Medical Ethics: Accounts of Ground-Breaking Cases

459 Pages·2016·6.888 MB·English

by  Gregory E. Pence

Medical Ethics
Accounts of
Ground-Breaking Cases
EIGHTH EDITION
Gregory E. Pence
University of Alabama at Birmingham
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MEDICAL ETHICS: ACCOUNTS OF GROUND-BREAKING CASES, EIGHTH EDITION
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ISBN 978-1-259-90794-4
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Library of Congress Cataloging-in-Publication Data
Names: Pence, Gregory E., author.
Title: Medical ethics: accounts of ground-breaking cases / Gregory E. Pence,
 University of Alabama at Birmingham.
Other titles: Classic cases in medical ethics
Description: Eighth edition. | New York, NY: MHE, [2017] | Audience: Age:
 18+ | Editions 1-5 published under: Classis cases in medical ethics. |
 Includes bibliographical references and index.
Identifiers: LCCN 2016026704 | ISBN 9781259907944 (alk. paper)
Subjects: LCSH: Medical ethics--Case studies.
Classification: LCC R724 .P36 2017 | DDC 174/.2--dc23 LC record available at
 https://lccn.loc.gov/2016026704
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Education does not guarantee the accuracy of the information presented at these sites.
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Preface
This new edition retains in-depth discussion of famous cases, while providing
updated, detailed analysis of the issues those cases raise. Each chapter also focuses
on a key question that could be debated in class.
Unique to this text is a single, authorial voice integrating description of the cases
and their issues with historical overviews. The text is the only one that follows cases
over decades to tell readers what did and, often, what did not, happen. Written by
a professor who helped found bioethics and who has published in the field for 40
years, the text gives students a sense of mastery over this exciting, complex field.
After they have read the book, I hope that students will feel that they have learned
something important and that time studying the material has been well spent.
New to the 8th Edition
New research was added to each chapter, and a new list of topics to debate was
included on the inside cover of the book. Every chapter has been rewritten, tight-
ened, and augmented; issues have been clarified. Highlights of the new edition are
outlined here.
A NEW CHAPTER ON ALCOHOLISM (and addiction): Conflicting views on causes
of alcoholism: Alcoholics Anonymous, neuroscience, Kant, genetics, social sciences,
Fingarette. Focus on the famous case of Ernie Crowfeather.
A MAJOR NEW CASE: The Bucharest Early Intervention Project: Is it the Tuskegee
Study of neuroscience? Research on vulnerable human populations?
A MAJOR NEW SECTON on research on people with schizophrenia, including
cases of patients harmed by such research.
Discussion of Ebola and Zika virus in AIDS chapter: How it has resembled our
responses to AIDS?
Discussion on CRISPR, the revolutionary method of changing genes that almost
any geneticist can use to change a species and its progeny.
Update on the Patient Protection and Affordable Care Act: Why it’s working
and what are its latest problems?
iii
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iv Preface
Death and Dying: The case of Brittany Maynard; the case of Jahi McMath.
Comas: Update on cases of Terri Schiavo, Belgian coma patient Rom Houben,
and minimally conscious states.
Abortion: Updates on death of Kenneth Edelin, declining numbers of abortion
in America. New topics: Telemedicine and early-stage self-abortions, the Planned
Parenthood video controversy, US Supreme Court decision limiting TRAP (Tar-
geted Regulation of Abortion Providers) laws.
Assisted Reproduction: Updates on the Gosselins, McCaughey septuplets, IVF
clinics, mistaken swaps of embryos, outsourced surrogates, and foreigners using
American surrogates; a sperm donor meets eight of his children, right-to-life
groups file in court to protect frozen embryos; state surrogacy laws, Snowflake
(embryo adoption and its high costs), brighter chances for infertile women aged
30–40 of having IVF baby on late tries.
Stem Cells, Cloning, and Embyros: Updates on stem cells, battles over embryos
among divorced couples and right-to-life friends, mitochondria-swapping to
cure genetic disease (“a child with three parents”); hucksterism in selling stem-
cell therapies; continuing problems in cloning primates.
Impaired Babies and Americans with Disabilities Act: Update on “Baby Jane Doe”
Keri-Lynn, Marlise Munoz case; UAB’s controversial SUPPORT study on
preemies, relevance to babies born with microcephaly from Zika virus.
Ethics of Research on Animals: Updates on the Great Ape Project, Edward Taub’s
work, legal protection for chimpanzees in research.
Transplants and Organ Allocation: Updates on numbers, costs, and outcomes,
especially for tracking bad outcomes of adult organ donors.
Genetics chapter: The pitfalls and promises of: personalized genetic testing and
Big Data, CRISPR, and testing for diseases with no treatments.
Chapter on Enhancement: New emphasis on relation of enhancements to people
with disabilities.
If you have suggestions for improvement, please email me at: [email protected].
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About the Author
Gregory E. Pence is professor and chair of the Department of Philosophy at the
University of Alabama at Birmingham. Between 1977 and 2011, he taught medical
ethics at the University of Alabama Medical School. He still directs its Early Medi-
cal School Acceptance Program.
In 2006, and for achievement in medical ethics, Samford University awarded
him a Pellegrino Medal. He testified about human cloning before committees of the
U.S. Congress in 2001 and the California Senate in 2003.
He graduated cum laude in Philosophy with a B.A. from the College of William and
Mary in 1970 and earned a Ph.D. from New York University in 1974, working mainly
under the visiting professor, Peter Singer.
In 2010, his UAB team was national champion of the Intercollegiate Ethics Bowl.
His teams won national championships of the Bioethics Bowl at Duke University in 2011
and Florida State University in 2015. At UAB, he has won both the Ingalls and President’s
Awards for excellence in teaching.
• He has written six trade books, including Who’s Afraid of Human Cloning?
(1998), Re-Creating Medicine: Ethical Issues at the Frontiers of Medicine (2000),
Designer Food: Mutant Harvest or Breadbasket of the World? (2002), Cloning
after Dolly: Who’s Still Afraid? (2004), How to Build a Better Human: An Eth-
ical Blueprint (2012), and What We Talk about When We Talk about Clone
Club: Bioethics and Philosophy in Orphan Black (2016).
• He has edited four books of general essays, Classic Works in Medical Ethics
(1995), Flesh of My Flesh: The Ethics of Cloning Humans (1998), The Ethics of
Food: A Reader for the Twenty-First Century (2002), and Brave New Bioethics
(2004).
• He has published over 60 op-ed essays in national publications: two each
in the New York Times, Los Angeles Times, Newsweek, and Chronicle of Higher
Education; one each in the Los Angeles Times, Atlanta Journal-Constitution,
and Philadelphia Inquirer; and 35 in the Sunday Birmingham News. His reader,
Brave New Bioethics, collects these essays from 1974 to 2002.
• A full list of books by Gregory Pence is available through Connect.
vii
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Acknowledgments
Several people helped in preparing the 8th edition of this text.
Users of this text also improved the new edition with their suggestions and
corrections. In particular, Charles Cardwell, Pellissippi State Community College in
Tennessee, and Jason Gray, who taught bioethics at UAB for two years, spotted
many errors and made many helpful suggestions, as did my colleagues Josh May
and Matt King. My research assistant Karan Jani wrote helpful summaries of the
Bucharest Early Intervention Project and CRISPR. Lillian Chien provided amazing
proofing at the last stage.
The ansrsource developmental editing, lead by Anne Sheroff and Reshmi
Rajeesh were the perfect editors and helped me take this text to a higher level. I
also appreciate the following reviewers for the eighth edition:
Brendan Shea, Rochester Community and Technical College, Minnesota
Sarah Schrader, University of California, Santa Cruz, California
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Brief Contents
Chapter 1 Good and Bad Ethical Reasoning; Moral Theories and Principles  1
Chapter 2 Requests to Die: Terminal and Nonterminal Patients  19
Chapter 3 Comas: Karen Quinlan, Nancy Cruzan, and Terri Schiavo  57
Chapter 4 Abortion: The Trial of Kenneth Edelin  84
Chapter 5 Assisted Reproduction, Multiple Gestations, Surrogacy, and Elderly
Parents  109
Chapter 6 Embryos, Stem Cells, and Reproductive Cloning  132
Chapter 7 Impaired Babies and the Americans with Disabilities Act  157
Chapter 8 Medical Research on Animals  179
Chapter 9 Medical Research on Vulnerable Populations  196
Chapter 10 Ethical Issues in First-Time Organ Surgeries  221
Chapter 11 The God Committee  243
Chapter 12 Using One Baby for Another  264
Chapter 13 Ethical Issues in the Treatment of Intersex and Transgender
Persons  284
Chapter 14 Involuntary Psychiatric Commitment and Research on People with
Schizophrenia  299
Chapter 15 Ethical Issues in Pre-Symptomatic Testing for Genetic Disease: Nancy
Wexler, Angelina Jolie, Diabetes and Alzheimer’s  325
Chapter 16 Ethical Issues in Stopping the Global Spread of Infectious Diseases:
AIDS, Ebola, and Zika  346
Chapter 17 Ethical Issues of the Patient Protection and Affordable Care Act  367
Chapter 18 Ethical Issues in Medical Enhancement (and their effect on people with
Disabilities)  392
Chapter 19 Ethical Issues in Treating Alcoholism  405
ix
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