Principles Of Biomedical Ethics - 6th edition

Tom L. Beauchamp is Professor of Philosophy and Senior Research Scholar at The Joseph and Rose Kennedy Institute of Ethics at Georgetown University. He is the coauthor of The Virtuous Journalist (Oxford, 1987) and A History and Theory of Informed Consent (Oxford, 1986). James F. Childress is Professor of Religious Studies and Medical Education at the University of Virginia. He is the author of Who Should Decide? Paternalism in Health Care (Oxford, cloth, 1982; paper, 1985).

Table of Contents

Pt. I Moral Foundations

1 Moral Norms 1

Normative and Nonnormative Ethics 1

The Common Morality as Universal Morality 2

Particular Moralities as Nonuniversal 5

Moral Dilemmas 10

A Framework of Moral Norms 12

Conflicting Moral Norms 14

Conclusion 25

2 Moral Character 30

Moral Virtues 30

Virtues in Professional Roles 33

The Virtue of Caring 36

Five Focal Virtues 38

Moral Virtues and Action Guides 45

Moral Ideals 47

Moral Excellence 51

Conclusion 57

3 Moral Status 64

The Problem of Moral Status 64

Theories of Moral Status 66

From Theories to Practical Guidelines 81

Vulnerable Populations 89

Conclusion 93

Pt. II Moral Principles

4 Respect for Autonomy 99

The Nature of Autonomy 99

The Capacity for Autonomous Choice 111

The Meaning and Justification of Informed Consent 117

Disclosure 121

Understanding 127

Voluntariness 132

A Framework of Standards for Surrogate Decision Making 135

Conclusion 140

5 Nonmaleficence 149

The Concept of Nonmaleficence 149

Distinctions and Rules Governing Nontreatment 155

Optional Treatments and Obligatory Treatments 166

Killing and Letting Die 172

The Justification of Intentionally Arranged Deaths 176

Protecting Incompetent Patients 185

Conclusion 190

6 Beneficence 197

The Concept of Beneficence 197

Obligatory Beneficence and Ideal Beneficence 198

Paternalism: Conflicts between Beneficence and Autonomy 206

Balancing Benefits, Costs, and Risks 221

The Value and Quality of Life 230

Conclusion 233

7 Justice 240

The Concept of Justice 241

Theories of Justice 244

Fair Opportunity and Unfair Discrimination 248

Vulnerability and Exploitation 253

National HealthPolicy and the Right to Health Care 258

Global Health Policy and the Right to Health 264

Allocating, Setting Priorities, and Rationing 267

Conclusion 280

8 Professional-Patient Relationships 288

Veracity 288

Privacy 296

Confidentiality 302

Fidelity 311

The Dual Roles of Clinician and Investigator 317

Conclusion 324

Pt. III Theory and Method

9 Moral Theories 333

Criteria for Theory Construction 334

Utilitarianism 336

Kantianism 343

Rights Theory 350

Communitarianism 356

Convergence of Theories 361

Conclusion 363

10 Method and Moral 368

Justification 368

Justification in Ethics 368

Top-Down Models: Theory and Application 369

Bottom-Up Models: Cases and Analogy 375

An Integrated Model Using Reflective Equilibrium 381

Common-Morality Theory 387

Conclusion 397

Index 403