Introduction: This book attempts to deepen common understandings of what considerations are relevant in discussions of bioethics. It is meant to offer a clearer picture of what morally acceptable health care might look like. I argue that a feminist understanding of the social realities of our world is necessary if we are to recognize and develop an adequate analysis of the ethical issues that arise in the context of health care.
The professional responsibilities of medicine
Publisher’s Note: The Blackwell Guide to Medical Ethics is a guide to the complex literature written on the increasingly dense topic of ethics in relation to the new technologies of medicine. Examines the key ethical issues and debates which have resulted from the rapid advances in biomedical technology Brings together the leading scholars from a wide range of disciplines, including philosophy, medicine, theology and law, to discuss these issues Tackles such topics as ending life, patient choice, selling body parts, resourcing and confidentiality Organized with a coherent structure that differentiates between the decisions of individuals and those of social policy
Cloning and Public Policy
Abstract: It seemed like only minutes after a team of Scottish scientists announced, in late February 1997, that they had successfully cloned a sheep, that governmental officials and private citizens throughout the world called for a ban on cloning human beings. The rush to legislate or issue executive orders was so swift, it is reasonable to wonder why the news that a mammal had been cloned ignited such a stampede to prohibit, even criminalize, attempts to clone humans. These events raise a series of separate, yet related questions. Why does the prospect of cloning human beings incite such strong reactions? What reasons have been proposed for enacting national laws or international conventions to prohibit cloning? Can these prohibitions be justified by sound ethical arguments? Before attempting to answer these questions, let us look first at the responses that called for public policy measures to ban human cloning.
Why a feminist approach to bioethics?
Abstract: Many have asked how and why feminist theory makes a distinctive contribution to bioethics. In this essay, I outline two ways in which feminist reflection can enrich bioethical studies. First, feminist theory may expose certain themes of androcentric reasoning that can affect, in sometimes crude but often subtle ways, the substantive analysis of topics in bioethics; second, it can unearth the gendered nature of certain basic philosophical concepts that form the working tools of ethical theory.
That Makes It Worse
Abstract: Essays on excusing conditions and their correlates, mitigating conditions, usually begin with the assumption that there is general agreement on what the standard excuses are, and on where they are inapplicable. This assumption is justified; criminal law and the history of discussions of excuses have produced accord, though now and then doubts are expressed about particulars. Essays on excuses typically aim not so much to convince one that such-and-such are the general types of excuses but, rather, to show how they work and what their operation reveals about the nature of voluntary acts, full responsibility, etc.
Individual Complicity: The Tortured Patient
Abstract: Medical complicity in torture is prohibited by international law and codes of professional ethics. But in the many countries in which torture is common, doctors frequently are expected to assist unethical acts that they are unable to prevent. Sometimes these doctors face a dilemma: they are asked to provide diagnoses or treatments that respond to genuine health needs but that also make further torture more likely or more effective. The duty to avoid complicity in torture then comes into conflict with the doctor’s duty to care for patients. Sometimes the right thing for a doctor to do requires complicity in torture. Whether this is the case depends on: the expected consequences of the doctor’s actions; the wishes of the patient; and the extent of the doctor’s complicity with wrongdoing. Medical associations can support physicians who face this dilemma while maintaining a commitment to clear principles denouncing torture.
Should the Baby Live? The Problem of Handicapped Infants
Publisher’s Note: Few subjects have generated so many newspaper headlines and such heated controversy as the treatment, or non-treatment, of handicapped newborns. In 1982, the case of Baby Doe, a child born with Down’s syndrome, stirred up a national debate in the United States, while in Britain a year earlier, Dr. Leonard Arthur stood trial for his decision to allow a baby with Down’s syndrome to die. Government intervention and these recent legal battles accentuate the need for a reassessment of the complex issues involved. This volume–by two authorities on medical ethics–presents a philosophical analysis of the subject based on particular case studies. Addressing the doctrine of the absolute sanctity of life, Singer and Kuhse examine some actual cases where decisions have been reached; consider the criteria for making these decisions; investigate the differences between killing and letting die; compare Western attitudes and practices with those of other cultures; and conclude by proposing a decision-making framework that offers a rational alternative to the polemics and confusion generated by this highly controversial topic.
The Sanctity-of-Life Doctrine in Medicine: A Critique
Publisher’s Note: 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.
Critical Notice: Why Killing Is Not Always Worse – and Is Sometimes Better – Than Letting Die
Abstract: 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
Cloning
Abstract: Every body cell of an animal or human being contains the same complete set of genes. In theory any of these cells can be used to start a new embryo. The technique has been employed in the case of frogs. The nucleus is taken out of a body cell of a frog and implanted in an enucleated frog’s egg. The resulting egg cell is stimulated to develop into a normal frog, and will be an exact copy of that frog which provided the nucleus with all the genetic information. In normal sexual reproduction, two parents each contribute half their genes, but in the case of cloning, one parent passes on all his or her genes