Bizarre Bioethics

The focus of bioethical debates on exceptional cases neglects the underlying values—like justice and community—that would lend to a broader, more well-rounded understanding of today's world. Discussions of ethical problems in health care too often concentrate on exceptional cases. Bioethical controversies triggered by experimental drugs, gene-edited babies, or life extension are understandably fascinating: they showcase the power of medical science and technology while addressing anxieties concerning health, disease, suffering, and death. However, the focus on rare individual cases in the media spotlight turns attention away from more pressing ethical issues that impact global populations, such as access to health care, safe food and water, and the prevention of emerging infectious diseases. In Bizarre Bioethics, Henk A.M.J. ten Have argues that this focus on bizarre cases leads to bizarre bioethics with a narrow agenda for ethical debate. In other words, although these extreme cases are undeniably real, they present a limited and skewed view of everyday moral reality. This focus also assumes that individuals are rational decision-makers, so that the role of feelings and emotions can be downgraded. Larger questions related to justice, solidarity, community, meaning, and ambiguity are not appreciated. Such questions used to be posed by philosophical and theological traditions, but they have been exorcised and marginalized in the development of bioethics. Science, ten Have writes, is not a value-free endeavor that provides facts and evidence: it is driven by underlying value perspectives that are often based on metaphors and world views from philosophical and theological traditions. Drawing on a rich analysis of the literature, ten Have explains how bioethical discussion can be enriched by these metaphors and develops a broader approach that critically delves into the imaginative world views that determine understanding of the world and human existence. Examining the roles of the metaphors of ghosts, monsters, pilgrims, prophets, and relics, ten Have illustrates how science and medicine are animated by imaginations that fuel the search for hope, salvation, healing, and a predictable future. Bizarre Bioethics invites students, researchers, policymakers and teachers interested in ethics and health care to think about the value perspectives on health and disease today.

Bizarre Bioethics invites students, researchers, policymakers and teachers interested in ethics and health care to think about the value perspectives on health and disease today.

The pervasive influence of law on medical practice and clinical bioethics is often noted with a combination of exasperation and lamentation. Physicians and non-physician bioethicists, generally speaking, consider the willingness of courts, legislatures, and regulatory agencies to insinuate themselves into clinical practice and medical research to be a distinctly negative aspect of contemporary American society. They are quick to point out that their colleagues in other Western developed nations are not similarly afflicted, and that the situation which obtains elsewhere is highly preferable to the legalization and purported over-regulation of medicine that has taken place in the United States during the last fifty years. In this book I offer a decidedly different perspective. It is, admittedly, not entirely without personal and professional bias. Prior to becoming a fu- time academic, teaching bioethics in the setting of an academic medical center, I was, for nearly 20 years, an attorney specializing in health law. Even after earning a doctorate in philosophy, I was frequently considered to be the “resident lawyer” on the bioethics faculty, much more frequently looked to for my insights on the law than my perspective as one who had formally studied moral philosophy and applied ethics. I note this not out ofa sense of frustration or disappointment, but as confirmation that even among physicians and n- physician bioethicists, there is widespread recognition that the law does have important contributions to make in assessing the practice ofmedicine and the conduct of medical research.

'Observing Bioethics' is written by two social scientists who have been participants in and observers of US bioethics since the field's emergence. The book views bioethics appreciatively and critically as a complex phenomenon that is related to advances in modern biology and medicine.

An argument against the “lifeboat ethic” of contemporary bioethics that views medicine as a commodity rather than a tradition of care and caring. Bioethics emerged in the 1960s from a conviction that physicians and researchers needed the guidance of philosophers in handling the issues raised by technological advances in medicine. It blossomed as a response to the perceived doctor-knows-best paternalism of the traditional medical ethic and today plays a critical role in health policies and treatment decisions. Bioethics claimed to offer a set of generally applicable, universally accepted guidelines that would simplify complex situations. In Thieves of Virtue, Tom Koch contends that bioethics has failed to deliver on its promises. Instead, he argues, bioethics has promoted a view of medicine as a commodity whose delivery is predicated not on care but on economic efficiency. At the heart of bioethics, Koch writes, is a “lifeboat ethic” that assumes “scarcity” of medical resources is a natural condition rather than the result of prior economic, political, and social choices. The idea of natural scarcity requiring ethical triage signaled a shift in ethical emphasis from patient care and the physician's responsibility for it to neoliberal accountancies and the promotion of research as the preeminent good. The solution to the failure of bioethics is not a new set of simplistic principles. Koch points the way to a transformed medical ethics that is humanist, responsible, and defensible.

This anthology represents all of the most important points of view on the most pressing topics in bioethics. Containing current essays and actual medical and legal cases written by outstanding scholars from around the globe, this book provides readers with diverse range of standpoints, including those of medical researchers and practitioners, legal exerts, and philosophers.

This new, thoroughly recast Second Edition has been acclaimed as "the most important book written since the beginning of that strange project called bioethics" (Stanley Hauerwas, Duke University). Its philosophical exploration of the foundations of secular bioethics has been substantially expanded. The book challenges the values of much of contemporary bioethics and health care policy by confronting their failure to secure the moral norms they seek to apply. The nature of health and disease, the definition of death, the morality of abortion, infanticide, euthanasia, physician-assisted suicide, germline genetic engineering, triage decisions and distributive justice in health care are all addressed within an integrated reconsideration of bioethics as a whole. New material has been added regarding social justice, health care reform and environmental ethics. The very possibility and meaning of a secular bioethics are re-explored.

This book provides insights into dynamic and complex interrelationships between professionalism and medical practice. It does so by looking into the most relevant and recent theoretical and practical frameworks and by systematizing and integrating extensive and growing literature on medical professionalism. Through honest and prudent contributions from very diverse backgrounds and contexts, this book provides an understanding of medical professionalism derived from a broader historical and cultural context in order to contribute to everyday professional life and practice – the very place of its existence. The book presents the conflicting and sometimes irreconcilable demands and challenges physicians face in everyday practice. A better understanding of these fundamental issues is the only way for medicine to maintain and preserve its unique morality, the same one that enabled its existence in the first place. The book is relevant for everyone immersed and interested in the subject of medical professionalism as a resource, which may ease or guide them through the complexities of issues at hand. It will also contribute to the ongoing debate on medical professionalism, medical ethics, bioethics, and professionalism and ethics in general.