Medical Ethics

The second edition of Medical Ethics introduces readers to key issues that arise within the world of bioethics, providing a strong theoretical foundation to the subject. This new edition has been greatly revised and updated; half of the selections are new to this volume, including two brand new essays on genetic enhancement, a new section on gender, race and culture, and a new essay on the Healthcare Affordability act. The volume is now introduced with an original discussion on ethical decision making. This accessible introduction provides clear insights into paternalism and autonomy; privacy and confidentiality; informed consent; gender, culture and race; euthanasia; abortion; genetic enhancement; and healthcare policy. An innovative section on health provides a strong theoretical context for the succeeding essays. Pedagogical features are included throughout, comprising case studies depicting situations related to topics discussed in the chapter′s readings and instructions on how to work–up cases into argumentative essays. A short story on organ allocation has been added, providing a vivid and lively approach for students. Many of the cases have been updated to reflect current problems, ensuring students are introduced to the very latest developments.

Notes on Contributors x Preface to the Second Edition xiii Source Credits xv 1 Ethical Reasoning 1 Michael Boylan 2 Health: The Aim of Medicine 12 Ethics, Infertility, and Public Health: Balancing Public Good and Private Choice 13 Rosemarie Tong Too Old for the Good of Health? 30 Anita Silvers Health as Self–Fulfillment 44 Michael Boylan Evaluating a Case Study: Developing a Practical Ethical Viewpoint 58 3 Physician, Nurse, and Patient: The Practice of Medicine 65 A. Paternalism and Autonomy 72 Medical Paternalism and Patient Autonomy 72 John–Stewart Gordon Rational Non–Interventional Paternalism: Why Doctors Ought to Make Judgments of What Is Best for Their Patients 83 Julian Savulescu B. Privacy and Confidentiality 90 Medical Privacy in the Age of Genomics 90 David Koepsell Ethical Issues Experienced by HIV–Infected African–American Women 98 Katharine V. Smith and Jan Russell C. Informed Consent 104 Should Informed Consent Be Based on Rational Beliefs? 104 Julian Savulescu and Richard W. Momeyer Cultural Diversity and Informed Consent 115 Ellen Agard, Daniel Finkelstein, and Edward Wallach D. Gender, Culture, and Race 120 On Treatment of Myopia: Feminist Standpoint Theory and Bioethics 120 Mary B. Mahowald Culture and Medical Intervention 131 Michael Boylan Healthcare Disparity and Changing the Complexion of Orthopedic Surgeons 146 Richard E. Grant and Michael Boylan Evaluating a Case Study: Finding the Conflicts 157 4 Issues of Life and Death 164 A. Euthanasia 167 Killing and Allowing to Die 167 Daniel Callahan Euthanasia in The Netherlands: Justifiable Euthanasia 171 Pieter V. Admiraal Why Doctors Must Not Kill 179 Leon R. Kass B. Abortion 184 An Almost Absolute Value in History 184 John T. Noonan Jr. A Defense of Abortion 190 Judith Jarvis Thomson The Abortion Debate in the Twenty–First Century 203 Michael Boylan Evaluating a Case Study: Assessing Embedded Levels 218 5 Genetic Enhancement 225 Ethical Issues in Human Enhancement 226 Nick Bostrom and Rebecca Roache Limitations on Scientific Research 251 Michael Boylan Evaluating a Case Study: Applying Ethical Issues 265 6 Healthcare Policy 271 A. The Right to Healthcare 275 There Is No “Right” to Healthcare 275 John David Lewis The Moral Right to Healthcare: Part Two 283 Michael Boylan B. The Organ Allocation Problem 298 A Review of Ethical Issues in Transplantation 298 Rosamond Rhodes Fault and the Allocation of Spare Organs 305 Brian Smart Applicants 313 Felicia Niume Ackerman C. International Public Health Policy and Ethics 324 Toward Control of Infectious Disease: Ethical Challenges for a Global Effort 324 Margaret P. Battin, Charles B. Smith, Leslie P. Francis, and Jay A. Jacobson Shaping Ethical Guidelines for an Influenza Pandemic 345 Rosemarie Tong TB Matters More 360 Michael J. Selgelid, Paul M. Kelly, and Adrian Sleigh Evaluating a Case Study: Structuring the Essay 373 Further Reading 379

Michael Boylan is Professor and Chair of Philosophy at Marymount University. He is the author and editor of 26 books, including his manifesto on social/political philosophy A Just Society (2004), and on cosmopolitanism Morality and Global Justice: Justifications and Applications (2011). Boylan was himself the focus of an edited volume, Morality and Justice: Reading Boylan’s A Just Society (2009). He has served on professional and governmental policy committees and was a fellow at the Center for American Progress and a program presenter at The Brookings Institution. He has been an invited speaker in nine countries around the world, including talks in Oxford, Cambridge, Cologne, Oslo, Dublin, Sydney, and the Sorbonne.