According to the "sanctity-of-life" view, all human lives are equally valuable and inviolable, and it would be wrong to base life-and-death medical decisions on the quality of the patient's life. Examining the ideas and assumptions behind the sanctity-of-life view, Kuhse argues against the traditional view that allowing someone to die is morally different from killing, and shows that quality-of-life judgments are ubiquitous. Refuting the sanctity-of-life view, she provides a sketch of a quality-of-life ethics based on the belief that there is (...) a profound difference between merely being alive and life being in the patient's interest. (shrink)

This volume provides a critical introduction to contemporary attempts to base nursing ethics on a feminine 'ethics of care'.

This second edition of _A Companion to Bioethics,_ fully revised and updated to reflect the current issues and developments in the field, covers all the material that the reader needs to thoroughly grasp the ideas and debates involved in bioethics. Thematically organized around an unparalleled range of issues, including discussion of the moral status of embryos and fetuses, new genetics, life and death, resource allocation, organ donations, AIDS, human and animal experimentation, health care, and teaching Now includes new essays on (...) currently controversial topics such as cloning and genetic enhancement Topics are clearly and compellingly presented by internationally renowned bioethicists A detailed index allows the reader to find terms and topics not listed in the titles of the essays themselves. (shrink)

Although euthanasia has been a pressing ethical and public issue, empirical data are lacking in Japan. We aimed to explore Japanese nurses’ attitudes to patients’ requests for euthanasia and to estimate the proportion of nurses who have taken active steps to hasten death. A postal survey was conducted between October and December 1999 among all nurse members of the Japanese Association of Palliative Medicine, using a self-administered questionnaire based on the one used in a previous survey with Australian nurses in (...) 1991. The response rate was 68%. A total of 53% of the respondents had been asked by patients to hasten their death, but none had taken active steps to bring about death. Only 23% regarded voluntary active euthanasia as something ethically right and 14% would practice it if it were legal. A comparison with empirical data from the previous Australian study suggests a significantly more conservative attitude among Japanese nurses. (shrink)

: In this paper, I consider objections to advance directives based on the claim that there is a discontinuity of interests, and of personal identity, between the time a person executes an advance directive and the time when the patient has become severely demented. Focusing narrowly on refusals of life-sustaining treatment for severely demented patients, I argue that acceptance of the psychological view of personal identity does not entail that treatment refusals should be overridden. Although severely demented patients are morally (...) considerable beings, and must be kept comfortable whilst alive, they no longer have an interest in receiving life-sustaining treatment. (shrink)

The expanded and revised edition of _Bioethics: An Anthology_ is a definitive one-volume collection of key primary texts for the study of bioethics. Brings together writings on a broad range of ethical issues relating such matters as reproduction, genetics, life and death, and animal experimentation. Now includes introductions to each of the sections. Features new coverage of the latest debates on hot topics such as genetic screening, the use of embryonic human stem cells, and resource allocation between patients. The selections (...) are independent of any particular approach to bioethics. Can be used as a source book to complement _A Companion to Bioethics_. (shrink)

New developments in reproductive technology have made headlines since the birth of the world's first in vitro fertilization baby in 1978. But is embryo experimentation ethically acceptable? What is the moral status of the early human embryo? And how should a democratic society deal with so controversial an issue, where conflicting views are based on differing religious and philosophical positions? These controversial questions are the subject of this book, which, as a current compendium of ideas and arguments on the subject, (...) makes an original contribution of major importance to this debate. (shrink)

Now fully revised and updated, Bioethics: An Anthology, 3rd edition, contains a wealth of new material reflecting the latest developments. This definitive text brings together writings on an unparalleled range of key ethical issues, compellingly presented by internationally renowned scholars. The latest edition of this definitive one-volume collection, now updated to reflect the latest developments in the field Includes several new additions, including important historical readings and new contemporary material published since the release of the last edition in 2006 Thematically (...) organized around an unparalleled range of issues, including discussion of the moral status of embryos and fetuses, new genetics, neuroethics, life and death, resource allocation, organ donations, public health, AIDS, human and animal experimentation, genetic screening, and issues facing nurses Subjects are clearly and captivatingly discussed by globally distinguished bioethicists A detailed index allows the reader to find terms and topics not listed in the titles of the essays themselves. (shrink)

To give priority to the young over the elderly has been labelled ‘ageism’. People who express ‘ageist’ preferences may feel that, all else equal, an individual has greater right to enjoy additional life years the fewer life years he or she has already had. We shall refer to this as egalitarian ageism. They may also emphasise the greater expected duration of health benefits in young people that derives from their greater life expectancy. We may call this utilitarian ageism. Both these (...) forms of ageism were observed in an empirical study of social preferences in Australia. The study lends some support to the assumptions in the QALY approach that duration of benefits, and hence old age, should count in prioritising at the budget level in health care. (shrink)

The philosophical debate over the moral difference between killing and letting die has obvious relevance for the contemporary public debate over voluntary euthanasia. Winston Nesbitt claims to have shown that killing someone is, other things being equal, always worse than allowing someone to die. But this conclusion is illegitimate. While Nesbitt is correct when he suggests that killing is sometimes worse than letting die, this is not always the case. In this article, I argue that there are occasions when it (...) is better to kill than to let die. (shrink)

The association of women with caring dispositions and thinking has become a persistent theme in recent feminist writing. There are a number of reasons for this. One reason is the impetus that has been provided by the empirical work of Carol Gilligan on women’s moral development. The fact that this association is not merely an ideologically or philosophically postulated one, but is argued for on empirical grounds, tends to add to its credibility. Another reason for the resilience of the association (...) is the existence of an increasingly prominent theme in feminist thought and action that focuses on the importance of women’s difference from men, both as a fact and as a goal. Within this theme, there are various views on what the relevant differences are between women and men, and why the differences ought to be emphasized and properly respected. Women’s caring, as will be seen, turns out to have a firm presence in all of these views, and as a result, many women argue that caring should form the basis of a distinctive feminist ethic. On these views, women’s approaches to understanding moral situations, defining selfconceptions, choosing goals and roles, and guiding behaviour, should all be informed by and based upon dispositions of caring. However, if this idea of a feminist ethic of care is to be plausible, it will need to be reconciled with another strong theme in feminism, according to which in fundamental moral respects women ought not be considered or treated differently from men. We will examine the standing of a feminist ethic of care in the context of this tension between the difference theme and the sameness theme in feminism. The discussion begins by re-characterizing the justice and care debate in terms of impartialist and partialist ethical perspectives, and it then goes on to indicate the various ways in which women’s presumed disposition to caring and partialism finds prominence within the difference theme. The central focus of the discussion, however, will be the question of how to reconcile the conflict that exists between impartialist, justice-based moral thinking, and a partialist, caring approach to morality.. (shrink)

Impartialism in ethics has been said to be the common ground shared by both Kantian and utilitarian approaches to ethics. Lawrence Blum describes this common ground as follows: Both views identify morality with a perspective of impartiality, impersonality, objectivity and universality. Both views imply the ‘ubiquity of impartiality” – that our commitments and projects derive their legitimacy only by reference to this impartial perspective.

This article presents an empirical study of approaches to ethical decision-making among nurses and doctors. It takes as its starting point the distinction between the perspectives of care and of justice in ethical thinking, and the view that nurses' thinking will be aligned with the former and doctors' with the latter. It goes on to argue that the differences in these approaches are best understood in terms of the distinction between partialist and impartialist modes of moral thinking. The study seeks (...) to determine the distribution of these modes of thinking between nurses and doctors, and finds that there are no signif icant differences between them. A 'two-level' philosophical view of the nature of moral thinking is appealed to in order to explain the study findings. (shrink)

According to a contemporary school of thought there is a specific female approach to ethics which is based not on abstract “male” ethical principles or rules, but on “care”. Nurses have taken a keen interest in these female approaches to ethics. Drawing on the views expounded by Carol Gilligan and Nel Noddings, nurses claim that a female “ethics of care” better captures their moral experiences than a traditional male “ethics of justice”. This paper argues that “care” is best understood in (...) a dispositional sense, that is, as sensitivity and responsiveness to the particularities of a situation and the needs of “concrete” others. While “care”, in this sense, is necessary for ethics, it is not sufficient. Ethics needs “justice” as well as “care”. If women and nurses excessively devalue principles and norms, they will be left without the theoretical tools to condemn some actions or practices, and to defend others. They will, like generations of nurses before them, be condemned to silence. (shrink)

_ _ _Unsanctifying Human Life_ offers a collection of Singer's best and most challenging articles from 1971 to the present. The book includes early critiques of various approaches to philosophy and the role of philosophers, followed by controversial works on the moral status of animals, infanticide, euthanasia, the allocation of scarce health care resources, embryo experimentation, environmental responsibility, and reflections on how we should live.

According to a contemporary school of thought there is a specific female approach to ethics which is based not on abstract “male” ethical principles or rules, but on “care”. Nurses have taken a keen interest in these female approaches to ethics. Drawing on the views expounded by Carol Gilligan and Nel Noddings, nurses claim that a female “ethics of care” better captures their moral experiences than a traditional male “ethics of justice”. This paper argues that “care” is best understood in (...) a dispositional sense, that is, as sensitivity and responsiveness to the particularities of a situation and the needs of “concrete” others. While “care”, in this sense, is necessary for ethics, it is not sufficient. Ethics needs “justice” as well as “care”. If women and nurses excessively devalue principles and norms, they will be left without the theoretical tools to condemn some actions or practices, and to defend others. They will, like generations of nurses before them, be condemned to silence. (shrink)

A collection celebrating some of the best essays from the Blackwell journals, Bioethics and Developing World Bioethics. Contributors include Helga Kuhse, Michael Selgelid and Baroness Mary Warnock, former Chair of the British Government’s Committee of Inquiry into Human Fertilization and Embryology’s. Traces some of the most important concerns of the 1980s, such as the ethics of euthanasia, reproductive technologies, the allocation of scarce medical resources, surrogate motherhood, through to a range of new issues debated today, particularly in the field of (...) genetics. Includes contributions that are still as hotly debated today as they were 20 years ago and serves as a salutary reminder that free and open discussion is vital to the health of the discipline itself. Includes eight sections comprising some of the journals' best publications in methodological issues, the health care professional-patient relationship, public health ethics, research ethics, genetics, as well as beginning- and end-of-life issues. Will serve the academic bioethicists as well as students of bioethics as an excellent source book. (shrink)

Giubilini and Minerva present a clear argument for the view that, other things being equal, reasons that justify abortion also hold for early infanticide.1 A reasoned argument deserves a reasoned response. Instead, many responses following the electronic publication of the article were mere outpourings of outrage and abuse to the authors and the editor of the Journal of Medical Ethics.2The principal arguments put by Giubilini and Minerva date back some 40 years, when Michael Tooley presented a strong case for the (...) moral equivalence of abortion and infanticide. According to Tooley, only ‘continuing selves’ are ‘persons’, and only persons can be ascribed a ‘right to life’. …. (shrink)

It has recently been suggested that doctors have a duty to act in their patient's best interest and that this duty demands that life-sustaining treatment—including food and fluids—should sometimes be withheld or withdrawn and the patient allowed to die. In this article, the author explores the scope of the ‘best interests principle’ in the context of treatment decisions for seriously handicapped newborn infants. She argues that those who hold that it is permissible to starve or dehydrate an infant to death (...) are mistaken to think that this course of action is in the infant's best interests. While it may be true that there are times whendeath is, everything considered, in an infant's best interests, a slow and distressingmethod of bringing death about is not. Since death by dehydration and starvation is not benign, the withholding of food and fluids is generally not in an infant's best interests. The author concludes by suggesting thatwhenever the withdrawal or non-employment of life-sustaining means imposes a heavy burden on the infant, the ‘best interests principle’ would demand that the infant be killed rather than allowed to die. (shrink)