wade, United States Supreme Court 378

Planned Parenthood of Southeastern Pennsylvania v. Casey, United States Supreme Court 384

Chapter 8 Reproductive Technology 391

In Vitro Fertilization 391

Fact File: Assisted Reproduction 392

In Depth: "Savior Siblings" 395

Surrogacy 397

In Depth: IVF and Children's Future Children 398

Cloning 400

In Depth; Cloning Time Line 403

Applying Major Theories 404

Key Terms 404

In Depth: Sherri Shepherd: How Surrogacy Can Go Wrong 405

Summary 405

Classic Case File: Baby M 406

Cases for Evaluation 407

Further Reading 409

Notes 410

Readings 411

"IVF: The Simple Case," Peter Singer 411

"The Presumptive Primacy of Procreative Liberty," John A. Robertson 415

"Surrogate Mothering: Exploitation or Empowerment?" Laura M. Purdy 422

"Is Women's Labor a Commodity?" Elizabeth S. Anderson 432

"Egg Donation and Commodification," Bonnie Steinbock 445

"Cloning Human Beings: An Assessment of the Ethical Issues Pro and Con," Dan W. Brock 454

Chapter 9 Genetic Choices 466

Genes and Genomes 466

Genetic Testing 467

Gene Therapy 473

Fact File: Genetic Testing for Cancer Risk 475

Stem Cells 478

Fact File: New Developments in Gene Therapy 479

Applying Major Theories 481

Classic Case File: The Kingsburys 482

Key Terms 483

Summary 483

Cases for Evaluation 483

Further Reading 486

Notes 486

Readings 487

"Genetics and Reproductive Risk: Can Having Children Be Immoral?" Laura M. Purdy 487

"The Morality of Screening for Disability," Jeff McMahan 494

"Genetic Dilemmas and the Child's Right to an Open Future," Dena S. Davis 498

"Disowning Knowledge: Issues in Genetic Testing," Robert Wachbroit 509

"The Non-Identity Problem and Genetic Harms-The Case of Wrongful Handicaps," Dan W. Brock 513

"Is Gene Therapy a Form of Eugenics?" John Harris 518

"Genetic Enhancement," Walter Glannon 524

"Genetic Interventions and the Ethics of Enhancement of Human Beings," Julian Savulescu 529

"Germ-Line Gene Therapy," LeRoy Walters Julie Gage Palmer 538

"What Does 'Respect for Embryos' Mean in the Context of Stem Cell Research?" Bonnie Steinbock 546

Declaration on the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells, Pontifical Academy for Life 549

Chapter 10 Euthanasia and Physician-Assisted Suicide 551

Deciding Life and Death 552

Legal Brief: Euthanasia and Assisted Suicide: Major Developments 554

In Depth: Assisted Suicide: What Do Doctors Think? 555

Autonomy, Mercy, and Harm 556

In Depth: Oregon's Death with Dignity Act 558

In Depth: End-of-Life Decisions in the Netherlands 560

Applying Major Theories 560

In Depth: Physician-Assisted Suicide and Public Opinion 561

Classic Case File: Nancy Cruzan 562

Key Terms 563

Summary 563

Cases for Evaluation 564

Further Reading 567

Notes 568

Readings 568

"Death and Dignity: A Case of Individualized Decision Making," Timothy E. Quill 568

"Voluntary Active Euthanasia," Dan W. Brock 572

"When Self-Determination Runs Amok," Daniel Callahan 584

"Active and Passive Euthanasia," James Rachels 589

"Dying at the Right Time: Reflections on (Un) Assisted Suicide," John Hardwig 593

"The Philosophers' Brief," Ronald Dworkin Thomas Nagel Robert Nozick John Rawls Thomas Scanlon Judith Jarvis Thomson 604

"Legalizing Assisted Dying Is Dangerous for Disabled People," Liz Carr 613

"For Now Have I My Death' 1: The 'Duty to Die' Versus the Duty to Help the Ill Stay Alive," Felicia Ackerman 615

Vacco v. Quill, United States Supreme Court 626

Part 4 Justice and Health Care 629

Chapter 11 Dividing Up Health Care Resources 631

Health Care in Trouble 631

Fact File: U.S. Health Care 634

Theories of Justice 635

In Depth: Comparing Health Care Systems: United States, Canada, and Germany 636

A Right to Health Care 638

In Depth: Public Health and Bioethics 639

The Ethics of Rationing 640

Classic Case File: Christine deMeurers 642

Key Terms 644

Summary 644

Cases for Evaluation 645

Further Reading 648

Notes 648

Readings 649

"Is There a Right to Health Care and, If So, What Does It Encompass?," Norman Daniels 649

"The Right to a Decent Minimum of Health Care," Allen E. Buchanan 656

"Rights to Health Care, Social Justice, and Fairness in Health Care Allocations: Frustrations in the Face of Finitude," H. Tristram Engelhardt, Jr. 662

"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. 670

"Public Health Ethics: Mapping the Terrain," James F. Childress Ruth R. Faden Ruth D. Gaare, et al. 675

"Human Rights Approach to Public Health Policy," D. Tarantola S. Gruskin 686

Chapter 12 Pandemic Ethics 697

Pandemic Facts 698

When Resources Are Scarce 699

Personal Choices 702

In Depth: The Privilege of Social Distancing 704

Covid Falsehoods 705

In Depth: Against Pandemic Falsehoods 707

Key Terms 708

Summary 708

Cases for Evaluation 709

Further Reading 711

Notes 711

Readings 712

"Why Some Americans Refuse to Social Distance and Wear Masks," Michael Sandel with Colleen Walsh 712

"Fair Allocation of Scarce Medical Resources in the Time of Covid-19," Ezekiel J. Emanuel Govind Persad Ross Upshur, et al. 715

"ICU Triage: How Many Lives or Whose Lives?" Angela Ballantyne 722

Chapter 13 Race, Racial Bias, and Health Care 725

Race and Racism 725

Health Disparities and Race 731

Implicit Bias in Health Care 733

In Depth: Can Implicit Biases Be Changed? 735

Racial Profiling in Medicine 735

Key Terms 737

Summary 737

Cases for Evaluation 738

Further Reading 739

Notes 739

Reading 740

"Racial Profiling in Medicine," Michael Root 740

Appendix 749

Glossary 751

Index 755

Editorial Reviews

Reviewer: E. Ann Jeschke, BSLA, MTS (Saint Louis University)
Description: This second edition bioethics textbook is a valuable pedagogical tool for new students to the field. The book provides information on the main bioethics controversies. The initial two chapters also provide a helpful overview of the major forms of moral reasoning, moral theories, and critical thinking used in bioethics.
Purpose: The purpose is to provide an in-depth understanding of the medical, social, scientific, and legal aspects of the most salient issues in bioethics. By including a new set of readings in this updated, second edition, the author seeks to place greater emphasis on concerns affecting a broader swath of healthcare professions.
Audience: It is intended for use as a standard introductory textbook in the bioethics classroom. Although it is an introduction to the concepts of bioethics, it also serves as an excellent resource for advanced students looking for a consolidated reference. However, the book is quite theoretical in nature, and health professionals who are less versed in abstract debates and more experienced in the daily aspects of healthcare delivery may find it difficult to read and apply the concepts.
Features: An overview of basic concepts in moral philosophy begins the book before it delves into specific controversies that emerge in the field of bioethics: paternalism and patient autonomy, truth-telling and confidentiality, informed consent, human research, abortion, reproductive technology, genetic choices, euthanasia and physician-assisted suicide, and dividing healthcare resources. Each chapter includes a general overview of a specific topic as well as previously published articles highlighting different sides of the debate. To assist teachers of bioethics, the book includes extensive ancillary information on each of the nine topics, including additional reading, a list of key terms, and a variety of illustrations that help elucidate concepts.
Assessment: This book is very helpful for beginning students in bioethics, as it covers an enormous amount of intellectual territory and it offers excellent supporting materials.

Doody's Review Service

"Vaughn's Bioethics is the best product on the market. It offers an excellent variety of essays on a broad range of topics, provides excellent supplementary information on each of the topics, and does so at a cost about half that of its competitors."—David Paul, Western Michigan University

"When I think of getting bang for the students' bucks, I think of Vaughn's book."—Joseph Farrell, Loyola University Maryland

"I have been very pleased with the student learning that Bioethics has helped facilitate. Students seem to have much better comprehension of this foundational material when using Vaughn's book."—Jennifer R. Hoheisel, Camden County College

From the Publisher