Medical Ethics: Accounts Of Ground-breaking Cases

Cover......Page 1
Title......Page 2
Copyright......Page 3
Contents......Page 11
Preface......Page 4
Giving Reasons......Page 22
Universalization......Page 23
Reasonableness......Page 24
Slippery Slope......Page 25
Straw Man/Red Herring......Page 26
Appeal to Authority......Page 27
Equivocation......Page 28
Moral Relativism......Page 29
Utilitarianism......Page 30
Problems of Utilitarianism......Page 31
Kantian Ethics......Page 32
The Ethics of Care......Page 33
Natural Law......Page 34
Rawls' Theory of Justice......Page 36
Four Principles of Bioethics......Page 37
The Case of Elizabeth Bouvia......Page 40
The Legal Battle: Refusing Sustenance......Page 41
The Case of Larry McAfee......Page 46
Greece and Rome......Page 48
Philosophers on Voluntary Death......Page 49
Easy to Kill Oneself?......Page 52
Rationality and Competence......Page 53
Autonomy......Page 54
Social Prejudice and Physical Disabilities......Page 55
Structural Discrimination Against the Disabled......Page 56
Disability Culture......Page 57
Discussion Questions......Page 58
Holland......Page 59
Jack Kevorkian......Page 60
Dr. Pou's Case, Continued......Page 62
Oregon's Legalization......Page 63
Background: Ancient Greece and the Hippocratic Oath......Page 64
The Nazis and "Euthanasia"......Page 65
Recent Legal Decisions......Page 67
Killing Is Always Wrong......Page 68
Killing vs. Letting Die......Page 69
Relief of Suffering......Page 70
Patient Autonomy......Page 71
The Slippery Slope......Page 72
Inefficient Means......Page 74
The Roles of Physicians......Page 75
Cries for Help......Page 76
Anna Pou, Again: Hero or Villain?......Page 77
Further Reading......Page 78
Discussion Questions......Page 79
The Quinlan Case......Page 80
Pulling the Plug or Weaning from a Ventilator?......Page 83
The Cruzan Case......Page 84
The Terri Schiavo Case......Page 87
Enter Lawyers and Politicians......Page 88
What Schiavo's Autopsy Showed......Page 91
Standards of Brain Death......Page 92
Chances of Regaining Consciousness from Coma and PVS......Page 93
Compassion and Its Interpretation......Page 96
Nagging Questions......Page 97
Some Distinctions......Page 98
The Schiavo Case, Bioethics and Politics......Page 101
Discussion Questions......Page 102
Kenneth Edelin's Controversial Abortion......Page 104
Abortion and the Bible......Page 108
The Experience of Illegal Abortions......Page 110
1973: Roe v. Wade......Page 111
Personhood......Page 112
Personhood as a Gradient......Page 113
The Deprivation Argument: Marquis and Quinn on Potentiality......Page 114
Viability......Page 115
The Argument from Marginal Cases......Page 116
Feminist Views......Page 117
A Culture of Life or a Culture of Death?......Page 118
Abortion and Gender Selection......Page 119
Anti-abortion Protests and Violence......Page 120
Fetal Tissue Research......Page 121
Maternal versus Fetal Rights......Page 122
Viability......Page 123
The Supreme Court Fine-Tunes Roe v. Wade......Page 124
Further Reading......Page 125
Discussion Questions......Page 126
The Octamom and the Gosselins......Page 127
Background: Louise Brown, The First Test Tube Baby......Page 128
Harm to Research from Alarmist Media......Page 129
Sperm and Egg Transfer......Page 130
Freezing Gamete Material......Page 132
Payment for Assisted Reproduction: Adoption......Page 133
Paid Surrogacy: The Baby M and Jaycee Cases......Page 134
Multiple Births: Before the Octamom and Gosselins......Page 135
Older Parents......Page 136
Unnatural......Page 137
Physical Harm to Babies Created in New Ways......Page 139
Paradoxes About Harm and Reproduction......Page 140
Wronging versus Harming......Page 141
Harm by Not Knowing One's Biological Parents?......Page 142
Screening for Genetic Disease: A New Eugenics?......Page 143
Designer Babies?......Page 144
Assisted Reproduction Worldwide......Page 145
Time to Regulate Fertility Clinics?......Page 146
Discussion Questions......Page 147
Historical Background of Embryonic Research......Page 149
Two Important Cases......Page 150
History: Embryo Research, Cloning, and Stem Cells......Page 151
Ethical Issues Involving Embryos in Research......Page 156
Slippery Slopes......Page 157
The Interest View......Page 158
Embryos and Respect......Page 159
My Tissue......Page 160
Reproductive Cloning: Myths about Cloned Persons......Page 161
The Right to a Unique Genetic Identity......Page 162
The Right to an Open Future......Page 163
Abnormalities......Page 164
Good of the Child......Page 165
Stronger Genetic Connection......Page 167
Liberty......Page 168
Links Between Embryonic and Reproductive Cloning......Page 169
Discussion Questions......Page 170
1971: The Johns Hopkins Cases......Page 171
1970s: Pediatric Intensivists Go Public......Page 172
1981: The Mueller Case: Conjoined Twins......Page 173
1982: The Infant Doe Case......Page 174
1982–1986: The Baby Doe Rules......Page 175
1983–1984: The Baby Jane Doe Case......Page 176
1983–1986: Baby Jane's Case in the Courts......Page 177
Follow-up on Baby Jane Doe......Page 178
Media Ethics and Bias......Page 180
Personal versus Public Cases......Page 181
Abortion versus Infanticide......Page 182
Personhood of Impaired Neonates......Page 183
Degrees of Defect......Page 184
Wrongful Birth versus Wrongful Life......Page 186
1992: The Americans with Disabilities Act (ADA)......Page 187
The Strength of Disability Advocates......Page 188
Further Reading......Page 189
Discussion Questions......Page 190
The Animal Liberation Front and Gennarelli's Research......Page 191
Evaluating the Philadelphia Study......Page 193
PETA and Edward Taub's Research on Monkeys......Page 194
The Law and Animal Research......Page 195
Numbers and Kinds of Animals in Research......Page 196
Descartes on Animal Pain......Page 197
Philosophy of Mind and Ethics......Page 198
Peter Singer on Speciesism......Page 199
Tom Regan on Animal Rights......Page 200
Why We Need Animals in Research: The Official View......Page 202
Critiquing the Official View......Page 203
Chimpanzees and Research......Page 204
Discussion Questions......Page 205
Nazi Medical Research......Page 207
Josef Mengele......Page 208
Questionable American Research......Page 209
Nature and History of Syphilis......Page 211
The Racial Environment......Page 212
A Study in Nature Begins......Page 213
Spinal Taps and Deception......Page 214
Revelation of the Study to the World......Page 215
Racism......Page 217
Harm to Subjects......Page 218
Effects on Subjects' Families......Page 219
HIV Prevention in Africa: Another Tuskegee Study?......Page 220
The Krieger Lead Paint Study......Page 222
Financial Conflicts and Twenty-First-Century Research......Page 223
Toward International Standards of Research Ethics......Page 224
The Collaborative Model......Page 225
The Death of Jesse Gelsinger......Page 226
Discussion Questions......Page 228
The First Heart Transplant......Page 229
The Post-Transplant Era: "Surgery Went Nuts"......Page 232
Barney Clark's Artificial Heart......Page 233
The Implant......Page 234
Post-Clark Implants......Page 236
Face Transplants......Page 238
The Desire to Be First and Famous......Page 240
Concerns about Criteria of Death......Page 242
Quality of Life......Page 243
Expensive Rescue versus Cheap Prevention......Page 245
Real Informed Consent?......Page 246
Further Reading......Page 247
Discussion Questions......Page 248
The God Committee and Artificial Kidneys......Page 249
Shana Alexander Publicizes the God Committee; Starts Bioethics......Page 251
The End-Stage Renal Disease Act (ESRD)......Page 252
Supply and Demand of Donated Organs......Page 253
Social Worth......Page 254
Personal Responsibility for Illness and Expensive Resources......Page 255
Kant and Rescher on Just Allocation......Page 256
Wealth, Celebrities, Justice, and Waiting Lists for Organs......Page 257
Retransplants......Page 259
The Rule of Rescue......Page 260
Sickest First, UNOS, and the Rule of Rescue......Page 261
Living Donors......Page 262
Costs and the Medical Commons......Page 264
Non-Heart-Beating Organ Transplantation......Page 265
The God Committee, Again......Page 267
Discussion Questions......Page 268
1984: Baby Fae......Page 270
1987: Baby Gabriel and Paul Holc......Page 272
1992: Baby Theresa......Page 274
1993: The Lakeberg Case: Separating Conjoined Twins......Page 275
Use of Animals as Resources for Humans......Page 276
Alternative Treatments?......Page 277
Babies as Subjects of Research......Page 278
Informed Consent......Page 279
The Media......Page 280
Therapy or Research?......Page 281
Ethics and Terminology: Infants as "Donors"......Page 283
Anencephalics and Brain Death......Page 284
Costs and Opportunity Costs......Page 286
Discussion Questions......Page 287
David Reimer......Page 288
Intersex People......Page 291
Congenital Adrenal Hyperplasia......Page 292
Fetal Dex......Page 293
What Is Normal and Who Defines It?......Page 294
Ending the Shame and Secrecy......Page 295
Transgender/Intersex and Civil Rights......Page 296
An Alternative, Conservative View......Page 297
Medical Exceptions......Page 298
Further Reading......Page 299
Discussion Questions......Page 300
The Case of Joyce Brown......Page 301
The Legal Conflict......Page 302
Ideology and Insanity......Page 305
Patients' Rights......Page 306
Legal Victories for Psychiatric Patients......Page 307
Deinstitutionalization......Page 308
Violence and the Mentally Ill Homeless in the Cities......Page 309
Paternalism, Autonomy, and Diminished Competence......Page 310
Homelessness and Commitment......Page 311
Psychiatry and Commitment......Page 312
Suffering and Commitment: Benefit and Harm......Page 313
Housing for the Mentally Ill as an Ethical Issue......Page 314
Mass Shootings and the Mentally Ill......Page 315
Discussion Questions......Page 316
Case 1: Angelina Jolie and Genetic Testing for Cancer......Page 317
Case 2: Nancy Wexler and Huntington's Disease......Page 318
The Eugenics Movement......Page 320
Case 3: Testing for Diabetes......Page 321
Case 4: Testing for Alzheimer's Disease......Page 323
Testing as Self-Interest......Page 324
Testing Only to Hear Good News......Page 325
Testing as a Duty to One's Family......Page 326
Testing One's Family by Testing Oneself......Page 327
Personal Responsibility for Disease......Page 328
Preventing Suicide by Not Knowing......Page 329
Testing Only with Good Counseling......Page 330
Premature Announcements and Over Simplifications......Page 331
Caveat Emptor: Making Money from Genetic Testing......Page 332
Preventing Genetic Disease: Final Thoughts......Page 333
Further Reading......Page 334
Discussion Questions......Page 335
Background: Epidemics, Plagues, and AIDS......Page 336
A Brief History of AIDS......Page 337
AIDS and Ideology......Page 338
Transmission of HIV and Testing for HIV......Page 340
Kimberly Bergalis's Case......Page 341
Homosexuality......Page 342
Stopping the Worldwide Spread of HIV: Five Views......Page 343
Educational Prevention......Page 345
Feminism......Page 346
Triage......Page 347
Structuralism......Page 348
Replies and Rebuttals......Page 349
Conclusion......Page 352
Discussion Questions......Page 353
Rosalyn Schwartz......Page 354
1962 to Present: Canada......Page 355
The American Medical System: 1962–2012......Page 356
1965: Medicaid Begins......Page 357
Tricare and VA Hospitals......Page 358
1993–1994: Clinton's Health Care Security Bill......Page 359
1962–2012: Coverage at Work through Private Plans......Page 360
Blue Cross/Blue Shield and Kinds of Ratings......Page 361
Oregon, Vermont, and Massachusetts Cover Everyone......Page 362
2010: The Patient Protection and Affordable Care Act......Page 363
Opposing the ACA #1: Illegal Immigrants......Page 364
Favoring the ACA #1: Illegal Immigrants......Page 365
Opposing the ACA #2: Federal Bureaucracy Is Inefficient......Page 366
Opposing the ACA #3: Government Cannot Make Medical Finance Rational......Page 367
Opposing the ACA #4: Health Care Is Not a Right......Page 368
Favoring the ACA #4: Minimal Health Care Is a Right......Page 369
Opposing the ACA #5: Health Care Is Not a Right......Page 371
Favoring the ACA #5: Costs Can Be Controlled......Page 373
Opposing the ACA #6: Intergenerational Injustice......Page 374
Discussion Questions......Page 375
19. Ethical Issues in Medical Enhancement......Page 377
What Counts as an Enhancement?......Page 378
An Arms Race......Page 379
Inauthentic......Page 380
Cheating......Page 381
Not Dangerous......Page 383
The Role of Physicians......Page 384
Further Reading......Page 385
Discussion Questions......Page 386
NOTES......Page 388
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