Perhaps the gradualist position on abortion has re-emerged repeatedly because it corresponds to pastoral experienceAt one level David Albert Jones’s paper is very successful. Despite the high reputation of the late Gordon Dunstan, first as a mediaeval historian, then as an ethicist of considerable influence within the Anglican church, and finally as a pioneer medical ethicist, his crucial 1984 article appears to be overdrawn. Some caution is now needed before endorsing his claim that the Christian tradition according the embryo the (...) full moral status of a human person from conception is “virtually a creation of the later nineteenth century”. Dr Jones produces a wealth of historical scholarship to challenge it.At another level, however, Dr Jones is not concerned about nuancing a historical claim but about demonstrating that “licensing destructive research on human embryos for the sake of medical progress…cannot be justified…on the basis of the Christian tradition”.1 Unfortunately there is quite a large gap between these two claims. Manifestly “the Christian tradition” is not a unified tradition even within Jones’s own historical account. He admits himself that the Roman Catholic tradition diverged at times from what he clearly regards as the norm . And he is less than frank in admitting that many Reformed Christians …. (shrink)

In the theater the fictional Dr. Kelekian’s relief that he does not have to talk to family members about his patient’s cancer treatment draws uneasy laughter from the audience. Doctors, patients, and family members alike recognize the situation, even if hearing it so baldly expressed discomfits them.Why do physicians and other health care professionals, including lawyers and bioethicists, so often view families as “trouble”? And why do families so often see medical professionals as uncaring and uncommunicative? Presumably everyone wants the (...) same goal—recovery or the best possible outcome for the patient. And yet trouble clearly exists. We do not see the problem as one of “dysfunctional families” or “callous doctors,” although there are undoubtedly many of each. (shrink)

Over the past decade or so, the predominant patient-centered ethos in American bioethics has come under attack by critics who claim that it is morally deficient in certain respects, particularly when viewed in the context of acute-care decisionmaking. One line of criticism has been that the current ethic of patient autonomy gives an individual competent patient far too much decisional authority over the terms of his own treatment so that the patient is at complete liberty to neglect the ways in (...) which his medical decisions can drastically and negatively affect the lives of other family members. Given that family members must help shoulder the financial, emotional, and rehabilitative burdens involved in the patient's care, it has been argued that they too have a legitimate interest in choosing what sort of medical treatment the patient eventually receives. Another closely related line of criticism is that the prevailing focus on patient autonomy gives short shrift to the moral significance of the family as a genuine community. Echoing a view of the person advanced by most communitarian political theorists, some commentators have argued that the patient comes to the clinic so thoroughly embedded in a complex web of familial relationships and obligations that it does not make sense to identify him as the only person in the family to make decisions about treatment. (shrink)