This Is Bioethics

Should editing the human genome be allowed? What are the ethical implications of social restrictions during a pandemic? Is it ethical to use animals in clinical research? Is prioritizing COVID-19 treatment increasing deaths from other causes? Bioethics is a dynamic field of inquiry that draws on interdisciplinary expertise and methodology to address normative issues in healthcare, medicine, biomedical research, biotechnology, public health, and the environment. This Is Bioethics is an ideal introductory textbook for students new to the field, exploring the fundamental questions, concepts, and issues within this rapidly evolving area of study.

Assuming no prior knowledge of the subject, this accessible volume helps students consider both traditional and cutting-edge questions, develop informed and defensible answers, and evaluate the strengths and weaknesses of a diverse range of ethical positions in medicine. The authors avoid complex technical terms and jargon in favor of an easy-to-follow, informal writing style with engaging chapters designed to stimulate student interest and encourage class discussion. The book also features a deep dive into the realm of global public health ethics, including the response to the COVID-19 pandemic. It considers topics like triage decision-making, the proportionality of society's response to COVID-19, whether doctors have a professional obligation to treat COVID-19 patients, and whether vaccines for this virus should be mandatory.

A timely addition to the acclaimed This Is Philosophy series, This Is Bioethics is the ideal primary textbook for undergraduate bioethics and practical ethics courses, and is a must-have reference for students in philosophy, biology, biochemistry, and medicine.

Auteur
RUTH F. CHADWICK is Professor Emerita, Cardiff University, and Visiting Professor, University of Leeds, UK. She is Joint Editor-in-Chief of the journal Bioethics and has served on numerous international bodies including the Council of the Human Genome Organization. She is Fellow of the Academy of Social Sciences, the Hastings Center, the Royal Society of Arts, the Royal Society of Biology, and the Learned Society of Wales. UDO SCHÜKLENK holds the Ontario Research Chair in Bioethics in the Department of Philosophy at Queen's University at Kingston, Canada. He is a Joint Editor-in-Chief of the journal Bioethics. His academic career has included teaching and research appointments in Australia, South Africa, and the UK. He is co-editor of Bioethics: An Anthology, Fourth Edition and co-author of 50 Great Myths About Atheism.

Contenu

About the Authors xi Preface and Acknowledgments xiii 1 Introduction to Ethics 1 1.1 Religion and Ethics 6 1.2 Law and Ethics 9 1.2.1 Legal and Moral Rights 12 1.3 Ethical Relativism 13 1.4 Why be Ethical? 15 2 Ethical Theory 21 2.1 Virtue Ethics 21 2.2 Feminist Ethics 23 2.3 Utilitarian Ethics 25 2.4 Rule-Based Ethics 29 2.5 'Georgetown Mantra' 30 2.5.1 Non-Maleficence 31 2.5.2 Beneficence 31 2.5.3 Respect for Autonomy 31 2.5.4 Justice 32 2.6 Contract Theory 34 3 Basics of Bioethics 37 3.1 History and Scope of Bioethics 37 3.2 Who Can Claim to be a Bioethicist? 41 3.3 Organizations and Journals 43 3.4 Policy Advice 43 3.5 Common Arguments in Bioethics 45 3.6 Playing God 46 3.7 Unnatural and Abnormal 47 3.8 Dignity 48 3.9 Nazi Arguments in Bioethics 51 3.10 Slippery-Slope Arguments 53 3.11 Treating Someone as a Means 55 4 Moral Standing: What Matters 59 4.1 Moral Standing and Moral Status 59 4.2 Species Membership 60 4.3 Sentientism 62 4.4 Capabilities 64 4.5 Biocentrism 64 4.6 Holism 65 4.7 The Future 66 5 Beginning of Life 69 5.1 Introduction 69 5.2 Ethical Arguments about Reproductive Rights and Responsibilities 70 5.2.1 Reproductive Autonomy and the Right to Reproduce 70 5.2.2 Consequentialism and Procreative Beneficence 71 5.2.3 'Do No Harm' and the Person-Affecting Restriction 72 5.2.4 The Non-Identity Problem 72 5.2.5 Virtue Ethics 73 5.2.6 Feminist Bioethics 73 5.3 Issues in Assisted Reproduction 74 5.3.1 Genetic Relatedness: How Important Is It? 75 5.3.2 Issues of Selection in Reproduction 77 5.4 Embryos, Fetuses and Abortion 79 5.4.1 Fetuses 80 5.4.2 Judith Jarvis Thomson and the Violinist 81 5.4.3 The 'Future-Like-Ours' Argument 81 5.4.4 The Impairment Argument Against Abortion 82 5.4.5 Women's Character 82 5.4.6 Abortion and Fetal Transplants 83 5.4.7 Savior Siblings 84 5.4.8 Infants and Infanticide 85 5.4.9 Severely Disabled Infants 86 5.4.10 Acts and Omissions 87 5.4.11 Newborn Screening 88 6 Health Care Professional-Patient Relationship 91 6.1 Informed Consent 92 6.2 Paternalism 96 6.3 Deciding for Others 97 6.3.1 Deciding for Others: Advance Directives 97 6.3.2 Deciding for Others: Patients Who Never Had Capacity 98 6.3.3 Deciding for Others: Incapacitated Patients without Advance Directives 99 6.4 Truth Telling 102 6.5 Confidentiality 105 6.6 Conscience Matters 107 6.7 Duty to Treat 110 7 Research Ethics 115 7.1 Elements of Ethical Research 117 7.2 Clinical Research: The Basics 118 7.3 Animal Experiments 120 7.4 Informed Consent 121 7.5 Trial-Related Injuries 122 7.6 Benefits 124 7.7 Benefiting from Evil 125 7.8 Ethical Issues Affecting Clinical Research Involving the Catastrophically Ill 127 7.9 Developing World 130 7.9.1 Utility of Research Question 130 7.9.2 Standards of Care 131 8 Genetics 135 8.1 Genetics and Genomics 135 8.1.1 Introduction - Genetics, Genomics and Bioethics: Is Genetics Special? 135 8.1.2 Issues in Clinical Genetics: Genetic Testing and Counseling 137 8.1.2.1 Non-Directiveness 137 8.1.2.2 Children 138 8.1.2.3 Genetic Screening 139 8.1.2.4 Direct-to-Consumer Testing 139 8.2 Gene Therapy: Somatic and Germline 140 8.2.1 Is There a Need for Germline Gene Therapy? 142 8.2.2 Risks and Irreversible Consequences 142 8.2.3 Future Generations and Lack of Consent 143 8.2.4 The Iconic Significance of the Germline 143 8.2.5 Gene Editing 144 8.3 Genomic Research 146 8.3.1 The Human Genome Project 146 8.3.2 Biobanks 147 8.3.3 Feedback of Findings 149 8.4 Personalized Medicine 150 8.4.1 Human Cloning - Therapeutic Cloning 151 8.4.2 Reproductive Cloning 153 8.5 Other Issues in Genetics and Genomics 155 9 Enhancement 159 9.1 Introduction 159 9.2 Enhancement and Superhumans 159 9.3 The Meaning of Enhancement 161 9.3.1 Enhancement and Improvement 161 9.4 Alternatives to the 'Improvement' Account 163 9.4.1 Therapy-Enhancement Distinction 163 9.4.2 Species-Normal Functioning 164 9.4.2.1 Quantitative Account of Enhancement 164 9.4.3 Enhancement: The Umbrella View 165 9.5 Ethical Issues 166 9.5.1 Is Enhancement Necessary? 166 9.5.2 Enhancement is Inevitable 167 9.5.3 A Compromise Position? 168 9.5.4 Autonomy 169 9.5.5 The Habermasian Concern 169 9.6 Social Inequalities and Social Justice 170 9.6.1 Consequences for the Future of Humans 171 9.7 Moral Enhancement 173 9.8 Cognitive Enhancement 176 10 Mental Health 181 10.1 Mental Illness 182 10.2 Diagnosis 184 10.3 Autonomy and Capacity 186 10.4 Least Restrictive Option 187 10.5 Best Interests 188 10.6 Treatment and Detention 189 10.6.1 Detention for the Good of the Service User 189 10.6.2 Detention for the Protection of Others 191 11 End of Life 195 11.1 Do You Want to Live Forever? 195 11.2 Terminology 201 11.3 Case for the Decriminalization of Assisted Dying 203 11.4 The Case Against the Decriminalization of Assisted Dying 207 11.4.1 In-Principle Reasons Against Assistance in Dying 207 11.4.2 Slippery-Slope Reasons Against Assistance in Dying 208 11.4.2.1 Pereira v. Downie 210 11.5 Violation of Health Care Professional Values and Traditions 213 12 Justice and Health Care 217 12.1 Introduction 217 12.2 Types of Justice 218 12.2.1 Justice and Discrimination 218 12.2.2 Justice in Distribution 219 12.2.3 Procedural Justice 220 12.2.4 Justice and Exploitation 220 12.3 The Concept of Justice and its Connection With Equality 222 12.3.1 Justice and Equality: Equal Treatment and Equal Consideration 222…