Practical Bioethics offers a mix of theory and readings, presented in a format that is succinct and approachable. Each chapter begins and ends with a case study, illustrating the core issues at play and emphasizing the practical nature of the dilemmas arising in medicine. Primary source texts are provided to flesh out the issues, and each of these is carefully edited and presented with interwoven explanatory comments to assist student readers. Throughout, J.K. Miles shows the importance of health-care ethics to us all, whether we be medical providers, patients, or both.
Comments
“Practical Bioethics has clearly been authored with an active and collaborative classroom in mind. It will be especially valuable to instructors who wish to provide their students with a balanced presentation of both secondary and primary sources, opening the door to conversation and exploration. This is a text aimed at not just presenting the central positions and arguments but also cultivating students’ critical thinking skills.” — Alex Feldt, University of Tennessee, Knoxville
“This is a comprehensive textbook designed with today’s students in mind. Each chapter contains an opening and closing case, ideal for promoting classroom discussion. J.K. Miles’s most novel contribution is the short asides embedded in each reading, which prompt further engagement while providing students with guideposts as they explore pivotal articles in the field. In the hands of a seasoned instructor, Practical Bioethics will do what many other texts do not: bring the exciting, dynamic field of bioethics alive for students.” — Deborah Barnbaum, Kent State University
“Practical Bioethics is aptly named: it is an eminently practical approach to the complex issues presented in clinical settings. It is also superbly designed: each chapter presents a case study, frames the conceptual issues at stake, provides balanced readings with helpful annotations to guide the reader, and ends with an ethics committee exercise. I have taught bioethics to undergraduate and graduate students for more than a decade, and in my opinion this text meets a longstanding need. In addition to serving ‘patients and practitioners,’ as the subtitle notes, it is also a superb platform for students.” — Matthew Hickey, Colorado State University
“Miles’s textbook provides an excellent guide to teaching bioethics, particularly, I think, to undergraduates and others without much formal philosophy training. The briefing on how to read bioethics papers combined with the scaffolding internal to each chapter makes the book as a whole a digestible and accessible and, perhaps more importantly, a truly thought-provoking introduction to bioethics in practice.” — Erica Bigelow, in Teaching Philosophy
Acknowledgments
A Note to Readers
How Bioethics Journal Articles Work
- Identifying Arguments
- Responding to Arguments
- Academic Conversations
- Thought Experiments
CHAPTER 1: Ethical Dilemmas in Medicine
- Opening Gambit: The Transposition of the Great Arteries
- What’s at Stake?
- What’s the Debate?
- Reading 1.1: W.D. Ross, “What Makes Right Actions Right?”
- Reading 1.2: John Stuart Mill, from Utilitarianism
- Reading 1.3: Stephen Toulmin, “How Medicine Saved the Life of Ethics”
- Ethics Committee: A Minor in a Research Trial
CHAPTER 2: Ethical Principles for Resolving Dilemmas
- Opening Gambit: Sophie’s Choice without the Nazis
- What’s at Stake?
- From Intuitions to Principles
- From Principles to Principlism
- From Principles to Theories
- What’s the Debate?
- Reading 2.1: Ruth Macklin, “Applying the Four Principles”
- Reading 2.2: E. Arries, “Virtue Ethics: An Approach to Moral Dilemmas in Nursing”
- Ethics Committee: Billy Likes to Eat Mud
CHAPTER 3: Dilemmas in the Patient−Provider Relationship
- Opening Gambit: Prescribing Cebocap
- What’s at Stake?
- What Counts as Informed Consent?
- The Duty to Warn
- Paternalism
- What’s the Debate?
- Reading 3.1: Gerald Dworkin, “Paternalism”
- Reading 3.2: Aanand D. Naik et al., “Patient Autonomy for the Management of Chronic Conditions: A Two-Component Re-Conceptualization”
- Reading 3.3: Camilla Scanlan and Ian H. Kerridge, “Autonomy and Chronic Illness: Not Two Components but Many”
- Ethics Committee: The Anxious Patient
CHAPTER 4: Dilemmas in Medical Research
- Opening Gambit: Fruit from the Poisonous Tree?
- What’s at Stake?
- Nuremberg and Helsinki and Belmont: The Trend toward Beneficence
- Clinical Trials
- What’s the Debate?
- Reading 4.1: World Medical Association, “Declaration of Helsinki”
- Reading 4.2: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, “The Belmont Report”
- Reading 4.3: Marcia Angell, “The Ethics of Clinical Research in the Third World”
- Reading 4.4: Baruch A. Brody, “Ethical Issues in Clinical Trials in Developing Countries”
- Reading 4.5: Christine Grady, “Money for Research Participation: Does It Jeopardize Informed Consent?”
- Reading 4.6: Mark Kuczewski, “Is Informed Consent Enough? Monetary Incentives for Research Participation and the Integrity of Biomedicine”
- Ethics Committee: African HIV Trials
CHAPTER 5: Dilemmas at the End of Life
- Opening Gambit: Mr. Perry Wants It ALL Unplugged
- What’s at Stake?
- What’s the Debate?
- Reading 5.1: James Rachels, “Active and Passive Euthanasia”
- Reading 5.2: Daniel Callahan, “When Self-Determination Runs Amok”
- Reading 5.3: J. McMahan, “Killing, Letting Die, and Withdrawing Aid”
- Ethics Committee: A Chilly Reception
CHAPTER 6: Dilemmas with Scarce Medical Resources
- Opening Gambit: Was the Drug Lottery Fair?
- What’s at Stake?
- Distributing Scarce Resources: Fairness vs. Equality
- Increasing the Supply of Scarce Resources: Nudging vs. Payment
- What’s the Debate?
- Reading 6.1: Leslie P. Scheunemann and Douglas B. White, “The Ethics and Reality of Rationing in Medicine”
- Reading 6.2: George Annas, “The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ Transplantation”
- Reading 6.3: Ezekiel J. Emanuel et al., “Fair Allocation of Scarce Medical Resources in the Time of COVID-19”
- Reading 6.4: Lynette Reid, “Triage of Critical Care Resources in COVID-19: A Stronger Role for Justice”
- Ethics Committee: Ira Harker Needs a Kidney
CHAPTER 7: Dilemmas in Genetic and Reproductive Technology
- Opening Gambit: Screening for the Breast Cancer Gene
- What’s at Stake?
- What’s the Debate?
- Reading 7.1: Julian Savulescu, “Procreative Beneficence: Why We Should Select the Best Children”
- Reading 7.2: Sarah E. Stoller, “Why We Are Not Morally Required to Select the Best Children: A Response to Savulescu”
- Reading 7.3: Rebecca Briscoe, “Ethical Considerations, Safety Precautions and Parenthood in Legalising Mitochondrial Donation”
- Reading 7.4: Katarina Lee, “Ethical Implications of Permitting Mitochondrial Replacement”
- Ethics Committee: Linda Huff Wants a Dwarf Child
CHAPTER 8: Dilemmas for Patients and Families
- Opening Gambit: Duty to Vaccinate?
- What’s at Stake?
- Patient Rights
- Patient Obligations or Duties
- Doubled Agency
- What’s the Debate?
- Reading 8.1: Leonard C. Groopman et al., “The Patient’s Work”
- Reading 8.2: Susan M. Wolf et al., “Sources of Concern about the Patient Self-Determination Act”
- Reading 8.3: J.K. Miles, “Taking Patient Virtue Seriously”
- Ethics Committee: The Ashley Treatment
CHAPTER 9: Dilemmas with Abortion
- Opening Gambit: Choosing for Two?
- What’s at Stake?
- What’s the Debate?
- Reading 9.1: Judith Jarvis Thomson, “A Defense of Abortion”
- Reading 9.2: Francis Beckwith, “Personal Bodily Rights, Abortion, and Unplugging the Violinist”
- Ethics Committee: Botched Abortion
Permissions Acknowledgments
Index
J.K. Miles is Professor of Philosophy at Quincy University. Dr. Miles is also author of the Substack newsletter Miles to Go, which offers commentary and case studies that can be used to supplement this book (jkmiles.substack.com).
A companion website for instructors offers supplemental quizzes and PowerPoint slides for each chapter. An access code to this website is included with all instructor copies. If you received an instructor copy but don’t have an access code, please contact us.
The author’s Substack newsletter, Miles to Go, offers updated commentary and case studies that can be used to supplement this book (jkmiles.substack.com).
