Encyclopedia of Bioethics

ENCYCLOPEDIA OF BIOETHICS Prospectus Center for Bioethics KENNEDY INSTITUTE Georgetown University Washington, D.C. 20007 The Encyclopedia of Bioethics project is being sup ported by the National Endowment for the Humanities, the Joseph P. Kennedy, Jr. Foundation, and the Raskob Foundation. It is being sponsored by the Center for Bioethics, a division of the Joseph and Rose Kennedy Institute for the Study of Human Reproduction and Bioethics at Georgetown University in Washington, D.C. ENCYCLOPEDIA OF BIOETHICS Editor-in-Chief WARREN T. REICH Associate Editors K. DANNER CLOUSER ALBERT R. JONSEN Department of the Humanities Health Policy Program College of Medicine School of Medicine Pennsylvania State University University of California, Hershey, Pennsylvania San Francisco ROBERT NEVILLE H. TRISTRAM ENGELHARDT, JR. Division of Humanities Institute for the Medical Humanities College at Purchase University of Texas Medical Branch State University of New York Galveston, Texas ROBERT M. VEATCH JOHN C. FLETCHER Institute of Society, Ethics Interfaith Metropolitan and the Life Sciences Theological Education Hastings-on-Hudson, New York Washington, D.C. LeROY WALTERS STANLEY HAUERWAS Center for Bioethics Department of Theology Kennedy Institute Notre Dame University Georgetown University Notre Dame, Indiana Washington, D.C. Consulting Editor PHILIP P. WIENER Department of Philosophy Temple University Philadelphia, Pennsylvania Managing Editor SANDRA M. HASS Editorial Offices Center for Bioethics ■ Kennedy Institute Georgetown University Washington, D.C. 20007 Tel. 202/625 2371 3 Editorial Advisory Board HENRY K. BEECHER PAUL B. CORNELY Department o f Anesthesia Department o f Preventive Harvard University Medicine Boston Howard University Washington, D.C. JEAN BERNARD Hematology Research Institute CHARLES E. CURRAN University of Paris Department o f Theology Catholic University of America GUNNAR BIORCK Washington, D.C. Karolinska Institute University of Stockholm WILLIAM J. CURRAN FRANZ BOCKLE Department o f Legal Medicine Faculty o f Theology Harvard University University o f Bonn Boston SISSELA BOK DAVID DAUBE Radcliffe Institute School o f Law Cambridge, Massachusetts University o f California, Berkeley JACOB BRONOWSKI The Salk Institute PANAGIOTES DEMETROPOULOS San Diego, California School o f Theology DANIEL CALLAHAN University o f Thessalonike Institute of Society, Ethics Greece and the Life Sciences Hastings-on-Hudson ARTHUR J. DYCK New York Population Ethics Harvard University ERIC J. CASSELL Boston Cornell Medical Center New York, New York PAUL EDWARDS Department o f Philosophy ROBERT E. COOKE City University of New York Center for Health Sciences University o f Wisconsin, CLAUDINE ESCOFFIER-LAMBIOTTE Madison Science Editor, Le Monde Paris THEODORE COOPER National Heart and Lung EMIL L. FACKENHEIM Institute Department o f Philosophy Bethesda, Maryland University of Toronto 4 JOEL FEINBERG BERNARD HARING Department o f Philosophy Academia Alfonsiana Rockefeller University Rome New York, New York ANDRE E. HELLEGERS DAVID M. FELDMAN Kennedy Institute Rabbi, Bay Ridge Jewish Center Georgetown University Brooklyn, New York Washington, D.C. RENEE C. FOX LOUIS M. HELLMAN Department of Sociology Department o f Health, Education and University o f Pennsylvania Welfare Philadelphia Washington, D.C. CHARLES FRANKEL MILTON HIMMELFARB Department o f Philosophy Institute o f Human Relations Columbia University New York, New York New York, New York IMMANUEL JAKOBOVITS ELIOT FREIDSON Chief Rabbi Department of Sociology United Hebrew Congregations New York University British Commonwealth o f Nations PAUL A. FREUND London Law School HANS JONAS Harvard University Department o f Philosophy Cambridge, Massachusetts New School for Social Research New York, New York JOSEF FUCHS Pontifical Gregorian University JAY KATZ Rome Law School WILLARD GAYLIN Yale University Institute o f Society, Ethics and New Haven, Connecticut the Life Sciences LESTER S. KING Hastings-on-Hudson Journal o f the American Medical New York Association OTTO E. GUTTENTAG Chicago Department o f Medicine THOMAS J. KING University o f California National Cancer Institute San Francisco Bethesda, Maryland R.M. HARE CHAUNCEY D. LEAKE Corpus Christi College Department o f Pharmacology Oxford University University o f California, San Francisco England (continued) 5 Editorial Advisory Board (continued) PHILIP R. LEE P. J. ROSCAM ABBING Health Policy Program Faculty o f Theology University o f California, San Francisco University o f Groningen The Netherlands JEROME LEJEUNE Institute of Procreation ELISABETH KUBLER ROSS University o f Paris Psychiatrist, Author Flossmoor, Illinois RICHARD A McCORMlCK Center for Bioethics NORMAN ST. JOHN-STEVAS Kennedy Institute Member of Parliament for Georgetown University Chelmford, Essex Washington, D.C. United Kingdom MARGARET MEAD GEORGE E. SCHREINER Curator Emeritus of Ethnology Nephrology Division American Museum o f Natural History Georgetown University Medical Center New York, New York Washington, D.C. JURGEN MOLTMANN SEYMOUR SIEGEL Faculty of Theology Jewish Theological Seminary University o f Tubingen, Germany New York, New York ROBERT F. MURRAY, JR. DAVID L. SILLS Medical Genetics Unit Social Science Research Council Howard University New York, New York Washington, D.C. A.G.M. VAN MELSEN JOHN T. NOONAN, JR. Department of Philosophy School o f Law University o f Nijmegen University of California, Berkeley The Netherlands TEIZO OGAWA CONRAD H. WADDINGTON Department o f Medical History Institute o f Animal Genetics Juntendo University, Tokyo University of Edinburgh EDMUND D. PELLEGRINO WILLIAM A. WALLACE Medical Units School o f Philosophy University o f Tennessee Catholic University o f America Memphis, Tennessee Washington, D.C. PAUL RAMSEY MAURICE H. F. WILKINS Department o f Religion Department o f Biophysics Princeton University King's College Princeton, New Jersey University o f London 6 An Encyclopedia for the Field of Bioethics Some of the recent advances in biomedical technology have created specific ethical dilemmas, such as those related to the prolongation of life and the allocation of scarce medical resources. Other developments have raised more fundamental moral questions, such as whether man should do all that the biomedical sciences enable him to do. However, many of the fundamental moral problems concerning health and disease, quality of life, human reproduction, death, etc.—the ethical questions surrounding medicine and the life sciences—have been part of the human condition for a very long time and have been discussed by many of the world’s great philosophers, religious teachers, scientists, and physi cians. Recently there has been a noticeably expanded interest in cross-disciplinary studies of the ethical and social implica tions of the biomedical sciences. These studies in bioethics have been pursued through a more intensified exchange of ideas and principles among moral and religious philosophers, biologists, and physicians. Important contributions have also been made to the developing field of bioethics from the social and behavioral sciences, as well as from the field of law. At the same time, more attention is now being given to the history of the humanistic aspects of health and science. The important literature dealing with bioethics in every period of history can be found among the writings of philosophers, theologians, biomedical and social scientists, physicians, lawyers, and scholars from other disciplines. The constantly growing body of recent literature has appeared in disparate journals, in codes of medical and professional ethics, and in volumes of collected essays. The establishment of several specialized journals in the area of bioethics has also given witness to the vitality of the field. The proliferation of 7 these studies and the demand for further inquiry in bio medical ethics makes it all the more desirable and necessary to have a basic educational and reference work which will make available to serious students, various professionals, and the larger, interested public an integrated source of knowl edge of the principal ideas and issues in the field of bioethics. Aims and Purposes The aim of the Encyclopedia of Bioethics is to present in a concise and comprehensive way the present state of knowl edge of the ethical aspects of the biomedical sciences, health care, and the health professions. An attempt will be made to synthesize, analyze, and compare the positions taken on the concepts, principles, and problems of bioethics, in the past as well as in the present, to indicate which issues require further exploring, and to point to anticipated developments in the ethics of biomedicine. The purposes of this work will be to stimulate original thought, assist in ethical decision-making, encourage further studies and new viewpoints in bioethics, and thus to assist the development of this field of study. To achieve these aims and purposes, the Encyclopedia is being developed according to a multidisciplinary and international plan. Scope As the term “bioethics” would indicate, the. Encyclopedia will include not only the topics customarily associated with medical ethics—the value problems which arise in the relationship between physicians and patients—but will extend beyond these limits to embrace the value questions, the moral issues, and the social implications which arise in connection with the biomedical sciences, health care, and the various health professions. Some of the principal areas covered

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