Case Studies in Biomedical Ethics Decision-Making, Principles, and Cases

The most comprehensive and up-to-date collection of its kind, Case Studies in Biomedical Ethics: Decision-Making, Principles, and Cases, Second Edition, explores fundamental ethical questions arising from real situations faced by health professionals, patients, and others.

Featuring a wide range of more than 100 case studies drawn from current events, court cases, and physicians' experiences, the book is divided into three parts. Part 1 presents a basic framework for ethical decision-making in healthcare, while Part 2 explains the relevant ethical principles: beneficence and nonmaleficence, justice, respect for autonomy, veracity, fidelity, and avoidance of killing. Parts 1 and 2 provide students with the background to analyze the ethical dilemmas presented in Part 3, which features cases on a broad spectrum of issues including abortion, mental health, experimentation on humans, the right to refuse treatment, and much more. The volume is enhanced by opening text boxes in each chapter that cross-reference relevant cases in other chapters, an appendix of important ethical codes, and a glossary of key terms.

Robert M. Veatch, Ph.D., is Professor of Medical Ethics and a former director at the Kennedy Institute of Ethics, Georgetown University.

Amy M. Haddad, Ph.D., is the Director of the Center for Health Policy & Ethics and the Dr. C.C. and Mabel L. Criss Endowed Chair in the Health Sciences at Creighton University.

Dan C. English, M.D., M.A., F.A.C.S., is Affiliated Scholar at the Center for Clinical Bioethics at Georgetown University.

*=New to this Edition
Introduction: Four Questions of Ethics
What Are the Source, Meaning, and Justification of Ethical Claims?
Distinguish between Evaluative Statements and Statements Presenting Non-evaluative Facts
Distinguish between Ethical and Nonethical Evaluations
Determine Who Ought to Decide
What Kinds of Acts Are Right?
Consequentialism
Deontological or "Duty-Based" Ethics
Other Issues of Normative Ethics
How Do Rules Apply to Specific Situations?
What Ought to Be Done in Specific Cases?
PART 1: ETHICS AND VALUES IN MEDICAL CASES
Chapter 1: A Model for Ethical Problem-Solving
The Five-Step Model
Application of the Model
Chapter 2: Values in Health and Illness
Identifying Value Judgments in Medicine
Separating Ethical and Other Evaluations
Chapter 3: What Is the Source of Moral Judgments?
Grounding Ethics in the Professional Code
Grounding Ethics in the Physician's Orders
Grounding Ethics in Institutional Policy
Grounding Ethics in the Patient's Values
Grounding Ethics in Religious or Philosophical Perspectives
PART 2: ETHICAL PRINCIPLES IN MEDICAL ETHICS
Chapter 4: Benefiting the Patient and Others: The Duty to Do Good and Avoid Harm
Benefiting the Patient
Health in Conflict with Other Goods
Relating Benefits and Harms
Benefits of Rules and Benefits in Specific Cases
Benefiting Society and Individuals Who Are Not Patients
Benefits to Society
Benefits to Specific Nonpatients
Benefit to the Profession
Benefit to the Health Professional and the Health Professional's Family
Chapter 5: Justice: The Allocation of Health Resources
Justice among Patients
Justice between Patients and Others
Justice in Public Policy
Justice and Other Ethical Principles
Chapter 6: Autonomy
Determining Whether a Patient Is Autonomous
External Constraints on Autonomy
Overriding the Choices of Autonomous Persons
Chapter 7: Veracity: Honesty with Patients
The Condition of Doubt
Lying in Order to Benefit
Protecting the Patient by Lying
Protecting the Welfare of Others
Special Cases of Truth-Telling
Patients Who Do Not Want to Be Told
Family Members Who Insist the Patient Not Be Told
The Right of Access to Medical Records
Chapter 8: Fidelity: Promise-Keeping, Loyalty to Patients, and Impaired Professionals
The Ethics of Promises: Explicit and Implicit
Fidelity and Conflicts of Interest
Incompetent and Dishonest Colleagues
Chapter 9: Avoidance of Killing
Active Killing versus Letting Die
Withholding versus Withdrawing Treatment
Direct versus Indirect Killing
Justifiable Omissions: The Problem of Nutrition and Hydration
Voluntary and Involuntary Killing
Killing as Punishment
PART 3: SPECIAL PROBLEM AREAS
Chapter 10: Abortion, Sterilization, and Contraception
Abortion
Abortion for Medical Problems of the Fetus
Abortion Following Sexual Assault
Abortion to Save the Life of the Pregnant Woman
Abortion and the Mentally Incapacitated Woman
Abortion for Socioeconomic Reasons
Sterilization
Contraception
Chapter 11: Genetics, Birth, and the Biological Revolution
Genetic Counseling
Genetic Screening
In Vitro Fertilization and Surrogate Motherhood
Preimplantation Diagnosis
Gene Therapy
Chapter 12: Mental Health and Behavior Control
The Concept of Mental Health
Mental Illness and Autonomous Behavior
Mental Illness and Third-Party Interests
Other Behavior-Controlling Therapies
Chapter 13: Confidentiality: Ethical Disclosure of Medical Information
Breaking Confidence to Benefit the Patient
Breaking Confidence to Benefit Others
Breaking Confidence as Required by Law
Chapter 14: Organ Transplants
Procuring Organs
Donation versus Salvaging
* The Grounds for Pronouncing Death
Diseased and Poor-Quality Organs
Preserving the Organs of the Dying
Socially Directed Organ Donation
Living Donor/Deceased Donor Organ Swaps
Children and Incompetent Persons as Living Organ Sources
* Transplanting Faces and Hands: Vascular Composite Allografts
Allocating Organs
Maximizing Benefits and Distributing Organs Fairly
When Voluntary Risks Cause a Need for Organs
* Age and the Allocation of Organs
Multiple Organs and Special Priority for Special People
Chapter 15: Health Insurance, Health System Planning, and Rationing
The Problem of Small, Incremental Benefits
Limits on Unproved Therapies
Marginally Beneficial, Expensive Therapy
Funding Care that Patients Have Refused
Pharmaceutical Manufacturers versus Insurers
Insurance and the Uninsured
* The Affordable Care Act
Chapter 16: Experimentation on Human Subjects
Calculating Risks and Benefits
Privacy and Confidentiality
Equity in Research
Conflicts of Interest in Research
Informed Consent in Research
Chapter 17: Consent and the Right to Refuse Treatment
The Elements of a Consent
The Standards for Consent
Comprehension and Voluntariness
Chapter 18: Death and Dying
The Definition of Death
Competent and Formerly Competent Patients
Never Competent Patients
Never Competent Persons without Available Family
Never Competent Persons with Available Family
Futile Care and Limits Based on the Interests of Others
Appendix: Codes of Ethics