This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

Bioethics represents a dramatic revision of the centuries-old professional ethics that governed the behavior of physicians and their relationships with patients. This venerable ethics code was challenged in the years after World War II by the remarkable advances in the biomedical sciences and medicine that raised questions about the definition of death, the use of life-support systems, organ transplantation, and reproductive interventions. In response, philosophers and theologians, lawyers and social scientists joined together with physicians and scientists to rethink and revise (...) the old standards. Governments established commissions to recommend policies. Courts heard arguments and legislatures passed laws. This book is the first broad history of the growing field of bioethics. Covering the period 1947-1987, it examines the origin and evolution of the debates over human experimentation, genetic engineering, organ transplantation, termination of life-sustaining treatment, and new reproductive technologies. It assesses the contributions of philosophy, theology, law and the social sciences to the expanding discourse of bioethics. Written by one of the field's founders, The Birth of Bioethics is based on extensive archival research into sources that are difficult to obtain and on interviews with many of the leading figures in the moral debates in medicine. A very readable and comprehensive account of the evolution of bioethics, this book stresses the history of ideas but does not neglect the social and cultural context and the people involved. It will serve the information needs of philosophers, ethicists, social historians, and everyone interested in the origins of some of today's most hotly debated issues. (shrink)

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

In this engaging study, the authors put casuistry into its historical context, tracing the origin of moral reasoning in antiquity, its peak during the sixteenth and early seventeenth century, and its subsequent fall into disrepute from the mid-seventeenth century.

A physician says, "I have an ethical obligation never to cause the death of a patient," another responds, "My ethical obligation is to relieve pain even if the patient dies." The current argument over the role of physicians in assisting patients to die constantly refers to the ethical duties of the profession. References to the Hippocratic Oath are often heard. Many modern problems, from assisted suicide to accessible health care, raise questions about the traditional ethics of medicine and the medical (...) profession. However, few know what the traditional ethics are and how they came into being. This book provides a brief tour of the complex story of medical ethics evolved over centuries in both Western and Eastern culture. It sets this story in the social and cultural contexts in which the work of healing was practiced and suggests that, behind the many different perceptions about the ethical duties of physicians, certain themes appear constantly, and may be relevant to modern debates. The book begins with the Hippocratic medicine of ancient Greece, moves through the Middle Ages, Renaissance and Enlightenment in Europe, and the long history of Indian and Chinese medicine, ending as the problems raised modern medical science and technology challenge the settled ethics of the long tradition. (shrink)

Casuistry is a traditional method of interpreting and resolving moral problems. It focuses on the circumstances of particular cases rather than on the application of ethical theories and principles. After a brief history of casuistry, the method is explained and its relation to theory and principles is discussed.

This essay focuses on how casuistry can become a useful technique of practical reasoning for the clinical ethicist or ethics consultant. Casuistry is defined, its relationship to rhetorical reasoning and its interpretation of cases, by employing three terms that, while they are not employed by the classical rhetoricians and casuists, conform, in a general way, to the features of their work. Those terms are (1) morphology, (2) taxonomy, (3) kinetics. The morphology of a case reveals the invariant structure of the (...) particular case whatever its contingent features, and also the invariant forms of argument relevant to any case of the same sort: these invariant features can be called topics. Taxonomy situates the instant case in a series of similar cases, allowing the similarities and differences between an instant case and a paradigm case to dictate the moral judgment about the instant case. This judgment is based, not merely on application of an ethical theory or principle, but upon the way in which circumstances and maxims appear in the morphology of the case itself and in comparison with other cases. Kinetics is an understanding of the way in which one case imparts a kind of moral movement to other cases, that is, different and sometimes unprecedented circumstances may move certain marginal or exceptional cases to the level of paradigm cases. In conclusion, casuistry is the exercise of prudential or practical reasoning in recognition of the relationship between maxims, circumstances and topics, as well as the relationship of paradigms to analogous cases. (shrink)

Introduction Watching the Doctor In some cultures, it is said, villagers cluster around a healer and a patient, eagerly listening to their conversation and ...

The article discusses the main trends in the development of artificial intelligence systems and robotics (AI&R). The main question that is considered in this context is whether artificial systems are going to become more and more anthropomorphic, both intellectually and physically. In the current article, the author analyzes the current state and prospects of technological development of artificial intelligence and robotics, and also determines the main aspects of the impact of these technologies on society and economy, indicating the geopolitical strategic (...) nature of this influence. The author considers various approaches to the definition of artificial intelligence and robotics, focusing on the subject-oriented and functional ones. It also compares AI&R abilities and human abilities in areas such as categorization, pattern recognition, planning and decision making, etc. Based on this comparison, we investigate in which areas AI&R’s performance is inferior to a human, and in which cases it is superior to one. The modern achievements in the field of robotics and artificial intelligence create the necessary basis for further discussion of the applicability of goal setting in engineering, in the form of a Turing test. It is shown that development of AI&R is associated with certain contradictions that impede the application of Turing’s methodology in its usual format. The basic contradictions in the development of AI&R technologies imply that there is to be a transition to a post-Turing methodology for assessing engineering implementations of artificial intelligence and robotics. In such implementations, on the one hand, the ‘Turing wall’ is removed, and on the other hand, artificial intelligence gets its physical implementation. (shrink)

What has moral theory to do with practical judgment? The practical ethicist can move by analogy from case to case, saying of most new cases, “Oh, I think I've been here before.” Theory, ascending to a broader view, can provide directions when the ethicist finds herself in unfamiliar territory.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Evolution of Pragmatism in India: Ambedkar, Dewey, and the Rhetoric of Reconstruction by Scott R. StroudAlbert R. SpencerBy Scott R. StroudThe Evolution of Pragmatism in India: Ambedkar, Dewey, and the Rhetoric of Reconstruction Chicago and London: The University of Chicago Press, 2023. 302 pp., incl. indexMore scholarly attention needs to be paid to the mutual influences between Asian and American thought, especially with regards to the development, (...) legacy, and future of pragmatism. Fortunately, there have been several notable attempts. Throughout his works, Richard Shusterman frequently incorporates the perspectives of various East Asian philosophies into his articulation of somaesthetics. Multiple scholars have explored John Dewey’s lectures in China and their political and educational impact, such as Jessica Ching-Sze Wang’s John Dewey in China or The Democracy of the Dead by Roger T. Ames and David L. Hall. Still others have highlighted the influence of Indian thought on pragmatism’s forerunners, such as American Philosophy Before Pragmatism (Goodman 2015), American Pragmatism: An Introduction (Spencer 2020), and The Ethics of Oneness (Engles 2021). Perhaps the most interesting inquiries into this influence can be found in a special volume of The Journal of Aesthetic Education (Vol. 43, No. 1) where multiple scholars discuss pragmatism’s connections and comparisons to The Bhagavad Gita, Confucianism, and Taoism. Among these scholars is Scott Stroud whose most recent publication The Evolution of Pragmatism in India (2023) represents the culmination of nearly two decades of research on the subject with special attention to the continuities between pragmatism and Indian thought. In it, he meticulously explores the influence of John Dewey on one of his students, Bhimrao Ambedkar (1891–1956), who was a transformative figure in the founding of the nascent Republic of India. The result is a work of scholarship that shows the global relevance of pragmatism in the 20th Century, [End Page 456] introduces the fascinating philosophy of Ambedkar to a non-Indian audience, and provides an entry for further scholarship on this profound thinker and activist.Bhimrao Ambedkar was a critical figure in the birth of modern India. Born an “untouchable” due to the rigid caste system, he tirelessly advocated for the right of Dalits (“crushed” or “untouchables”). By the mid-20th century, he had greatly influenced Indian politics, safeguarded the interests of the oppressed, and played a key role in drafting the Indian Constitution. Separate to his role as a statesman, Ambedkar promoted Buddhism in the 1950s as an escape from caste oppression, culminating in his publication, The Buddha and His Dhamma (1957). While his name is less familiar outside of India, he was voted the “Greatest Indian” in a 2012 poll due to his profound impact on the nation’s post-independence development. These accomplishments were supported by an extensive education, but unlike most subjects of the British Empire, Ambedkar also studied in the United States. Stroud initiates his study by focusing on this formative period, specifically his time at Columbia University and the influence of the philosopher and psychologist John Dewey. While their relationship has been acknowledged, Stroud is the first to explore this relationship in depth and he not only reconstructs the influence of Dewey on Ambedkar’s Navayana Pragmatism but illuminates the ways that Ambedkar integrated, modified, and even resisted Dewey’s pragmatism.Stroud masterfully builds his reconstruction of this synergy between Dewey’s pragmatism and Ambedkar’s philosophy not out of ephemeral conjecture or pithy textual evidence, but through painstaking, detailed, and exhaustive scholarship. He draws on comparative evidence in their major and minor works, their private correspondence, interviews of Ambedekar’s cohort at Columbia, Dewey’s voluminous lecture notes, and even the marginalia and notecards found between the pages of Ambedkar’s pragmatism bookshelf. Indeed, I often found myself pleasantly distracted as I imagined Stroud’s academic pilgrimage throughout India, Columbia University, and the Center for Dewey Studies to find every scrap of relevant information. In our age of instant information and digital archives, it is refreshing and inspiring to encounter a scholar still willing to trek across the globe for answers to his inquiries. Despite his passion to uncover the influence of Dewey on Ambedekar, Stroud never reduces the... (shrink)

The essays in this Special Section are about the ethics of Commercialism in Medicine. They are written, for the most part, by bioethicists, with the support of several prominent physicians and a health policy lawyer. This journal is, of course, devoted to ethics. Thus, our intent is to subject the question of commercialism in medicine to ethical scrutiny. Much has been written about commercialism in healthcare but very little about the ethics of commercialism in healthcare. One of our authors, Dr. (...) Jerome Kassirer, has encouraged a national dialogue about these issues. We hope to start that dialogue in the bioethical community and, through that community, into the nation. (shrink)

Many years ago, the esteemed patriarch of bioethics, Joseph Fletcher, spoke loud and clear in favor of rationality in reproduction. By rationality, he meant not merely limiting population growth, which he certainly favored, but bringing to bear human analytic and creative intelligence on the random and instinctive activities of sexual intercourse and procreation that we share with all mammals. In his 1974 book, The Ethics of Genetic Control: Ending Reproductive Roulette, he foresaw most of the issues that we are facing (...) today. He reflected on artificial insemination, prenatal diagnosis, cloning, eugenics, ectogenesis, ovum transfers, and genetic engineering. He examined these innovations to the extent that he felt that each of them represents a way of exercising rational and responsible control over life and reproduction. The subtitle of his book, “Ending Reproductive Roulette,” proclaims his faith. Dr. Fletcher's dedication to rationality led him to make the astonishing statement, “Man is a maker and the more rationally contrived and deliberate anything is, the more human it is. Therefore, laboratory reproduction is radically human compared to conception by ordinary heterosexual intercourse.”. (shrink)

For the last century, moral philosophy has stressed theory for the analysis of moral argument and concepts. In the last decade, interest in the ethical issues of health care has stimulated attention to cases and particular instances. This has revealed the gap between ethical theory and practice. This article reviews the history and method of casuistry which for many centuries provided an approach to practical ethics. Its strengths and weaknesses are noted and its potential for contemporary use explored.

Book reviewed in this article: Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine. By Albert R. Jonsen, Mark Siegler, and William J. Winslade.

The era of replacing human organs and their functions began with chronic dialysis and renal transplantation in the 1960s. These significant medical advances brought unprecedented problems. Among these, the selection of patients for a scarce resource was most troubling. In Seattle, where dialysis originated, a “God Committee” selected which patients would live and die. The debates over such a committee stimulated the origins of bioethics.

Book reviewed in this article: The Abuse of Casuistry: A History of Moral Reasoning. By Albert R. Jonsen and Stephen Toulmin.

The theology of John Calvin has deeply affected the American mentality through two streams of thought, Puritanism and Jansenism. These traditions formulate moral problems in terms of absolute, clear principles and avoid casuistic analysis of moral problems. This approach is designated American moralism. This article suggests that the bioethics movement in the United States was stimulated by the moralistic mentality but that the work of the bioethics has departed from this viewpoint. Keywords: bioethics, Calvinism, casuistry, Jansenism, moralism, moral principle, Puritanism (...) CiteULike Connotea Del.icio.us What's this? (shrink)

This is the God Squad. It is faceless, impersonal, unmoved by tragedy, almost terrorist in aspect. The photo appeared in LIFE magazine on November 9, 1962, and it depicted the Admissions and Policy Committee of the Seattle Artificial Kidney Center. The Committee had been established in 1962 to select those few persons who would be admitted to the new and tiny dialysis unit that was created by Dr. Belding Scribner, inventor of the arteriovenous shunt. It consisted of seven anonymous members (...) – a minister, a lawyer, a businessman, a homemaker, a labor leader, and two physicians. Each month they received a pile of charts about persons with end-stage renal disease. A prior medical evaluation had rated them all medically suitable for dialysis. The Committee’s task was to select one or two out of a dozen or so to take the available spots. The others were left to die. After several years of this agonizing work, the amendments to the Social Security Act provided financial support for renal dialysis and transplant, allowing the Admission Committee some peace of mind. (shrink)

“Bioethics began in religion, but religion has faded from bioethics.” This interpretation is commonplace among many who have an opinion on bioethics. This chapter examines this.