The Contributers

Introduction: Moral Reasoning in the Medical Context

Bioethics: Nature and Scope

Sources of Bioethical Problems and Concerns

Challenges to Ethical Theory

Moral Theories and Perspectives

Religious Ethics

"Rights-Based" Approaches

Communitarian Ethics

Feminist Ethics

Virtue Ethics

Nonmoral Considerations

Modes of Moral Reasoning

PART ONE: Foundations of the Health Professional-Patient Relationship

Section 1: Autonomy, Paternalism, and Medical Models

Hippocratic Oath

The Refutation of Medical Paternalism | Alan Goldman

Case Study: Beneficience Today, or Autonomy (Maybe) Tomorrow?

Commentary | Bernice S. Elger

Commentary | Jean-Claude Chevrolet

Why Doctors Should Intervene | Terrence F. Ackerman

Four Models of the Physician-Patient Relationship | Ezekiel J. Emanuel and Linda L. Emanuel

Section 2: Informed Consent and Truth-Telling

Case Study: Antihypertensives and the Risk of Temporary Impotence: A Case Study in Informed Consent | John D. Arras

Errors in Medicine: Nurturing Truthfulness | Françoise Baylis

Bioethics in a Different Tongue: The Case of Truth-Telling | Leslie J. Blackhall, Gelya Frank, Sheila Murphy and Vicki Mitchel

Section 3: Conflicting Professional Roles and Responsibilities

Case Study: Vitaly Tarasoff et al. v. The Regents of the University of California et al., Defendants and Respondents

Case Study: Please Don't Tell

Commentary | Leonard Fleck

Commentary | Marcia Angell

Case Study: Disclosing Misattributed Paternity | Lainie Friedman Ross

The Lessons of SARS | Ezekiel J. Emanuel

The Limits of Conscientious Objections—May Pharmacists Refuse to Fill Prescriptions for Emergency Contraception? | Julie Cantor and Ken Baum

Case Study: Why Physicians Participate in Executions | Atul Gawande

"To Comfort Always": Physician Participation in Executions | Ken Baum

Recommended Supplmentary Reading

PART TWO: Allocation, Social Justice, and Health Policy

Section 1: Justice, Health, and Health Care

Case Study: The Young Invincibles | David Amsden

An Ethical Framework for Access to Health Care | President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research

Equal Opportunity and Health Care | Norman Daniels

Growth Hormone Therapy for the Disability of Short Stature | David B. Allen

The Genome Project, Individual Differences, and Just Health Care | Norman Daniels

Foundational Ethics of the Health Care System: The Moral and Practical Superiority of Free Market Reforms | Robert M. Sade

The Realistic Moral Right to a Basic Minimum of Accessible Health Care | Paul T. Menzel

Why the United States Is Not Number One in Health | Ichiro Kawachi

Opportunity Is Not the Key | Gopal Sreenivasan

Section 2: Allocating Scarce Resources

Case Study: Bone Marrow Transplants for Advanced Breast Cancer: The Story of Christine Demeurers | Alex John London

Justice and the High Cost of Health | Ronald Dworkin

Responsibility in Health Care: A Liberal Egalitarian Approach | Alexander W. Cappelen and Ole Frithjof Norheim

Last-Chance Therapies and Managed Care: Pluralism, Fair Procedures, and Legitimacy | Norman Daniels and James Sabin

Principles for Allocation of Scarce Medical Interventions | Govind Persad, Alan Wertheimer, and Ezekiel J. Emanuel

Section 3: Organ Transplantation: Gifts Versus Markets

The Case for Allowing Kidney Sales | Janet Radcliffe-Richards, Abdallah S. Daar, Ronald D. Guttman, Raymond Hoffenberg, Ian Kennedy, Margaret Lock, Robert A. Sells, Nicholas L. Tilney, for the International Forum for Transplant Ethics

An Ethical Market in Human Organs | Charles A. Erin and John Harris

Body Values: The Case against Compensating for Transplant Organs | Donald Joralemon and Phil Cox

Section 4: Poverty, Health, and Justice Beyond National Borders

Responsibilities for Poverty-Related Illness | Thomas W. Pogge

What's Wrong with the Global Migration of Health Care Professionals? | James Dwyer

Do We Owe the Global Poor Assistance or Rectification? | Mathias Risse

Recommended Supplementary Reading

PART THREE: Forgoing Life-Sustaining Treatment and Euthanasia

Section 1: Decisional Capacity and the Right to Refuse Treatment

Case Study: State of Tennessee Department of Human Services v. Mary C. Northern

Transcript of Proceedings: Testimony of Mary C. Northern

Deciding for Others: Competency | Allen Buchanan and Dan W. Brock

Case Study: A Chronicle: Dax's Case as It Happened | Keith Burton

Confronting Death: Who Chooses, Who Controls? | Dax Cowart and Robert Burt

Section 2: Advance Directives

Enough: The Failure of the Living Will | Angela Fagerlin and Carl E. Schneider

Testing the Limits of Prospective Autonomy: Five Scenarios | Norman L. Cantor

Section 3: Choosing for Once-Competent Patients

Case Study: Erring on the Side of Theresa Schiavo: Reflections of the Special Guardian ad Litem | Jay Wolfson

Case Study: In the Matter of Claire C. Conroy

The Severely Demented, Minimally Functional Patient: An Ethical Analysis | John D. Arras

Nutrition and Hydration: Moral and Pastoral Reflections | U.S. Bishops' Pro-Life Committee

Quality of Life and Non-Treatment Decisions for Incompetent Patients: A Critique of the Orthodox Approach | Rebecca S. Dresser and John A. Robertson

The Limits of Legal Objectivity | Nancy K. Rhoden

Section 4: Choosing for Never-Competent Patients

Case Study: Termination of Life-Support for a Never-Competent Patient: The Case of Sheila Pouliot | Alicia R. Ouellette

Extreme Prematurity and Parental Rights After Baby Doe | John A. Robertson

Parental Refusal of Medical Treatment for a Newborn | John J. Paris, Michael D. Schreiber, and Michael P. Moreland

Section 5: Physician-Assisted Death

Case Study: Death and Dignity: A Case of Individualized Decision Making | Timothy E. Quill

Voluntary Active Euthanasia | Dan W. Brock

Physician-Assisted Suicide: A Tragic View | John D. Arras

Case Study: ‘To Thine Own Self Be True’: On The Loss of Integrity as a Kind of Suffering | Henri Wijsbek

Euthanasia: The Way We Do It, the Way They Do It:End-of-Life Practices in the Developed World | Margaret P. Battin

Is There a Duty to Die? | John Hardwig

"For Now Have I My Death": The "Duty to Die" versus the Duty to Help the Ill Stay Alive | Felicia Nimue Ackerman

Recommended Supplementary Reading

PART FOUR: Life, Death, and Moral Status

Section 1: The Significance of Death

The Whole-Brain Concept of Death Remains Optimum Public Policy | James L. Bernat

Personal Statement of Edmund D. Pellegrino, M.D.

An Alternative to Brain Death | Jeff McMahan

"Human Non-Person": Terri Schiavo, Bioethics, and Our Future | Wesley J. Smith

How Much of the Brain Must Be Dead? | Baruch A. Brody

Section 2: The Morality of Abortion

The Unspeakable Crime of Abortion | Pope John Paul II

On the Moral and Legal Status of Abortion | Mary Anne Warren

Why Abortion Is Immoral | Don Marquis

A Defense of Abortion | Judith Jarvis Thomson

Section 3: Embryonic Stem-Cell Research

Embryo Ethics—The Moral Logic of Stem-Cell Research | Michael J. Sandel

Acorns and Embryos | Robert P. George and Patrick Lee

PART FIVE: Reproduction

Section 1: Procreative Responsibility

Case Study: Melissa Rowland | Susan M. Haack

Melissa Rowland and the Rights of Pregnant Women | Howard Minkoff and Lynn M. Paltrow

The Rights and Responsibilities of Pregnant Women | Susan M. Haack

Reproductive Freedom and Prevention of Genetically Transmitted Harmful Conditions | Allen Buchanan, Dan W. Brock, Norman Daniels and Daniel Wikler

Prenatal Diagnosis and Selective Abortion: A Challenge to Practice and Policy | Adrienne Asch

Disability, Prenatal Testing, and Selective Abortion | Bonnie Steinbock

Case Study: Molly and Adam Nash: Using Preimplantation Genetic Diagnosis to Save a Sibling | Bonnie Steinbock

Section 2: Assisted Reproduction

The Presumptive Primacy of Procreative Liberty | John Robertson

Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation | Vatican, Congregation for the Doctrine of the Faith

What are Families For? Getting to an Ethics of Reproductive Technology | Thomas H. Murray

Case Study: Grade A: The Market for a Yale Woman's Eggs | Jessica Cohen

Payment for Egg Donation | Bonnie Steinbock

Section 3: Reproductive Cloning

The Case against Cloning-to-Produce-Children | The President's Council on Bioethics

Reproductive Cloning: Another Look | Bonnie Steinbock

Even If It Worked, Cloning Wouldn't Bring Her Back | Thomas H. Murray

Recommended Supplementary Reading

PART SIX: Experimentation on Human Subjects

Section 1: Born in Scandal: The Origins of U.S. Research Ethics

The Nuremburg Code

Case Study: The Jewish Chronic Disease Hospital Case | John D. Arras

Case Study: The Tuskegee Syphilis Experiment | James H. Jones

The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research | The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research

Section 2: The Ethics of Randomized Clinical Trials

Ethical Difficulties with Randomized Clinical Trials Involving Cancer Patients: Examples from the Field of Gynecologic Oncology | Maurie Markman

Of Mice but Not Men: Problems of the Randomized Clinical Trial | Samuel Hellman and Deborah S. Hellman

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

Section 3: Deprivation and Less Than the Best Standard of Care

Case Study: The Willowbrook Hepatitis Studies | David J. Rothman and Sheila M. Rothman

Unethical Trials of Interventions to Reduce Perinatal Transmission of the Human Immunodeficiency Virus in Developing Countries | Peter Lurie and Sidney M. Wolfe

Case Study: Children and "Minimal Risk" Research: The Kennedy-Krieger Lead Paint Study | Alex John London

AZT Trials and Tribulations | Robert A. Crouch and John D. Arras

The Ambiguity and the Exigency: Clarifying "Standard of Care" Arguments in International Research | Alex John London

Risk Standards for Pediatric Research: Rethinking the Grimes Ruling | David Wendler

Recommended Supplementary Reading

PART SEVEN: Emerging Technologies

Section 1: Behavioral Genetics

Using Genetics to Understand Human Behavior: Promises and Risks | Steven E. Hyman

My Genome, My Self | Steven Pinker

Section 2: Enhancing Humans and Remaking Nature

The Designer Baby Myth | Steven Pinker

Genetic Interventions and the Ethics of Enhancement of Human Beings | Julian Savulescu

The Case Against Perfection: What's Wrong with Designer Children, Bionic Athletes, and Genetic Engineering | Michael J. Sandel

The Intrinsic Scientific Value of Reprogramming Life | Mark A. Bedau

Section 3: Neuroethics

Neuroethics: A Guide for the Perplexed | Martha J. Farah

Recommended Supplementary Reading