Bioethics An Anthology

1583 Pages·2015·5.31 MB·English

by  Helga Kuhse

Table of Contents
Cover
Title Page
Acknowledgments
Introduction
Part I: Abortion
Introduction
1 Abortion and Health Care Ethics
Most People Begin at Fertilization
Justice, Beneficence and Non-maleficence for Mother and Child
Rape
Prenatal Screening and Genetic Counselling
Participation
Embryo Experimentation
Benevolence and Autonomy
References
2 Abortion and Infanticide
I Abortion and Infanticide
II Terminology: “Person” versus “Human Being”
III The Basic Issue: When is a Member of the Species Homo
sapiens a Person?
IV Some Critical Comments on Alternative Proposals
V Refutation of the Conservative Position
VI Summary and Conclusions
3 A Defense of Abortion
4 Why Abortion Is Immoral
I
II
III
IV
V
VI
Part II: Issues in Reproduction
Introduction
Assisted Reproduction
Prenatal Screening, Sex Selection, and Cloning
Assisted Reproduction
5 Multiple Gestation and Damaged Babies
6 Assisted Reproduction in Same Sex Couples
Historical Overview of Same Sex Reproduction in the USA
The Emergence of Assisted Reproduction for Lesbians and Gay
Men
Barriers to Assisted Reproduction for Gay Couples
Key Issues Regarding Same Sex Reproduction: Review of the
Literature
Motivations for Parenthood
Family Relationships, Attitudes, and Behaviors
Gender Identity and Sexual Orientation of Children of Gay
Parents
The Social and Psychological Adjustment of Children of Gay
Parents
Gay Fatherhood through Assisted Reproduction
Medical Aspects of Reproduction for Same Sex Couples
Lesbian Couples
Gay Male Couples
Social and Psychological Aspects of Same Sex Reproduction
Homophobia
Family and Social Support
Legal Issues
Decision-Making for Prospective Gay Parents
Lesbians: Who Will Carry the Pregnancy?
Lesbians: Decisions about the Donor
Gay Male Couples: Who Will Provide the Sperm?
Gay Male Couples: Decisions about Donors and Surrogates
Psychological Evaluation of Same Sex Couples Entering ART
Summary and Conclusions
References
7 Rights, Interests, and Possible People
8 The Ethics of Uterus Transplantation
Introduction
Ethical Foundation of Transplantation
What Can UTx Deliver?
UTx, Medical Harms and Risk of Pregnancy
Questions Concerning Informed Consent to UTx
Donor Issues
Alternatives to UTx?
Reproductive Autonomy and Uterus Transplantation as ART
Conclusion
Prenatal Screening, Sex Selection, and Cloning
9 Genetics and Reproductive Risk
Huntington's Disease
Possible Children and Potential Parents
10 Prenatal Diagnosis and Selective Abortion
Contrasting Medical and Social Paradigms of Disability
Implications for People with Disabilities
Implications for Family Life
Implications for Professional Practice
Acknowledgments
References
11 Genetic Technology
Introduction
Work in Genetics and Its Social Impact
A Philosophical Response
Child-Centred Approach
The Adult-Centred Approach
The Deaf Community Argument
Conclusion
References
12 Sex Selection and Preimplantation Genetic Diagnosis
Background
The General Ethical Debate
Preimplantation Genetic Diagnosis and Sex Selection: Joining the
Particular Issues
Recommendations
13 Sex Selection and Preimplantation Diagnosis
Introduction
References
14 Conception to Obtain Hematopoietic Stem Cells
The Need for Transplants
Creating a Child
Assuring a Match
Prenatal Diagnosis
Preimplantation Genetic Diagnosis
Embryonic Stem Cells
Policy and Practice
References
15 Why We Should Not Permit Embryos to Be Selected as Tissue
Donors
Children as Things
What Kind of Ethics Do We Need?
16 The Moral Status of the Cloning of Humans
Introduction
Cloning: Persons, Human Beings, Organs, and Tissue
Cloning in the Present Context
Is It Intrinsically Wrong to Produce a Person by Cloning?
Considerations in Support of the Cloning of Persons
Objections to the Cloning of Humans
Conclusion
Bibliography
Part III: Genetic Manipulation
Introduction
17 Questions about Some Uses of Genetic Engineering
Avoiding the Debate about Genes and the Environment
Methods of Changing the Genetic Composition of Future
Generations
The Positive–Negative Distinction
The View That Overall Improvement Is Unlikely or Impossible
The Family and Our Descendants
Risks and Mistakes
Not Playing God
The Genetic Supermarket
A Mixed System
Values
18 The Moral Significance of the Therapy–Enhancement Distinction
in Human Genetics
Introduction
Somatic versus Germline Interventions
The Concepts of Health and Disease
The Goals of Medicine
Our Humanness
The Rights of the Unborn
Eugenics
Conclusion: The Significance of the Distinction
19 Should We Undertake Genetic Research on Intelligence?
Introduction
The First Hurdle – What Is Intelligence?
What Is Currently Known about the Genetics of Intelligence?
Behavioural Genetic Studies of Intelligence
Molecular Genetic Studies of Intelligence
Should Genetic Research into Intelligence Be Done?
What Should We Do with the Results of This Research?
Conclusion
Acknowledgments
20 In Defense of Posthuman Dignity
Transhumanists vs. Bioconservatives
Two Fears about the Posthuman
Is Human Dignity Incompatible with Posthuman Dignity?
Why We Need Posthuman Dignity
Part IV: Life and Death Issues
Introduction
Killing and Letting Die
Severely Disabled Newborns
Brain Death
Advance Directives
Voluntary Euthanasia and Medically Assisted Suicide
21 The Sanctity of Life
1 Direct Objections and Side-Effects
2 Stating the Principle of the Sanctity of Life
3 The Boundary between Life and Death
4 ‘Being Alive Is Intrinsically Valuable’
5 ‘Being Conscious Is Intrinsically Valuable’
6 ‘Being Human Is Intrinsically Valuable’
7 The Concept of a ‘Life Worth Living’
8 Is the Desire to Live the Criterion of a Worthwhile Life?
9 Length of Life
10 The ‘No Trade-Off’ View
11 The Social Effects of Abandoning the Sanctity of Life
References
22 Declaration on Euthanasia
I The Value of Human Life
II Euthanasia
III The Meaning of Suffering for Christians and the Use of
Painkillers
IV Due Proportion in the Use of Remedies
Conclusion
Killing and Letting Die
23 The Morality of Killing
The Morality of Killing
24 Active and Passive Euthanasia
Reference
25 Is Killing No Worse Than Letting Die?
2
3
4
26 Why Killing is Not Always Worse – and Sometimes Better – Than
Letting Die
I
II
III
27 Moral Fictions and Medical Ethics
The Concept of Moral Fictions
Exposing the Moral Fictions
The Moral Work of Moral Fictions
Abandoning the Moral Fictions
Severely Disabled Newborns
28 When Care Cannot Cure
Extreme Prematurity
Birth Defects: Conditions That Can Be Fixed
Birth Defects: Conditions That Cannot Be Fixed
Withholding Treatment
29 The Abnormal Child
30 Right to Life of Handicapped
31 Conjoined Twins, Embodied Personhood, and Surgical Separation
1 Conjoined Twins
2 The Issue of Separation
3 The History of Metaphysical Assumptions about Conjoined
Twins
4 Embodied Personhood in Singletons, Non-Conjoined Twins,
and Conjoined Twins
5 Some Conclusions
Acknowledgments
References
Brain Death
32 A Definition of Irreversible Coma
Characteristics of Irreversible Coma
Other Procedures
Comment
Summary
Reference
33 Are Recent Defences of the Brain Death Concept Adequate?
Flaws in the BD Concept and Criterion
Recent Expert Explanations and Defences of the BD Concept
Conclusion
34 Is the Sanctity of Life Ethic Terminally Ill?
I Introduction
II Revolution by Stealth: The Redefinition of Death
III Revolution by the Law Lords: The Case of Anthony Bland
IV Conclusion
Advance Directives
35 Life Past Reason
Autonomy
36 Dworkin on Dementia
Advance Directives and Precedent Autonomy
Critical and Experiential Interests: Problems with the Model
The State's Interest in Margo's Life
Acknowledgment
Voluntary Euthanasia and Medically Assisted Suicide
37 The Note
Statement
38 When Self-Determination Runs Amok
Self-Determination
Killing and Allowing to Die
Calculating the Consequences
Euthanasia and Medical Practice
39 When Abstract Moralizing Runs Amok
40 Trends in End-of-Life Practices Before and After the Enactment of
the Euthanasia Law in the Netherlands from 1990 to 2010
Introduction
Methods
Results
Discussion
References
41 Euthanasia in the Netherlands
References