Outcome Uncertain: Cases and Contexts in Bioethics
Preface. INTRODUCTION. A Foundation of Bioethics: Ethical Theories, Moral Principles, and Medical Decisions. BASIC ETHICAL THEORIES. Utilitarianism. Kant's Ethics. Ross's Ethics. Rawls's Theory of Justice. Natural Law Ethics and Moral Theology. MAJOR MORAL PRINCIPLES. The Principle of Nonmaleficence. The Principle of Beneficence. The Principle of Utility. Principles of Distributive Justice. The Principle of Autonomy. THEORIES WITHOUT PRINCIPLE. Virtue Ethics. Care Ethics. Feminist Ethics. RETROSPECT. Part I: RIGHTS. 1: Research Ethics: Informed Consent and Medical Research. CLASSIC CASE PRESENTATION: Baby Fae. ORIENTATION. Drug Testing. The "Informed" Part of Informed Consent. The "Consent" Part of Informed Consent. Medical Research and Medical Therapy. Therapeutic and Non-therapeutic Research. Research Involving Children. Research Involving Prisoners. Research Involving the Poor. Research Involving the Terminally Ill. Research Involving Fetuses. Research Involving Animals. Women and Medical Research. Summary. Ethical Theories: Medical Research and Informed Consent. SOCIAL CONTEXT: Clinical Trials, HIV, and Pregnancy: A Third World Tuskegee? SOCIAL CONTEXT: The Cold-War Radiation Experiments. CASE PRESENTATION: Echoes of Willowbrook or Tuskegee? Experimenting with Children. CASE PRESENTATION: The Use of Morally Tainted Sources: The Pernkopf Anatomy. 2: Physicians, Patients, and Others: Autonomy, Truth-Telling, and Confidentiality. CLASSIC CASE PRESENTATION: Dax Cowart. ORIENTATION. Autonomy. Paternalism. Personal Paternalism in Medical and Health Care. Informed Consent and Medical Treatment. Truth-Telling in Medicine. Dignity and Consent. Ethical Theories: Autonomy, Truth-Telling, Confidentiality. CASE PRESENTATION: Will Teresa Blair Take Her AIDS Medicine? CASE PRESENTATION: A Duty to Violate Confidentiality? CASE PRESENTATION: Medical ID Cards and Privacy. SOCIAL CONTEXT: Autonomy and Pregnancy. CASE PRESENTATION: The Death of Robyn Twitchell - Medicine vs. Religion. 3: Race, Gender, and Medicine. CLASSIC CASE PRESENTATION: The Tuskegee Syphilis Study. ORIENTATION. African-Americans and Health Care. American Indians and Alaska Natives. Asian Americans and Pacific Islanders. Hispanic Americans/Latinos. Women and Health Care. Conclusion. SOCIAL CONTEXT: The Mammography Debate. SOCIAL CONTEXT: The Prostate Cancer Epidemic. CASE PRESENTATION: Cultures in Conflict. Part II: CONTROLS. 4: Genetic Control. CLASSIC CASE PRESENTATION: Huntington's Disease - Genetic Testing and Ethical Dilemmas. ORIENTATION. Genetic Intervention. Genetic Screening. Genetic Counseling. Prenatal Genetic Diagnosis. Difficulties with Genetic Intervention. Eugenics. Negative and Positive Eugenics. Use of Desirable Germ Cells. Difficulties with Eugenics. Genetic Research, Therapy, and Technology. Recombinant DNA. Gene Therapy. Biohazards. Ethical Difficulties. SOCIAL CONTEXT: The Stem-Cell Debate. SOCIAL CONTEXT: The Human Genome Project. SOCIAL CONTEXT: Genetic Testing and Screening. CASE PRESENTATION: Gene Therapy. 5: Reproductive Control. CLASSIC CASE PRESENTATION: Louise Brown - First "Test-Tube Baby." ORIENTATION. IVF, GIFT, ZIFT, and Other Techniques. Need, Success Rates, and Costs of Assisted Reproduction. Multiple Births. Freezing Embryos. Gestational Surrogates and Donor Ova. Criticisms of Assisted Reproduction Practices. Benefits of IVF and Other Forms of Assisted Reproduction. Ethical and Social Difficulties. Cloning and Twinning. Artificial Insemination. Issues in Artificial Insemination. Surrogate Pregnancy. Ethical Theories and Reproductive Control. SOCIAL CONTEXT: Hello, Dolly - The Advent of Cloning. CASE PRESENTATION: Septuplets - The Perils of Multiple Pregnancies. SOCIAL CONTEXT: Postmenopausal Motherhood. CASE PRESENTATION: Embryos in Court - The Davis and Nahmani Cases. SOCIAL CONTEXT: Father Shopping - Sperm by Mail. CASE PRESENTATION: Baby M. and Mary Beth Whitehead - Surrogate Pregnancy in Court. CASE PRESENTATION: The Calvert Case - A Surrogate Changes Her Mind. Part III: RESOURCES. 6: Scarce Medical Resources. CLASSIC CASE PRESENTATION: Selection Committee for Dialysis. ORIENTATION. Transplants, Kidneys, and Machines. Controlling Rejection. Allocation and Scarcity. Seattle and Kidney Machines. Dialysis Costs and Decisions. Microallocation vs. Macroallocation. Ethical Theories and the Allocation of Medical Resources. SOCIAL CONTEXT: Acquiring and Allocating Transplant Organs. CASE PRESENTATION: Sandra Jensen Gets a Transplant. CASE PRESENTATION: The Ayalas' Solution to a Shortage - Having a Child to Save a Life. SOCIAL CONTEXT: Fetal-Cell Implants. CASE PRESENTATION: Drug Lottery. 7: Paying for Health Care. SOCIAL CONTEXT: A Problem for All, A Crisis for Many. ORIENTATION. Claim-Rights, Legal Rights, and Statutory Rights. Moral Rights. Political Rights. SOCIAL CONTEXT: A Patients' Bill of Right - Protecting Patients from Managed Care. CASE PRESENTATION: Oregon Rations Health Care. CASE PRESENTATION: The Canadian System. CASE PRESENTATION: Employer-Mandated Health Insurance. Part IV: TERMINATION. 8: Abortion. CLASSIC CASE PRESENTATION: Sherrie Finkbine and Thalidomide. ORIENTATION. Human Development and Abortion. The Status of the Fetus. Pregnancy, Abortion, and the Rights of Women. Therapeutic Abortion. Abortion and the Law. Ethical Theories and Abortion. SOCIAL CONTEXT: The Present Picture - Widespread Ambivalence. SOCIAL CONTEXT: Crucial Legal and Policy Decisions. CASE PRESENTATION: The Ordeal of Alice Wilson. SOCIAL CONTEXT: The Conflict over RU486 - "The Abortion Pill." SOCIAL CONTEXT: "The Morning-After Pill." 9: Euthanasia and Physician-Assisted Suicide. CASE PRESENTATION: Karen Quinlan - The Debate Begins. ORIENTATION. Active and Passive Euthanasia. Voluntary, Involuntary, and Nonvoluntary Euthanasia. Defining "Death." The Dutch Experience. Advance Directives. Ethical Theories and Euthanasia. SOCIAL CONTEXT: The Physician-Assisted Suicide Law in Oregon. SOCIAL CONTEXT: The Cruzan Case - The Supreme Court Upholds the Right to Die. CASE PRESENTATION: Dr. Jack Kevorkian. CASE PRESENTATION: The Lingering Death of Baby Owens. Notes and References for Orientations, Cases, and Contexts. General Resources in Bioethics. Resources by Chapter and Topic.