Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

Discharge planning for vulnerable infants and children is a collaborative, inter-disciplinary, decision-making activity that is grounded in the ethical complexities of clinical practice. Although it is a psychosocial intervention that frequently causes moral distress for professionals and has the potential to inflict harm on children and their families, the process has received little attention from ethicists. An ongoing study of the transition of technology-dependent children from hospital to home suggests that the ethical issues embedded in the discharge-planning process may be (...) concealed by dominant cultural values, institutional policies, clinical standards, historical precedents, and legal regulations. (shrink)

How do we respond to the patient who no longer needs inpatient care but refuses to leave the hospital? Complex hospital discharges commonly involve consideration of legal, financial, clinical, and practical issues. Yet, the ethical and contextual issues embedded in complex inpatient discharges are of concern and have not received adequate attention by medical ethicists. The aim of this work is to encourage clinicians and administrators to incorporate a justice rubric when approaching inpatient discharge dilemmas. This paper presents justice as (...) the ethical principle most neglected in situations involving complex discharges and suggests that a justice focused lens allows clinicians and administrators to move beyond notions of patient autonomy in crafting morally responsible hospital discharge decisions that reflect efficient stewardship of an appropriate share of medically indicated services. This issue deserves additional attention from medical ethicists in the future. (shrink)

In Dependent Rational Animals, Alasdair MacIntyre attempts to ground the virtues in a biological account of humans. Drawing from this attempt, he also tries to answer the question of why we should care for the severely disabled. MacIntyre’s difficulty in answering this question begins with the fact that his communities of practices do not naturally include the severely disabled within their membership and care. In response to this difficulty, he provides four reasons for why we should care for the severely (...) disabled. I argue that three of these reasons are inadequate, and that the fourth is incomplete although it does point in a promising direction. I conclude that a more satisfactory answer requires a further extension of the central development from After Virtue to Dependent Rational Animals, and I draw from Wendell Berry, whose work MacIntyre admires, to provide an illuminating illustration of what such an answer might look like. (shrink)

Book reviewed in this article: Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church. By Stanley Hauerwas.

For Lack of a Better Plan: A Framework for Ethical, Legal, and Clinical Challenges in Complex Inpatient Discharge Planning Content Type Journal Article Pages 311-326 DOI 10.1007/s10730-009-9117-6 Authors Jane Jankowski, Albany Medical Center Albany NY 12208 USA Terese Seastrum, Northeast Health 2212 Burdett Ave. Troy NY 12180 USA Robert N. Swidler, Northeast Health 2212 Burdett Ave. Troy NY 12180 USA Wayne Shelton, Alden March Bioethics Institute, Albany Medical College 47 New Scotland Avenue, MC 153 Albany NY 12208-3478 USA Journal HEC (...) Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume 21, Number 4. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

In debates over issues such as abortion, a primary principle on which the Roman Catholic outlook is based is the natural law mandate to respect human life rooted in the Aristotelian philosophy of Thomas Aquinas. This principle, however, is limited by focusing on the obligation not to kill innocent humans and thereby neglects another important facet of the Aristotelian-Thomistic ethical viewpoint—namely, obligations that bind human beings in relationships of mutual dependence and responsibility. I argue that there is a need to (...) cultivate a “virtue of acknowledged responsibility” and conclude by addressing a prevalent issue in contemporary society: absent paternal responsibility. My aim is to show that there is an interesting and often neglected rationale in Catholic moral understanding for “deadbeat dad” laws that compel men to take responsibility for any children or fetuses they father and to assist women who give birth to those children or carry those fetuses. (shrink)

In debates over issues such as abortion, a primary principle on which the Roman Catholic outlook is based is the natural law mandate to respect human life rooted in the Aristotelian philosophy of Thomas Aquinas. This principle, however, is limited by focusing on the obligation not to kill innocent humans and thereby neglects another important facet of the Aristotelian-Thomistic ethical viewpoint—namely, obligations that bind human beings in relationships of mutual dependence and responsibility. I argue that there is a need to (...) cultivate a “virtue of acknowledged responsibility” and conclude by addressing a prevalent issue in contemporary society: absent paternal responsibility. My aim is to show that there is an interesting and often neglected rationale in Catholic moral understanding for “deadbeat dad” laws that compel men to take responsibility for any children or fetuses they father and to assist women who give birth to those children or carry those fetuses. (shrink)

This work examines contemporary views on medical ethics, such as preventing death, defining family relations, and reproductive and disabled issues.