The Blackwell Guide to Medical Ethics (Blackwell Philosophy Guides)

443 Pages·2007·2.43 MB·English

by  Leslie P. Francis, Anita Silvers, Rosamond Rhodes, Frances M. Kamm, Kenneth Kipnis, Robert T. Pennock, Julian Savulescu

The Blackwell Guide to
Medical Ethics
Blackwell Philosophy Guides
Series Editor: Steven M. Cahn, City University of New York Graduate School
Written by an international assembly of distinguished philosophers, the Blackwell Philosophy Guides
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21 The Blackwell Guide to MEDICAL ETHICS
edited by Rosamond Rhodes, Leslie P. Francis, and Anita Silvers
The Blackwell Guide to
Medical Ethics
Edited by
Rosamond Rhodes, Leslie P. Francis,
and Anita Silvers
© 2007 by Blackwell Publishing Ltd
BLACKWELL PUBLISHING
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The right of Rosamond Rhodes, Leslie P. Francis, and Anita Silvers
to be identifi ed as the Authors of the Editorial Material in this Work has been asserted
in accordance with the UK Copyright, Designs, and Patents Act 1988.
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prior permission of the p ublisher.
First published 2007 by Blackwell Publishing Ltd
2 2007
Library of Congress Cataloging-i n- Publication Data
The Blackwell guide to medical ethics / edited by Rosamond Rhodes,
Leslie P. Francis, Anita Silvers
p. cm. — (Blackwell Philosophy Guides; 21)
Includes bibliographical references and index
ISBN- 13: 978–1-4 051–2583–3 (hardback: alk. paper)
ISBN-1 3: 978–1- 4051–2584–0 (pbk.: alk. paper)
1. Medical ethics. I. Rhodes, Rosamond. II. Francis, Leslie, 1946– III.
Silvers, Anita. IV. Title: Guide to medical ethics. V. Series = 20
[DNLM: 1. Ethics, Medical. 2. Bioethical Issues—legislation & jurisprudence.
3. Patient Rights—ethics. 4. Public Policy. W 50 B632 2007]
R724.B515 2007
174.2—dc22 2006027510
A catalogue record for this title is available from the British L ibrary.
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Contents
Notes on Contributors vii
Introduction 1
Rosamond Rhodes, Leslie P. Francis, and Anita Silvers
Part I Individual Decisions About Clinical Issues
I.1 Patient Decisions 15
1 A utonomy, the Good Life, and Controversial Choices 17
Julian Savulescu
2 I ndividual Responsibility and Reproduction 38
Rachel A. Ankeny
3 P atient and Family Decisions about Life-E xtension and Death 52
Felicia Nimue Ackerman
I.2 Individual Decisions of Physicians and Other Health Care Professionals 69
4 T he Professional Responsibilities of Medicine 71
Rosamond Rhodes
5 T ruth Telling 88
Roger Higgs
6 M edical Confi dentiality 104
Kenneth Kipnis
7 Patient Competence and Surrogate Decision-M aking 128
D an W. Brock
8 Ending Life 142
F.M. Kamm
9 Discrimination in Medical Practice: Justice and the Obligations of
Health Care Providers to Disadvantaged Patients 162
Leslie P. Francis
v
Contents
10 Institutional Practices, Ethics, and the Physician 180
Mary V. Rorty , Ann E. Mills, and Patricia H. Werhane
Part II Legislative and Judicial Decisions about Social Policy
I.1 Liberty 19
11 Reproductive Choice 201
Rebecca Bennett and John Harris
12 Public Policy and Ending Lives 220
Evert van Leeuwen and Gerrit Kimsma
13 Drug Legalization 238
Douglas N. Husak
14 Selling Organs, Gametes, and Surrogacy Services 254
Janet Radcliffe Richards
15 The Patient as Victim and Vector: The Challenge of Infectious
Disease for Bioethics 269
Margaret P. Battin, Leslie P. Francis Jay A. Jacobson, and
Charles B. Smith
16 Abuses of Science in Medical Ethics 289
Glenn McGee and Dýrleif Bjarnadóttir
I.2 Justice 303
17 Allocation of Scarce Resources 305
Paul Menzel
18 Just Caring: The Challenges of Priority-S etting in Public Health 323
Leonard M. Fleck
19 Justice and the Financing of Health Care 341
Stephen R. Latham
20 Judgment and Justice: Evaluating Health Care for Chronically Ill
and Disabled Patients 354
Anita Silvers
21 Justice in Research on Human Subjects 373
David R. Buchanan and Franklin G. Miller
22 Ethics of Disclosure Following a Medical Injury: Time for Reform? 393
Troyen Anthony Brennan
23 Pre-e xisting Conditions: Genetic Testing, Causation, and the Justice
of Medical Insurance 407
Robert T. Pennock
Index 425
vi
Notes on Contributors
Felicia Nimue Ackerman PhD is Professor of Philosophy at Brown University,
Providence, Rhode Island, USA. Her essays on bioethics have appeared in the
Hastings Center Report, the Oxford Handbook of Bioethics (2007), and elsewhere.
Her short stories on bioethical themes are published in Prize Stories 1990: The
O. Henry Awards, Commentary, and elsewhere. Her poems on bioethics are in
Ragged Edge Online and elsewhere. She is preparing Bioethics Through Fiction, a
volume of her stories and essays that will be published by Rowman & L ittlefi eld.
Rachel A. Ankeny PhD is Senior Lecturer of the Unit for History and Philosophy
of Science, University of Sydney, Australia. Her research interests include the
history and philosophy of the biomedical sciences, particularly epistemological and
ethical issues; the philosophy of medicine; the public understanding of biomedical
sciences; and ethical issues associated with transplantation, genetics, reproductive
technologies, and p harmaceuticals.
Margaret P. Battin MFA, PhD is Distinguished Professor in the Department
of Philosophy and Adjunct Professor in the Division of Medical Ethics, Depart-
ment of Internal Medicine at the University of Utah. She is the author or editor
of a dozen books, most recently, Ending Life: Ethics and the Way We Die (Oxford,
2005). Her current areas of interest and research include suicide, physician-a ssisted
suicide and euthanasia, ethics and infectious disease, and reproductive issues.
Rebecca Bennett PhD teaches in The Centre for Social Ethics and Policy, School of
Law, University of Manchester, Manchester, UK. Dr Bennett has taught bioe thics
for 12 years and has published widely on diverse issues in bioethics. Her particu-
lar area of interest is the ethics of human reproduction including ante natal HIV
and genetic testing, pre-l implatation genetic diagnosis, cloning, stem cell research,
ectogenesis, and paternal rights. She is also responsible for d evising, developing,
and running the innovative distance learning MA/Postgraduate Diploma in Health
Care Ethics and Law.
vi
Notes on Contributors
Dýrleif Bjarnadóttir MA, MS is a Senior Research Fellow at the Alden March
Bioethics Institute in Albany NY, and is currently completing a dissertation in
reproductive ethics. Her recent research has included newborn screening, the obli-
gations of parents to their children, and the signifi cance of cultural variances in the
invocation of parental autonomy in treatment decisions for n eonates.
Troyen Anthony Brennan MD is the Chief Medical Offi cer at Aetna. He was pre-
viously Professor of Medicine at Harvard Medical School.
Dan W. Brock PhD is the Frances Glessner Lee Professor of Medical Ethics at
Harvard Medical School. He is the author (with Allen Buchanan) of Decid-
ing for Others: The Ethics of Surrogate Decision Making (Cambridge University
Press, 1989) as well as (with others) From Chance to Choice: Genetics and Justice
(Cambridge University Press, 2000). His current research focuses on resource pri-
oritization in the health sector.
David R. Buchanan DrPH, MA, is Research Fellow at the National Cancer Insti-
tute, Bethesda, Maryland, USA. Dr Buchanan has written extensively about the
ethics of health promotion, public health ethics, and research ethics from a public
health perspective. His most recent books include An Ethic for Health Promotion
(Oxford University Press, 2000), and Ethical and Legal Issues in Research with
High Risk Populations (APA Press, in press).
Leonard M. Fleck PhD, Professor of Philosophy and Medical Ethics, Michigan
State University, East Lansing, Michigan, USA, has written extensively on the role
of rational democratic deliberation in more justly addressing problems of health
care rationing and priority-s etting as well as ethical and policy issues related to
genetics and reproductive decision-m aking.
Leslie P. Francis PhD, JD is Professor of Philosophy and the Alfred C. Emery
Professor of Law, Adjunct Professor of Political Science at the University of Utah,
and Adjunct Professor in the Division of Medical Ethics, Department of Internal
Medicine at the University of Utah School of Medicine. Current areas of interest
and research include bioethics and the law of bioethics, health law, the philosophy
of law, and research ethics.
John Harris FMedSci is Sir David Alliance Professor of Bioethics, School of Law,
University of Manchester and is joint Editor- in- Chief of The Journal of Medical Ethics.
He has been a member of The United Kingdom Human Genetics Commission since
its foundation in 1999. Recent books include Clones, Genes and Immortality (Oxford
University Press, 1998); John Harris (ed.), Bioethics, Oxford Readings in Philosophy
Series, (Oxford University Press, 2001); Justine C. Burley and John Harris (eds.), A
Companion To Genethics: Philosophy and the Genetic Revolution, Blackwell’s Compan-
ions to Philosophy series (Blackwell, 2002); and On Cloning, (Routledge, 2004).
viii
Notes on Contributors
Roger Higgs MBE, MA, FRCP, FRCGP is a physician and ethicist. He is Profes-
sor Emeritus at King’s College London, specializing in general (family) practice
and primary care, and ethics. He retired from active primary medical care in 2004
after 30 years as a physician, educator, and innovator in south London. He has
published on psychological issues, health care development, and clinical ethics.
Douglas N. Husak PhD, JD is Professor of Philosophy at Rutgers University,
New Jersey, USA. He works in legal philosophy generally, and in the philosophy of
criminal law in particular. He is the author of Philosophy of Criminal Law (Rowman
& Littlefi eld, 1987), Drugs and Rights (Cambridge University Press, 1992), and
Legalize This (Verso, 2002).
Jay A. Jacobson MD is Professor of Internal Medicine, Chief of the Division of
Medical Ethics, and a member of the Division of Infectious Disease at LDS Hospi-
tal and the Department of Medicine at the University of Utah School of Medicine.
Current areas of interest and research include clinical and classroom teaching of
medical ethics, infectious diseases, sub- specialty consultation and patient care, end
of life care, and informed consent and medical decision-m aking.
F. M. Kamm PhD is Littauer Professor of Philosophy and Public Policy, Kennedy
School of Government, and Professor of Philosophy, FAS, Harvard University,
Massachusetts, USA. She specializes in normative ethical theory and practical
ethics. Professor Kamm is the author of Creation and Abortion (Oxford University
Press, 1992), Morality, Mortality , vols. 1 and 2 (Oxford University Press, 1993
and 1996), Intricate Ethics (Oxford University Press, 2006), and numerous essays
in ethical theory and practical ethics.
Gerrit Kimsma, MD, drs Phil, is a general practitioner and fellow of the Center
of Ethics and Philosopy, at Vrije Universiteit Medisch Centrum in Amsterdam,
the Netherlands. His writing has focused on death and dying and the professional
ethics of physicians. He is a member of the Euthanasia Committee of South-
H olland and co-e ditor of Asking to Die: Inside the Dutch Euthanasia Debate
(Kluwer, 1998).
Kenneth Kipnis PhD is a professor in the Department of Philosophy at the
University of Hawaii at Manoa. His publications touch on ethical issues across
a range of fi elds – law, medicine, early childhood education, engineering, and
research on human subjects – and he has been writing about confi dentiality for
more than 25 years.
Stephen R. Latham JD, PhD is Professor of Law and Director of the Center
for Health Law and Ethics at the Quinnipiac University School of Law in
Hamden, Connecticut, USA. He was a former research fellow at the University
of Edinburgh’s Institute for Advanced Studies in the Humanities. His writings on
ix