Biomedical ethics : a Canadian focus PDF
Preview Biomedical ethics : a Canadian focus
(cid:9) OXFORD THIRD EDITION BIOMEDICA EllICS A CANADIAN FOCUS Roma 111 EDITED BY FISHER RUSSELL BROWNE r BURKHOLDER 1.I CCM ©40 THIRD EDITION 5\A I L_ A CANADIAN FOCUS EDITED BY JOHNNA FISHER I J.S. RUSSELL ALISTER BROWNE I LESLIE BURKHOLDER OXFORD UNIVERSITY PRESS 11 III I (cid:9) W (cid:9) I I(cid:9) ill(cid:9) 1111111 OXFORD UNIVERSITY PRESS Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries. Published in Canada by Oxford University Press 8 Sampson Mews, Suite 204, Don Mills, Ontario M3C OHS Canada wwwoupcanada.com Copyright 0 Oxford University Press Canada 2018 The moral rights of the authors have been asserted Database right Oxford University Press (maker) First Edition published in 2009 Second Edition published in 2013 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by licence, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Permissions Department at the address above or through the following url: www.oupcanada.com/permission/permission_request.php Every effort has been made to determine and contact copyright holders. In the case of any omissions, the publisher will be pleased to make suitable acknowledgement in future editions. Library and Archives Canada Cataloguing in Publication Biomedical ethics : a Canadian focus / edited by Johnna Fisher, J.S. Russell, Alister Browne and Leslie Burkholder. — Third edition. Includes bibliographical references and index. Issued in print and electronic formats. ISBN 978-0-19-902228-1 (softcover).—ISBN 978-0-19-902229-8 (PDF) 1. Medical ethics(cid:9) Canada. 2. Bioethics—Canada. 3. Medical ethics—Canada—C se studies. I. Fisher, Johnna, 1964-, editor (cid:9) R724.8565 2018 174.20971(cid:9) C2017-906106-2 C2017-906107-0 Cover image: Assembly/Iconica/Getty Images Cover and interior design: Sherill Chapman Oxford University Press is committed to our environment. Wherever possible, our books are printed on paper which comes from responsible sources. Printed and bound in the United States of America 1 2 3 4-21 20 19 18 Contents Preface xiii 1(cid:9) Morality and Moral Decision-Making: A Brief Introduction 1 1.1 The Indispensability of Biomedical Ethics 1 1.2 The Case of Hassan Rasouli 2 1.3 Taking Morality Seriously 3 1.4 Normative Ethical Theories 7 1.5 Moral Reasoning in Biomedical Ethics 17 1.6 Professional Codes of Ethics and Law 19 1.7 Looking Ahead 20 1.8 Study Questions 21 1.9 Suggested Readings and Resources 22 2 Medical Decision-Making: Self-Determination and Deciding for Others 23 2.1 Introduction 23 2.2 Determining Decision-Making Capacity 32 Standards of Competence 32 Allen E. Buchanan and Dan W. Brock A Relational Approach to Autonomy in Health Care 35 Susan Sherwin 2.3 Informed Consent 45 The Nuts and Bolts of Obtaining Consent to Treatment 45 L.E. and F.A. Rozovsky The Concept of Informed Consent 47 Ruth R. Faden and Tom L Beauchamp Transparency: Informed Consent in Primary Care 51 Howard Brody Culture, Power, and Informed Consent:The Impact of Aboriginal Health Interpreters on Decision-Making 56 Joseph Kaufert and John O'Neil no i(cid:9) LI(cid:9) II JII(cid:9) III Wil ® Contents Informed Consent and Public Health 60 Onora O'Neill 2.4 Substituted Judgments 63 Enough:The Failure of the Living Will 63 Angela Fagerlin and Carl E. Schneider Advance Directives for Resuscitation and Other Life-Saving or Life-Sustaining Measures 76 Canadian Medical Association 2.5 Best-Interest Judgments 76 Involving Children in Medical Decisions 76 Christine Harrison, Nuala P Kenny, Mona Sidarous, and Mary Rowell Position Statement: Treatment Decisions Regarding Infants, Children, and Adolescents 80 Christine Harrison; Canadian Paediatric Society, Bioethics Committee Withholding or Withdrawing Life-Sustaining Treatment in Children 81 Royal College of Paediatrics and Child Health Deciding to Forego Life-Sustaining Treatment 82 Judicial Council, American Medical Association Ethical Relativism in a Multicultural Society 83 Ruth Macklin 2.6 Cases 91 Case 1 Scott Starson: Refusing Treatment while Incompetent 91 Case 2 No Chemotherapy for Anael: Surrogate Refusal ofTreatment for a Minor Child 92 Case 3 Do Everything for Mom: Advance Directives and a Surrogate's Right to Demand Treatment 93 Case 4 Treatment for Jehovah's Witnesses: Adults and Children 94 Case 5 Markayla Sault: Caring for an Aboriginal Patient 95 2.7 Study Questions 95 2.8 Suggested Further Reading 96 3(cid:9) Management of Medical Information 98 3.1 Introduction 98 3.2 Patient Access to Information 106 On the Supposed Right to Lie from Benevolent Motives 106 Immanuel Kant Telling the Truth to Patients: A Clinical Ethics Exploration 107 David C. Thomasma Telling Patients the Truth 110 Robert Scott Stewart Medical Secrecy: Patients' Right of Access to Medical Records 113 Arthur Schafer 3.3 Confidentiality of Information 117 A Defense of Unqualified Medical Confidentiality 117 Kenneth Kipnis Contents Breaching Confidentiality 128 Dave Unger How Should Health Data Be Used? Privacy, Secondary Use, and Big Data Sales 134 Bonnie Kaplan 3.4 Genetic Information 147 Genetic Exceptionalism and "Future Diaries": Is Genetic Information Different from Other Medical Information? 147 Thomas H. Murray 3.5 Cases 153 Case 1 George VI's Cancer 153 Case 2 Arndt v Smith 154 Case 3 The Crash of Germanwings Flight 9525 155 Case 4 Personal Genome Mapping 156 3.6 Study Questions 157 3.7 Suggested Further Reading 158 4 Professional Ethics 159 4.1 Introduction 159 4.2 The Nature and Limits of Professional Autonomy and Professional Responsibility 165 Patient and Physician Autonomy. Conflicting Rights and Obligations in the Physician-Patient Relationship 165 Edmund D. Pellegrino The Problem with Futility 176 Robert D. Truog, Allan S. Brett, and Joel Frader Should Physicians Be Gatekeepers of Medical Resources? 181 Milton C. Weinstein Caring in a Crisis:The Ethical Obligations of Physicians and Society during a Pandemic 188 Canadian Medical Association Why Medical Professionals Have No Moral Claim to Conscientious Objection Accommodation in Liberal Democracies 191 Udo Schuklenk and Ricardo Smalling The Functions and Limitations of Professional Codes of Ethics 201 Dale Beyerstein 4.3 Cases 205 Case 1 Hassan Rasouli and Medical Futility 205 Case 2 MRS in Toronto: A Duty to Care 206 Case 3 Is It Ever Right to Violate Rules of Rationing? 207 Case 4 BC Physicians "Cherry-Picking" Patients for Ease of Care, Refusing Those in Need 207 Case 5 Helping Residents to Live at Risk 208 Case 6 When Is Treatment Futile? 209 4.4 Study Questions 209 4.5 Suggested Further Reading 210 11(cid:9) I(cid:9) I I(cid:9) ill(cid:9) 111111 Contents 5(cid:9) Reproductive Ethics 211 5.1 Introduction 211 5.2 Starting Reproduction 218 Reproductive Freedom, Autonomy, and Reproductive Rights 218 Christine Overall Preconception Gender Selection 226 John A. Robertson Preconception Arrangements 233 Royal Commission on New Reproductive Technologies 5.3 Stopping Reproduction 238 Why Abortion Is Immoral 238 Don Marquis On the Moral and Legal Status of Abortion 248 Maly Anne Warren A Defence of Abortion 253 Judith Ja►vis Thomson A Third Way 262 L.W. Sumner Abortion through a Feminist Ethics Lens 268 Susan Sherwin 5.4 Completing Reproduction 277 Judicial Intervention in Pregnancy and Birth 277 Royal Commission on New Reproductive Technologies Dissent on Judicial Intervention in Pregnancy and Birth (Royal Commission on New Reproductive Technologies) 281 Suzanne Rozell Scorsone 5.5 Cases 282 Case 1 Sex Selection in Canada 282 Case 2 Prenatal Diagnosis and Abortion or Infanticide through Declining Treatment 282 Case 3 Abortion of Suspected Female Fetus 283 Case 4 Ms G and Refusal of Treatment while Pregnant 283 Case 5 Endangering Behaviour in a Pregnant Woman 284 Case 6 Abortion of a Fetus Due to Diagnosis of Down Syndrome 284 5.6 Study Questions 285 5.7 Suggested Further Reading 286 6 End-of-Life Decision-Making 287 6.1 Introduction 287 6.2 Withholding or Withdrawing Life-Sustaining Treatment and Physician-Assisted Death 295 Withholding and Withdrawal of Potentially Life-Sustaining Treatment 295 Health Law Institute, Dalhousie University Voluntary Active Euthanasia 297 Dan W. Brock Contents ® Active and Passive Euthanasia 309 James Rachels When Self-Determination Runs Amok 312 Daniel Callahan Medical Ethics and Double Effect:The Case of Terminal Sedation 316 Joseph M. Boyle 6.3 Physician-Assisted Dying in Canada 321 Controlling the Risks of PAD 321 British Columbia Supreme Court Legislative Background: Medical Assistance in Dying (Bill C-14) 323 Department ofJustice Mature Minors, Mental Illness, Advance Directives, and Conscientious Objection 328 Provincial-Territorial Expert Advisory Group on Physician-Assisted Dying and the Special Joint Committee on Physician-Assisted Dying 6.4 The Concept of Death and Its Practical Implications 338 Defining Death 338 Alister Browne 6.5 Cases 341 Case 1 Nancy B.: Withdrawing Life-Sustaining Treatment 341 Case 2 Dr Nancy Morrison: Nonvoluntary Active Euthanasia of an Adult 341 Case 3 Tracy Latimer: Nonvoluntary Active Euthanasia of a Minor 342 Case 4 Mr McCullough: Recommending Voluntary Passive Euthanasia 344 Case 5 Elizabeth and Eric MacDonald: Assisted Suicide 344 6.6 Study Questions 345 6.7 Suggested Further Reading 345 7(cid:9) Delivery of Health Care and Resource Allocation 349 7.1 Introduction 349 7.2 Access to Health Care in Canada 357 Sustaining Medicare:The Commission on the Future of Health Care in Canada 357 Roy Romanow 7.3 The Right to Health Care, Macroallocation, and Setting Priorities 367 The Right to a Decent Minimum of Health Care 367 Allen E Buchanan Justice and the High Cost of Health 372 Ronald Dworkin Why UndervaluingnStatisticar People Costs Lives 377 Tony Hope QALYs vs DALYs vs LYs Gained: What Are the Differences, and What Difference Do They Make for Health Care Priority Setting? 382 Bjarne Robberstad O Contents 7.4 Microallocation: Decisions at the Bedside 391 The Allocation of Exotic Medical Life-Saving Therapy 391 Nicholas P. Rescher Just Caring: In Defense of Limited Age-Based Healthcare Rationing 399 Leonard M. Fleck 7.5 Increasing Resources 407 Human Organs, Scarcities, and Sale: Morality Revisited 407 R.R. Kishore 7.6 Cases 412 Case 1 Optimal Care versus Cost Containment: What Is a Doctor to Do? 412 Case 2 Having an Estate Sale of One's Organs 413 Case 3 Rationing Services to an Elder Who Is Responsible for His Medical Condition 413 Case 4 Buying a Kidney in India but Requesting Canadian After-Care 413 Case 5 Does Clifford Olson Deserve Medical Treatment? 414 7.7 Study Questions 415 7.8 Suggested Further Reading 415 8 Public Health 418 8.1 Introduction 418 8.2 Collective Action Problems 427 The Measles and Free Riders: California's Mandatory Vaccination Law 427 Katharine Browne Free Riding and Organ Donation 431 Walter Glannon 8.3 Screening for Disease 434 Direct-to-Consumer Genetics and Health Policy: A Worst-Case Scenario? 434 Timothy Caulfield The Ethics of Screening: Is "Screeningitis" an Incurable Disease? 436 Darren Shickle and Ruth Chadwick 8.4 Harm Reduction Programs 443 Canada's Highest Court Unchains Injection Drug Users; Implications for Harm Reduction as Standard of Healthcare 443 Dan Small Virtue Ethics as an Alternative to Deontological and Consequential Reasoning in the Harm Reduction Debate 451 Timothy Christie, Louis Groarke, and William Sweet 8.5 Inequality in Health 458 When Are Health Inequalities Unjust?—The Social Determinants of Health 458 Norman Daniels 8.6 Cases 471 Case 1 Health Care Workers and Flu Shots 471 Case 2 Students and Study-Enhancing Drugs 472
The list of books you might like
