Table Of ContentAUTONOMY AND HUMAN RIGHTS IN HEALTH CARE
INTERNATIONALLIBRARYOFETHICS, LAW,
AND THE NEWMEDICINE
Founding Editors
DAVID C. THOMASMA†
DAVID N. WEISSTUB, Université de Montréal, Canada
THOMASINE KIMBROUGH KUSHNER, University of California, Berkeley, U.S.A.
Editor
DAVID N. WEISSTUB, Université de Montréal, Canada
Editorial Board
TERRYCARNEY, University of Sydney, Australia
MARCUS DÜWELL, Utrecht University, Utrecht, the Netherlands
SØREN HOLM, University of Cardiff, Wales,United Kingdom
GERRITK. KIMSMA, Vrije Universiteit, Amsterdam, the Netherlands
DAVID NOVAK, University of Toronto, Canada
EDMUND D. PELLEGRINO, Georgetown University, Washington D.C., U.S.A.
DOM RENZO PEGORARO, Fondazione Lanza and University of Padua, Italy
DANIELP. SULMASY, Saint Vincent Catholic Medical Centers, New York, U.S.A.
LAWRENCE TANCREDI, New York University, New York, U.S.A.
VOLUME 36
The titles published in this series are listed at the end of this volume.
Autonomy and Human Rights
in Health Care
An International Perspective
Edited by
DAVID N. WEISSTUB
Université de Montréal,
QC, Canada
GUILLERMO DÍAZ PINTOS
Universidad de Castilla-La Mancha,
Ciudad Real, Spain
AC.I.P. Catalogue record for this book is available from the Library of Congress.
ISBN 978-1-4020-5840-0 (HB)
ISBN978-1-4020-5841-7 (e-book)
Published by Springer,
P.O. Box 17, 3300 AADordrecht, The Netherlands.
www.springer.com
Printed on acid-free paper
All Rights Reserved
© 2008 Springer
No part of this work may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming, recording
or otherwise, without written permission from the Publisher, with the exception
of any material supplied specifically for the purpose of being entered
and executed on a computer system, for exclusive use by the purchaser of the work.
CONTENTS
Preface ix
EDMUND D. PELLEGRINO
Contributors xiii
Introduction 1
GUILLERMO DÍAZ PINTOS AND DAVID N. WEISSTUB
PART I: HEALTH CARE, HUMAN RIGHTS AND SOCIAL POLICY
1. Evolving Bioethics and International Human Rights 11
DAVID C. THOMASMA
2. Dignity, Rights, Health Care, and Human Flourishing 25
DAVID P. SULMASY
3. Human Rights: The Ethics of Globalization 37
GUILLERMO DÍAZ PINTOS
4. Human Rights and the Right to Health Care 45
AMNON GOLDWORTH
5. Religion, International Human Rights and Women’s Health: Synthesizing
Principles and Politics 55
DAVID E. GUINN
PART II: THE CENTRALITY AND LIMITS OF AUTONOMY
6. The Limitations and Accomplishments of Autonomy as a Basic Principle
in Bioethics and Biolaw 75
JACOB D. RENDTORFF
7. Person and Human Being in Bioethics and Biolaw 89
LAURA PALAZZANI
8. Welfare Rights and Health Care 99
JUAN RAMÓN DE PÁRAMOARGÜELLES
v
vi CONTENTS
9. Autonomy and the Rights of Minors 111
WAYNE VAUGHT
10 Domestic Violence 123
GEORGE P. PALERMO
11. Balancing Autonomy and Traditional Values in Treating Terminally
Ill Patients: Towards Locating the Right Questions for Japan 143
DAVID N. WEISSTUB
PART III: PLURALISM, RACE AND HEALTH
12. Culture, Community or Rights 155
TERRY CARNEY
13. Bioethics Between Nature and Culture 173
ANA MARTA GONZÁLEZ
14. Medical Practice as the Primary Context for Medical Ethics 189
HENK JOCHEMSEN
15. Euthanasia and Multiculturalism 205
ANDRÉS OLLERO
PART IV: FUTURE LEGAL ORDERING AND SOCIAL PLANNING
16. International Law and Genetic Counselling 217
CARLOS M. ROMEO-CASABONA
17. International Perspective on Organ Donation 235
ELISA J. GORDON
18. Justice in the Distribution of Transplant Organs 257
ROSAMOND RHODES
19. Human Cloning and Human Dignity 271
ÁNGELA APARISI MIRALLES AND JOSÉ LÓPEZ GUZMÁN
20. Accessing Health Care Resources: Economic, Medical, Ethical
and Socio-Legal Challenges 291
GEORGE P. SMITH, II
21. Mental Health Rights: The Relation between Constitution and Bioethics 309
JULIO ARBOLEDA-FLÓREZ AND DAVID N. WEISSTUB
CONTENTS vii
PART V: INDIVIDUAL INTEGRITY, RESEARCH ETHICS
AND HUMAN RIGHTS
22. The “Vulnerability” Quagmire in International Research 331
JUDITH KISSELL
23. Human Rights, Health Care and Biomedical Innovation: Confronting
the Research Imperative 341
GEORGE F. TOMOSSY
24. The Rights to Die and the Duty to Save: A Reflection on Ethical
Presuppositions in Suicide Research 353
BRIAN MISHARA AND DAVID N.WEISSTUB
25. The Right to Bodily Security vis-à-vis the Needs of Others 375
AUSTEN GARWOOD-GOWERS
Index 399
PREFACE
EDMUND D. PELLEGRINO
David C. Thomasma—In Memoriam
For a Friend and Teacher
Rejoice you dead, wher’er your spirits dwell
Rejoice that yet on Earth your fame is bright.
Robert Bridges, Ode to Music
1844–1930
It has often been said that we really die only when we are forgotten. If there is
any truth in these words, David Thomasma will live for a long time in the memories
of his professional colleagues world-wide. We need not ask whether the man or his
work will live longer, as William Osler did in his Preface to the life of Louis Pasteur
(Vallery-Radat 1928). In David Thomasma, the man and his work, his mind and his
heart were inseparable.
They were an amalgam in which one blended imperceptibly into the other.
David was a rarity, a humanist philosopher whose critical intelligence was
always modulated by his humanity. His benevolence for his fellow humans was not
that of the sophisticate who loves the species but abhors the man. David always
closed the distance between himself and his students or colleagues to engage hearts
as well as minds.
The springhouse of his intellect was amply fed from the vast reservoir of the
works of Aristotle and Aquinas. From Aristotle he imbibed a taste for an orderly
perspective on the real world and a respect for its openness to human reason. From
Thomas David imbibed the enrichment of reason by faith, and the intellectual
humility to see whatever portion of truth was latent in the thought of others. This
was especially true of the modern philosophers he studied with equal passion.
David was an omnivorous reader, a polymath who eschewed pontification but
convinced by the depth and incisiveness of his knowledge. His knowledge ranged
well beyond philosophy and ethics to embrace the sports pages, the public media,
contemporary music and the latest gossip circulating in the bioethics community.
Language and social barriers could not contain his energetic pursuit of knowledge.
That pursuit was always conducted with geniality, humor and obvious good will.
David was superbly equipped to be a collaborator in all sorts of scholarly
endeavors. He co-authored books and papers with half a dozen different colleagues
from within and outside philosophy. Some were physicians, some social scientists
ix
x PREFACE
and others were European scholars with whom he was working to establish better
international understandings of bioethics. Indeed collaboration and cooperation were
David’s forte. David was a pioneer in the meetings he sponsored in Europe bringing
scholars from Europe and America into effective communication with each other.
Those meetings will be remembered as much for their conviviality as their
intellectual substance. David emerged as our Benjamin Franklin, an ambassador
without portfolio for American bioethics, spreading erudition, with American
practicality and personal diplomatic aplomb.
I had the extraordinary privilege of enjoying David’s gifts as a collaborator for
two decades. During that time we produced five books, and more than half dozen
articles. We were working on a revision of our major work – A Philosophical Basis
of Medical Practice – when he died unexpectedly. Nothing could convince me more
of his irreplacability in our joint works than my efforts since his death to complete
the task of revision. No small part of my problem has been asking myself about each
change in the text – “Would David approve?”
During our collaboration I can remember no instance of serious disagreement. A
good part of this was related to the similarity of our intellectual formations and
interests. David and I both majored in chemistry and still felt ourselves disposed, in
the spirit of Albertus Magnus, to experimental science as well as philosophy. We
were likewise formed in the tradition of Fides et Ratio, of the compatibility,
necessity and mutual enrichment of medicine by theology and philosophy. Our
conclusions were sometimes rejected because of our refusal to see incommensurability
in the relations of science and theology. All too often we had to chide our critics and
ask them to deal with our reasoning and conclusions and not with the fact that they
might be compatible with religion.
Our writing sessions were sources of the greatest pleasure to me. David sat at his
computer; I sat at my old mechanical Olivetti typewriter. Each would write a draft
which the other would edit and criticize mercilessly. After many passages back and
forth, we would agree and move on. We both wrote with classical music in the
background. David’s tastes were far more cosmopolitan than mine however.
Our writing styles were different and some critics claim to know who wrote
what. However the case may be I cannot tell even now how much of any passage
was David’s and how much mine – except that David’s words were more concrete
than mine. Our love for Latin and Greek came through here and there and had to be
curtailed since our memories of these languages often had to be refurbished. David’s
familiarity with German and Dutch gave us access to some of the best Europe was
producing at the time.
Thomasma enjoyed debates, whether the subject was moral philosophy, the
relative merits of competing sports teams or justice in the health care system. He
interlaced his debates with choice stories, practical jokes and insight. His
conclusions were always clear, tempered by his signature combination of moral
insight and compassion.
It was easy to see David as the jolly friar, with cincture around his ample
rotundity. He filled his discourses with humor, but motivating him always were the
same vocation to healing, helping, counseling and comforting that led him to enter
