Bioethics in Context: Moral, Legal, and Social Perspectives

In Bioethics in Context, Gary Jones and Joseph DeMarco connect ethical theory, medicine, and the law, guiding readers toward a practical and legally grounded understanding of key issues in health-care ethics. This book is uniquely up-to-date in its discussion of health-care law and unpacks the complex web of American policies, including the Patient Protection and Affordable Care Act. Useful case studies and examples are embedded throughout, and a companion website offers a thorough, curated database of relevant legal precedents as well as additional case studies and other resources.

Table of Contents:
Acknowledgments Introduction Chapter 1: Moral Theory in Bioethics Consequentialism and Deontology Consequentialism Rule Consequentialism Hare’s Utilitarianism Kantian Deontology Rule Theory Case Study: Dr. Mando Alternative Approaches Principlism Particularism Virtue Ethics Feminist Ethics and the Ethics of Care Casuistry Conclusion Exercises and Discussion Questions Chapter 2: Basic Law The American Legal System Common Law Statutory Law Executive Orders and Agencies Constitutional Law State Court Systems The Federal Court System Legal Processes and Lawsuits Legal Processes Lawsuits Ethics and the Law Conclusion Exercises and Discussion Questions Chapter 3: Justice and the Right to Care The Meaning of Justice Justice and Equality Equality of Resources: Ronald Dworkin Group Equality: R.H. Tawney Complex Equality: Michael Walzer Criteria of Just Distribution Theories of Justice Utilitarian Theory Social Contract Theory Libertarian Theory Feminist Ethics and Just Health Care Norman Daniels’s Approach to Health-Care Justice Just Health Care: Beauchamp and Childress Allocation of Health Care Models for the Allocation of Health Care to Individuals The Proprietary Model The Merit Model The Social Worth Model The Need Model Policy Options for the Allocation of Health Care Fee-for-Service Model The Universal and Comprehensive Provision of Benefits Model Fee-for-Service with a Safety Net Model Universal Basic Health-Care Model Professional Considerations Containment of Health-Care Costs Rationing of Health Care Patient Protection and Affordable Care Act The PPACA and the Iron Triangle Accessibility Quality Cost Concerns about the Viability of the PPACA The PPACA and the US Constitution Expansion of Medicaid Individual Mandate Ethical Aspects of the Individual Mandate and Medicaid Expansion Conclusion Exercises and Discussion Questions Chapter 4: The Duty to Treat Physicians and Other Health-Care Providers In General, No Duty to Treat Duty Not to Abandon Is There a Moral Duty to Treat? Standards of Care Malpractice Good Samaritan Laws Hospitals Medicare Medicaid Emergency Treatment Staff Physicians Nurses Rights and Duties of Third-Party Payers ERISA: Employment Retirement Income Security Act Conclusion Exercises and Discussion Questions Chapter 5: Informed Consent The Basics of Informed Consent Three Concepts of Informed Consent Elements of Informed Consent Disclosure Waiving and Delegating Informed Consent Proxy Decision Making Advance Directives Assessing Capacity The Meaning of Decisional Capacity Mental Illness and Capacity to Consent Enhancing Capacity Capacity: Young and Old Religion and Capacity Does Rejection of Treatment Indicate Incapacity? Erring on the Side of Autonomy Assessing Capacity Informed Consent: Ethical Issues Constraints on Informed Consent Coercion Manipulation Offers and Rewards Influence Medical Paternalism Autonomy vs. Beneficence Ethical Evaluation of Informed Consent Informed Consent and Ethics Committees Informed Consent: Legal Issues The Scope of Informed Consent Community of Physicians Standard Reasonable Physician Standard Objective Patient Standard Subjective Patient Standard Three Exceptions to Informed Consent Incompetency Emergency Care The Therapeutic Privilege Legal Consequences of the Failure to Obtain Informed Consent Revising Informed Consent False Imprisonment Special Problem Areas Conclusion Exercises and Discussion Questions Chapter 6: Informed Refusal and the Discontinuation of Treatment The Criteria for and Meaning of Death Persistent Vegetative States Religious Objections to the Brain-Death Criterion Medical Futility What Is Medical Futility? Physiological or Strict Futility Quantitative Futility Qualitative Futility Case Studies of Medical Futility Are Wanglie and Baby K Cases of Medical Futility? Who Decides? What Is the Chance of Success? Policies on Futility The AMA Policy The Texas Statute Discontinuing Medical Treatment Determining Whether to Discontinue Treatment Family Consent Substituted Judgment Best Interest Standard Mixed Standard: Limited Objective Test Withdrawing versus Withholding Treatment Passive Euthanasia Active Euthanasia and Physician-Assisted Suicide The Ethics and Laws of Assisted Suicide Ethical and Legal Foundations of Informed Refusal The Ethics of Informed Refusal Legal Foundations of Informed Refusal Karen Quinlan: Privacy and Treatment Nancy Cruzan: Clear and Convincing Evidence Elizabeth Bouvia: Do Motives Matter? Removing Respirators versus Removing Feeding Tubes Other Cases: Schiavo and Borenstein Treatment Decisions Involving Children Birth Defects and Treatments Parental Autonomy and Mandated Treatment Refusal of Treatment for Religious Reasons Conclusion Exercises and Discussion Questions Chapter 7: Nursing: Legal and Moral Issues What is Nursing? Licensure and Credentialing Nurse Practice Acts and Nursing Boards Standard of Care Nurses and Conscience Clauses The Limits of Nurses’ Responsibilities Nurses and Diagnoses Whose Obligation: Nurse’s or Physician’s? Nurses Practicing Medicine? Advocating for a Patient Boundary Violations Nurses in Emergencies Some Particular Duties and Obligations Nursing Assessment Acquiring Informed Consent Duty to Protect against Patient Self-Harm v Duty to Warn Third Parties Reporting Suspected Child Abuse Conclusion Exercises and discussion questions Chapter 8: Privacy and Confidentiality Privacy Privacy as a Moral Rule Utilitarian Justifications for Privacy Covert Surveillance The Legal Right to Privacy The Right to Privacy of Conduct The Right to Privacy of Information Confidentiality The Physician–Patient Relationship The Physician’s Obligation of Confidentiality HIPAA Regulations Maintaining Confidentiality Other Legal Exceptions to Confidentiality Evaluating the Tarasoff Case HIV and the Law Duty to Warn of Genetic Risk Conclusion Exercises and Discussion Questions Chapter 9: Cultural Competency The Importance of Cultural Competency Reasons in Support of Cultural Competency Medical Diagnoses and Cultural Difference Reacting to Patients: Responding to Differences Respecting Differences and Negotiating Biases Responding to Patient Biases Not All People in Any Culture Are the Same Whose Culture Dominates? The Initial Encounter with Patients Cultural Competency and Informed Consent Cultural Competency and Informed Refusal Cultural Competency and Translation Translation and the Law When Culture Conflicts with the Law Deciding to Report Balancing Moral and Legal Obligations The Affordable Care Act Conclusion Exercises and Discussion Questions Chapter 10: Issues in Human Reproduction Abortion Fetuses and Personhood Philosophical Perspectives on Abortion Legal Aspects of Abortion The Legal Status of the Fetus In Vitro Fertilization Surrogate Motherhood Involuntary Sterilization Genetic Testing and Treatments Genetics and Disease Genetic Testing Preimplantation Genetic Diagnosis Genetic Enhancements Senescence Happiness The Stem-Cell Debate Human Cloning Cloning to Produce Children Cloning for Research Purposes Conclusion Exercises and Discussion Questions Chapter 11: Mental Illness What is Mental Illness? Commitment, Consent, and Decision Making Institutional Commitment and Consent Treatment Decisions Incompetence The Use of Restraints Legal Responsibilities and Liabilities Malpractice Duties to Third Parties Conclusion Exercises and Discussion Questions Chapter 12: Medical Research: Clinical Trials What are Clinical Trials? Protecting Research Subjects Historical Abuse The Belmont Report The Declaration of Helsinki Placebos Types of Clinical Trials Phase I Trials Phase II Trials Phase III Trials Protocols Clinical Equipoise Participation in a Clinical Trial Federal Regulations Legal Issues in Clinical Trials Abney, et al. v. Amgen Inc. Grimes v. Kennedy Krieger Institute, Inc.; Myron Higgins, A Minor, Etc., et al. v. Kennedy Krieger Institute, Inc. Kristina Ann Dahl, MD, et al. v. HEM Pharmaceuticals, Inc., et al. Estate of Kevin Baker v. University of Vermont Greenberg, et al. v. Miami Children’s Hospital Research Institute, Inc., et al. Conclusion Exercises and Discussion Questions Chapter 13: Transplantation Ethics Organ Donation Evaluating Prospective Organ Recipients Selling Organs Live Donors Donors Lacking Competence Donations against One’s Will Prisoners as Organ Donors Conclusion Exercises and Discussion Questions Index Index of Court Cases Index of Statutes Index of Model Acts

About the Author :
Gary E. Jones is Professor of Philosophy at the University of San Diego and a member of the California Bar Association. Joseph P. DeMarco is Professor Emeritus of Philosophy at Cleveland State University.

Review :
“This is a terrific, highly engaging introduction to bioethics. It gives practitioners and students of medicine, nursing, and law the language, theoretical background, and basic legal knowledge to join the conversation about important contemporary problems in bioethics, and it includes plenty of practice thinking through knotty problems.” —Michelle M. Mello, Stanford Law School “Bioethics in Context is a welcome book for bioethics instructors. Most bioethics issues are inextricably tied to legal concerns, so they cannot be understood without an appreciation of the current laws. This text is unique in its recognition of the importance of this relationship. It addresses the ethical and legal issues together, providing a robust understanding of the topics. The authors have done an admirable job of making both ethics and the law accessible for students.” —Joan McGregor, Arizona State University “Bioethics in Context should be enthusiastically received by teachers of biomedical ethics. Gary Jones and Joseph DeMarco provide up-to-date coverage of all the principal issues in the field, masterfully discussing the main positions, arguments, and contributors to current debates. The authors provide a wealth of concrete case studies and emphasize how ethical, legal, and social norms intersect and sometimes conflict. Highly recommended.” —David Svolba, Fitchburg State University