Cover image for Practical decision making in health care ethics : cases and concepts
Practical decision making in health care ethics : cases and concepts
Devettere, Raymond J.
Personal Author:
Second edition.
Publication Information:
Washington, DC : Georgetown University Press, [2000]

Physical Description:
xxi, 639 pages ; 25 cm
Format :


Call Number
Material Type
Home Location
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R724 .D48 2000 Adult Non-Fiction Non-Fiction Area

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This edition includes chapters on managed care and medical genetics, as well as an expanded chapter on virtue and decision making. It updates accounts of controversies, including late-term abortion, cloning, germ-line genetic research, the human genome project, brain death, non-heart beating organ donors, and physician-assisted suicide. Case studies, drawn from landmark public cases, illustrate such issues as medical futility, genetic screening, AIDS research, managed-care mix-ups, and the ignoring of patients' wishes by doctors.

Author Notes

Raymond J. Devettere teaches health care ethics at Emmanuel College and Boston College.

Table of Contents

Prefacep. xiii
Preface to the Second Editionp. xv
Introductionp. xvii
1 What Is Ethics?p. 1
Defining Ethicsp. 1
Two Kinds of Ethicsp. 9
Historical Versions of the Ethics of Obligationp. 10
Moral Reasoning and the Theories of Obligationp. 14
Contrasting the Ethics of Obligation with an Ethics of the Goodp. 17
Retrieving the Ethics of the Goodp. 18
Bioethics Todayp. 21
Suggested Readingsp. 23
2 Prudence and Living A Good Lifep. 26
The Goodp. 26
Happinessp. 28
Moral Virtuep. 37
Prudencep. 41
Suggested Readingsp. 57
3 The Language of Health Care Ethicsp. 62
Distinctions That Can Misleadp. 64
Helpful Distinctionsp. 80
Suggested Readingsp. 87
4 Making Health Care Decisionsp. 91
Complexity of Health Care Decisionsp. 91
Decision-Making Capacityp. 95
Informed Consentp. 99
Advance Directivesp. 111
The Patient Self-Determination Actp. 117
The Case of Hazel Welchp. 119
Final Reflectionsp. 122
Suggested Readingsp. 124
5 Deciding for Othersp. 127
Becoming a Proxyp. 128
Standards for Making Proxy Decisionsp. 132
Deciding for Older Childrenp. 138
Deciding for the Mentally Illp. 146
Deciding for Patients of Another Culturep. 156
Final Reflections on Deciding for Othersp. 157
Suggested Readingsp. 159
6 Determining Life and Deathp. 162
The Classical Conceptual Frameworkp. 164
A New Conceptual Frameworkp. 173
When Does One of Us Begin?p. 176
When Does One of Us Die?p. 179
Ethical Reflectionsp. 191
Suggested Readingsp. 193
7 Life-Sustaining Treatmentsp. 198
Ventilatorsp. 199
The Case of Karen Quinlanp. 201
The Case of Brother Foxp. 207
The Case of William Bartlingp. 210
The Case of Helga Wangliep. 215
Dialysisp. 221
The Case of Earle Springp. 222
Surgeryp. 227
The Case of Rosaria Candurap. 228
Other Life-Sustaining Treatmentsp. 231
Suggested Readingsp. 232
8 Cardiopulmonary Resuscitationp. 235
Terminologyp. 236
A Brief History of Resuscitation Attemptsp. 236
The Effectiveness of Attempting CPRp. 237
Learning to Withhold CPRp. 239
Important Ethical Elements for a DNR Policyp. 240
XYZ Hospital Policy for "Do Not Resuscitate" Ordersp. 243
DNR Policyp. 207
Lingering Questions about DNR Ordersp. 246
The Case of Maria M.p. 251
The Case of Shirley Dinnersteinp. 255
The Case of Bethp. 258
The Case of Catherine Gilgunnp. 261
Suggested Readingsp. 267
9 Medical Nutrition and Hydrationp. 270
The Techniques and Technologiesp. 270
Conceptualizing Medical Nutrition and Hydrationp. 272
The Case of Clarence Herbertp. 274
The Case of Claire Conroyp. 279
The Case of Elizabeth Bouviap. 284
The Case of Mary O'Connorp. 289
The Case of Nancy Cruzanp. 293
Suggested Readingsp. 301
10 Reproductive Issuesp. 304
Contraception and Sterilizationp. 305
Medically Assisted Pregnancyp. 319
The Case of Baby Mp. 335
Suggested Readingsp. 340
11 Prenatal Lifep. 345
Abortionp. 346
Maternal-Fetal Conflictsp. 363
The Case of Angiep. 364
Using Fetal Tissuep. 369
Suggested Readingsp. 375
12 Neonatal Lifep. 380
Historical Backgroundp. 381
A Sampling of Neonatal Abnormalitiesp. 383
Special Difficulties in Deciding for Neonates and Small Childrenp. 388
The Baby Doe Regulationsp. 391
The Case of Baby Doep. 397
The Case of Baby Jane Doep. 401
The Case of Daniellep. 405
The Case of Baby Kp. 412
Suggested Readingsp. 417
13 Euthanasia and Physician-Assisted Suicidep. 420
Historical Overviewp. 420
Recent Developmentsp. 425
Court Battlesp. 427
Relevant Distinctionsp. 431
Moral Reasoning and Euthanasiap. 434
Reasons for Euthanasia and Physician-Assisted Suicidep. 436
Reasons Against Euthanasia and Physician-Assisted Suicidep. 438
The Case of Dianep. 452
Concluding Reflectionsp. 459
Suggested Readingsp. 460
14 Medical Researchp. 466
Notorious Examples of Questionable Ethics in Researchp. 467
Reactions to the Questionable Medical Researchp. 473
Research on Embryos and Fetusesp. 482
Research on Minorsp. 491
Research in Developing Countriesp. 492
The Case of Controversial AIDS Researchp. 494
Other Special Populations in Researchp. 500
The Case of Compound Qp. 501
Animals and Medical Researchp. 504
Suggested Readingsp. 508
15 Transplantationp. 513
Transplantation of Organs from Dead Human Donorsp. 515
The Case of Jamie Fiskep. 528
The Case of Jesse Sepulvedap. 530
Transplantation of Organs from Living Human Donorsp. 535
Transplantation of Organs from Animalsp. 540
The Case of Baby Faep. 540
Implantation of Artificial Heartsp. 545
Suggested Readingsp. 548
16 Medical Geneticsp. 552
Genetic Testingp. 556
A Case of Concern About Cancerp. 559
A Case of Premarital Worryp. 565
Genetic Screeningp. 572
Gene Therapyp. 576
Genetic Enhancementp. 583
Human Genome Projectp. 586
Suggested Readingsp. 588
17 Managed Carep. 593
Historical Backgroundp. 593
The Managed Care Revolutionp. 599
The Case of James Adamsp. 605
Suggested Readingsp. 617
Glossaryp. 620
Index of Casesp. 629
Subject Indexp. 631