Much debate concerning ‘precedent autonomy’ – that is, the authority of former, competent selves to govern the welfare of later, non-competent selves – has assumed a radical discontinuity between selves, and has overlooked the ‘bridging’ role of intimate proxy decision-makers. I consider a recent proposal by Lynn et al. (1999) that presents a provocative alternative, foregrounding an imagined dialogue between the formerly competent patient and her/his trusted others. I consider what standards must be met for such dialogues to have moral (...) force, appealing to narrative and feminist ethics. I then critique the dualistic construction of selves implicit in much of the advance directive literature, noting the continuities of dependence, character, and body, as well as the social dimension of the construction of selves. (shrink)

Readings in Health Care Ethics provides a wide-ranging selection of important and engaging contributions to the field of health care ethics. The second edition adds a chapter on health care in Canada, and the introduction has been expanded to include discussion of a new direction in feminist naturalized ethics. The book presupposes no prior knowledge, only an interest in the bioethical issues that are shaping our world.

In “Where Is the Sin in Synecdoche?” (2005) Adrienne Asch and David Wasserman criticize the choice to use prenatal testing (PNT) to determine disability. Notwithstanding the multiple meanings, motives, and circumstances behind people’s reproductive choices, Asch and Wasserman argue that individual choices to reject impaired potential offspring should be the subject of moral scrutiny, since they are likely to be the result of synecdoche—“the uncritical reliance on a stigma-driven inference from a single feature to a whole future life” (181). Such (...) synecdochal choices, they argue, assume that in virtue of impairment, the future child in question would be “incapable of [the] intimacy and community” involved in family.. (shrink)

Well and Good presents a combination of "classic" and little-known cases in health care ethics. These cases, accompanied by information about the major ethical theories, give students a chance to grapple with the ethical challenges faced by health care practitioners, policy makers, and recipients. The authors' narrative style and leading questions provoke student interest and engagement, while allowing instructors the freedom to draw from the theoretical perspectives they consider most useful. This fourth edition includes an expanded discussion of feminist ethics, (...) and new cases addressing pandemic ethics, humanitarian aid, the social determinants of health, research and aboriginal communities, and a number of other emerging issues. (shrink)