Biomedical Ethics: A Canadian Focus
|Author||Fisher, Johnna (Ed)|
Biomedical Ethics: A Canadian Focus, second edition, is an anthology of classic and contemporary readings designed to introduce students to the main debates and issues faced by practitioners in the medical professions. The book is organized into nine chapters. Each chapter includes an introduction followed by a selection of articles, many of which explore ethical issues specific to the Canadian health care system. The readings are supported by end-of-chapter case studies, covering the issues highlighted in the articles; study questions; suggested further readings; and an appendix illustrating how to provide case commentary on an ethical issue.
Table of Contents
Preface 1. Morality and Ethics 1.1 Introduction 1.2 Morality and Ethics 1.3 Moral Theories 2. Medical Decision-Making: Patient Self-Determination and Deciding for Others 2.1 Introduction 2.2 Who Decides for the Patient? Autonomy, Competence, and Surrogacy Allen E. Buchanan and Dan W. Brock: - Standards of Competence Christine Harrison, Nuala P. Kenny, Mona Sidarous, and Mary Rowell: - Involving Children in Medical Decisions Canadian Medical Association: - Advance Directives for Resuscitation and Other Life-Saving or Life-Sustaining Measures Susan Sherwin: - A Relational Approach to Autonomy in Health Care 2.3 Informed Consent Ruth R. Faden and Tom L. Beauchamp: - The Concept of Informed Consent Ruth Macklin: - Consent, Coercion, and Conflicts of Rights Howard Brody: - Transparency: Informed Consent in Primary Care Joseph Kaufert and John O'Neil: - Culture, Power, and Informed Consent: The Impact of Aboriginal Health Interpreters on Decision-Making 2.4 Differing Opinions of Patient Best Interest Kenneth Kipnis: - Quality Care and the Wounds of Diversity Ruth Macklin: - Ethical Relativism in a Multicultural Society 2.5 Individual Interests versus Family Interests John Hardwig: - What About the Family? Thomas A. Mappes and Jane S. Zembaty: - Patient Choices, Family Interests, and Physician Obligations 2.6 Cases - Scott Starson: Refusing Treatment while Incompetent - No Chemotherapy for Anael: Surrogate Refusal of Treatment for a Minor Child - Refusal to Consent to a DNR for a Minor Child: Manitoba Court of Appeal Case Child and Family Services of Central Manitoba v. R.L. - Do Everything for Mom: Advance Directives and a Surrogate's Right to Demand Treatment - Treatment for Jehovah's Witnesses: Adult, Teen, and Infant - Current Wishes Conflict with Prior Instructions 3. Management of Medical Information 3.1 Introduction 3.2 Privacy and Confidentiality Canadian HIV/AIDS Legal Network: - Privacy: Human Rights, Public Policy, and Law Mark Siegler: - Confidentiality in Medicine: A Decrepit Concept Patricia A. Roche and George J. Annas: - DNA Testing, Banking, and Genetic Privacy NEW Mireille Lacroix, Gillian Nycum, Beatrice Godard, and Bartha Maria Knoppers: - Should Physicians Warn Patients' Relatives of Genetic Risks? NEW 3.3 Truth-Telling Mack Lipkin: - On Telling Truth to Patients David C. Thomasma: - Telling the Truth to Patients: A Clinical Ethics Exploration 3.4 Cases Leonard Fleck and Marcia Angell: - Please Don't Tell!: A Case about HIV and Confidentiality - John Reibl: Information Disclosure, Comprehension, and Informed Consent - Do Patients Have a Right to the Information in Their Medical Files? Canadian Supreme Court Case of McInerney v. MacDonald (1992) - Breach of Lawyer-Client Confidentiality Appropriate When Poses Public Danger: Canadian Supreme Court Case of Smith v. Jones (1999) - Breaching Privacy to Save Lives: HCP Knowledge of Possible Risk to Non-Patient Family Members 4. Moral Status of the Human Fetus and Infant 4.1 Introduction 4.2 Positions on Fetal Moral Status: Conservative, Moderate, and Liberal Nancy Miller Chenier: - Reproductive Technologies: Royal Commission Final Report Don Marquis: - Why Abortion Is Immoral Mary Anne Warren: - On the Moral and Legal Status of Abortion Judith Jarvis Thomson: - A Defence of Abortion Susan Sherwin: - Abortion Through a Feminist Ethics Lens 4.3 Declining Treatment during Pregnancy and Immediately after Birth John Seymour: - A Pregnant Woman's Decision to Decline Treatment: How Should the Law Respond? Mary B.Mahowald: - Decisions Regarding Disabled Newborns 4.4 Cases - Prenatal Diagnosis and Abortion or Infanticide through Declining Treatment - Failed Abortion and Offer of Third-Trimester Abortion - Abortion of Suspected Female Fetus - Ms G and Refusal of Treatment while Pregnant - Endangering Behaviour in a Pregnant Woman - Abortion of a Fetus due to Diagnosis of Down Syndrome 5. End-of-Life Decision-Making 5.1 Introduction 5.2 Refusal or Withdrawal of Treatment, Medical Futility, and Terminal Sedation Health Law Institute, Dalhousie University: - Withholding and Withdrawal of Potentially Life-Sustaining Treatment Mark R. Wicclair: - Medical Futility: A Conceptual and Ethical Analysis Joseph M. Boyle: - Medical Ethics and Double Effect: The Case of Terminal Sedation 5.3 Voluntary Active Euthanasia and Physician-Assisted Suicide Dan W. Brock: - Voluntary Active Euthanasia James Rachels: - Active and Passive Euthanasia James V. Lavery, Bernard M. Dickens, Joseph M. Boyle, and Peter A. Singer: - Bioethics for Clinicians: Euthanasia and Assisted Suicide Daniel Callahan: - When Self-Determination Runs Amok Susan Wolf: - Gender, Feminism, and Death: Physician-Assisted Suicide and Euthanasia 5.4 Rights to Die and Duties to Die Leon R. Kass: - Is There a Right to Die? John Hardwig: - Is There a Duty to Die? 5.5 Cases - Sue Rodriguez: Physician-Assisted Suicide - Dr Nancy Morrison: (Non)Voluntary Active Euthanasia of an Adult - Tracy Latimer: Nonvoluntary Active Euthanasia of a Minor - Mr McCullough: Recommending Voluntary Passive Euthanasia - Elizabeth and Eric MacDonald: Assisted Suicide - Baby Joseph: HCP Refusal of Futile Treatment Leading to Passive Euthanasia and Parental Disagreement 6. Genetic Technology Use 6.1 Introduction 6.2 Eugenics Jonathan Glover: - Eugenics: Some Lessons from the Nazi Experience Jana Grekul, Harvey Krahn, and Dave Odynak: - Sterilizing the 'Feeble-Minded': Eugenics in Alberta, Canada, 1929-1972 Veronica Pearson: - Population Policy and Eugenics in China 6.3 Cloning and Stem Cell Usage Leon R. Kass: - Cloning of Human Beings John D. Russell and Andrew S. Irvine: - A Rose Is a Rose, but Clones Will Differ Katrien Devolder: - Creating and Sacrificing Embryos for Stem Cells 6.4 Genetic Treatment and Enhancement Walter Glannon: - Genetic Enhancement Dan W. Brock: - Genetic Engineering Francoise Baylis and Jason Scott Robert: - The Inevitability of Genetic Enhancement 6.5 Genetic Testing Leon R. Kass: - Implications of Prenatal Diagnosis for the Human Right to Life Laura M. Purdy: - Genetics and Reproductive Risk: Can Having Children Be Immoral? Abby Lippman: - Prenatal Genetic Testing and Screening: Constructing Needs and Reinforcing Inequities Timothy Caulfield: - Direct-to-Consumer Genetics and Health Policy: A Worst-Case Scenario? NEW Christopher F. C. Jordens, Ian H. Kerridge, and Gabrielle N. Samuel: - Direct-to-Consumer Personal Genome Testing: The Problem Is Not Ignorance - It Is Market Failure NEW 6.6 Cases Douglas Wahlsten: - Leilani Muir versus the Philosopher King: Eugenics on Trial in Alberta - Changing Socially Undesirable Characteristics - Predictive Testing for Criminal Behaviour: Genes and Environment - Testing for Late-Onset Genetic Disorders in Children - Direct-to-Consumer Personal Genomic Testing for Mother and Adolescent Daughters 7. Access to Health Care 7.1 Introduction 7.2 Macroallocation: Is There a Right to Health Care? Allen E. Buchanan: - The Right to a Decent Minimum of Health Care Pat Armstrong: - Managing Care the Canadian Way Edmund D. Pellegrino: - The Commodification of Medical and Health Care: The Moral Consequences of a Paradigm Shift from a Professional to a Market Ethic Roy Romanow: - Sustaining Medicare: The Commission on the Future of Health Care in Canada Kai Nielson: - Autonomy, Equality, and a Just Health Care System 7.3 Cases - Belinda Stronach Travels to California for Health Care - BC Physicians 'Cherry-Picking' Patients for Ease of Care, Refusing Those in Need - Refusal of Life-Saving Treatment - Failure to Fund a Beneficial Drug - Universal Care: Less Time, Less Efficacy - Multiple Transplants 8. Allocation of Scarce Medical Resources 8.1 Introduction 8.2 Microallocation: The Necessity of Rationing Nicholas P. Rescher: - The Allocation of Exotic Medical Life-Saving Therapy Daniel Callahan: - Allocating Resources to the Elderly 8.3 Increasing Resources Through Commodification R.R. Kishore: - Human Organs, Scarcities, and Sale: Morality Revisited Nancy Scheper-Hughes: - Keeping an Eye on the Global Traffic in Human Organs Wayne Kondro: - Debate over Online Recruitment of Organ Donors 8.4 Cases - No Lungs for Linda - Rationing Services to an Elder Who Is Responsible for His Medical Condition - Buying a Kidney in India but Requesting Canadian After-Care - Does Clifford Olson Deserve Medical Treatment? - Having an Estate Sale of One's Organs 9. Research with Humans 9.1 Introduction 9.2 The Dark History of Human Research Gregory E. Pence: - The Tuskegee Study Colin A. Ross: - Dr Ewen Cameron Arthur Schafer: - Biomedical Conflicts of Interest: A Defence of the Sequestration Thesis - Learning from the Cases of Nancy Olivieri and David Healy Steven Lewis, Patricia Baird, Robert G. Evans, William A. Ghali, Charles J. Wright, Elaine Gibson, and Francoise Baylis: - Dancing with the Porcupine: Rules for Governing the University-Industry Relationship Barbara K. Redman, Thomas N. Templin, and Jon. F. Merz: - Research Misconduct Among Clinical Trial Staff NEW 9.3 Codes and Guidelines Nuremburg Military Tribunal: - The Nuremburg Code World Medical Association: - Declaration of Helsinki Canadian Institutes of Health Research: - Tri-council Policy Statement: Ethical Conduct for Research Involving Humans Sandra L. Titus, James A. Wells, and Lawrence J. Rhoades: - Repairing Research Integrity NEW 9.4 Use of Children and Noncompetent Patients in Research Alexander M. Capron: - Ethical and Human-Rights Issues in Research on Mental Disorders that May Affect Decision-Making Capacity Lainie Freidman Ross: - The Child as Research Subject George J. Annas: - Baby Fae: The "Anything Goes" School of Human Experimentation 9.5 Cases - Stanley Milgram: Lies and Invalid Consent a Necessary Part of the Research - Mr Halushka: Human Research and Harm to Participants - Nonclinical Research on Alzheimer's Patients - Sabotaging a Colleague to Get Ahead - Jesse Gelsinger Appendix - Clarifying Contextual Details of the Case: A Case Study Approach NEW Glossary Bibliography Permissions Index Note: All chapters include Study Questions and Suggested Further Readings
"The scope of the book is very good. . . . The introductory chapter on morality and ethics is exceptional-among the very best I've seen." --Chris MacDonald, Ryerson University
"The review of ethical theory in this text is exceptional. . . . The text also does a fine job balancing 'classic' older articles with newer entries." --Ken Kirkwood, University of Western Ontario