Practical Decision Making in Health Care Ethics

Raymond J. Devettere is a professor of philosophy at Emmanuel College where he directs the values-based education program and serves on the institutional review board. He taught health care ethics at Boston College for twenty-five years and is a member of the institutional review board at Newton-Wellesley Hospital.

Preface to the Fourth Edition Introduction 1. What Is Ethics?Defining Ethics; Two Kinds of Ethics; Historical Versions of the Ethicsof Obligation; Moral Reasoning and the Theories of Obligation;Contrasting the Ethics of Obligation with an Ethics of the Good;Retrieving the Ethics of the Good; Bioethics Today; Suggested Readings 2. Prudence and Living a Good Life The Good We Desire; Happiness; Virtue; Moral Virtues; Prudence:The Master Virtue; Suggested Readings 3. The Language of Health Care EthicsDistinctions That Can Mislead; Helpful Distinctions;Suggested Readings 4. Making Health Care Decisions Decision-Making Capacity; Informed Consent; Advance Directives;The Patient Self-Determination Act; The Case of Hazel Welch; FinalReflections; Suggested Readings5. Deciding for Others Becoming a Proxy; Standards for Making Proxy Decisions; Decidingfor Older Children; Deciding for the Mentally Ill; Deciding for Patientsof Another Culture; Final Reflections; Suggested Readings 6. Determining Life and DeathThe Classical Conceptual Framework; A New ConceptualFramework; When Does One of Us Begin?; When Does One of UsDie?; Controversies over Determining Death; Ethical Reflections;Suggested Readings 7. Life-Sustaining Treatments Ventilators: The Case of Karen Quinlan, The Case of William Bartling,The Case of Helga Wanglie, The Case of Barbara Howe; Dialysis: The Case of Earle Spring; Surgery: The Case of Rosaria Candura; OtherLife-Sustaining Treatments; Suggested Readings 8. Cardiopulmonary ResuscitationTerminology; A Brief History of Resuscitation Attempts; TheEffectiveness of Attempting CPR; Learning to Withhold CPR;Important Ethical Elements for a DNR Policy; Lingering Questionsabout DNR Orders; Resolving Questions about CPR: The Case ofMaria M, The Case of Shirley Dinnerstein, The Case of CatherineGilgunn; Suggested Readings 9. Medical Nutrition and Hydration The Techniques and Technologies; Conceptualizing Medical Nutritionand Hydration; Early Cases about Feeding Tubes: The Case of ClarenceHerbert, The Case of Claire Conroy, The Case of Elizabeth Bouvia;Cases of Persistent Vegetative State: The Case of Nancy Cruzan,The Case of Terri Schiavo; Recent Breakthroughs in the Diagnosis ofConsciousness Disorders; An Unresolved Controversy: The Vatican andFeeding Tubes; An Emerging Controversy: VSED; Suggested Readings 10. Reproductive Issues Contraception and Sterilization; Medically Assisted Pregnancy; Posthumous Motherhood: A Request for Posthumous Motherhood; Cloning; Surrogate Motherhood: The Case of Baby M; Ethical Reflections; Suggested Readings 11. Prenatal Life Abortion: Abortion in History, Abortion and the Supreme Court;Moral Issues of Abortion: Abortion and Excommunication at a Catholic Hospital; RU-486; Maternal-Fetal Conflicts: The Case of Angie, The Case of Samantha Burton; Ethical reflections; Suggested Readings 12. Infants and ChildrenHistorical Background; A Sampling of Neonatal Abnormalities;Special Difficulties in Deciding for Neonates and Small Children;The Baby Doe Regulations: The Case of Baby Doe, The Case ofDanielle, The Case of Baby K, The Case of Ashley; Infant Euthanasiain the Netherlands; Suggested Readings 13. Euthanasia and Physician-Assisted Suicide Historical Overview; Recent Developments; Relevant Distinctions; Moral Reasoning and Euthanasia; Legalization of Euthanasia and Physician-Assisted Suicide: A Slippery Slope; TheStory of a Landmark Suicide: The Case of Diane; ConcludingReflections; Suggested Readings 14. Medical and Behavioral Research Notorious Examples of Questionable Ethics in Research; Reactionsto the Questionable Medical Research; Research on Embryos;Research on Fetuses; Research on Minors; Controversial Researchon Babies: The SUPPORT Study; Research in Developing Countries;Other Special Populations in Research; Animals and MedicalResearch; Suggested Readings 15. Transplantation Transplantation of Organs from Dead Human Donors: The Case ofJamie Fiske, The Case of Jesse Sepulveda; Transplantation of Organsfrom Living Human Donors; Transplantation of Organs fromAnimals: The Case of Baby Fae; Implantation of Artificial Hearts;Suggested Readings 16. Medical Genetics and GenomicsPart 1: Ethics and the Genomic Revolution; Part 2: Ethical Issues inGenetic Testing; Part 3: Screening Newborns and Fetuses; Part 4:Research to Develop Genetic Therapy: The Case of Jesse Gelsinger;Suggested Readings Glossary Index of CasesIndex