Bioethics for Beginners

Dr. Glenn McGee is President of the Division of Research Ethics at Celltex Therapeutics, a stem cell research company in Houston, Texas. He held two successive endowed chairs in bioethics after serving for a decade as professor at the University of Pennsylvania Department of Medical Ethics. He is the founding editor of The American Journal of Bioethics and a leading authority on ethical issues in science and medicine. McGee has been a columnist for The Scientist, New York Times News Service, and MSNBC, and a frequent guest and commentator for National Public Radio, CNN, Fox, CBS, the New York Times, Washington Post, and Oprah, among others. McGee's books include The Perfect Baby (2nd edn., 2000), The Human Cloning Debate (with A. Caplan, 4th edn., 2004), and the best-selling Beyond Genetics: The User's Guide to DNA (2004). In addition, he has authored hundreds of scholarly papers about ethical, legal, and social issues in medicine.

Preface xi

Acknowledgements xv

Caution 1 Tip-Toe When Walking on the Bleeding Edge 1

Case 1 The Dangers of Creating Life in the Lab 1

Case 2 Design: More Intelligent Every Day 3

Case 3 “Shroom” Science: Safe and Effective? 4

Case 4 A Robot Code of Ethics 6

Case 5 No More Periods, Period 8

Case 6 Search Me, Shape Me, Any Way You Want Me 10

Case 7 A Bloody Mess 11

Case 8 Stem Cells: The Goo of Life and the Debate of the Century 14

Caution 2 Everybody Lies 17

Case 9 Lies, Damn Lies . . . and Scientific Misconduct 17

Case 10 Conflict of Interest Means Business at NIH 18

Case 11 While You’re Here, How about a Spinal Tap? 21

Case 12 Study Subject or Human Guinea Pig? 22

Case 13 The New Tuskegee: Exploiting the Poor in Clinical Trials 23

Case 14 Salt in the Wound: Will India Rise up Against the Oppression of Foreign Clinical Trials? 26

Case 15 Dr. Hwang and the Bad Apple Theory of Scientific Misconduct 27

Caution 3 The Genome Isn’t What It Used to Be 34

Case 16 Becoming Genomic: Just What Does it Mean Anyway? 34

Case 17 Enhancement Comes from Insecurity 36

Case 18 Wearing Genes from the Gulf War 37

Caution 4 Reproduce at Your Own Peril 40

Case 19 Tomorrow’s Child: Making Babies in the Twenty-First Century 40

Case 20 An Argument against Human Cloning 42

Case 21 Two Genetic Moms: High-Tech Trouble or Double the Love? 49

Case 22 Grave Robbing the Cradle 51

Case 23 Baby Banking 53

Case 24 Cash Strapped American Fertility Docs Cry Out for Mercy 54

Caution 5 Don’t Sweat the Nano-Sized Stuff 57

Case 25 “Nanoethics”: The ELSI of Twenty-First-Century Bioethics? 57

Case 26 The Devil and the Deep Blue Sea 62

Case 27 The Merging of Man and Machine 64

Case 28 My Eye’s on You 66

Caution 6 The State Will Protect Your Health Right Up Until It Doesn’t 69

Case 29 Has the Spread of HPV Vaccine Marketing Conveyed Immunity to Common Sense? 69

Case 30 Is the New Cigarette a Smoking Gun? Eclipse Unethical, Unregulated Research 71

Case 31 “Universal” Healthcare: A Long Way Off 73

Case 32 Newborn Screening with a Twist 75

Case 33 HIV Testing Must Be Routine 76

Case 34 Re-creating Flu: A Recipe for Disaster 78

Case 35 Pandemic Influenza Requires Trust in Government Healthcare 79

Case 36 A Hostile Environment for Environmental Protection Documents 82

Case 37 To Quarantine or Not to Quarantine, Is That the Question? 83

Caution 7 “Do No Harm” Has Become “Care for Yourself” 86

Case 38 Medicine Is Not a Steel Mill 86

Case 39 Does Your Doctor Have Skeletons? Good Luck Finding Them 87

Case 40 Medicine’s Dirty Laundry 89

Case 41 Dr. Koop: Meet Dr. Ethics 91

Case 42 Organ Donation: Why Isn’t There an App for That? 94

Case 43 Docu-Medical Shows Lack Reality 95

Caution 8 You Aren’t Dead Until Someone Tells You So 98

Case 44 Redefining Retirement: Beyond Rest and Recreation 98

Case 45 Medicare Is Going South: What Do We Owe the Aging? 99

Case 46 The Fight to Die Well: We Will Expect More from Death Than Our Ancestors Did 100

Case 47 The Case of the Body Snatchers 102

Case 48 A Few Conclusions from the Terri Schiavo Case 104

Case 49 Living Wills Save Money? Dude, Did You Really Say That Out Loud? 106

Case 50 The Plural of Anecdote Is Not Ambien 107

Caution 9 Eat Only Food for Thought 110

Case 51 Fat in America 110

Case 52 Breakfast for Thought 111

Case 53 Want Fish? Ethics First, Please 113

Case 54 Dying for Food 115

Caution 10 Beware of Ideologues and Demagogues 117

Case 55 Bioethics for Christians, Corporate Whores, and Atheists 117

Case 56 Pharma Owns Bioethics (and Other Fables) 120

Case 57 The Kevorkianization of Cloning 123

Case 58 Not in the Bush Leagues Anymore 125

Case 59 Professor Hurlbut, Your 15 Minutes Are Up 128

Case 60 The Heady Days of Proposition 71: Stem Cell Research in the California Sun 139

Conclusion: Move Slowly and Stay Cool 146

A Hot and Cold Running Genius 146

Science Must Slow Its Speed 148

Sources and Credits 150

Index 160