PRINCIPLES OF HEALTH CARE ETHICS Second Edition Edited by Richard E. Ashcroft Queen Mary, University of London, Barts and the London Medical School, Institute of Health Sciences Education, London, UK Angus Dawson Centre for Professional Ethics, School of Law, Keele University, Staffordshire, UK Heather Draper Centre for Biomedical Ethics, University of Birmingham, Birmingham, UK John R. McMillan Philosophy Department, The University of Hull, Hull, UK PRINCIPLES OF HEALTH CARE ETHICS Second Edition PRINCIPLES OF HEALTH CARE ETHICS Second Edition Edited by Richard E. Ashcroft Queen Mary, University of London, Barts and the London Medical School, Institute of Health Sciences Education, London, UK Angus Dawson Centre for Professional Ethics, School of Law, Keele University, Staffordshire, UK Heather Draper Centre for Biomedical Ethics, University of Birmingham, Birmingham, UK John R. McMillan Philosophy Department, The University of Hull, Hull, UK Copyright © 2007 John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex PO19 8SQ, England Telephone (ϩ44) 1243 779777 Email (for orders and customer service enquiries): [email protected] Visit our Home Page on www.wileyeurope.com or www.wiley.com All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except under the terms of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London W1T 4LP, UK, without the permission in writing of the Publisher. 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Other Wiley Editorial Offi ces John Wiley & Sons Inc., 111 River Street, Hoboken, NJ 07030, USA Jossey-Bass, 989 Market Street, San Francisco, CA 94103-1741, USA Wiley-VCH Verlag GmbH, Boschstr. 12, D-69469 Weinheim, Germany John Wiley & Sons Australia Ltd, 42 McDougall Street, Milton, Queensland 4064, Australia John Wiley & Sons (Asia) Pte Ltd, 2 Clementi Loop #02-01, Jin Xing Distripark, Singapore 129809 John Wiley & Sons Canada Ltd, 6045 Freemont Blvd, Mississauga, Ontario, L5R 4J3, Canada Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Anniversary Logo Design: Richard J. Pacifi co Library of Congress Cataloging-in-Publication Data Principles of health care ethics. – 2nd ed. / edited by Richard E. Ashcroft... [et al.]. p.; cm. Includes bibliographical references and index. ISBN-13: 978-0-470-02713-4 1. Medical ethics. I. Ashcroft, Richard E. [DNLM: 1. Ethics, Clinical. 2. Bioethical Issues. 3. Biomedical Technology–ethics. 4. Delivery of Health Care–ethics. 5. Professional-Patient Relations–ethics. 6. Social Medicine. WB 60 P957 2007] R724.P69 2007 174.2–dc22 2006038748 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 978-0-470-02713-4 Typeset in 9/11pt Times by Thomson Digital Printed and bound in Great Britain by Antony Rowe Ltd, Chippenham, Wiltshire This book is printed on acid-free paper responsibly manufactured from sustainable forestry in which at least two trees are planted for each one used for paper production. Contents List of Contributors xi Foreword: Raanan E. Gillon xix Foreword: Tony Hope xxi Preface xxiii PART I: METHODOLOGY AND PERSPECTIVES Introduction by John R. McMillan 1 1 The ‘Four Principles’ Approach to Health Care Ethics 3 Tom L. Beauchamp 2 Theories of Autonomy 11 Natalie Stoljar 3 Benefi cence 19 Garrett Cullity 4 Responsibilities for Poverty-Related Ill Health 27 Thomas Pogge 5 Liberalism and Communitarianism 35 Colin Tyler 6 How Many Principles for Bioethics? 43 Robert M. Veatch 7 Casuistical Reasoning in Medical Ethics 51 Albert R. Jonsen 8 Utilitarianism and Bioethics 57 Matti Häyry 9 Deontology 65 David A. McNaughton and J. Piers Rawling 10 Kantian Ethics 73 Onora O’Neill 11 Feminist Approaches to Health Care Ethics 79 Susan Sherwin 12 Virtue Theory 87 Justin Oakley 13 Moral Relativism 93 Mark Sheehan 14 Christian Approaches to Bioethics 99 Heather Widdows 15 Judaism and Medicine: Jewish Medical Ethics 109 Fred Rosner vi CONTENTS 16 The Search for Islamic Bioethics Principles 117 Abdulaziz Sachedina 17 Buddhist Bioethics 127 James Hughes 18 South Asian Approaches to Health Care Ethics 135 Harold Coward 19 The Specious Idea of an Asian Bioethics: Beyond Dichotomizing East and West 143 Jing-Bao Nie 20 Narrative Ethics 151 Howard Brody 21 Empirical Approaches to Health Care Ethics 159 Jeremy Sugarman, Robert A. Pearlman, Holly A. Taylor 22 Medical Sociology and the Redundancy of Empirical Ethics 167 Adam Hedgecoe 23 The Use of Thought Experiments in Health Care Ethics 177 Adrian Walsh 24 Deliberative Bioethics 185 Michael Parker 25 Law, Ethics and Health Care 193 Sheila A.M. McLean 26 Medical Humanities: An Overview 199 Martyn Evans 27 Refl ective Equilibrium as a Method in Health Care Ethics 207 Theo van Willigenburg 28 Hermeneutic Ethics between Practice and Theory 215 Guy A.M. Widdershoven, Tineke A. Abma 29 Paternalism in Health Care and Health Policy 223 James F. Childress 30 Need: An Instrumental View 231 Anthony J. Culyer 31 Rights 239 James G.S. Wilson 32 Exploitation in Health Care 247 Alan Wertheimer 33 Competence to Consent 255 Monique F. Jonas 34 The Doctrine of Double Effect 263 Suzanne Uniacke 35 Ordinary and Extraordinary Means 269 Stephen D. John 36 Acts and Omissions 273 Tuija Takala 37 Personhood and Moral Status 277 Ainsley J. Newson 38 Commodifi cation 285 Stephen Wilkinson PART II: ISSUES IN HEALTH CARE PRACTICE Introduction by Heather Draper 293 39 Consent and Informed Consent 297 Neil C. Manson CONTENTS vii 40 Treatment Decisions for Incapacitated Patients 305 Rebecca S. Dresser 41 Children’s Consent to Medical Treatment 311 David W. Archard 42 Patients and Disclosure of Surgical Risk 319 Justin Oakley 43 Confi dentiality 325 Rebecca Bennett 44 Truth Telling, Lying and the Doctor–Patient Relationship 333 Roger Higgs 45 Personal Beliefs and Patient Care 339 Jennifer Jackson 46 Conscience and Health Care Ethics 345 Piers Benn 47 Care in Families 351 Hilde Lindemann 48 The Ethics of Primary Health Care 357 Annettee J. Braunack-Mayer 49 The Nurse–Patient Relationship: A ‘Principles plus Care’ Account 365 Steven D. Edwards 50 Dual Responsibilities: Do They Raise Any Different Ethical Issues from ‘Normal’ Therapeutic Relationships? 371 Ann Sommerville and Veronica English 51 Violent and Abusive Patients: An Ethically Informed Response 379 G.M. Behr, J.S. Emmanuel, J.P. Ruddock 52 The Moral Signifi cance of the Human Foetus 387 Norman Ford 53 Will We Need Abortion in Utopia? 393 Adrienne Asch 54 Maternal–Foetal Confl ict 401 Rosamund Scott 55 Limits to Reproductive Liberty 409 Thomas H. Murray 56 Disability without Denial 415 Tom Sorell 57 Disability and Equity: Should Difference Be Welcomed? 421 Tom Shakespeare 58 Genetic Counselling 427 Angus Clarke 59 Ethics and Psychotherapy: An Issue of Trust 435 Tim Bond 60 Mental Illness and Compulsory Treatment 443 John R. McMillan 61 Personality Disorders and Compulsory Detention 449 Matt Matravers 62 Labia mea, Domine: Media, Morality and Eating Disorders 455 Simona Giordano 63 Intellectual Disability 463 Pekka Louhiala 64 Ethical Issues and Health Care for Older People 469 Julian C. Hughes 65 Organs and Tissues for Transplantation and Research 475 David P.T. Price viii CONTENTS 66 Living Donor Organ Transplantation 483 Timothy M. Wilkinson 67 Euthanasia and Principled Health Care Ethics: From Confl ict to Compromise? 489 Richard Huxtable 68 Understanding and Misunderstanding Death 497 David Lamb 69 Ethics without Boundaries: Medical Tourism 505 Guido Pennings 70 Ethics of Performance Enhancement in Sport: Drugs and Gene Doping 511 Bennett Foddy, Julian Savulescu 71 Training Good Professionals: Ethics and Health Care Education 521 Nafsika Athanassoulis 72 Ethics Consultation and Ethics Committees 527 Anne Slowther PART III: MEDICINE IN SOCIETY Introduction by Angus Dawson 535 73 The Concepts of Health and Illness 537 Lennart Y. Nordenfelt 74 Community in Public Health Ethics 543 Bruce Jennings 75 Health Promotion, Society and Health Care Ethics 549 Alan Cribb 76 Preventing Disease 557 Marcel Verweij 77 Quantitative Methods for Priority-Setting in Health: Ethical Issues 563 Daniel Wikler, Dan W. Brock, Sarah Marchand, and Tessa Tan Torres 78 Economics, Political Philosophy and Ethics: The Role of Public Preferences in Health Care Decision-Making 569 Jeff Richardson, John McKie 79 Decision Analysis: The Ethical Approach to Most Health Decision Making 577 Jack Dowie 80 Health Inequities and the Social Determinants of Health 585 Wendy Rogers 81 Organizational Ethics in Health Care 593 Jacob E. Kurlander, Marion Danis 82 Ethical Issues in Epidemiology 601 Steven S. Coughlin 83 Screening: Ethical Aspects 607 Niklas Juth, Christian Munthe 84 Vaccination Ethics 617 Angus Dawson 85 The Patient as Victim and Vector: Bioethics and the Challenge of Infectious Diseases 623 Margaret P. Battin, Linda S. Carr-Lee, Leslie P. Francis, Jay A. Jacobson, Charles B.