I explore some new directions—suggested by feminism—for medical ethics and for philosophical ethics generally. Moral philosophers need to confront two issues. The first is deciding which moral issues merit attention. Questions which incorporate the perspectives of women need to be posed—e. g., about the unequal treatment of women in health care, about the roles of physician and nurse, and about relationship issues other than power struggles. “Crisis issues” currently dominate medical ethics, to the neglect of what I call “housekeeping issues.” (...) The second issue is how philosophical moral debates are conducted, especially how ulterior motives influence our beliefs and arguments. Both what we select—and neglect—to study as well as the “games” we play may be sending a message as loud as the words we do speak on ethics. (shrink)

Work on representing women's voices in ethics has produced a vision of moral understanding profoundly subversive of the traditional philosophical conception of moral knowledge. 1 explicate this alternative moral “epistemology,” identify how it challenges the prevailing view, and indicate some of its resources for a liberatory feminist critique of philosophical ethics.

Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

"The medical establishment has become a major threat to health. The disabling impact of professional control over medicine has reached the proportions of an epidemic. Iatrogenesis, the name for this new epidemic, comes from iatros, the Greek word for physician, and genesis, meaning origin. Discussion of the disease of medical progress has moved up on the agendas of medical conferences, researchers concentrate on the sick-making powers of diagnosis and therapy, and reports on paradoxical damage caused by cures for sickness take (...) up increasing space in medical dope-sheets [...] The public has been alerted to the perplexity and uncertainty of the best among its hygienic caretakers [...] This book argues that panic is out of place. Thoughtful public discussion of the iatrogenic pandemic, beginning with an insistence upon demystification of all medical matters, will not be dangerous to the commonweal."-- from Introduction. (shrink)

The social ethics of medicine is the study and ethical analysis of social structures which impact on the provision of health care by physicians. There are many such social structures. Not all these structures are responsive to the influence of physicians as health professionals. But some social structures which impact on health care are prompted by or supported by important preconceptions of medical practice. In this article, three such elements of the philosophy of medicine are examined in terms of the (...) negative impact on health care of the social structures to which they contribute. The responsibilities of the medical profession and of individual physicians to work to change these social structures are then examined in the light of a theory of profession. (shrink)

Consider the odd fact—later I will try to show how very odd it is—that the only popular views about the morality of abortion are also the most extreme. Philosophical views are no exception; indeed I will argue that this extremism has deeply philosophical roots. It follows directly from the insistence on “drawing a line” dividing persons from non persons. We can't, so the usual arguments go, draw such a line anywhere except at the very beginning or the very end of (...) fetal development. But on the practical level, as most of us know first-hand, that extremism remains problematic: it yields a factious and clumsy casuistry. It is equally difficult—and, surely, equally inhumane—to believe that a conceptus two days old is the moral equivalent of a fully functioning human being and that a fetus just prior to birth is the moral equivalent of a tumor. The division between persons and non persons, however, is linked in turn with certain others. Not only may the possibility of dividing any concept's denotation from its neighbors' seem to be at stake here; the division between persons and non persons depends more particularly—so I will argue—on the contemporary division in moral theory between moral reasons and other kinds of reasons, and in particular on the division between the moral and the self-interested “points of view.” That division in turn I trace back, in part, to the Hobbesian picture of the social world, on which the most fundamental division of all runs between persons and other persons. So one division points beyond itself to others. The critic is launched on a kind of odyssey through the theoretical presuppositions of applied ethics. (shrink)

This debate-style reader is designed to introduce students to controversies in bioethical issues through readings that reflect a variety of viewpoints. Each issue is framed with an issue summary, an issue introduction, and a postscript. The Taking Sides readers feature annotated listings of selected World Wide Web sites. Taking Sides is supported by our student website at www.dushkin.com/online/.

This best-selling anthology of readings with case studies provides insightful and comprehensive treatment of ethical issues in medicine. Appropriate for courses taught in philosophy departments as well as in schools of medicine and nursing, the collection covers provocative topics such as conflicts of interest in medicine, advance directives, physician-assisted suicide, and the rationing of health care. The text's effective pedagogical features include chapter introductions, argument sketches, explanations of medical terms, headnotes, and annotated bibliographies.

In analyzing the factors that have improved health and enhanced longevity during the last three centuries, Thomas McKeown contends that nutritional, environmental, and behavioral changes have been and will be more important than specific medical measures, especially clinical or curative" measures. Originally published in 1980. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These paperback editions preserve the original texts of these important books while (...) presenting them in durable paperback editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

Consider the odd fact—later I will try to show how very odd it is—that the only popular views about the morality of abortion are also the most extreme. Philosophical views are no exception; indeed I will argue that this extremism has deeply philosophical roots. It follows directly from the insistence on “drawing a line” dividing persons from non persons. We can't, so the usual arguments go, draw such a line anywhere except at the very beginning or the very end of (...) fetal development. But on the practical level, as most of us know first-hand, that extremism remains problematic: it yields a factious and clumsy casuistry. It is equally difficult—and, surely, equally inhumane—to believe that a conceptus two days old is the moral equivalent of a fully functioning human being and that a fetus just prior to birth is the moral equivalent of a tumor. The division between persons and non persons, however, is linked in turn with certain others. Not only may the possibility of dividing any concept's denotation from its neighbors' seem to be at stake here; the division between persons and non persons depends more particularly—so I will argue—on the contemporary division in moral theory between moral reasons and other kinds of reasons, and in particular on the division between the moral and the self-interested “points of view.” That division in turn I trace back, in part, to the Hobbesian picture of the social world, on which the most fundamental division of all runs between persons and other persons. So one division points beyond itself to others. The critic is launched on a kind of odyssey through the theoretical presuppositions of applied ethics. (shrink)

Feminist ethics and medical ethics are critical of contemporary moral theory in several similar respects. There is a shared sense of frustration with the level of abstraction and generality that characterizes traditional philosophic work in ethics and a common commitment to including contextual details and allowing room for the personal aspects of relationships in ethical analysis. This paper explores the ways in which context is appealed to in feminist and medical ethics, the sort of details that should be included in (...) the recommended narrative approaches to ethical problems, and the difference it makes to our ethical deliberations if we add an explicitly feminist political analysis to our discussion of context. It is claimed that an analysis of gender is needed for feminist medical ethics and that this requires a certain degree of generality, i.e. a political understanding of context. (shrink)

Work on representing women's voices in ethics has produced a vision of moral understanding profoundly subversive of the traditional philosophical conception of moral knowledge. I explicate this alternative moral "epistemology," identify how it challenges the prevailing view, and indicate some of its resources for a liberatory feminist critique of philosophical ethics.

Cost‐effectiveness analysis (CEA) raises questions that are too important to be left to policy analysts and economists. Those who utilize CEA should acknowledge its inherent value system and adapt it to a more ethical usage.