Medical Ethics

Michael Boylan is Professor and Chair of Philosophy at Marymount University. He is the author and editor of 26 books, including his manifesto on social/political philosophy A Just Society (2004), and on cosmopolitanism Morality and Global Justice: Justifications and Applications (2011). Boylan was himself the focus of an edited volume, Morality and Justice: Reading Boylan’s A Just Society (2009). He has served on professional and governmental policy committees and was a fellow at the Center for American Progress and a program presenter at The Brookings Institution. He has been an invited speaker in nine countries around the world, including talks in Oxford, Cambridge, Cologne, Oslo, Dublin, Sydney, and the Sorbonne.

Notes on Contributors x

Preface to the Second Edition xiii

Source Credits xv

1 Ethical Reasoning 1
Michael Boylan

2 Health: The Aim of Medicine 12

Ethics, Infertility, and Public Health: Balancing Public Good and Private Choice 13
Rosemarie Tong

Too Old for the Good of Health? 30
Anita Silvers

Health as Self-Fulfillment 44
Michael Boylan

Evaluating a Case Study: Developing a Practical Ethical Viewpoint 58

3 Physician, Nurse, and Patient: The Practice of Medicine 65
A. Paternalism and Autonomy 72

Medical Paternalism and Patient Autonomy 72
John-Stewart Gordon

Rational Non-Interventional Paternalism: Why Doctors Ought to Make Judgments of What Is Best for Their Patients 83
Julian Savulescu

B. Privacy and Confidentiality 90

Medical Privacy in the Age of Genomics 90
David Koepsell

Ethical Issues Experienced by HIV-Infected African-American Women 98
Katharine V. Smith and Jan Russell

C. Informed Consent 104

Should Informed Consent Be Based on Rational Beliefs? 104
Julian Savulescu and Richard W. Momeyer

Cultural Diversity and Informed Consent 115
Ellen Agard, Daniel Finkelstein, and Edward Wallach

D. Gender, Culture, and Race 120

On Treatment of Myopia: Feminist Standpoint Theory and Bioethics 120
Mary B. Mahowald

Culture and Medical Intervention 131
Michael Boylan

Healthcare Disparity and Changing the Complexion of Orthopedic Surgeons 146
Richard E. Grant and Michael Boylan

Evaluating a Case Study: Finding the Conflicts 157

4 Issues of Life and Death 164
A. Euthanasia 167

Killing and Allowing to Die 167
Daniel Callahan

Euthanasia in The Netherlands: Justifiable Euthanasia 171
Pieter V. Admiraal

Why Doctors Must Not Kill 179
Leon R. Kass

B. Abortion 184

An Almost Absolute Value in History 184
John T. Noonan Jr.

A Defense of Abortion 190
Judith Jarvis Thomson

The Abortion Debate in the Twenty-First Century 203
Michael Boylan

Evaluating a Case Study: Assessing Embedded Levels 218

5 Genetic Enhancement 225

Ethical Issues in Human Enhancement 226
Nick Bostrom and Rebecca Roache

Limitations on Scientific Research 251
Michael Boylan

Evaluating a Case Study: Applying Ethical Issues 265

6 Healthcare Policy 271
A. The Right to Healthcare 275

There Is No “Right” to Healthcare 275
John David Lewis

The Moral Right to Healthcare: Part Two 283
Michael Boylan

B. The Organ Allocation Problem 298

A Review of Ethical Issues in Transplantation 298
Rosamond Rhodes

Fault and the Allocation of Spare Organs 305
Brian Smart

Applicants 313
Felicia Niume Ackerman

C. International Public Health Policy and Ethics 324

Toward Control of Infectious Disease: Ethical Challenges for a Global Effort 324
Margaret P. Battin, Charles B. Smith, Leslie P. Francis, and Jay A. Jacobson

Shaping Ethical Guidelines for an Influenza Pandemic 345
Rosemarie Tong

TB Matters More 360
Michael J. Selgelid, Paul M. Kelly, and Adrian Sleigh

Evaluating a Case Study: Structuring the Essay 373

Further Reading 379