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Case Studies in Biomedical Ethics


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Table of Contents

List of Cases: New to this Edition: Preface: *=New to this Edition Introduction: Four Questions of Ethics What Are the Source, Meaning, and Justification of Ethical Claims? Distinguish between Evaluative Statements and Statements Presenting Nonevaluative Facts: Distinguish between Ethical and Nonethical Evaluations: Determine Who Ought to Decide: What Kinds of Acts Are Right? Consequentialism: Deontological or "Duty-Based" Ethics: Other Issues of Normative Ethics: How Do Rules Apply to Specific Situations? What Ought to Be Done in Specific Cases? PART 1: ETHICS AND VALUES IN MEDICAL CASES Chapter 1: A Model for Ethical Problem-Solving The Five-Step Model Application of the Model Chapter 2: Values in Health and Illness Identifying Value Judgments in Medicine Separating Ethical and Other Evaluations Chapter 3: What Is the Source of Moral Judgments? Grounding Ethics in the Professional Code Grounding Ethics in the Physician's Orders Grounding Ethics in Institutional Policy Grounding Ethics in the Patient's Values Grounding Ethics in Religious or Philosophical Perspectives PART 2: ETHICAL PRINCIPLES IN MEDICAL ETHICS Chapter 4: Benefiting the Patient and Others: The Duty to Do Good and Avoid Harm Benefiting the Patient Health in Conflict with Other Goods: Relating Benefits and Harms: Benefits of Rules and Benefits in Specific Cases: Benefiting Society and Individuals Who Are Not Patients Benefits to Society: Benefits to Specific Nonpatients: Benefit to the Profession: Benefit to the Health Professional and the Health Professional's Family: Chapter 5: Justice: The Allocation of Health Resources Justice among Patients Justice between Patients and Others Justice in Public Policy Justice and Other Ethical Principles Chapter 6: Autonomy Determining Whether a Patient Is Autonomous External Constraints on Autonomy Overriding the Choices of Autonomous Persons Chapter 7: Veracity: Honesty with Patients The Condition of Doubt Lying in Order to Benefit Protecting the Patient by Lying: Protecting the Welfare of Others: Special Cases of Truth-Telling Patients Who Do Not Want to Be Told: Family Members Who Insist the Patient Not Be Told: The Right of Access to Medical Records Chapter 8: Fidelity: Promise-Keeping, Loyalty to Patients, and Impaired Professionals The Ethics of Promises: Explicit and Implicit Fidelity and Conflicts of Interest Incompetent and Dishonest Colleagues Chapter 9: Avoidance of Killing Active Killing versus Letting Die Withholding versus Withdrawing Treatment Direct versus Indirect Killing Justifiable Omissions: The Problem of Nutrition and Hydration Voluntary and Involuntary Killing Killing as Punishment PART 3: SPECIAL PROBLEM AREAS Chapter 10: Abortion, Sterilization, and Contraception Abortion Abortion for Medical Problems of the Fetus: Abortion Following Sexual Assault: Abortion to Save the Life of the Pregnant Woman: Abortion and the Mentally Incapacitated Woman: Abortion for Socioeconomic Reasons: Sterilization Contraception Chapter 11: Genetics, Birth, and the Biological Revolution Genetic Counseling Genetic Screening In Vitro Fertilization and Surrogate Motherhood Preimplantation Diagnosis Gene Therapy Chapter 12: Mental Health and Behavior Control The Concept of Mental Health Mental Illness and Autonomous Behavior Mental Illness and Third-Party Interests Other Behavior-Controlling Therapies Chapter 13: Confidentiality: Ethical Disclosure of Medical Information Breaking Confidence to Benefit the Patient Breaking Confidence to Benefit Others Breaking Confidence as Required by Law Chapter 14: Organ Transplants Procuring Organs Donation versus Salvaging: * The Grounds for Pronouncing Death: Diseased and Poor-Quality Organs: Preserving the Organs of the Dying: Socially Directed Organ Donation: Living Donor/Deceased Donor Organ Swaps: Children and Incompetent Persons as Living Organ Sources: * Transplanting Faces and Hands: Vascular Composite Allografts: Allocating Organs Maximizing Benefits and Distributing Organs Fairly: When Voluntary Risks Cause a Need for Organs: * Age and the Allocation of Organs: Multiple Organs and Special Priority for Special People: Chapter 15: Health Insurance, Health System Planning, and Rationing The Problem of Small, Incremental Benefits Limits on Unproved Therapies Marginally Beneficial, Expensive Therapy Funding Care That Patients Have Refused Pharmaceutical Manufacturers versus Insurers Insurance and the Uninsured * The Affordable Care Act: Chapter 16: Experimentation on Human Subjects Calculating Risks and Benefits Privacy and Confidentiality Equity in Research Conflicts of Interest in Research Informed Consent in Research Chapter 17: Consent and the Right to Refuse Treatment The Elements of a Consent The Standards for Consent Comprehension and Voluntariness Chapter 18: Death and Dying The Definition of Death Competent and Formerly Competent Patients Never-Competent Patients Never-Competent Persons without Available Family: Never-Competent Persons with Available Family: Futile Care and Limits Based on the Interests of Others Appendix: Codes of Ethics Glossary: List of Cases from Public Sources: Index:

About the Author

Robert M. Veatch, Ph.D., is Professor of Medical Ethics and a former director at the Kennedy Institute of Ethics, Georgetown University. Amy M. Haddad, Ph.D., is the Director of the Center for Health Policy & Ethics and the Dr. C.C. and Mabel L. Criss Endowed Chair in the Health Sciences at Creighton University. Dan C. English, M.D., M.A., F.A.C.S., is Affiliated Scholar at the Center for Clinical Bioethics at Georgetown University.


"I have found this to be an excellent textbook for my bioethics students. One of its major strengths is that it is so up to date. The authors obviously have a very strong grasp of current issues in health care today."--Robert Hurd, Xavier University "Case Studies in Biomedical Ethics is extremely well written."--Robert V. Doyle, Loyola Marymount University

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