Practical Reasoning in Bioethics

"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 and 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.

In his latest book, renowned ethicist James F. Childress uses various metaphors and analogies to highlight the role of imagination in practical reasoning. Childress shows how principles, metaphors, and analogies illuminate moral problems and issues in science, medicine, and health care. The issues he considers include screening and testing for HIV infection, informed consent to and refusal of life-sustaining treatment, allocating scarce health care resources, providing access to and controlling the costs of health care, and obtaining organs and tissues for transplantation.

Includes bibliographical references (p. [329]-375) and index.

James F. Childress is the Edwin B. Kyle Professor of Religious Studies and Professor of Medical Education at the University of Virginia, where he also co-directs the Virginia Health Policy Center. He is the author of over a hundred articles, many of them in biomedical ethics; his several books include Principles of Biomedical Ethics (with Tom L. Beauchamp), Who Should Decide? Paternalism in Health Care, and Priorities in Biomedical Ethics.

Preface

Acknowledgments

Part One: Principles, Metaphors, and Analogies

1. Metaphor and Analogy in Bioethics

2. Ethical Theories, Principles, and Casuistry in Bioethics: An Interpretation and Defense

of Principlism

3. Metaphors and Models of Doctor-Patient Relationships: Their Implications for

Autonomy with Mark Siegler

Part Two: Respect for Autonomy: Its Implications and Limitations

4. If You Let Them, They'd Stay in Bed All Morning: The Principle of Respect for

Autonomy and the Tyranny of Regulation in Nursing Home Life

5. How Much Should the Cancer Patient Know and Decide? with Bettina Schoene-Seifert

6. Mandatory HIV Screening and Testing

Part Three: Termination of Life-Sustaining Treatment

7. "Who Is a Doctor to Decide Whether a Person Lives or Dies?": Reflections on Dax's

Case with Courtney S. Campbell

8. Must Patients Always Be Given Food and Water? with Joanne Lynn

9. When Is It Morally Justifiable to Discontinue Medical Nutrition and Hydration?

Part Four: Allocation of Health Care

10. Who Shall Live When Not All Can Live?

11. Triage in Intensive Care: The Possibilities and Limitations of a Metaphor

12. Fairness in the Allocation and Delivery of Health Care: A Case Study of Organ

Transplantation

13. Rights to Health Care in a Democratic Society

Part Five: Obtaining Organs and Tissues for Transplantation

14. Ethical Criteria for Policies to Obtain Organs for Transplantation

15. Human Body Parts as Property: An Assessment of Ownership, Sales, and Financial

Incentives

16. Ethics, Public Policy, and Human Fetal Tissue Transplantation

Research

Notes

Index