Bioethics Reenvisioned

Bioethics needs an expanded moral vision. Born in the ferment of the 1970s, the field responded to rapid developments in biomedical technology and injustices in clinical care and research. Since then, bioethics has predominantly focused on respect for autonomy, beneficence and nonmaleficence, and the zero-sum "lifeboat" ethics of distributive justice, applying these principles almost exclusively within the walls of medical institutions. It is now time for bioethics to take full account of the problems of health disparities and structural injustice that are made newly urgent by the COVID-19 pandemic and the effects of climate change. This book shows why and how the field must embrace a broader and more meaningful view of justice, principally by incorporating the tools and insights of the social sciences, epidemiology, and public health. Nancy M. P. King, Gail E. Henderson, and Larry R. Churchill make the case for a more social understanding and application of justice, a deeper humility in assessing expertise in bioethics consulting, a broader and more relevant research agenda, and greater appreciation of the profound health implications of global warming.

This volume brings together a collection of essays that rigorously examine the concept of human dignity from its metaphysical foundations to its polemical deployment in bioethical controversies. It explores the source and meaning of human dignity, examines the legitimacy of the concept of dignity in documents by international political bodies, and looks at the rhetoric of human dignity in specific controversies: embryonic stem cell research, abortion, human-animal chimeras, euthanasia and palliative care, psychotropic drugs, and assisted reproductive technologies.

This volume engages in conversation with the thinking and work of Max Charlesworth as well as the many questions, tasks and challenges in academic and public life that he posed. It addresses philosophical, religious and cultural issues, ranging from bioethics to Australian Songlines, and from consultation in a liberal society to intentionality. The volume honours Max Charlesworth, a renowned and celebrated Australian public intellectual, who founded the journal Sophia, and trained a number of the present heirs to both Sophia and academic disciplines as they were further developed and enhanced in Australia: Indigenous Australian studies, philosophy of religion, the study of the tension between tradition and modernity, phenomenology and existentialism, hermeneutics, feminist philosophy, and philosophy of science that is responsive to environmental issues.

"This is a valuable clarification, re-statement and defence of principlism as an approach to applied ethics. It is strongly recommended to many teachers of bioethics..." -- Journal of the American Medical Association "Childress' book deserves careful study by all concerned with the ethical aspect of contemporary biomedical challenges." -- Science Books & Films "An ideal supplement for a graduate seminar on bioethics or for upper-division undergraduates needing more information in this area." -- Choice In these revised and updated essays, renowned ethicist James F. Childress highlights the role of imagination in practical reasoning through various metaphors and analogies. His discussion of ethical problems contributes to a better understanding of the scope and strength of different moral principles, such as justice, beneficence, and respect for autonomy. At the same time, Childress demonstrates the major role of metaphorical, analogical, and symbolic reasoning in biomedical ethics, largely in conjunction with, rather than in opposition to, principled reasoning.

The field of bioethics was deeply influenced by religious thinkers as it emerged in the 1960s and early 1970s. Since that time, however, a seemingly neutral political liberalism has pervaded the public sphere, resulting in a deep suspicion of those bringing religious values to bear on questions of bioethics and public policy. As a theological ethicist and progressive Catholic, Lisa Sowle Cahill does not want to cede the "religious perspective" to fundamentalists and the pro-life movement, nor does she want to submit to the gospel of a political liberalism that champions individual autonomy as holy writ. In Theological Bioethics, Cahill calls for progressive religious thinkers and believers to join in the effort to reclaim the best of their traditions through jointly engaging political forces at both community and national levels. In Cahill's eyes, just access to health care must be the number one priority for this type of "participatory bioethics." She describes a new understanding of theological bioethics that must go beyond decrying injustice, beyond opposing social practices that commercialize human beings, beyond painting a vision of a more egalitarian future. Such a participatory bioethics, she argues, must also take account of and take part in a global social network of mobilization for change; it must seek out those in solidarity, those involved in a common calling to create a more just social, political, and economic system. During the past two decades Cahill has made profound contributions to theological ethics and bioethics. This is a magisterial and programmatic statement that will alter how the religiously inclined understand their role in the great bioethics debates of today and tomorrow that yearn for clear thinking and prophetic wisdom.

Prominent bioethicists whose work is rooted in philosophy, religion, medicine, nursing, literature, history, and policy analysis join together to discuss their methods and professional insights, as well as to better define the field and its future development. Writing from the perspective of their own specialties, the authors: review just how their personal disciplines have contributed to bioethics, debate the current and future bioethical issues they face, and identify the most significant strengths and weaknesses in the current practice of bioethics. Seeking a sound foundation for the discipline, they also consider what basic knowledge and skills are necessary to be competent in bioethics, what methods and theoretical approaches are most promising for its future development, and what issues or perspectives have been neglected.

Over the last twenty years, type 2 diabetes skyrocketed to the forefront of global public health concern. In this book, Mari Armstrong-Hough examines the rise in and response to the disease in two societies: the United States and Japan. Both societies have faced rising rates of diabetes, but their social and biomedical responses to its ascendance have diverged. To explain the emergence of these distinctive strategies, Armstrong-Hough argues that physicians act not only on increasingly globalized professional standards but also on local knowledge, explanatory models, and cultural toolkits. As a result, strategies for clinical management diverge sharply from one country to another. Armstrong-Hough demonstrates how distinctive practices endure in the midst of intensifying biomedicalization, both on the part of patients and on the part of physicians, and how these differences grow from broader cultural narratives about diabetes in each setting.

For more than three decades, Dr. Hadler has studied the experience of low back pain in people who are otherwise healthy. The author argues that regional back pain is overly medicalized by doctors and that the design of worker's compensation actually thwarts getting well.