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Fifth Edition

Lewis Vaughn

Available: April 2022

ISBN: 9780197610039

832 pages
Online Resource

Retail Price to Students: $0.01

Marketing Message: The #1 Bioethics book on the market, combining a wide variety of current readings; classic and contemporary cases; extensive explanations; and more robust pedagogy than any other text.


Bioethics: Principles, Issues, and Cases explores the philosophical, medical, social, and legal aspects of key bioethical issues. Opening with a thorough introduction to ethics, bioethics, and moral reasoning, it then covers influential moral theories and the criteria for evaluating them. Integrating eighty-nine readings, numerous classic bioethical cases, and abundant pedagogical tools, this text addresses the most provocative and controversial topics in bioethics.

New to this Edition

  • A Chapter on Pandemic Ethics.
  • A Chapter on Race, Racial Bias, and Health Care.
  • Updates include: Abortion and public opinion (survey); "Savior siblings"; New developments in gene therapy; Euthanasia and assisted suicie: major developments; U.S. Health Care: the uninsured, per capita spending, and health care quality.
  • New readings, including ones from Michael Sandel with Colleen Walsh, Angela Ballantyne, David R. Williams and Ronald Wyatt, Michael Root, and Ezekiel J. Emmanuel, Govind Persad, Ross Upshur, et. al.


  • A two-chapter introduction to bioethics, moral reasoning, moral theories, and critical thinking.
  • Each issues chapter contains: analyses of the most important arguments, a section titled "Applying Major Theories," a section titledm "Classic Case File," and a bank of "Cases for Evaluation."
  • A diverse package of pedagogical aids.

About the Author(s)

Lewis Vaughn is the author or coauthor of numerous books, including Philosophy: Here and Now, Fourth Edition (2022), Bioethics, Fourth Edition (2020), The Power of Critical Thinking, Sixth Edition (2019), and Living Philosophy, Third Edition (2021), all published by Oxford University Press.

Table of Contents

    Part 1. Principles and Theories
    Chapter 1 moral reasoning in bioethics?3
    Chapter 2 bioethics and moral theories?34
    Part 2. Medical Professional and Patient
    Chapter 3 paternalism and patient autonomy?97
    Chapter 4 truth-telling and confidentiality?176
    Chapter 5 informed consent?228
    Chapter 6 human research?271
    Part 3. Life and Death
    Chapter 7 abortion?339
    Chapter 8 reproductive technology?440
    Chapter 9 genetic choices?562
    Chapter 10 euthanasia and physician-assisted suicide?648
    Part 4. Justice and Health Care
    Chapter 11 dividing up health care resources?743
    Chapter 12 PANDEMIC ETHICS
    Part 1. Principles and Theories
    Chapter 1
    moral reasoning in bioethics?3
    Ethics and Bioethics?3
    Ethics and the Moral Life?5
    In Depth: Morality and the Law?7
    Moral Principles in Bioethics?8
    Ethical Relativism?13
    In Depth: Anthropology and Moral Diversity?14
    Ethics and Religion?17
    Moral Arguments?19
    Argument Fundamentals?19
    Patterns of Moral Arguments?22
    Review: Valid and Invalid Argument Forms?23
    In Depth: Fallacies in Moral Reasoning?24
    Evaluating Premises?26
    Assessing Whole Arguments?28
    Obstacles to Critical Reasoning
    Key Terms?29
    Argument Exercises?30
    Further Reading?32
    Chapter 2
    bioethics and moral theories?34
    The Nature of Moral Theories?34
    Influential Moral Theories?35
    In Depth: Utilitarianism and the Golden Rule?38
    Kantian Ethics?38
    Natural Law Theory?41
    Rawls' Contract Theory?43
    Virtue Ethics?44
    In Depth: Can Virtue Be Taught??46
    The Ethics of Care?46
    Feminist Ethics?47
    Criteria for Judging Moral Theories?49
    Review: Evaluating Moral Theories: Criteria of Adequacy?50
    Applying the Criteria?50
    Kant's Theory?52
    Key Terms?53
    Further Reading?54
    “Utilitarianism,” John Stuart Mill?55
    “The Moral Law,” Immanuel Kant?58
    Nicomachean Ethics, Aristotle?63
    “The Need for More Than Justice,” Annette C. Baier?78
    “Moral Saints,” Susan Wolf?86
    Part 2. Medical Professional and Patient
    Chapter 3
    paternalism and patient autonomy?97
    Shades of Autonomy and Paternalism?97
    Refusing Treatment?98
    In Depth: Physician Autonomy?100
    Legal Brief: Advance Directives?101
    Futile Treatment?102
    Legal Brief: Refusing Treatment for Children on Religious Grounds?103
    In Depth: CPR and DNR?104
    In Depth: Moral Conflicts in Nursing?104
    Classic Case File: Elizabeth Bouvia?105
    Applying Major Theories?106
    Key Terms?107
    Cases for Evaluation?108
    Further Reading?110
    “Paternalism,” Gerald Dworkin?111
    “The Refutation of Medical Paternalism,” Alan Goldman?121
    “Why Doctors Should Intervene,” Terrence F. Ackerman?127
    “Autonomy, Futility, and the Limits of Medicine,” Robert L. Schwartz?132
    “Four Models of the Physician-Patient Relationship,” Ezekiel J. Emanuel
    and Linda L. Emanuel?137
    “Confronting Death: Who Chooses, Who Controls? A Dialogue Between Dax
    Cowart and Robert Burt,” Dax Cowart and Robert Burt?150
    Bouvia v. Superior Court, California Court of Appeal?160
    “Fundamental Elements of the Patient-Physician Relationship,” AMA
    Council on Ethical and Judicial Affairs?165
    “Advocacy or Subservience for the Sake of Patients?” Helga Kuhse?166
    Chapter 4
    truth-telling and confidentiality?176
    Paternalism and Deception?176
    In Depth: Do Patients Want the Truth? Do Physicians Tell It??177
    Confidential Truths?179
    Legal Brief: Confidentiality and a Duty to Warn?180
    In Depth: Truth-Telling and Cultural Diversity?181
    Classic Case File: Carlos R.?182
    Applying Major Theories?183
    Key Terms?183
    Cases for Evaluation?184
    Further Reading?186
    “On Telling Patients the Truth,” Mack Lipkin?191
    “Is It Ever OK to Lie to Patients?,” Shelly K. Schwartz?193
    “Why Privacy Is Important,” James Rachels?204
    “Confidentiality in Medicine-A Decrepit Concept,” Mark Siegler?209
    Tarasoff v. Regents of the University of California, Supreme
    Court of California?223
    Chapter 5
    informed consent?228
    Autonomy and Consent?228
    Conditions of Informed Consent?229
    In Depth: Decision-Making Capacity?231
    In Depth: Two Views of Informed Consent?233
    Legal Brief: Important Informed Consent Cases?
    Applying Major Theories
    Classic Case File: Jerry Canterbury
    Key Terms
    Cases for Evaluation
    Further Reading
    “The Concept of Informed Consent,” Ruth R. Faden and Tom L. Beauchamp
    “Informed Consent-Must It Remain a Fairy Tale?” Jay Katz
    “Transparency: Informed Consent in Primary Care,” Howard Brody
    Canterbury v. Spence, United States Court of Appeals
    Chapter 6
    human research
    The Science of Clinical Trials
    In Depth: The Tuskegee Tragedy
    Beneficence, Science, and Placebos
    Science and Informed Consent
    In Depth: Women in Clinical Trials
    Research on the Vulnerable
    In Depth: Why Enter a Clinical Trial?
    Applying Major Theories
    Key Terms
    Classic Case File: The UCLA Schizophrenia Study
    Cases for Evaluation
    Further Reading
    The Nuremberg Code
    Declaration of Helsinki: Ethical Principles for Medical Research
    Involving Human Subjects, World Medical Association
    “The Belmont Report,” The National Commission for the Protection
    of Human Subjects of Biomedical and Behavioral Research
    “Final Report: Human Radiation Experiments,” Advisory Committee
    on Human Radiation Experiments
    “Of Mice but Not Men: Problems of the Randomized Clinical Trial,”
    Samuel Hellman and Deborah S. Hellman
    “A Response to a Purported Ethical Difficulty with Randomized Clinical
    Trials Involving Cancer Patients,” Benjamin Freedman
    “Racism and Research: The Case of the Tuskegee Syphilis Study,”
    Allan M. Brandt
    “The Ethics of Clinical Research in the Third World,” Marcia Angell
    “Ethical Issues in Clinical Trials in Developing Countries,” Baruch Brody
    Part 3. Life and Death
    Chapter 7
    Starting Point: The Basics
    Fact File: U.S. Abortions
    In Depth: Abortion and Public Opinion?2021
    The Legal Struggle
    In Depth: Abortions Performed Later in Pregnancy
    Persons and Rights
    In Depth: Does a Fetus Feel Pain?
    Applying Major Theories
    Key Terms
    Classic Case File: Nancy Klein
    Cases for Evaluation
    Further Reading
    “A Defense of Abortion,” Judith Jarvis Thomson
    “Why Abortion Is Immoral,” Don Marquis
    “On the Moral and Legal Status of Abortion,” Mary Anne Warren
    “Abortion and the Concept of a Person,” Jane English
    “Abortion,” Margaret Olivia Little
    “Abortion Through a Feminist Ethics Lens,” Susan Sherwin
    Roe v. Wade, United States Supreme Court
    Planned Parenthood of Southeastern Pennsylvania v. Casey, United
    States Supreme Court
    Chapter 8
    reproductive technology
    In Vitro Fertilization
    Fact File: Assisted Reproduction
    In Depth: “Savior Siblings”
    In Depth: IVF and Children's Future Children
    In Depth: Cloning Time Line
    Applying Major Theories
    In Depth: Sherri Shepherd: How Surrogacy Can Go Wrong
    Key Terms
    Classic Case File: Baby M
    Cases for Evaluation
    Further Reading
    “IVF: The Simple Case,” Peter Singer
    “The Presumptive Primacy of Procreative Liberty,” John A. Robertson
    “Surrogate Mothering: Exploitation or Empowerment?” Laura M. Purdy
    “Egg Donation and Commodification,” Bonnie Steinbock
    “Cloning Human Beings: An Assessment of the Ethical Issues Pro
    and Con,” Dan W. Brock
    Chapter 9
    genetic choices
    Genes and Genomes
    Genetic Testing
    Gene Therapy
    Fact File: Genetic Testing for Cancer Risk
    Fact File: New Developments in Gene Therapy
    Stem Cells
    Applying Major Theories
    Classic Case File: The Kingsburys
    Key Terms
    Cases for Evaluation
    Further Reading
    “Genetics and Reproductive Risk: Can Having Children Be Immoral?”
    Laura M. Purdy
    “The Morality of Screening for Disability,” Jeff McMahan
    “Genetic Dilemmas and the Child's Right to an Open Future,”
    Dena S. Davis
    “Disowning Knowledge: Issues in Genetic Testing,”
    Robert Wachbroit
    “The Non-Identity Problem and Genetic Harms-The Case of Wrongful
    Handicaps,” Dan W. Brock
    “Is Gene Therapy a Form of Eugenics?” John Harris
    “Genetic Enhancement,” Walter Glannon
    “Genetic Interventions and the Ethics of Enhancement of Human Beings,”
    Julian Savulescu
    “Germ-Line Gene Therapy,” LeRoy Walters and Julie Gage Palmer
    “What Does 'Respect for Embryos' Mean in the Context of Stem Cell
    Research?” Bonnie Steinbock
    Declaration on the Production and the Scientific and Therapeutic
    Use of Human Embryonic Stem Cells, Pontifical Academy for Life
    Chapter 10
    euthanasia and physician-assisted suicide
    Deciding Life and Death
    Legal Brief: Euthanasia and Assisted Suicide: Major Developments
    In Depth: Assisted Suicide: What Do Doctors Think?
    Autonomy, Mercy, and Harm
    In Depth: Oregon's Death With Dignity Act
    In Depth: End-of-Life Decisions in the Netherlands
    Applying Major Theories
    In Depth: Physician-Assisted Suicide and Public Opinion
    Classic Case File: Nancy Cruzan
    Key Terms
    Cases for Evaluation
    Further Reading
    “Death and Dignity: A Case of Individualized Decision Making,”
    Timothy E. Quill
    “Voluntary Active Euthanasia,” Dan W. Brock
    “When Self-Determination Runs Amok,” Daniel Callahan
    “Active and Passive Euthanasia,” James Rachels
    “Dying at the Right Time: Reflections on (Un)Assisted Suicide,”
    John Hardwig
    “The Philosophers' Brief,” Ronald Dworkin, Thomas Nagel, Robert Nozick,
    John Rawls, Thomas Scanlon, and Judith Jarvis Thomson
    “Legalizing Assisted Dying Is Dangerous for Disabled People,” Liz Carr
    “'For Now Have I My Death': The 'Duty to Die' Versus the Duty to Help
    the Ill Stay Alive,” Felicia Ackerman
    Vacco v. Quill, United States Supreme Court
    Part 4. Justice and Health Care
    Chapter 11
    dividing up health care resources
    Health Care in Trouble
    Fact File: U.S. Health Care
    Theories of Justice
    In Depth: Comparing Health Care Systems: United States,
    Canada, and Germany
    A Right to Health Care
    In Depth: Public Health and Bioethics
    The Ethics of Rationing
    Classic Case File: Christine deMeurers
    Key Terms
    Cases for Evaluation
    Further Reading
    “Is There a Right to Health Care and, if So, What Does It Encompass?,”
    Norman Daniels
    “The Right to a Decent Minimum of Health Care,” Allen E. Buchanan
    “Rights to Health Care, Social Justice, and Fairness in Health Care
    Allocations: Frustrations in the Face of Finitude,”
    H. Tristram Engelhardt, Jr.
    “Mirror, Mirror?2017: International Comparison Reflects Flaws and
    Opportunities for Better U.S. Health Care,” Eric C. Schneider,
    Dana O. Sarnak, David Squires, et al.
    “Public Health Ethics: Mapping the Terrain,” James F. Childress et al.
    “Human Rights Approach to Public Health Policy,” D. Tarantola and S. Gruskin
    Chapter 12
    Pandemic Facts
    When Resources Are Scarce
    Personal Choices
    In Depth: The Privilege of Social Distancing
    Covid Falsehoods
    In Depth: Against Pandemic Falsehoods
    Key Terms
    Cases for Evaluation
    Further Reading
    “Why Some Americans Refuse to Social Distance and Wear Masks,” Michael Sandel and Colleen Walsh
    “Fair Allocation of Scarce Medical Resources in the Time of Covid-19,” Ezekiel J. Emanuel, Govind Persad, Ross Upshur, et al
    “ICU Triage: How Many Lives or Whose Lives?” Angela Ballantyne
    Chapter 13
    Race and Racism
    Health Disparities and Race
    Implicit Bias in Health Care
    In Depth: Can Implicit Biases Be Changed?
    Racial Profiling in Medicine
    Key Terms
    Cases for Evaluation
    Further Reading
    “Racial Profiling in Medicine,” Michael Root

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