According to Frankena, “the moral point of view is what Alison Wilde and Heather Badcock did not have.” Most of us, however, are not such extreme examples. We are capable of the moral point of view, but we fail to take the necessary time or make the required efforts. We resist pulling ourselves from other distractions to focus on the plight of others and what we might do to ameliorate their suffering. Perhaps compassion is rooted in understanding what it is (...) that connects us with others rather than what separates us, and rests on developing sufficient awareness, to internalize what our actions, or lack of them, mean in the lives of others. (shrink)

In many countries the debate over the role that physicians may play in ending life has been limited to the judiciary and other law making institutions, professional medical organizations; and academics. Because of their multidisciplinary and diverse membership, ethics committees may be a particularly appropriate venue through which these discussions can be expanded to include a much larger community. In addition, ethics committees generally act in only advisory capacities because they do not actually make decisions, so they may provide a (...) forum for open discussions in ways that the court and the medical boards cannot. (shrink)

As a medical student doing a rotation, I was feeling positive as we knocked on the door of an elderly lady who I'd seen just 2 days earlier. Even though seriously ill for many months, this patient had always lived life in her own way, refusing to go to a nursing home. It was clear that her condition had deteriorated rapidly, and the nurse informed me privately that she was dying, sooner rather than later.

Our attitudes toward aging change in that “old” depends on where you are. When I was 16, and my sister Nancy was 29, I suddenly realized, to my horror, that one of us was about to be 30. I went around saying to everyone, “Poor Nancy, she's almost 40,” because to me at that time, 30 and 40 were about the same. Later, when Nancy was 40, she said she didn't mind because, according to me, she had been 40 for (...) a decade. (shrink)

In an effort to create a mechanism for addressing a critical need of providing medicines for economically developing countries, the Chiron Corporation and the Global Alliance for TB Drug Development have entered into an innovative public-private partnership. In the following interview, Craig Wheeler discusses the origins and nature of this agreement that could set a pattern for how corporations and nonprofit organizations can work together in drug development.

In the fall of 2001, Baxter International, Inc., was faced with a crisis after more than 50 people died using Baxter dialyzers. In this interview, Harry M. Jansen Kraemer, Jr., Chairman and Chief Executive Officer of Baxter, and Sally Benjamin Young, Vice President, Communications, discuss how the company managed this emergency situation.

The failure of medical codes to provide adequate guidance for physicians' moral dilemmas points to the fact that some rules of analysis, informed by moral theory, are needed to assist in resolving perplexing ethical problems occurring with increasing frequency as medical technology advances. Initially, deontological and teleological theories appear more helpful, but critcisms can be lodged against both, and neither proves to be sufficient in itself. This paper suggests that to elude the limitations of previous approaches, a method of moral (...) decision making must be developed incorporating both coherence methodology and some independently supported theoretical foundations. Wide Reflective Equilibrium is offered, and its process described along with a theory of the person which is used to animate the process. Steps are outlined to be used in the process, leading to the application of the method to an actual case. (shrink)

Is your ethics committee developing a project that would be of interest to other committees? If so, send a brief description to Cynthia B. Cohen, Ph.D., J.D., The Hastings Center, 255 Elm Road, Briarcliff Manor, NY 10510. Does your committee have questions about a difficult case (of general interest) that you would like to see addressed? Send them to Thomasine Kushner, Ph.D., Health and Medical Sciences Program, T-7, Room 106, University of California, Berkeley, CA 94720.

Chris Shaw is the Chair of Biotechnology and Head of the Pharmaceutical Biotechnology Research Group at the University of Ulster in Northern Ireland. His concern for the unequal distribution of benefits has prompted him to take a leading role in developing partnership models for scientists doing research in underdeveloped countries.

While Eastern and Western cultures agree that life is sacred, and that morality demands its protection, they differ sharply as to how the term life is to be interpreted, and therefore what prohibitions against killing should entail. l examine some of these conflicting perspectives, explore life as an ambiguous term, and suggest are interpretation of the concept, which permits moral ruIes against killing to be applied more rationally.

This book serves as a tool to help patients and families deal rationally with the perplexing and often irrational world of healthcare. It covers the topics and addresses the challenges that experts in a variety of healthcare fields believe to be the most vital to meeting the challenges of decision-making when people feel most vulnerable. With contributions from leading healthcare specialists, Surviving Health Care: A Manual for Patients and their Families examines a wide array of topics, including advance planning for (...) healthcare, medical emergencies, genetic testing, pain management, and care of elders. It is a unique resource that aims above all to help patients reach their best healthcare decisions. (shrink)

As duplicating techniques in art become more sophisticated and less easily detectable, Concern mounts as to what the status of these aesthetic clones should be. Can they be considered works of art; and to what extent do they share in the value of the original? this paper examines these questions, Using examples from audio and visual arts, And concludes that talk of an original and its copies has to do with the art market and not with the creative process. The (...) implication for aesthetic clones is that they are no different from their originals as far as aesthetic value is concerned. (shrink)

Baby Theresa, in her short 9-day life, cast a national spotlight on the question “Should anencephalic infants be used for organ procurement?” In denying her parents′ wishes to donate the baby's healthy organs to other children in need of kidneys, liver, heart, and lungs, Circuit Court Judge Estella Moriarty said, “I cannot authorized someone to take your baby's life, however short, however unsatisfactory, to save another child.”In citing a1988 Florida statute that does not allow a person to be declared dead (...) while any part of the brain is functioning, Judge Moriarty ruled that doctors could only remove organs not vital to Theresa Ann's life. As the baby slowly died, so too did her vital organs. (shrink)

The existing literature in medical ethics does not serve the practical needs of medical students and trainees very well. Medical students or junior doctors often have their own set of ethical concerns and the dilemmas that arise are generally beyond their direct control. The editors have addressed the gap in the literature by compiling a series of case studies from around the world and inviting an international team of leading ethicists and clinicians to comment on them. This volume includes over (...) 80 actual cases that cover the range of possible problems a medical trainee may encounter on the ward. (shrink)

According to Frankena, “the moral point of view is what Alison Wilde and Heather Badcock did not have.” Most of us, however, are not such extreme examples. We are capable of the moral point of view, but we fail to take the necessary time or make the required efforts. We resist pulling ourselves from other distractions to focus on the plight of others and what we might do to ameliorate their suffering. Perhaps compassion is rooted in understanding what it is (...) that connects us with others rather than what separates us, and rests on developing sufficient awareness, to internalize what our actions, or lack of them, mean in the lives of others. (shrink)

Biology has been advancing with explosive pace over the last few years and in so doing has raised a host of ethical issues. This book, aimed at the general reader, reviews the major advances of recent years in biology and medicine and explores their ethical implications. From birth to death the reader is taken on a tour of human biology - covering genetics, reproduction, development, transplantation, aging, dying and also the use of animals in research and the impact of human (...) populations on this planet. In each chapter there is a sketch of a field's most recent scientific advances, combined with discussions of the ethical and moral principles and implications for social frameworks and public policy raised by those advances. Anybody interested or concerned about the ethical dilemmas caused by advances in science and medicine should read this book. (shrink)

New beginnings give us the opportunity to do better “the next time.” In the rush to welcome the new millennium, it is fitting to take time to look more thoughtfully at issues not adequately covered in decades past. Robert Frost's musing about less traveled roads gives poetic life to the theme of this CQ Special Section, exploring some of the all too unknown territory between doctors and patients.

From reason to practice in bioethics brings together original contributions from some of the world's leading scholars in the field of bioethics. With a particular focus on, and critical engagement with, the influential work of Professor John Harris, the book provides a detailed exploration of some of the most interesting and challenging philosophical and practical questions raised in bioethics.

A profoundly inspiring yet practical guide to well-being from one of modern Judaism's most beloved sages.As a congregational rabbi for half a century and the bestselling author of When Bad Things Happen to Good People and twelve other books on faith, ethics, and how to translate the timeless wisdom of religious thought into dealing with everyday challenges, Harold Kushner knows a thing or two about living a good life. In this compassionate new work, Kushner distills nine essential lessons (...) from the sum of his teaching, study and experience, offering a lifetime's worth of spiritual food for thought, pragmatic advice, inspiration for better living, and strength for trying times. With vital, original insights into everything from belief ("there is no commandment in Judaism to believe in God"), to conscience (the Garden of Eden story as you've never heard it), to mercy ("forgiveness is a favor you do yourself, not a favor to the person who offended you"), grounded in Kushner's brilliant readings of Scripture, history and popular culture, Nine Essential Things I've Learned About Life is a capstone addition to Kushner's oeuvre. (shrink)

This title is playful, of course. It is designed merely to attract curiosity and attention … It dates back to a childhood game of which I have forgotten both rules and stakes. An imaginary sovereign was roused from his indifference and responded with an approximate repetition of Marie-Antoinette's suggestion that if the people were hungry, food should be thrown to them. I took such caricatures of kings as anti-models, replacing bread with symbols. Now we are all too disturbed, individually and (...) collectively, by the economic discomfort which is a generalized hunger and, in too many parts of the world and - not only in the third world - by actual famines, not to be aware, on a daily basis, of the responsibility it is to cultivate and transmit to others substance which is purely symbolic. Certain statistics, which now form part of our daily life, are capable of discrediting definitively the ivory tower which our universities are accused of representing, or of having represented in the past. In my own country, Canada, one child in five lives in poverty. The economic worth of the poorest forty-eight countries in the world is equal to the combined wealth of the ten richest individuals. There were twenty million refugees in 1997. One billion two hundred million human beings are short of fresh water this year, etc. This type of figure is, sadly, all too familiar. And it is a case of preaching to the converted to assert the extent to which culture, education and all their constituent disciplines are nourishment of a different order to physical food, because intellectual work is genuine work, providing a living for those who work at it professionally, and above all also those who benefit from its immediate and continuing fruits - i.e. ideally, the whole of society, and in all countries. In this respect - and this is implicit, but through depending habitually on what is implicit nothing is ever sufficiently explicit - it is generally acknowledged (thanks to UNESCO in particular) to what extent the development of economic resources is linked with the advancement and communication of knowledge, on a scale which is regional as well as national, within cities, rural communities, families. (shrink)

Now that the age-old dream, which never materialized, of a universal language has evaporated, we note that English is in the process of becoming if not the universal at least an omnipresent language. In many multilingual countries it has become the language of communication. Globally it is imposing itself as the language of business, aviation and scientific research. Is this a pure benefit for humanity, or does it conceal risks or even dangers? Is the spreading of English a secondary effect (...) of Americanization? Is linguistic diversity being sacrificed? Only if the countries affected submit to linguistic and cultural homogenization. The ideal - which remains within reach - would be to accept English as a practical tool of communication without ceasing to strive for the maintenance and strength of other languages in symbiosis with their own cultures. (shrink)

Social inclusion/exclusion involves just/unjust social relations and social structures enabling or constraining opportunities for participation and health. In this paper, social inclusion/exclusion is explored as a dialectic. Three discourses – discourses on recognition, capabilities, and equality and citizenship – are identified within Canadian literature. Each discourse highlights a different view of the injustices leading to social exclusion and the conditions supporting inclusion and social justice. An Integrated Framework for Social Justice that incorporates the three discourses is developed and used to (...) critique the dominant focus on distributive justice within foundational Canadian nursing documents. We propose a broader conceptualization of social (in)justice that includes both relational and structural dimensions. Opportunities for multilevel interventions to promote social justice are identified. This framework is congruent with nursing's moral imperative to promote health equity and with the multiple roles played by nurses to promote social justice in everyday practice. (shrink)