Elements of Bioethics » (1st Edition)

Gregory Pence is one of the pioneering bioethicists of America. Having taught for thirty years in a medical school, he has seen many past prophecies of doom fail. He is optimistic about biotechnology.

He is internationally famous for defending cloning and genetically modified food against bioLuddites who oppose research on stem cells and cloning. Because of his views, his talks have been picketed by Greenpeace and anti-cloning zealots.

His Classic Cases in Medical Ethics: Accounts of the Cases that Shaped Medical Ethics, 4th ed., 2003, is one of the standard textbooks of bioethics. His Who's Afraid of Human Cloning? (1998) is already regarded as a classic in bioethics for its rigorous attack on opponents of cloning. His Cloning After Dolly: Who's STILL Afraid of Human Cloning? will appear in late 2004. His Designer Food: Mutant Harvest or Breadbasket of the World? won a Choice Outstanding Academic Title in 2003.

He doesn't think the sky will fall if a cloned baby is born. In opposing laws against cloning, he was asked to testify in 2001 before Congress and in 2002 before the California Senate.

Constantly in demand for national television, Pence has been interviewed on Bobby Battista's "Talk Back Live" with Bobby Battista, "The Point" with Gretta von Susteren on CNN, "The Early Show with Bryant Gumbel" on CBS, "Wolf Blitzer's Washington" on CNN, as well as on National Public Radio's "Marketplace" and its "Weekend Edition." He has also been interviewed by TIME magazine, the New York Times, and most national publications. He has published in Newsweek, the New York Times, and the Wall Street Journal.

Pence has given the Soundings Lecture at Castleton State College, VT, the Thornton Lecture at Alma College, MI, the Seidman Trust Lecture at Rhodes College, TN, and the Hughes Memorial Lecture at West Liberty State College in WVA. He has talked at Princeton, Yale, and Stanford. He has given keynote talks about cloning at universities in Portugal, London, Switzerland, and Australia.

Pence teaches at the medical school at the University of Alabama in Birmingham (UAB), where he also directs a program for gifted undergraduates pre-admitted to UAB medical school. There, he has been voted Best Teacher.

He grew up in Washington, D.C., was graduated from the College of William and Mary cum laude in Philosophy, and earned his doctorate from New York University in 1974, where he worked on his dissertation under bioethicist Peter Singer, now at Princeton University.

This book is designed for the biomedical ethics course as a core introduction to biomedical issues in the context of ethical theory. Each chapter unfolds timely, paradigm case examples—many of which have never before been explored in a bioethics text—and presents these topics amidst discussion of their key ethical issues. This short volume complements Pence’s popular Classic Cases in Medical Ethics: Accounts of the Cases that have Shaped Medical Ethics, Fourth Edition (ISBN 0-07-282935-4), and Classic Works in Medical Ethics: Core Philosophical Readings (ISBN 0-07-038115-1).

Preface
1. LYING TO PATIENTS AND ETHICAL RELATIVISM

1.1 Ethical Relativism & Ethical Subjectivism

1.2 Impartiality and Moral Reasoning

1.3 Kant On Lying

1.4 Utilitarian Ethics

1.5 Omitting the Truth vs. Lying

1.6 Apologizing for Mistakes & Taking Responsibility for Mistakes

1.7 Virtue Ethics: Truthfulness, Complicity, and Responsibility

1.8 Conceptual Issues: What is a Mistake?

2. KANT ON WHETHER ALCOHOLISM IS A DISEASE

2.1 The God Committee: Who Shall Live When Not All Can?

2.2 Free Will

2.3 Kant on Human Dignity

2.4 Is Alcoholism a Disease?

2.5 Sociologists and Geneticists on Alcoholism

2.6 Kant’s Critique of the Disease Model

2.7 Fingarette’s Research

2.8 Harm Reduction vs. Moralism in Medicine

2.9 Liver Transplants for Alcoholics?

3. KANT’S CRITIQUE OF ADULT ORGAN DONATION

3.1 Kant: Some Things Must Not Be Done

3.2 Background: Crossing the Ethical Bright Line in Organ Procurement

3.3 The Utilitarian Defense of Live Organ Donation

3.4 Act versus Rule Utilitarianism

3.5 The Utilitarian Rebuttal

3.6 Autonomous Live Organ Donation for Kantians?

3.7 Utilitarians and Payment for Organs

3.8 Virtue Ethics and Live Organ Donors

3.9 Organ Transplantation and Race

4. UTILITARIANS VS. KANTIANS ON STOPPING AIDS

4.1 History of Utilitarian Ethics

4.2 Virtue Ethics, Medical Saints, and Paul Farmer

4.3 Utilitarians and Numbers: Applying Triage

4.4 Stopping AIDS: The Challenge to Ethical Theories

4.5 Kantian and Utilitarian Ideas about Patient Care

4.6 Mill’s Critique of Kantian Ethics

4.7 Farmer and Rawls on Just Medical Care

4.8 Placebos with AIDS Drugs on Vulnerable Africans

4.9 Costs of AIDS Drugs

5. EMOTIVISM AND BANNING SOME CONCEPTIONS

5.1 History of Assisted Reproduction

5.2 Emotivism

5.3 Paradoxes about Conception

5.4 Multiple Embryo Implantation

5.5 Sex Selection

5.6 Age of Parents and the Good of the Child

5.7 Hume, Kant, and Aristotle on the Emotions

5.8 Surrogate Mothers & Compensating Gametic Donors

5.9 Reproductive Cloning

6. TERRI SCHIAVO: WHEN DOES PERSONHOOD END?

6.1 Cessation of Personhood

6.2 Background: Brain Death and the Quinlan and Cruzan Cases

6.3 Families, Criteria of Personhood, and Character Issues

6.4 A New Category of Consciousness?

6.5 Religious Issues

6.6 Disability Issues

6.7 Virtue Ethics: The Many Faces of Compassion

6.8 The Politicization of the Schiavo Case

6.9 What the Autopsy Showed

7. ARE GENETIC ABORTIONS EUGENIC?

7.1 Down Syndrome

7.2 Roe vs. Wade and the Legalization of Abortion

7.3 Choosing Against Pregnancy vs. Choosing Against Abnormality

7.4 Abortion and Personhood

7.5 New Genetic Tests, Disability Advocates, and Eugenics

7.6 Eugenics

7.7 Genetic Testing, and Malpractice and Insurance Companies

7.8 Newborn Genetic Screening

7.9 Sending the Wrong Message?

8. CAN RESEARCH BE JUST ON PEOPLE WITH SCHIZOPHRENIA?

8.1 Research to Cure Schizophrenia, Money, and Care for the Mentally Ill

8.2 Nazi and American Research, and the Tuskegee Study

8.3 Schizophrenia

8.4 Informed Consent and Schizophrenia Studies

8.5 Virtue Ethics, Integrity, and Conflicts of Interest

8.6 Harm to Subjects and the Kantian Ideal of Patient Care

8.7 Vulnerable Subjects and Social Justice

8.8 Structural Critiques of Modern Psychiatric Research

8.9 NBAC’s Report on Psychiatric Research

9. IS THERE A DUTY TO DIE?

9.1 Gov. Lamm’s Famous Remarks and His Historical Predecessors

9.2 John Hardwig: Defending a Duty to Die

9.3 Alzheimer’s and Dementia

9.4 Rawls and Callahan on Justice and Natural Limits

9.5 Global Reallocation? Dying Simply so Others Can Simply Live

9.6 Mary Warnock vs. Felicia Ackerman on a Duty to Die

9.7 Within the Family: Our Parents’ Keepers

9.8 Dworkin’s Defense of Advance Directives and Autonomy

9.9 Medical Professionals and Medical Futility

10. TREATING JEHOVAH’S WITNESSES PROFESSIONALLY

10.1 Jehovah Witnesses and Medicine

10.2 Professionalism, Religious Minorities, and Tolerance

10.3 Parental Owners vs. Parental Stewards of Children

10.4 Virtue Ethics, Treatment Refusal, amd Religious Minorities

10.5 Legal Issues

10.6 Medicine and Good of the Child/Adolescent

10.7 Bloodless Surgery and Jehovah Witnesses

10.8 Consistency in Handling Cases of Minority Views in Medicine

Endnotes

Index