Bioethics In America

In Bioethics in America, Tina Stevens challenges the view that the origins of the bioethics movement can be found in the 1960s, a decade mounting challenges to all variety of authority. Instead, Stevens sees bioethics as one more product of a "centuries-long cultural legacy of American ambivalence toward progress," and she finds its modern roots in the responsible science movement that emerged following detonation of the atomic bomb. Rather than challenging authority, she says, the bioethics movement was an aid to authority, in that it allowed medical doctors and researchers to proceed on course while bioethicists managed public fears about medicine's new technologies. That is, the public was reassured by bioethical oversight of biomedicine; in reality, however, bioethicists belonged to the same mainstream that produced the doctors and researchers whom the bioethicists were guiding.

​The goal of this open access book is to develop an approach to clinical health care ethics that is more accessible to, and usable by, health professionals than the now-dominant approaches that focus, for example, on the application of ethical principles. The book elaborates the view that health professionals have the emotional and intellectual resources to discuss and address ethical issues in clinical health care without needing to rely on the expertise of bioethicists. The early chapters review the history of bioethics and explain how academics from outside health care came to dominate the field of health care ethics, both in professional schools and in clinical health care. The middle chapters elaborate a series of concepts, drawn from philosophy and the social sciences, that set the stage for developing a framework that builds upon the individual moral experience of health professionals, that explains the discontinuities between the demands of bioethics and the experience and perceptions of health professionals, and that enables the articulation of a full theory of clinical ethics with clinicians themselves as the foundation. Against that background, the first of three chapters on professional education presents a general framework for teaching clinical ethics; the second discusses how to integrate ethics into formal health care curricula; and the third addresses the opportunities for teaching available in clinical settings. The final chapter, "Empowering Clinicians", brings together the various dimensions of the argument and anticipates potential questions about the framework developed in earlier chapters.

NOW FEATURING A NEW AFTERWORD, "PANDEMIC ETHICS" From two eminent scholars comes a provocative examination of bioethics and our culture’s obsession with having it all without paying the price. Shockingly, the United States has among the lowest life expectancies and highest infant mortality rates of any high-income nation, yet, as Amy Gutmann and Jonathan D. Moreno show, we spend twice as much per capita on medical care without insuring everyone. A “remarkable, highly readable journey” (Judy Woodruff ) sure to become a classic on bioethics, Everybody Wants to Go to Heaven but Nobody Wants to Die explores the troubling contradictions between expanding medical research and neglecting human rights, from testing anthrax vaccines on children to using brain science for marketing campaigns. Providing “a clear and compassionate presentation” (Library Journal) of such complex topics as radical changes in doctor-patient relations, legal controversies over in vitro babies, experiments on humans, unaffordable new drugs, and limited access to hospice care, this urgent and incisive history is “required reading for anyone with a heartbeat” (Andrea Mitchell).

When his teenaged son Christopher, brain-damaged in an auto accident, developed a 106-degree fever following weeks of unconsciousness, John Campbell asked the attending physician for help. The doctor refused. Why bother? The boy's life was effectively over. Campbell refused to accept this verdict. He demanded treatment and threatened legal action. The doctor finally relented. With treatment, Christopher's temperature subsided almost immediately. Soon afterwards he regained consciousness and today he is learning to walk again. This story is one of many Wesley Smith recounts in his groundbreaking new book, The Culture of Death. Smith believes that American medicine ''is changing from a system based on the sanctity of human life into a starkly utilitarian model in which the medically defenseless are seen as having not just a 'right' but a 'duty' to die.'' Going behind the current scenes of our health care system, he shows how doctors withdraw desired care based on Futile Care Theory rather than provide it as required by the Hippocratic Oath. And how ''bioethicists'' influence policy by considering questions such as whether organs may be harvested from the terminally ill and disabled. This is a passionate, yet coolly reasoned book about the current crisis in medical ethics by an author who has made ''the new thanatology'' his consuming interest.

Catholic health care is one of the key places where the church lives Catholic social teaching (CST). Yet the individualistic methodology of Catholic bioethics inherited from the manualist tradition has yet to incorporate this critical component of the Catholic moral tradition. Informed by the places where Catholic health care intersects with the diverse societal injustices embodied in the patients it encounters, this book brings the lens of CST to bear on Catholic health care, illuminating a new spectrum of ethical issues and practical recommendations from social determinants of health, immigration, diversity and disparities, behavioral health, gender-questioning patients, and environmental and global health issues.

In Bioethics in America, Tina Stevens challenges the view that the origins of the bioethics movement can be found in the 1960s, a decade mounting challenges to all variety of authority. Instead, Stevens sees bioethics as one more product of a "centuries-long cultural legacy of American ambivalence toward progress," and she finds its modern roots in the responsible science movement that emerged following detonation of the atomic bomb. Rather than challenging authority, she says, the bioethics movement was an aid to authority, in that it allowed medical doctors and researchers to proceed on course while bioethicists managed public fears about medicine's new technologies. That is, the public was reassured by bioethical oversight of biomedicine; in reality, however, bioethicists belonged to the same mainstream that produced the doctors and researchers whom the bioethicists were guiding.

In only four decades, bioethics has transformed from a fledgling field into a complex, rapidly expanding, multidisciplinary field of inquiry and practice. Its influence can be found not only in our intellectual and biomedical institutions, but also in almost every facet of our social, cultural, and political life. This volume maps the remarkable development of bioethics in American culture, uncovering the important historical factors that brought it into existence, analyzing its cultural, philosophical, and professional dimensions, and surveying its potential future trajectories. Bringing together a collection of original essays by seminal figures in the fields of medical ethics and bioethics, it addresses such questions as the following: - Are there precise moments, events, socio-political conditions, legal cases, and/or works of scholarship to which we can trace the emergence of bioethics as a field of inquiry in the United States? - What is the relationship between the historico-causal factors that gave birth to bioethics and the factors that sustain and encourage its continued development today? - Is it possible and/or useful to view the history of bioethics in discrete periods with well-defined boundaries? - If so, are there discernible forces that reveal why transitions occurred when they did? What are the key concepts that ultimately frame the field and how have they evolved and developed over time? - Is the field of bioethics in a period of transformation into biopolitics? Contributors include George Annas, Howard Brody, Eric J. Cassell, H. Tristram Engelhardt Jr., Edmund L. Erde, John Collins Harvey, Albert R. Jonsen, Loretta M. Kopelman, Laurence B. McCullough, Edmund D. Pellegrino, Warren T. Reich, Carson Strong, Robert M. Veatch, and Richard M. Zaner.

This book presents a unique view of the current state of development of bioethics in Latin America. Twelve Latin American thinkers who share a primary interest in bioethics address a vast range of questions, including autonomy, rights, justice, and the role of culture and religion in bioethics. These studies contribute to an understanding of Latin American thought, and they make possible a transcultural dialogue on bioethical issues.