A Time to Be Born and a Time to Die: The Ethics of Choice

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Barry S. Kogan
Transaction Publishers - Medical - 267 pages

This volume brings together original essays by many of the best and most prominent figures in the emerging field of biomedical ethics and presents them in a dialogue that significantly updates their earlier work. Focusing on the moral dilemmas that recent medical advances have created at both ends of the life course, the contributors discuss such issues as patient autonomy, hospital policies of risk-management, new developments in the abortion debate, genetic counseling and perinatal care, euthanasia and physician-assisted suicide, testing and treatment policies for HIV infection, and fairness in allocating health care and donated organs.

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Contents

Mortal Choices Today A Survey of the Moral Issues
19
Birth Death and the Criminal Law The New Politics of Privacy
35
Rethinking Controversial Questions
55
Abortion in a Pluralistic Society Can Freedom and Moral Probity Coexist?
57
Morality and Choice A Response to Daniel Callahan
73
Dilemmas in Fetal Research Genetic Counseling and Neonatal Care
83
Fetal Therapy Anencephalics as Organ Donors and Genetic Screening and Counseling
103
Death With Dignity and the Sanctity of Life
117
Obstacles and Opportunities in Responding to the Epidemic of HIV Infection A Response to LeRoy Walters
169
Fairness in the Allocation and Delivery of Health Care The Case of Organ Transplantation
179
Equality Justice and Rightness in Allocating Health Care A Response to James Childress
205
Drawing Guidance from our Traditions
217
How to Draw Guidance from a Heritage Jewish Approaches to Mortal Choices
219
How to Draw Guidance from a Heritage A Catholic Approach to Mortal Choices
233
How to Draw Guidance from a Heritage A Protestant Approach to Mortal Choices
241
Biographical Sketch of the Contributors
257

Good Rules Have Good Reasons A Response to Leon Kass
147
Ethics and the Epidemic of HIV Infection
157
Index
259
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Page 38 - It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes.... Three generations of imbeciles are enough
Page 39 - If the right of privacy means anything, it is the right of the individual, married or single, to be free from unwarranted governmental intrusion into matters so fundamentally affecting a person as the decision whether to bear or beget a child.
Page 39 - This right of privacy, whether it be founded in the Fourteenth Amendment's concept of personal liberty and restrictions upon state action, as we feel it is, or as the District Court determined, in the Ninth Amendment's reservation of rights to the people, is broad enough to encompass a woman's decision whether or not to terminate her pregnancy.
Page 38 - We are dealing here with legislation which involves one of the basic civil rights of man. Marriage and procreation are fundamental to the very existence and survival of the race. The power to sterilize, if exercised, may have subtle, far-reaching and devastating effects. In evil or reckless hands it can cause races or types which are inimical to the dominant group to wither and disappear.
Page 40 - For the stage subsequent to viability, the State in promoting its interest in the potentiality of human life may, if it chooses, regulate, and even proscribe, abortion except where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother.
Page 39 - The detriment that the State would impose upon the pregnant woman by denying this choice altogether is apparent. Specific and direct harm medically diagnosable even in early pregnancy may be involved. Maternity, or additional offspring, may force upon the woman a distressful life and future. Psychological harm may be imminent. Mental and physical health may be taxed by child care. There is also the distress, for all concerned, associated with the unwanted child, and there is the problem of bringing...
Page 52 - A society based on the letter of the law and never reaching any higher fails to take advantage of the full range of human possibilities. The letter of the law is too cold and formal to have a beneficial influence on society. Whenever the tissue of life is woven of legalistic relationships, this creates an atmosphere of spiritual mediocrity that paralyzes man's noblest impulses.
Page 44 - Presumably this right is broad enough to encompass a patient's decision to decline medical treatment under certain circumstances, in much the same way as it is broad enough to encompass a woman's decision to terminate pregnancy under certain conditions.
Page 126 - Whoso sheddeth man's blood, by man shall his blood be shed; for in the image of God made He man.

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