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Case Studies in Biomedical Ethics

The most comprehensive and up-to-date collection of its kind, Case Studies in Biomedical Ethics: Decision-Making, Principles, and Cases addresses the most critical and timely ethical issues in healthcare. Drawing on over 100 case studies from current events, court cases, and physicians' experiences, the book is divided into three parts. Part I presents a basic framework for ethical decision-making in healthcare, covering such issues as separating evaluative questions from questions of fact; distinguishing between ethical and nonethical evaluations; and identifying the source of ethical judgments. Expanding upon this framework, Part II explains the ethical principles: beneficence and nonmaleficence, justice, respect for autonomy, veracity, fidelity, and avoidance of killing. Parts I and II provide students with the background to analyze the ethical dilemmas presented in Part III, which features cases on a broad spectrum of issues including abortion, genetics, mental health, confidentiality, health insurance, experimentation on humans, the right to refuse treatment, and death and dying. Each case is accompanied by the authors' commentary, which guides students in considering the issues. The new edition adds many new cases, including those at the forefront of public debate: Richard Norris (one of the first face transplant cases), The Hobby Lobby contraceptive insurance case (whether The Affordable Care Act should require employers to cover contraception and abortifacients), Terri Schiavo (the public controversy over withdrawing nutrition), and Sarah Murnaghan (the lung transplant case), and the SUPPORT study (the raging controversy over whether parents need to be informed of a randomization in the care of premature infants). Ideal for courses in biomedical ethics, bioethics, and medical ethics.
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Table of Contents

Table of Contents ; Case Studies in Biomedical Ethics: Decision-Making, Principles, and Cases ; Table of Contents ; List of Cases ; Preface to the Second Edition ; Preface to the First Edition ; Introduction: Four Questions of Ethics ; What Are the Source, Meaning, and Justification of Ethical Claims? ; Distinguish between Evaluative Statements and Statements Presenting Non-evaluative 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 ; Virtues: Praiseworthy Traits of Character 42 Values: Positively Evaluated Consequences ; How Do Rules Apply to Specific Situations? ; What Ought to Be Done in Specific Cases? ; Notes ; PART 1: ETHICS AND VALUES IN MEDICAL CASES ; Chapter 1 A Model for Ethical Problem Solving ; The Five-Step Model ; Application of the Model ; Notes ; Chapter 2 : Values in Health and Illness ; Identifying Value Judgments in Medicine ; Separating Ethical and Other Evaluations ; Notes ; 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 ; Notes ; 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 ; Notes ; 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 ; Notes ; Chapter 6 : Autonomy ; Determining Whether a Patient Is Autonomous ; External Constraints on Autonomy ; Overriding the Choices of Autonomous Persons ; Notes ; 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 ; Notes ; Chapter 8 : Fidelity: Promise-Keeping, Loyalty To Patients, And Impaired ProfessionalsOther Cases Involving Fidelity ; The Ethics of Promises: Explicit and Implicit ; Fidelity and Conflicts of Interest ; Incompetent and Dishonest Colleagues ; Notes ; 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 ; Notes ; 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 ; Notes ; Chapter 11 : Genetics, Birth, and the Biological Revolution ; Genetic Counseling ; Genetic Screening ; In Vitro Fertilization and Surrogate Motherhood ; Preimplantation Diagnosis ; Gene Therapy ; Notes ; 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 ; Notes ; 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 ; Notes ; 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 ; Notes ; 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 ; Notes ; 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 ; Notes ; Chapter 17 : Consent and the Right to Refuse Treatment ; The Elements of a Consent ; The Standards for Consent ; Comprehension and Voluntariness ; Notes ; 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 ; Notes ; Appendix: Codes of Ethics ; Glossary ; List of Cases from Public Sources

About the Author

Robert M. Veatch, Ph. D., is Professor of Medical Ethics and the former Director of the Kennedy Institute of Ethics at Georgetown University. He is also professor in the Philosophy Department and has held appointment as adjunct professor in the Georgetown Department of Community and Family Medicine. His most recent book is Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict (2012). He served as the Senior Editor of the Kennedy Institute of Ethics Journal for twenty years and has served on the editorial boards of the JAMA, Journal of Medicine and Philosophy, American Journal of Bioethics, and Death Studies.


Case Studies in Biomedical Ethics is extremely well written. * Robert V. Doyle, Loyola Marymount 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 *

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