Arthur L. Caplan

Harris Wiseman

The Limits of Moral Enhancement

Myth of the Moral Brain

An interdisciplinary exploration of whether modern genetics and bioengineering are leading us to a posthuman future.

Genetics, Bioengineering, and the Future of the Human Condition

Is Human Nature Obsolete?

Reinhard Priester

Dianne M. Bartels

Dorothy E. Vawter

Arthur L. Caplan It is commonly said, especially when the subject is assisted reproduction, that medical technology has out stripped our morality. Yet, as the essays in this volume make clear, that is not an accurate assessment of the situ ation. Medical technology has not overwhelmed our moral ity. It would be more accurate to say that our society has not yet achieved consensus about the complex ethical iss ues that arise when medicine tries to assist those who seek its services in order to reproduce. Nevertheless, there is no shortage of ethical opinion about what we ought to do with respect to the use of surrogate mothers, in vitro fertil ization, embryo transfer, artificial insemination, or fertil ity drugs. Nor is it entirely accurate to describe assisted repro duction as technology. The term "technology" carries with it connotations of machines buzzing and technicians scurrying about trying to control a vast array of equip ment. Yet, most of the methods used to assist reproduc tion that are discussed in this volume do not involve exotic technologies or complicated hardware. It is technique, more than technology, that dominates the field of assisted reproduction. Efforts to help the infertile by means of the manipu lation of human reproductive materials and organs date 1 2 Caplan back at least to Biblical times. Human beings have en gaged in all manner of sexual practices and manipulations in attempts to achieve reproduction when nature has balked at allowing life to begin.

Ethical Issues in New Reproductive Techniques

Beyond Baby M

Bernard Rosen

Ethics in the Undergraduate Curriculum

Thomas H. Murray

The fate of seriously ill newborns has captured the atten tion of the public, of national and state legislators, and of powerful interest groups. For the most part, the debate has been cast in the narrowest possible terms: "discrimination against the handicapped"; "physician authority"; "family autonomy." We believe that something much more profound is happening: the debate over the care of sick and dying babies appears to be both a manifestation of great changes in our feelings about infants, children, and families, and a reflection of deep and abiding attitudes toward the newborn, the handi capped, and perhaps other humans who are "less than" nor mal, rational adults. How could we cast some light on those feelings and attitudes that seemed to determine silently the course of the public debate? We chose to enlist the humanities-the dis players and critics of our cultural forms. Rather than closing down the public discussion, we wanted to open it up, to illuminate it with the light of history, religion, philosophy, literature, jurisprudence, and humanistically oriented sociol ogy. This book is a first effort to place the hotly contested Baby Doe debate into a broader cultural context.

Humanistic Dimensions of the Care of Imperiled Newborns

Which Babies Shall Live?

Robert H. Blank

Janna C. Merrick

In April 1982, an infant boy was born in Bloomington, Indiana, with Down syndrome and a defective, but surgically correctable, esophagus. His parents refused to consent to surgery or intravenous feeding. The hospital unsuccessfully sought a court order to force treatment, and appeals to higher courts also failed. The child, identified as Baby Doe by the news media, subsequently died. The events in Bloomington became the catalyst for action by the Reagan administration, the courts, and Congress that culminated in a federal policy that makes failure to treat newborns with disabilities a form of child neglect. This book centers on the public policy aspects of withholding treatment from critically ill newborns who are disabled. Specifically, it deals with why the policy was enacted and what impact it has had on health care workers, families, and infants. Some of the contributors to this book spearheaded the early debate on withholding treatment. Anthony Shaw's New York Times Magazine article in 1972 was the first to address these issues in the popular press. The following year, he published a related article in the New England Journal of Medicine. Also appearing in this same issue of NEJM, was the pathbreaking study, coauthored by A. G. M. Campbell, on withholding treatment in the special care nursery at Yale-New Haven Hospital. Each of these articles promoted much public and professional discussion.

Government Intervention in the Treatment of Critically Ill Newborns

Compelled Compassion

Brendan Parent

Sport is often thought of as simply "games," but it can in fact be much more. Sport can be responsible for guiding social justice movements, igniting city-wide riots, uniting countries, permanently injuring youth, revolutionizing views about race, gender and class, and producing several of the most successful global industries. Reports of ethical crises in athletics are constant fodder for popular attention, whether performance enhancing drugs in baseball, corruption in college athletics, the epidemic of brain damage among NFL players, and others too numerous to mention. As a proxy for social concerns, we naturally think of sport in inherently moral terms. Yet we can hardly define the term "sport" or agree on acceptable levels of sporting risk, or determine clear roles and responsibilities for fans, players, coaches, owners, media and health care personnel. Bringing together 27 of the most essential recent articles from philosophy, history, sociology, medicine, and law, this collection explores intersections of sports and ethics and brings attention to the immense role of sports in shaping and reflecting social values.

Essential Readings

The Ethics of Sport

"An important contribution to a debate that will continue for some time." -- Health and Canadian Society "Insightful and thought-provoking.... As Caplan has demonstrated so clearly... we would all be better off if the ethicists spoke first and not last." -- The Washington Post "Caplan's views are important and instructive.... [This] book represents some of his best work." -- New England Journal of Medicine "Caplan's [book] is thought provoking, insightful, and well argued. I recommend it highly."Â -- The Journal of the American Medical Association "... a generously illustrated discourse on method in medical and practical ethics." -- Ethics A member of the President's Task Force on National Health Care Reform examines some of the most controversial biomedical issues of our time.

And Other Essays on the Ethics of Health Care

If I Were a Rich Man Could I Buy a Pancreas?

Daniel P. Reid

James J. McCartney

In Replacement Parts, internationally recognized bioethicist Arthur L. Caplan and coeditors James J. McCartney and Daniel P. Reid assemble seminal writings from medicine, philosophy, economics, and religion that address the ethical challenges raised by organ transplantation. Caplan's new lead essay explains the shortfalls of present policies. From there, book sections take an interdisciplinary approach to fundamental issues like the determination of death and the dead donor rule; the divisive case of using anencephalic infants as organ donors; the sale of cadaveric or live organs; possible strategies for increasing the number of available organs, including market solutions and the idea of presumed consent; and questions surrounding transplant tourism and "gaming the system" by using the media to gain access to organs. Timely and balanced, Replacement Parts is a first-of-its-kind collection aimed at surgeons, physicians, nurses, and other professionals involved in this essential lifesaving activity that is often fraught with ethical controversy.

The Ethics of Procuring and Replacing Organs in Humans

Replacement Parts

James J. McCartney, OSA

Dominic A. Sisti

In the 1850s, "Drapetomania" was the medical term for a disease found among black slaves in the United States. The main symptom was a strange desire to run away from their masters. In earlier centuries gout was understood as a metabolic disease of the affluent, so much so that it became a badge of uppercrust honor—and a medical excuse to avoid hard work. Today, is there such a thing as mental illness, or is mental illness just a myth? Is Alzheimer's really a disease? What is menopause—a biological or a social construction? Historically one can see that health, disease, and illness are concepts that have been ever fluid. Modern science, sociology, philosophy, even society—among other factors—constantly have these issues under microscopes, learning more, defining and redefining ever more exactly. Yet often that scrutiny, instead of leading toward hard answers, only leads to more questions. Health, Disease, and Illness brings together a sterling list of classic and contemporary thinkers to examine the history, state, and future of ever-changing "concepts" in medicine. Divided into four parts—Historical Discussions; Characterizing Health, Disease, and Illness; Clinical Applications of Health and Disease; and Normalcy, Genetic Disease, and Enhancement: The Future of the Concepts of Health and Disease—the reader can see the evolutionary arc of medical concepts from the Greek physician Galen of Pergamum (ca. 150 ce) who proposed that "the best doctor is also a philosopher," to contemporary discussions of the genome and morality. The editors have recognized a crucial need for a deeper integration of medicine and philosophy with each other, particularly in an age of dynamically changing medical science—and what it means, medically, philosophically, to be human.

Concepts in Medicine

Health, Disease, and Illness

In When Medicine Went Mad, one of the nation's leading bioethicists-and an extraordinary panel of experts and concentration camp survivors-examine problems first raised by Nazi medical experimentation that remain difficult and relevant even today. The importance of these issues to contemporary bioethical disputes-particularly in the thorny areas of medical genetics, human experimentation, and euthanasia-are explored in detail and with sensitivity.

Bioethics and the Holocaust

When Medicine Went Mad

This collection of essays emphasizes society’s increasingly responsible engagement with ethical challenges in emerging medical technology. Expansion of technological capacity and attention to patient safety have long been integral to improving healthcare delivery but only relatively recently have concepts like respect, distributive justice, privacy, and autonomy gained some power to shape the development, use, and refinement of medical tools and techniques. Medical ethics goes beyond making better medicine to thinking about how to make the field of medicine better. These essays showcase several ways in which modern ethical thinking is improving safety, efficacy and efficiency of medical technology, increasing access to medical care, and empowering patients to choose care that comports with their desires and beliefs. Included are complimentary ethical approaches as well as compelling counter-arguments. Together, the articles demonstrate how improving the quality of medical technology relies on every stakeholder -- not just medical researchers and scientists -- to assess each given technology’s strengths and pitfalls. This collection also portends one of the next major issues in the ethics of medical technology: developing the requisite moral framework to accompany shifts toward patient-centred personalized healthcare.

The Ethical Challenges of Emerging Medical Technologies

Robert Arp

Contemporary Debates in Bioethics features a timely collection of highly readable, debate-style arguments contributed by many of today’s top bioethics scholars, focusing on core bioethical concerns of the twenty-first century. Written in an engaging, debate-style format for accessibility to non-specialists Features general introductions to each topic that precede scholarly debates Presents the latest, cutting-edge thoughts on relevant bioethics ideas, arguments, and debates

Contemporary Debates in Bioethics

Jason L. Schwartz

A comprehensive overview of important and contested issues in vaccination ethics and policy by experts from history, science, policy, law, and ethics. Vaccination has long been a familiar, highly effective form of medicine and a triumph of public health. Because vaccination is both an individual medical intervention and a central component of public health efforts, it raises a distinct set of legal and ethical issues--from debates over their risks and benefits to the use of government vaccination requirements--and makes vaccine policymaking uniquely challenging. This volume examines the full range of ethical and policy issues related to the development and use of vaccines in the United States and around the world. Forty essays, articles, and reports by experts in the field look at all aspects of the vaccine life cycle. After an overview of vaccine history, they consider research and development, regulation and safety, vaccination promotion and requirements, pandemics and bioterrorism, and the frontier of vaccination. The texts cover such topics as vaccine safety controversies; the ethics of vaccine trials; vaccine injury compensation; vaccine refusal and the risks of vaccine-preventable diseases; equitable access to vaccines in emergencies; lessons from the eradication of smallpox; and possible future vaccines against cancer, malaria, and Ebola. The volume intentionally includes texts that take opposing viewpoints, offering readers a range of arguments. The book will be an essential reference for professionals, scholars, and students. Contributors Jeffrey P. Baker, Seth Berkley, Luciana Borio, Arthur L. Caplan, R. Alta Charo, Dave A. Chokshi, James Colgrove, Katherine M. Cook, Louis Z. Cooper, Edward Cox, Douglas S. Diekema, Ezekiel J. Emanuel, Claudia I. Emerson, Geoffrey Evans, Ruth R. Faden, Chris Feudtner, David P. Fidler, Fiona Godlee, D. A. Henderson, Alan R. Hinman, Peter Hotez, Robert M. Jacobson, Aaron S. Kesselheim, Heidi J. Larson, Robert J. Levine, Donald W. Light, Adel Mahmoud, Edgar K. Marcuse, Howard Markel, Michelle M. Mello, Paul A. Offit, Saad B. Omer, Walter A. Orenstein, Gregory A. Poland, Lance E. Rodewald, Daniel A. Salmon, Anne Schuchat, Jason L. Schwartz, Peter A. Singer, Michael Specter, Alexandra Minna Stern, Jeremy Sugarman, Thomas R. Talbot, Robert Temple, Stephen P. Teret, Alan Wertheimer, Tadataka Yamada

An Introduction with Readings

Vaccination Ethics and Policy

What do you think about cloning, stem cell research, brain enhancement, or doing experiments on newly dead patients? Read Smart Mice, Not so Smart People and you'll know what Art Caplan thinks. But this assortment of pithy, provocative opinions on all things bioethical does more than simply give you a piece of the author's mind—it also invites and even dares you to make up your own mind. In his typical style, Caplan—one of the most sought-after bioethicists of our time—provokes discussion on issues at the center of the new genetics, cloning in the laboratory and in the media, stem cell research, experiments on human subjects, blood donation and organ transplantation, and healthcare delivery. Are new developments in these areas good or bad? As an engaged citizen in a democratic society, it is your responsibility to decide. This book will help you do it.

Arthur L. Caplan

Books

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