Virtue ethics has a rich history; yet, its application in health ethics has been minimal compared to other major ethical frameworks. Even more, its application to health policy and population-level questions has been almost nonexistent. A new concept in moral theology, structures of virtue, provides impetus for ethicists to consider how virtue ethics can be a valuable addition to existing frameworks in public health ethics. This article offers a basic overview of virtue ethics and its value for analysis of social (...) structures in public health. It does so by explaining how virtue can be seen not only in the process of public health—the promotion of habituated behavior—but also in the content of public health—values such as temperance, fortitude and prudence. It concludes with two extended applications of virtue ethics: vaccination policy and healthy eating. (shrink)

End-of-life medical decision making presents a major challenge to patients and physicians alike. In order to determine whether it is ethically justifiable to forgo medical treatment in such scenarios, clinical data must be interpreted alongside patient values, as well as in light of the physician's ethical commitments. Though much has been written about this ethical issue from religious perspectives , little work has been done from an Islamic point of view. To fill the gap in the literature around Islamic bioethical (...) perspectives on the matter, we derive a theologically rooted rubric for goals of care. We use the Islamic obligation for Muslims to seek medical treatment as the foundation for determining the clinical conditions under which Muslim physicians have a duty to treat. We next link the theological concept of accountability before God to quality-of-life assessment. Using this construct, we suggest that a Muslim physician is not obligated to maintain or conti.. (shrink)

I will argue that there are difficulties with the application of the four principles approach to incompetent children. The most important principle – respect for autonomy – is not directly applicable to incompetent children and the most appropriate modification of the principle for them is not clear. The principle of beneficence – that one should act in the child’s interests – is complicated by difficulties in assessing what a child’s interests are and to which standard of interests those choosing for (...) children should be held. A further problem with the four principles approach is that parental authority does not follow clearly from the four principles. (shrink)

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 Common Good and Christian Ethics rethinks the ancient tradition of the common good in a way that addresses contemporary social divisions, both urban and global. David Hollenbach draws on social analysis, moral philosophy, and theological ethics to chart new directions in both urban life and global society. He argues that the division between the middle class and the poor in major cities and the challenges of globalisation require a new commitment to the common good and that both believers and (...) secular people must move towards new forms of solidarity if they are to live good lives together. Hollenbach proposes a positive vision of how a reconstructed understanding of the common good can lead to better lives for all today, both in cities and globally. This interdisciplinary study makes both practical and theoretical contributions to the developing shape of social, cultural, and religious life today. (shrink)

Many people are vaguely disquieted by developments (real or imagined) that could alter minds and bodies in novel ways. Romantics and Greens tend to idealize the natural and demonize technology. Traditionalists and conservatives by temperament distrust radical change. Egalitarians worry about an arms race in enhancement techniques. And anyone is likely to have a "yuck" response when contemplating unprecedented manipulations of our biology. The President's Council has become a forum for the airing of this disquiet, and the concept of "dignity" (...) a rubric for expounding on it. This collection of essays is the culmination of a long effort by the Council to place dignity at the center of bioethics. The general feeling is that, even if a new technology would improve life and health and decrease suffering and waste, it might have to be rejected, or even outlawed, if it affronted human dignity. (shrink)

Daniel Callahan's life time work in bioethics has again and again returned to the root problems of health, progress, technology, and death. How we think about each of them individually and in relation to each other will shape the way we approach and deal with the most common dilemmas of modern medicine. They are at the roots of the field.

In lieu of an abstract, here is a brief excerpt of the content:THE CONTRIBUTIONS OF THEOLOGY TO MEDICAL ETHICS* JAMES M. GUSTAFSOm The purpose of this article is to develop a position on the contribution that theology can make to medical ethics, attending both to the forms of the contribution and to the substance of it. The order of development of the argument is as follows. First, it is necessary to indicate clearly what I mean when I speak of theology (...) and of the work of a theologian, for different persons have different perceptions and convictions about what theology is. In a similar way, I shall indicate briefly what I think are the relevant dimensions of ethics. Second, theology is a source of many substantive themes which pertain to ethics, and to medical ethics particularly; I have isolated three affirmations to use illustratively in order to develop the more inclusive intention of this lecture. These are delineated and developed with reference to their contributions to a theological moral point of view, to certain relevant moral attitudes toward human life, and to a basic intentionality that informs action. In the course of the article I indicate some of the ways in which the contribution of theology to medical ethics must be supplemented from other resources adequately to address particular clinical moral issues. Theology and Ethics Some clarification is required ofthe term "theology"; at least the way it is used here must be delineated. My view is stated in fewer words than desirable but I hope with intelligibility. I regard all of theology as reflection upon human experience. Theology is reflection on human experience with reference to a particular dimension of the human experience denoted "religious." For many persons in the world of religion these days, any dimension of experience *This is an abbreviated version of the 1975 Pere Marquette Theology Lecture, used by permission. No offprints of this version are available. The complete lecture is available for purchase from the Theology Department, Marquette University, Milwaukee, Wisconsin 53233. l'University Professor of Theological Ethics, University of Chicago. Perspectives in Biology and Medicine · Winter 1976 | 247 that is ultimate, integrative, or passionately felt is "religious." I distinguish my usage from such elastic references to the word "religious." I reserve the word "religious" for that dimension of experience (in which not all persons consciously share) that senses a relationship to an ultimate power that sustains and stands over against humans and the world. Thus, in this usage there is nothing properly called religion where there is no sense of the reality of an ultimate power, or of objective powers (to remember that there are polytheistic religions). The ultimate power is never experienced directly and immediately (perhaps an exception might be a rare experience of a rare mystic) but is always experienced indirectly and in a mediated way. Thus, to paraphrase John E. Smith of Yale, an experience of the reality of God is always at one and the same time an experience of something else.1 Alas, that statement is not convertible : an experience of an historical event, for example, is not necessarily a meaningful experience of God. Thus, to speak of the religious dimensions of experience is not to assert that every person is aware of such, or that persons who are aware of such are conscious of their significance in every experience they have. The oddity of religion lies in the fact that some persons do meaningfully and affectively experience an ultimate power sustaining and standing over against them. Sometimes this is in facing death, sometimes in eating a hot dog, sometimes in sequences of historical events, and sometimes in the voice of a friend. Theology is an intellectual discipline that seeks to draw inferences (in a perhaps imprecise use of that term) from those dimensions of experience with reference to the power that is experienced. Thus, telling a story of a life experience is not itself theology. Rather, a story is merely data for theological reflection. Theology seeks to determine, on the basis ofinferences from the religious dimensions ofexperience, what qualities and characteristics can be appropriately attributed to the ultimate power, what purposes and intentions can be plausibly claimed for it, and what its relations are to the world. Philosophers with certain interests... (shrink)

There is more to modern health than new scientific discoveries, the development of new technologies, or emerging or re‐emerging diseases. World events and experiences, such as the AIDS epidemic and the humanitarian emergencies in Bosnia and Rwanda, have made this evident by creating new relationships among medicine, public health, ethics, and human rights. Each domain has seeped into the other, making allies of public health and human rights, pressing the need for an ethics of public health, and revealing the rights‐related (...) responsibilities of physicians and other health care workers. (shrink)

Bioethics represents a dramatic revision of the centuries-old professional ethics that governed the behavior of physicians and their relationships with patients. This venerable ethics code was challenged in the years after World War II by the remarkable advances in the biomedical sciences and medicine that raised questions about the definition of death, the use of life-support systems, organ transplantation, and reproductive interventions. In response, philosophers and theologians, lawyers and social scientists joined together with physicians and scientists to rethink and revise (...) the old standards. Governments established commissions to recommend policies. Courts heard arguments and legislatures passed laws. This book is the first broad history of the growing field of bioethics. Covering the period 1947-1987, it examines the origin and evolution of the debates over human experimentation, genetic engineering, organ transplantation, termination of life-sustaining treatment, and new reproductive technologies. It assesses the contributions of philosophy, theology, law and the social sciences to the expanding discourse of bioethics. Written by one of the field's founders, The Birth of Bioethics is based on extensive archival research into sources that are difficult to obtain and on interviews with many of the leading figures in the moral debates in medicine. A very readable and comprehensive account of the evolution of bioethics, this book stresses the history of ideas but does not neglect the social and cultural context and the people involved. It will serve the information needs of philosophers, ethicists, social historians, and everyone interested in the origins of some of today's most hotly debated issues. (shrink)

Serious ethical violations in medicine, such as sexual abuse, criminal prescribing of opioids, and unnecessary surgeries, directly harm patients and undermine trust in the profession of medicine. We review the literature on violations in medicine and present an analysis of 280 cases. Nearly all cases involved repeated instances of intentional wrongdoing, by males in nonacademic medical settings, with oversight problems and a selfish motive such as financial gain or sex. More than half of cases involved a wrongdoer with a suspected (...) personality disorder or substance use disorder. Despite clear patterns, no factors provide readily observable red flags, making prevention difficult. Early identification and intervention in cases requires significant policy shifts that prioritize the safety of patients over physician interests in privacy, fair processes, and proportionate disciplinary actions. We explore a series of 10 questions regarding policy, oversight, discipline, and education options. Satisfactory answers to these questions will require input from diverse stakeholders to help society negotiate effective and ethically balanced solutions. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

Catholic ethical teaching has increasingly relied on a concept of the common good for making and evaluating social decisions. The authors have argued that the common good is a maximal and ideal concept about which people and communities differ fundamentally. In practice, it does not resolve moral and social disagreements. The concept of the common harm is preferable because it is a minimal standard that can be more clearly identified and agreed for individuals and society, providing a basis for legislative (...) and social action. Bioethics and public health both have strong roots in doing no harm and preventing harm to both individuals and communities in society. The authors argue that the application of the concept of the common harm from these disciplines into wider use in the health professions and public policy would be beneficial. National Catholic Bioethics Quarterly 14.3 : 449–455. (shrink)

The problems of racism and racially motivated violence in predominantly African American communities in the United States are complex, multifactorial, and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems. We consider how bioethicists can offer meaningful contributions to the public discourse, research, teaching, training, policy development, and (...) academic scholarship in response to the alarming and persistent patterns of racism and implicit biases associated with it. To make any useful contribution, bioethicists will require preparation and should expect to play a significant role through collaborative action with others. (shrink)

The Oxford Handbook of Jewish Ethics and Morality offers a collection of original essays--historical and contemporary, as well as philosophical and practical--by leading scholars from around the world. The first section of the volume describes the history of the Jewish tradition's moral thought, from the Bible to contemporary Jewish approaches. The second part includes chapters on specific fields in ethics, including the ethics of medicine, business, sex, speech, politics, war, and the environment.

In its third edition, this is a primer on the major bioethics issues of our time with helpful discussion questions and bibliography. All of the chapters have been revised and updated.

Some commentators have criticized bioethics as failing to engage religion both as a matter of theory and practice. Bioethics should work toward understanding the influence of religion as it represents people's beliefs and practices, but bioethics should nevertheless observe limits in regard to religion as it does its normative work. Irreligious skepticism toward religious views about health, healthcare practices and institutions, and responses to biomedical innovations can yield important benefits to the field. Irreligious skepticism makes it possible to raise questions (...) that otherwise go unasked and to protect against the overreach of religion. In this sense, bioethics needs a vigorous irreligious outlook every bit as much as it needs descriptive understandings of religion. (shrink)

Because the United States has failed to provide a pathway to citizenship for its long-term undocumented population, clinical ethicists have more than 20 years of addressing issues that arise in caring for this population. I illustrate that these challenges fall into two sets of issues. First-generation issues involve finding ethical ways to treat and discharge patients who are uninsured and ineligible for safety-net resources. More recently, ethicists have been invited to help address second-generation issues that involve facilitating the presentation for (...) care of undocumented patients. In the current environment of widespread fear of deportation in the immigrant community, ethicists are working with health care providers to address patient concerns that prevent them from seeking care. I illustrate that in both generations of issues, values implicit within health care, namely, caring, efficiency, and promotion of public health, guide the strategies that are acceptable and recommended. (shrink)

Jonathan Beever and Nicolae Morar’s (2016) article “The Porosity of Autonomy: Social and Biological Constitution of the Patient in Biomedicine” and its accompanying commentaries in the American Journal of Bioethics—though insightful, innovative, and provocative—overlook key interlocutors necessary for any discussion of whether the mid-twentieth-century biomedical principle of autonomy should be revised or revoked. The conversation sparked by “The Porosity of Autonomy” will remain both incomplete and politically untenable so long as there is no meaningful engagement with persons/communities who appeal to (...) the principle of patient autonomy in order to articulate and challenge the conditions of their oppression. (shrink)

This chapter begins with a discussion of fundamental convictions of Judaism that affect Jewish approaches to moral issues at the beginning of life, and then considers Jewish views about preventing pregnancy through contraception and abortion, and, conversely, assisting those with infertility problems. The analysis is also used to discuss embryonic stem cell research and genetic testing.