Contemporary Issues in Biomedical Ethics

Not long ago, a colleague chided me for using the term "the biological revolution. " Like many others, I have employed it as an umbrella term to refer to the seemingly vast, rapidly-moving, and fre quently bewildering developments of contemporary biomedicine: psy chosurgery, genetic counseling and engineering, artificial heart-lung machines, organ transplants-and on and on. The real "biological revo lution," he pointed out, began back in the nineteenth century in Europe. For it was then that death rates and infant mortality began to decline, the germ theory of disease was firmly established, Darwin took his famous trip on the Beagle, and Gregor Mendel stumbled on to some fundamental principles of heredity. My friend, I think, was both right and wrong. The biological revolution did have its roots in the nineteenth century; that is when it first began to unfold. Yet, like many intellectual and scientific upheav als, its force was not felt for decades. Indeed, it seems fair to say that it was not until after the Second World War that the full force of the earlier discoveries in biology and medicine began to have a major impact, an impact that was all the more heightened by the rapid bi omedical developments after the war.

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Not long ago, a colleague chided me for using the term "the biological revolution. " Like many others, I have employed it as an umbrella term to refer to the seemingly vast, rapidly-moving, and fre­ quently bewildering developments of contemporary biomedicine: psy­ chosurgery, genetic counseling and engineering, artificial heart-lung machines, organ transplants-and on and on. The real "biological revo­ lution," he pointed out, began back in the nineteenth century in Europe. For it was then that death rates and infant mortality began to decline, the germ theory of disease was firmly established, Darwin took his famous trip on the Beagle, and Gregor Mendel stumbled on to some fundamental principles of heredity. My friend, I think, was both right and wrong. The biological revolution did have its roots in the nineteenth century; that is when it first began to unfold. Yet, like many intellectual and scientific upheav­ als, its force was not felt for decades. Indeed, it seems fair to say that it was not until after the Second World War that the full force of the earlier discoveries in biology and medicine began to have a major impact, an impact that was all the more heightened by the rapid bi­ omedical developments after the war.

Contenu
I. Rights and Moral Decisions.- 1 Legalism and Medical Ethics.- 2 Comments on Legalism and Medical Ethics.- 3 The Moral Rights of the Terminally I11.- 4 Comments on The Moral Rights of the Terminally I11.- II. Issues in Genetics.- 5 On Getting Genetic Out of Genetic Disease.- 6 Protecting the Unconceived.- 7 Comments on Protecting the Unconceived: Butchers, Bakers, & Candlestick Makers.- 8 Sterilization, Privacy, and the Value of Reproduction.- 9 Comments on Sterilization, Privacy, and the Value of Reproduction.- 10 Reply to Buckner.- III. The Role of the Physician.- 11 Hippocrates Lost, A Professional Ethic Regained: Reflections on the Death of the Hippocratic Tradition.- 12 Comments on Hippocrates Lost, A Professional Ethic Regained: Reflections on the Death of the Hippocratic Tradition.- 13 Physicians as Body Mechanics.- 14 Physician as Body MechanicPatient as Scrap Metal: What's Wrong with the Analogy.- 15 Internal or External Physician-Patient Relationships, A Response to Clements.- IV. Informed Consent and Paternalism.- 16 The Ethical Content of Legally Informed Consent.- 17 Comments on The Ethical Content of Legally Informed Consent.- 18 Involuntary Commitment of the Mentally 111: Some Moral Issues.- 19 Comments on Brock's Involuntary Commitment of the Mentally 111: Some Moral Issues.- 20 On Paternalism and Health Care.- 21 Comments on Paternalism and Health Care.- V. Professional Responsibility.- 22 Teaching Compassion: Professional Education for Humane Care.- 23 Accountability in Health Care Practice: Ethical Implications for Nurses.- 24 Biomedical Developments and The Public Responsibility of Philosophy.