The Basics of Bioethics
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The Basics of Bioethics

Robert M. Veatch, Laura K. Guidry-Grimes

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eBook - ePub

The Basics of Bioethics

Robert M. Veatch, Laura K. Guidry-Grimes

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About This Book

The Basics of Bioethics, Fourth Edition offers an easy-to-follow introduction to this dynamic field, intended for healthcare professionals, teachers, students, and anyone interested in bioethics. Accessible and enjoyable for readers of all backgrounds, the book contains numerous cases—including ones that recently have dominated international headlines—to help anchor the broader discussion. The text is suitable for use in short courses in schools of medicine, nursing, and other health professions; continuing professional education; various undergraduate departments; and adult education. Chapters are organized around common moral themes in order to help readers understand the values and other connections that tie together different positions in bioethics. This fourth edition adds a new chapter on alternative frameworks in bioethics, including narrative ethics and casuistry, feminist approaches, care ethics, and virtue ethics. Due to significant advances in genetics and reproductive possibilities, this new edition devotes a full chapter to each. The combined teaching, research, and clinical experience of the two authors helps make this edition current with the evolving field of bioethics, while still embedding the major issues in a systematic framework that allows readers easily to navigate the larger field.

Key Changes to the Fourth Edition:
• An added chapter on new and emerging approaches in bioethics, including those based on virtue ethics, casuistry and narrative ethics, feminist ethics, and care ethics
• Updates throughout the book based on developments in ethical theory and new medical research
• Revisions and updates to the Learning Objectives, Key Terms, Bibliographies, and URLs
• The addition of multiple recent case studies, including:

  • Jahi McMath

  • an undocumented patient who needs a rule bent

  • a pediatrician who turns away unvaccinated patients

  • a minor eligible for pediatric bariatric surgery

  • a daughter suing a hospital for non-disclosure of her father's Huntington's diagnosis

  • CRISPR-edited newborn babies
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A Map of the Terrain of Ethics

The physicians, Jahi’s mother, and everyone else involved in this case face some difficult and controversial ethical choices. They need to determine the proper definition of death, the role of parents and other surrogates in deciding about medical care for a minor, the proper ethics of terminal care, the morality of using scarce medical resources, and the role that minority religious perspectives ought to play in modern, secular medical care. In order to sort out these disparate and complex ethical issues we need a map of the ethical terrain: an overview of the kinds of ethical issues at stake and the terminology for labeling the disputes. This chapter will provide a basic map of that terrain. Once that overview is in place, we can begin sorting out the issues facing Jahi McMath’s parents and physicians.

The Levels of Moral Discourse

The Level of the Case

Often in bioethics, the discussion begins with a case problem. Someone faces a concrete moral dilemma or two people disagree about what in a specific situation is the morally appropriate response. Some people may mistakenly think that ethical choices do not occur all that often in medicine. They think that an “ethics case” is an unusual, special event. In fact, ethical and other value choices occur constantly, but, fortunately, in almost all situations the ethically correct course is obvious. The decision can be made with little or no conscious thought. Ethical choices have still been made—even if the decision-maker does not even realize it. He or she can rely on well-ingrained moral beliefs and get by quite adequately. Occasionally, however, the choice does not come as easily. As in the case of Jahi McMath, the choice requires more careful, conscious thought. The physician faced with a choice may turn to colleagues or to a hospital ethics committee for advice. A lay person may turn to friends or to a trusted religious or secular group for guidance.
One kind of advice may come in the form of mentioning other cases that seem similar, cases that have been resolved in the past. They may be in the form of a Biblical story or a legal case about which the culture has reached agreement. These agreed-upon cases are sometimes referred to as “paradigm cases.” Most people can agree that, in matters of ethics, similar cases should be treated similarly. In fact, one of the identifying characteristics of an ethical judgment (as opposed to a matter of mere taste or preference) is this awareness that if the relevant features are similar, then cases should be treated alike. As long as people can agree on what should be done in the paradigm case and can agree that the new case is similar in all relevant respects, they will be able to resolve their problem. This approach relying on paradigm cases is sometimes called casuistry. As seen in Figure 1, this is the lowest or most specific level of what can be considered the four major levels of moral discourse. This figure is a simplified version of the more elaborate map of the ethical terrain that appears at the front of this book.

Rules and Rights (Codes of Ethics)

But what if the basic ethics we learned as children does not settle the problem? What if we cannot agree on a paradigm case or cannot agree that our present problem is like the paradigm case in all relevant respects? We may, at that point, move to a second level of moral discourse, the level of moral rules and rights. Sometimes rules and rights tell us what is legal, but they may also describe what is ethical. Since not everything that is legal is also ethical (and not everything that is illegal is necessarily unethical), it will be important to note the difference. If a rule or a right is considered ethical, it will be seen as grounded in a moral system, an ultimate system of beliefs and norms about the rightness or wrongness of human conduct and character. Groups of rules or rights claims are sometimes called codes of ethics.
Jahi McMath’s physicians may consult the Code of Ethics of the American Medical Association to see whether that group considers it ethical to stop treatment in such cases. His parents might consult an Islamic code. Some of the parties in the dispute may bring out the Hippocratic Oath or a “patients’ bill of rights.”
Sometimes the parties to an ethical dispute may cite a rule-like maxim. “Always get consent before non-emergent surgery” or “a patient’s medical information must be kept confidential” are examples of such maxims. These rule-like statements are usually quite specific. A large number of them would be needed to cover all medical ethi...

Table of contents

Citation styles for The Basics of Bioethics
APA 6 Citation
Veatch, R., & Guidry-Grimes, L. (2019). The Basics of Bioethics (4th ed.). Taylor and Francis. Retrieved from (Original work published 2019)
Chicago Citation
Veatch, Robert, and Laura Guidry-Grimes. (2019) 2019. The Basics of Bioethics. 4th ed. Taylor and Francis.
Harvard Citation
Veatch, R. and Guidry-Grimes, L. (2019) The Basics of Bioethics. 4th edn. Taylor and Francis. Available at: (Accessed: 15 October 2022).
MLA 7 Citation
Veatch, Robert, and Laura Guidry-Grimes. The Basics of Bioethics. 4th ed. Taylor and Francis, 2019. Web. 15 Oct. 2022.