American healthcare -- Bioterror and bioart -- State of emergency -- Licensed to torture -- Hunger strikes -- War -- Cancer -- Drug dealing -- Toxic tinkering -- Abortion -- Culture of death -- Patient safety -- Global health -- Statue of security -- Pandemic fear -- Bioidentifiers -- Genetic genocide.

The use of antibiotics by one person can profoundly affect the welfare of other people. I will argue that efforts to combat antimicrobial resistance generate a global collective action problem that only a well-designed international treaty can overcome. I begin by describing the problem of resistance and outlining some market-friendly policy tools that participants in a global treaty could use to control the problem. I then defend the claim that these policies can achieve their aim while protecting individual liberty and (...) state autonomy. Finally, I offer some suggestions for a treaty, drawing lessons from the failure of the Kyoto Protocol on climate change and the success of the Montreal Protocol on ozone depletion. (shrink)

In the long history of moral theory, non-human animals—hereafter, just animals—have often been neglected entirely or have been relegated to some secondary status. Since its emergence in the early 19th century, utilitarianism has made a difference in that respect by focusing upon happiness or well-being (and their contraries) rather than upon the beings who suffer or enjoy. Inevitably, that has meant that human relations to and use of other animals have appeared in a different light. Some cases have seemed easy: (...) once admit that the interests of animals matter and there can be little hesitation in condemning their cruel treatment. Among the more difficult cases has been the bearing of utilitarianism upon the use of animals in various kinds of research where, though the animals might suffer, there were believed to be prospects of great human benefit and where no cruel or malicious motives need be involved. What I shall provide in the current paper is an extended discussion of the bearing of utilitarianism upon practices of animal research. Since such practices have attracted both utilitarian criticism and defense, this will require the examination of arguments on both sides, including consideration of the human benefits, the animal costs, and the ways in which the one can be weighed against the other. (shrink)

The concept of human dignity is increasingly invoked in bioethical debate and, indeed, in international instruments concerned with biotechnology and biomedicine. While some commentators consider appeals to human dignity to be little more than rhetoric and not worthy of serious consideration, the authors of this groundbreaking new study give such appeals distinct and defensible meaning through an application of the moral theory of Alan Gewirth.

Policymakers, employers, insurance companies, researchers, and health care providers have developed an increasing interest in using principles from behavioral economics and psychology to persuade people to change their health-related behaviors, lifestyles, and habits. In this article, we examine how principles from behavioral economics and psychology are being used to nudge people (the public, patients, or health care providers) toward particular decisions or behaviors related to health or health care, and we identify the ethically relevant dimensions that should be considered for (...) the utilization of each principle. (shrink)

In this paper, I critically summarize John Cartwrtight’s Evolution and Human Behavior and evaluate what he says about certain moral implications of Darwinian views of human behavior. He takes a Darwinism-doesn’t-rock-the-boat approach and argues that Darwinism, even if it is allied with evolutionary psychology, does not give us reason to be worried about the alterability of our behavior, nor does it give us reason to think that we may have to change our ordinary practices and views concerning free-will and moral (...) responsibility. In response, I contend that Darwinism, when it is allied with evolutionary psychology, makes for a more potent cocktail than Cartwright suspects. (shrink)

General Practice and Ethics explores the ethical issues faced by general physicans in their everyday practice, addressing two central themes: the uncertainty of outcomes and effectiveness in general practice and the changing pattern of general practitioners' responsibilities.

"Carl Elliott always writes intriguing essays at the intersection between ethics, medicine, and general philosophy, so it is a real pleasure to have a new ...

This book is a survey of practical moral issues applying the Middle Way (as developed in 'A Theory of Moral Objectivity') as the basis of 'Buddhist' Ethics. No appeal is made to Buddhist traditions or scriptures, but instead the Middle Way is applied consistently as a universal philosophical and practical principle to suggest the direction of resolutions to moral debates. Practical ethics topics covered include sexual ethics, medical ethics, environmental ethics, animals, violence, the arts, scientific issues and political ethics.

The intriguing issue of pain and suffering in patients with disorders of consciousness (DOCs), particularly in Unresponsive Wakefulness Syndrome/Vegetative State (UWS/VS) and Minimally Conscious State (MCS), is assessed from a theoretical point of view, through an overview of recent neuroscientific literature, in order to sketch an ethical analysis. In conclusion, from a legal and ethical point of view, formal guidelines and a situationist ethics are proposed in order to best manage the critical scientific uncertainty about pain and suffering in DOCs (...) and ensure the best possible care for the patient. (shrink)

This paper critically examines the predominant arguments that have been proposed either in favour or against non-benefit medical research with human subjects incapable of informed consent. It is argued that none of the arguments succeeds, while acknowledging that such research is necessary.

This volume illustrates the central importance of diversity of human values throughout healthcare.

What role should religion play in a religiously pluralistic liberal society? Public bioethics unavoidably raises this question in a particularly insistent fashion. As the 20 papers in this collection demonstrate, the issues are complex and multifaceted. The authors address specific and highly contested issues as assisted suicide, stem cell research, cloning, reproductive health, and alternative medicine as well as more general questions such as who legitimately speaks for religion in public bioethics, what religion can add to our understanding of justice, (...) and the value of faith-based contributions to healthcare. Christian (Catholic and Protestant), Jewish, Islamic, and Buddhist viewpoints are represented. The first book to focus on the interface of religion and bioethics, this collection fills a significant void in the literature. (shrink)

Topic Read 01. Jan 09 Introduction/Pretest/Critical Thinking 02. Jan 11 Ethical Theory Homepage 03. Jan 16 More about Ethical Theory 04. Jan 18 Euthanasia CC-2 05. Jan 23 More about Euthanasia CC-4 06. Jan 25 Birth Defects CC-9 07. Jan 30 Euthanasia/Birth Defects Symposium 08. Feb 01 Animals as Research Subjects CC-10 09. Feb 06 More about Animals as Research Subjects 10. Feb 08 Humans as Research Subjects CC-11 11. Feb 13 Organ/Tissue Donation & Xenografts CC-13/14 12. Feb 15 Research (...) Symposium 13. Feb 20 MID-TERM EXAM 14. Feb 22 Sexual Orientation/Discrimination 15. Feb 27 Human Sexuality/Sexual Ethics Homepage 16. Mar 01 Human Sexuality Symposium 17. Mar 06 Pharmaceuticals & Empiricism 18. Mar 08 Recreational Drugs 19. Mar 20 HIV/AIDS CC-17 20. Mar 22 Contraception 21. Mar 27 Drugs/AIDS Symposium 22. Mar 29 Abortion CC-5 23. Apr 03 More about Abortion 24. Apr 05 Abortion Symposium 25. Apr 10 Assisted Reproduction CC-6 26. Apr 12 Cloning and Stem Cell Research CC-7/8 27. Apr 17 Cloning and Stem Cell Research Symposium 28. Apr 19 LATE-TERM EXAM 29. Apr 24 Medicare/HMO CC-18 30. Apr 26 Medicare/HMO Symposium.. (shrink)

This book is for those interested in an extensive review of the field of bioethics. It is for philosophers who wish to understand the core conceptual issues in health care ethics, and for bioethicists who wish to better understand classical problems in philosophy that have a bearing on health care ethics. The Handbook of Bioethics: Taking Stock of the Field from a Philosophical Perspective: -presents a comprehensive survey of bioethics in one volume; -has 27 of the most prominent scholars in (...) the field take stock of the issues they helped define; -contains essays that outline areas where future research is needed; -identifies potential areas for fruitful collaboration between traditional philosophers and bioethicists; -is an ideal text for graduate or upper level undergraduate courses. (shrink)

A growing number of medical professionals claim a right of conscience, a right to refuse to perform any professional duty they deem immoral—and to do so with impunity. We argue that professionals do not have the unqualified right of conscience. At most they have a highly qualified right. We focus on the claims of pharmacists, since they are the professionals most commonly claiming this right.

A compilation of 16 papers selected from two UNESCO Bangkok Bioethics Roundtables, with research and policy dialogues from different countries in the region. It includes papers on informed consent, ethics committees, communication, organ transplants, traditional medicines and sex selection.

We are unlikely to stop seeking pleasure, as this would prejudice our health and well-being. Yet many psychoactive substances providing pleasure are outlawed as illicit recreational drugs, despite the fact that only some of them are addictive to some people. Efforts to redress their prohibition, or to reform legislation so that penalties are proportionate to harm have largely failed. Yet, if choices over seeking pleasure are ethical insofar as they avoid harm to oneself or others, public health strategies should foster (...) ethical choice by moving beyond current risk management practices embodied in the harm reduction movement. The neuroscience of pleasure has much to offer neuroethics and public health strategies. Distinguishing between ‘wanting’ and ‘liking’ fosters new understandings of addiction. These hold promise for directing the search for pharmacotherapies which prevent addiction and relapse or disrupt associated neuromechanisms. They could inform new research into creating lawful psychoactive substances which give us pleasure without provoking addiction. As the health and well being of human and other animals rests upon the experience of pleasure, this would be an ethical objective within public health strategy. Were ethical and neurobiological obstacles to ending addiction to be overcome, problems associated with excessive consumption, the lure of unlawful psychoactive substances and the paucity of lawful means to achieve pleasurable altered states would remain. Non-addictive designer drugs, which reliably provided lawful access to pleasures and altered states, would ameliorate these public health concerns insofar as they fostered citizens’ informed, ethical choices according to a neurobiological taxonomy of pleasures. (shrink)

" This book has been carefully crafted in that spirit.

All persons, while different from one another, have the same value: this is the author's relatively uncontroversial starting point. Her end point is not uncontroversial: an ideal of justice as human flourishing, based on each person's unique set of capabilities. Because the book's focus is women's health care, gender justice, a necessary component of justice, is central to examination of the issues. Classical pragmatists and feminist standpoint theorists are enlisted in support of a strategy by which gender justice is promoted. (...) Two features of the book are unique: (1) the topics presented cover the entire life span of women, not just those related to reproduction; (2) a range views about moral status are applied not only to fetuses but also to individuals already born. Attention to these features is intended to facilitate ethical consistency or moral integrity and respect for those who hold different moral views. While delineating and defending the book's perspective, the first section provides an overview of bioethics, critiques prevalent approaches to bioethics and models of the physician-patient relationship, and sketches distinguishing aspects of women's health care that are prevalently neglected. Positions about moral status are also presented. The second section identifies topics that are indirectly as well as directly related to women's health, such as domestic violence and caregiving. Brief cases illustrate variables relevant to each topic. Empirical and theoretical considerations follow each set of cases; these are intended to precipitate more expansive and critical examination of the issues raised. The last section is devoted to an egalitarian ideal that may be pursued through an ethic of virtue or supererogation rather than obligation. By embracing this ideal, according to the author, moral agents support a more demanding level of morality than guidelines or laws require. (shrink)

In apparent conflict with the popular conception of veterinarians as animals' best friends, the Veterinarian's Oath, as well as its clarifying Principles of Animal Welfare, imply that animal welfare is entirely derivative from human welfare. This article calls for an explicit alignment of the Oath and Principles with the priority of nonhuman animals.

Various commentaries on the use of animals in biomedical research and related.

Timely and provocative essays on bioethical questions brought to the forefront by the bioterrorist threat.

This book offers a thorough reflection on the relationship between autonomy and paternalism, and argues that, from both theoretical and practical angles, the ...

This volume explores the focus of interest in community and the emerging theoretical opposition between communitarianism and liberalism, including the practical, theoretical and ethical issues that relate to community in the healthcare professions.

This book shows how environmental decline relates to human health and to health care practices in the U.S. and other industrialized countries. It outlines the environmental trends that will strongly affect health, and challenges us to see the connections between ways of practicing medicine and the very environmental problems that damage ecosystems and make people sick. In addition to philosophical analysis of the converging values of bioethics and envrionmental ethics, the book offers case studies as well as a number of (...) practical suggestions for moving health care toward sustainability. (shrink)

This new series of books brings thoughtful, biblically informed perspectives to contemporary issues in bioethics.

The conviction that high self-esteem is beneficial both to the individual and to society in general has been pervasive both in academia and in popular culture. If it is indeed beneficial, it is a prime candidate for pharmacological enhancement. There is evidence to suggest, however, that the benefits of high self-esteem to the individual have been exaggerated; and that there are few - if any - social benefits. With this evidence in mind, I consider in what ways high self-esteem is (...) valuable, and suggest how enhancement could play a role in maximising its valuable aspects. (shrink)

This paper examines the morality of kidney markets through the lens of choice, inequality, and weak agency looking at the case for limiting such markets under both non-ideal and ideal circumstances. Regulating markets can go some way to addressing the problems of inequality and weak agency. The choice issue is different and this paper shows that the choice for some to sell their kidneys can have external effects on those who do not want to do so, constraining the options that (...) are now open to them. I believe that this is the strongest argument against such markets. (shrink)

Critical review of Glenn McGee, ed., Pragmatic Bioethics.

Along the way, she calls upon us to recognize the mysteries that lie at the heart of our lives and the metaphysical reality that gives meaning to life.The ...

This collection of papers explores one of the central debates in the field of bioethics in the new century. It evaluates the controversy between the claim that there is a common morality accepted by all and the opposing view that there are different moral visions and moral rationalities, within which complex bioethical issues demand a solution. Contributions within this volume offer different approaches and perspectives on the pursuit of global ethics in the new century. They are organized under five major (...) themes. The first theme explores the different plausible understandings of the foundations of bioethics and contemporary reflections on the nature and role of moral theory. The second theme analyses the impact of moral loss and moral diversity on the character of bioethics and the search for alternative perspectives in post-traditional and post-modern societies. The third theme examines a number of theoretical issues raised by concrete examples of bioethnological applications, which bear importantly on contemporary debates between the possibility and impossibility of global bioethics. The fourth theme discusses examples of moral conflicts and dilemmas in everyday health care practice regarding the permissible treatment of humans by humans under different ethical perspectives and cultural traditions. The fifth theme explores alternative suggestions for opening up new modes of self-understanding and new strategies for bioethical exploration in the new century. The volume is an important work of reference for philosophers, moral theologians, ethicists, counsellors, doctors, nurses, sociologists, journalists, health care professionals, public policy makers and everyone who is interested in the profound ethical issues arising from modern technological advancements which are not only transforming our lives but are also demanding urgent ethical decision-making and `pragmatic' solutions from a cross-cultural perspective. (shrink)

The topic of professionalism has dominated the content of major academic medicine publications (e.g. Journal of the American Medical Association, New England Journal of Medicine, Academic Medicine, Annals of Internal Medicine, The Lancet) during the past decade and continues to do so. The message of this current wave of professionalism is that medical educators need to be more attentive to the moral sensibilities of trainees, to their interpersonal and affective dimensions, and to their social conscience, all to the end of (...) skilled, humanistic physicians. Urgent calls to address professionalism from such groups as the Association of American Medical Colleges (representing the nation's 126 accredited medical schools and nearly 400 major teaching hospitals), the American Board of Internal Medicine, and the Accreditation Council for Graduate Medical Education, among others. In fact, at the 2004 annual meeting of the AAMC six separate presentations addressed professionalism with such titles as "Evaluating Humanism and Professionalism," Professionalism: Expectation, Education, Evaluation," or "Toward Assessing Professional Behaviors of Medical Students through Peer Observations" (note the preoccupation with assessment). Professionalism, then, has become part of the current academic medicine parlance, used by administrators, clinical faculty, residency programs, and professional organizations with an expectation of shared meanings and goals. All of these stakeholders focus on what has become a consistent list of attributes deemed to be the essence of professionalism, which usually include variations on altruism, duty, excellence, honor and integrity, accountability, and respect. In fact, most of the scholarly work to date has been listing (attributes of professionalism), describing (activities that may foster it), decrying (the environment that works against it), and measuring/evaluating it. In this collection of essays, we don’t argue with these attributes. Instead, we ask questions of the discourse from which they arise, how the specialized language of academic medicine disciplines has defined, organized, contained, and made seemingly immutable a group of attitudes, values, and behaviors subsumed under the label "professional" or "professionalism." This collection aims to be a critical text, one that questions the profession’s beliefs about the nature of its work and how such beliefs are enacted (or not) in medical education, particularly as they fuel the professionalism discourse. In addition, we will scrutinize how the discourse is enacted in both the formal and hidden curriculum, and in the larger medical environment. (shrink)

The author raises the ethical problem of the widespread use of drugs such as Prozac, among individuals with normal mental disorders, such as nostalgia or discomfort. Referring to the work of practitioner P. Kramer, the author shows that Prozac is a psychiatric tool allowing individuals to better integrate into a society increasingly medicalized.

Three main claims are made in this paper. First, it is argued that Onora O’Neill has uncovered a serious problem in the way medical ethicists have thought about both respect for autonomy and informed consent. Medical ethicists have tended to think that autonomous choices are intrinsically worthy of respect, and that informed consent procedures are the best way to respect the autonomous choices of individuals. However, O’Neill convincingly argues that we should abandon both these thoughts. Second, it is argued that (...) O’Neill’s proposed solution to this problem is inadequate. O’Neill’s approach requires that a more modest view of the purpose of informed consent procedures be adopted. In her view, the purpose of informed consent procedures is simply to avoid deception and coercion, and the ethical justification for informed consent derives from a different ethical principle, which she calls principled autonomy. It is argued that contrary to what O’Neill claims, the wrongness of coercion cannot be derived from principled autonomy, and so its credentials as a justification for informed consent procedures is weak. Third, it is argued that we do better to rethink autonomy and informed consent in terms of respecting persons as ends in themselves, and a characteristically liberal commitment to allowing individuals to make certain categories of decisions for themselves. -/- Respect for autonomy is in trouble. In recent work in this journal1 and elsewhere,2 O’Neill has forcefully argued that respect for autonomy, as it has come to be used in medical ethics, is philosophically indefensible. If her arguments are sound, then, contrary to the standard view, respect for autonomy cannot be the source of the ethical requirement to seek informed consent before treating a patient or enrolling a participant in a trial. So her critique goes to the heart of contemporary medical ethics: if O’Neill is right, medical ethicists have systematically misunderstood two of the most fundamental concepts they deal with—respect for autonomy and informed consent. -/- This paper has four sections. Section 1 distinguishes between three different ways of talking about respect for autonomy, and looks in more detail at the one that has come to be central to bioethical writing on informed consent—namely, the idea that we should respect autonomous choices. Section 2 argues, following O’Neill, that it is implausible to think that the purpose of informed consent requirements is to respect autonomous choices. Section 3 argues that O’Neill’s proposed reworking of autonomy and informed consent is inadequate. O’Neill’s approach requires us to adopt a more modest view of the purpose of informed consent procedures. In her view, the purpose of informed consent procedures is simply to avoid deception and coercion, and the ethical justification for informed consent derives from a different ethical principle, which she calls principled autonomy. I argue that contrary to what O’Neill claims, we cannot derive the wrongness of coercion from principled autonomy, and so its credentials as a justification for informed consent procedures is weak. Section 4 argues that we do better to rethink autonomy and informed consent in terms of respecting persons as ends in themselves, and a characteristically liberal commitment to allowing individuals to make certain categories of decisions for themselves. (shrink)