Principles of Health Care Ethics (eBook)

Richard Edmund Ashcroft, Reader in Biomedical Ethics, Imperial College, London, UK. Angus Dawson, Director, Centre for Professional Ethics, University of Keele, UK. Heather Draper, Senior Lecturer in Healthcare Ethics, University of Birmingham, UK. John McMillan, Senior Lecturer in Medical Ethics, Hull-York Medical School, UK.

Principles of Health Care Ethics 3
Contents 7
List of Contributors 13
Foreword: Raanan E. Gillon 21
Foreword: Tony Hope 23
Preface 25
PART I: Methodology And Perspectives 27
1 The ‘Four Principles’ Approach to Health Care Ethics 29
2 Theories of Autonomy 37
3 Beneficence 45
4 Responsibilities for Poverty-Related Ill Health 53
5 Liberalism and Communitarianism 61
6 How Many Principles for Bioethics? 69
7 Casuistical Reasoning in Medical Ethics 77
8 Utilitarianism and Bioethics 83
9 Deontology 91
10 Kantian Ethics 99
11 Feminist Approaches to Health Care Ethics 105
12 Virtue Theory 113
13 Moral Relativism 119
14 Christian Approaches to Bioethics 125
15 Judaism and Medicine: Jewish Medical Ethics 135
16 The Search for Islamic Bioethics Principles 143
17 Buddhist Bioethics 153
18 South Asian Approaches to Health Care Ethics 161
19 The Specious Idea of an Asian Bioethics: Beyond Dichotomizing East and West 169
20 Narrative Ethics 177
21 Empirical Approaches to Health Care Ethics {Private} 185
22 Medical Sociology and the Redundancy of Empirical Ethics 193
23 The Use of Thought Experiments in Health Care Ethics 203
24 Deliberative Bioethics 211
25 Law, Ethics and Health Care 219
26 Medical Humanities: An Overview 225
27 Reflective Equilibrium as a Method in Health Care Ethics 233
28 Hermeneutic Ethics between Practice and Theory 241
29 Paternalism in Health Care and Health Policy 249
30 Need: An Instrumental View 257
31 Rights 265
32 Exploitation in Health Care 273
33 Competence to Consent 281
34 The Doctrine of Double Effect 289
35 Ordinary and Extraordinary Means 295
36 Acts and Omissions 299
37 Personhood and Moral Status 303
38 Commodification 311
PART II: Issues In Health Care Practice 319
39 Consent and Informed Consent 323
40 Treatment Decisions for Incapacitated Patients 331
41 Children’s Consent to Medical Treatment 337
42 Patients and Disclosure of Surgical Risk 345
43 Confidentiality 351
44 Truth-telling, Lying and the Doctor–Patient Relationship 359
45 Personal Beliefs and Patient Care 365
46 Conscience and Health Care Ethics 371
47 Care in Families 377
48 The Ethics of Primary Health Care 383
49 The Nurse–Patient Relationship: A ‘Principles plus Care’ Account 391
50 Dual Responsibilities: Do They Raise Any Different Ethical Issues than ‘Normal’ Therapeutic Relationships? 397
51 Violent and Abusive Patients: An Ethically Informed Response 405
52 The Moral Signifi cance of the Human Foetus 413
53 Will We Need Abortion in Utopia? 419
54 Maternal–Foetal Conflict 427
55 Limits to Reproductive Liberty 435
56 Disability without Denial 441
57 Disability and Equality: Should Difference Be Welcomed? 447
58 Genetic Counselling 453
59 Ethics and Psychotherapy: An Issue of Trust 461
60 Mental Illness and Compulsory Treatment 469
61 Personality Disorders and Compulsory Detention 475
62 Labia Mea, Domine: Media, Morality and Eating Disorders 481
63 Intellectual Disability 489
64 Ethical Issues and Health Care for Older People 495
65 Organs and Tissues for Transplantation and Research 501
66 Living Donor Organ Transplantation 509
67 Euthanasia and Principled Health Care Ethics: From Conflict to Compromise? 515
68 Understanding and Misunderstanding Death 523
69 Ethics without Boundaries: Medical Tourism 531
70 Ethics of Performance Enhancement in Sport: Drugs and Gene Doping 537
71 Training Good Professionals: Ethics and Health Care Education 547
72 Ethics Consultation and Ethics Committees 553
PART III: Medicine In Society 561
73 The Concepts of Health and Illness 563
74 Community in Public Health Ethics 569
75 Health Promotion, Society and Health Care Ethics 575
76 Preventing Disease 583
77 Quantitative Methods for Priority-Setting in Health: Ethical Issues 589
78 Economics, Political Philosophy and Ethics: The Role of Public Preferences in Health Care Decision-Making 595
79 Decision Analysis: The Ethical Approach to Most Health Decision Making 603
80 Health Inequities and the Social Determinants of Health 611
81 Organizational Ethics in Health Care 619
82 Ethical Issues in Epidemiology 627
83 Screening: Ethical Aspects 633
84 Vaccination Ethics 643
85 The Patient as Victim and Vector: Bioethics and the Challenge of Infectious Disease 649
86 Bioterrorism, Society and Health Care Ethics 657
87 Drug Addiction, Society and Ethics 665
88 Smoking: Is Acceptance of the Risks Fully Voluntary? 673
89 Doctors and Human Rights 681
90 Duties to Refugees and Asylum Seekers in Host Countries’ Medical Systems 689
91 Medical Aid in Disaster Relief 697
PART IV: Research Ethics And Ethics Of New Technologies 705
92 The Ethics and Governance of Medical Research 707
93 On The Ethics of Animal Research 715
94 The Ethical Requirement for Systematic Reviews for Randomized Trials 723
95 Informed Consent for Research 729
96 Evaluating Benefits and Harms in Clinical Research 737
97 Patients’ Obligations? 745
98 Standard of Care Owed to Participants in Clinical Trials: Different Standards in Different Countries? 755
99 Justice and Priority Setting in International Health Care Research 761
100 Obligations of the Pharmaceutical Industry 769
101 Ethics and Medical Publishing 777
102 Human Reproductive Cloning 785
103 Obtaining Human Eggs for Stem Cell Research: Ethical Issues 793
104 The Ethics of Xenotransplantation 801
105 Pharmacogenomics 809
106 Ethical Issues in Human Gene Transfer: A Historical Overview 815
107 The Ethics of Ageing, Immortality and Genetics 823
108 Ethical Issues of Enhancement Technologies 829
109 Psychosurgery and Neuroimplantation: Changing What is Deep Within a Person 837
110 Resisting Addiction: Novel Application of Vaccines 845
Index 853

"It is probably now the single most comprehensive bioethics
textbook available ... This is a very fine book indeed."
(BMA Medical Book Competition - Programme and Award Winners,
September 2008)

"Serve[s] as a reference text of concise reviews and as a
medical ethics sampler. Such approachable original essays by
authors who are experts in their respective fields will serve as
excellent teaching tools, and I anticipate referring house staff,
nurses, and therapists to them ... .Serve[s] as a source of
intriguing insights on topics not commonly on the clinical ethics
table. It offers clinicians and medical practitioners a starting
place to understand key concepts and problems in medical ethics. As
such, it is a valuable reference text." (Respiratory
Care, April 2008)

"This is a well though out book covering a wide variety of
ethical problems in healthcare. It provides those interested in
healthcare ethics a great resource for starting their inquiry and
would be a valuable inquisition." (Doody's, November
2007)