Christianity and Modern Medicine raises moral questions that were merely hypothetical just decades ago. Moreover, traditional moral models are incessantly challenged by the medical community at large, shifting the conversation to patient and societal rights within a framework of moral relativism and rendering the decision-making process morally vague and confusing. In Christianity and Modern Medicine, bioethicist Mark Wesley Foreman and attorney Lindsay C. Leonard delve into the major ethical issues facing today's medical professionals with the purpose of providing principles and (...) guidelines for making critical ethical decisions where medical knowledge, technologies, and capabilities are constantly evolving. Topics covered include: procreational ethics, genetic ethics, abortion, medical research, infanticide, clinical ethics, physician-assisted suicide, legal issues. While Christianity and Modern Medicine is designed specifically for students planning careers in the medical field, it is accessible to any Christian interested in steering through the moral fog in the practice of medicine today. (shrink)

Next SectionPublic discourse in continental Europe gives a uniquely prominent place to human dignity. The European Christianities have always taken this notion to be an outgrowth of their theological commitments. This sense of a conceptual continuity between Christianity and secular morality contributes to the way in which these Christianities, especially (but not exclusively) in Germany, have perceived their public role. In an exemplary manner, this essay engages the secularized societal environment. In meeting the secular discourse on its own home ground, (...) it seeks to recapture the theological roots of that discourse's defining value commitments. The challenges that modern societies present for Christians are seen not as a threat that would destroy a presumed original societas Christiana. Instead, these challenges create an opportunity to transform the Gospel's message so as to have it conform to, but also allow it to criticize, contemporary scientific knowledge about the world and man. Bonhoeffer's rendering of the Lutheran doctrine of the two kingdoms here makes it possible to link the Christian understanding of man as “in the image of God” with the secular affirmation of human dignity. As an intermediate concept, “incarnate reason” allows the bioethical discourse to preserve crucial aspects of the Christian tradition, while at the same time giving space to a constructive as well as critical exchange with secular discourse partners. (shrink)

Given intractable moral pluralism, what ought one to make of the bioethics that arose in the early 1970s, grounded as it was in the false assumption that there is a common secular morality that secular bioethics ought to apply? It is as if bioethics developed without recognition of the crisis at the heart of secular morality itself. Secular moral rationality cannot of itself provide the foundations to identify a particular morality and its bioethics as canonical. (...) One is not just confronted with intractable moral and bioethical pluralism, but with the absence of a secular ground that can show why one should act morally rather than self-interestedly. The result is not merely the deflation of much of traditional Western morality to life-style and death-style choices, but the threat of deflating to political slogans the now-dominant secular morality, including its affirmation of human autonomy, equality, social justice, and human dignity. All of this invites one critically to reconsider the meaning and force of secular bioethics. (shrink)

This book is an updated approach to a discipline of special importance in our changing world. It allows a full knowledge from the epistemological and historical basis that allows understanding the discipline from the beginning. The chapters devoted to the analysis of how bioethics is used to analyze complex situations in biomedical fields permits the understanding of its importance to solve them and protecting human beings. One important contribution of the book is looking at current and future challenges that (...) will need an ethical consideration to make sure that biomedical research is not divorced from human rights. (shrink)

The project of articulating a coherent, canonical, content-full, secular morality-cum-bioethics fails, because it does not acknowledge sin, which is to say, it does not acknowledge the centrality of holiness, which is essential to a non-distorted understanding of human existence and of morality. Secular morality cannot establish a particular moral content, the harmony of the good and the right, or the necessary precedence of morality over prudence, because such is possible only in terms of an ultimate point of reference: God. (...) The necessity of a rightly ordered appreciation of God places centrally the focus on holiness and the avoidance of sin. Because the cardinal relationship of creatures to their Creator is worship, and because the cardinal corporate act of human worship is the Liturgy, morality in general and bioethics in particular can be understood in terms of the conditions necessary, so as worthily to enter into Eucharistic liturgical participation. Morality can be summed up in terms of the requirements of ritual purity. A liturgical anthropology is foundational to an account of the content-full morality and bioethics that should bind humans, since humans are first and foremost creatures obliged to join in rightly ordered worship of their Creator. When humans worship correctly, when they avoid sin and pursue holiness, they participate in restoring created reality. (shrink)

James Drane's More Humane Medicine: A Liberal Catholic Bioethics is an outstanding contribution to the study of bioethics in our day. Catholics and others who are interested in the issues discussed here will benefit from this masterful treatment. The author opens with a set of definitions, starting with what he means by a “more humane medicine.” Drane contends that a more humane medicine has become necessary and desired, but not because the traditional medical ethic as “a self-declared and (...) self-imposed ethic, outlining what noble service to others entails” is no longer valid. Rather he defines it as an advance on the traditional ethic; a “new foundation” based on a “lived set of obligations derived from a felt commitment to other persons … an ethics based on the relationship between doctors and patients and essentially an ethics of virtue.” Drane's work is a “liberal Catholic Bioethics” in which he challenges his own faith tradition, the Roman Catholic Church, on such topics as sexuality, birth control, abortion, cloning, stem cell research, aging and dying, and euthanasia and physician-assisted suicide. The present article is a critical essay that analyzes the author's statements and conclusions. (shrink)

Just as the physics of Newton and Einstein are separated by foundationally different paradigms, so that key terms such as time, space, mass, and energy have different meanings in the different physics, this is also the case with respect to the various Christianities. Given different theological frameworks, the ‘same term’ can have different extensions and intensions. This essay explores the implications of the differences in the theological paradigm shaping Orthodox Christianity in contrast to Western Christianity, in particular Roman Catholicism, with (...) a special focus on the differences in the communities’ appreciation of the wrongness of abortion. Using the example of abortion, the contrast between Orthodox Christianity’s noetically grounded approach to moral-theological issues and that which developed in the West and gave centrality to a philosophically shaped moral theology is explored. (shrink)

Volume 24, Issue 12, December 2024, Page 59-62.

This book is the result of over 30 years of collaboration among its authors. It uses the systematic account of our common morality developed by one of its authors to provide a useful foundation for dealing with the moral problems and disputes that occur in the practice of medicine. The analyses of impartiality, rationality, and of morality as a public system not only explain why some bioethical questions, such as the moral acceptability of abortion, cannot be resolved, but also provide (...) a method for determining the correct answer for those occasions when a bioethical question has a unique correct answer. This new edition includes an entire chapter that has been added to address the controversial issue of abortion within the authors' distinct framework. This book presents the latest revisions of the authors' orignial analyses of the concepts of death and disease, analyses that have had a significant impact on the field of bioethics. It also includes an added chapter on mental disorders, where the authors' definition influenced what psychiatry classifies as a mental disorder, and so has had an impact that reveals beyond the field of bioethics. In this edition, the authors also offer a new, more developed perspective on the concept of valid or informed consent by considering what information physicians should be required to know before proposing screening, diagnostic testing, prescribing medications, or performing surgery. The book also integrates some of the important insights of the field of clinical epidemiology into its discussion of valid consent. Its account of paternalism and its justification, perhaps the most ubiquitous moral problem in medical ethics, has had considerable influence. Its discussion of euthanasia and physician assisted suicide challenges the standard views that have been put forward by both proponents and opponents of physician assisted suicide and voluntary active euthanasia. (shrink)

Translational ethics (TE) has been developed into a specific approach, which revolves around the argument that strategies for bridging the theory‐practice gap in bioethics must themselves be justified on ethical terms. This version of TE incorporates normative, empirical and foundational ethics research and continues to develop through application and in the face of new ethical challenges. Here, I explore the idea that the academic field of bioethics has not yet sufficiently analysed its own philosophical foundation for how it (...) can, and should, be practically relevant; neither has it comprehensively discussed the limitations on what impacts bioethicists should pursue. As a result, there has not been adequate training on how to suitably and appropriately impact real‐world practices. Moreover, bioethical perspectives are often competing with other strong interests, for example, economic and political, which may weaken their impact on policy‐making. The TE approach I propose can not only facilitate practical impacts of academic bioethics by being better informed by real‐world ethical issues but it also supports targeted and ethical justifications of the actual impact of academic work in real‐world contexts. In this paper, I clarify the premises for this TE approach, identify further challenges and sketch out potential solutions for the implementation of this methodological framework. (shrink)

We were not surprised by the opinion piece written for the CambridgeQuarterly by George J. Agich, Ph.D., who chairs the Cleveland Clinic Foundation's bioethics department. Dr. Agich uses the article to attack those who criticized his institution's proposed non-heart-beating organ donor protocol. Because we reported on this controversy for 60Minutes in April 1997, we wanted to set the record straight.

Presents a metaphysical foundation for ethics grounded in non-relative, personalist values that can be communicated cross-culturally. Examines the philosophical bases of ethical criteria and applies them to issues in medical practice ranging from genetic engineering to euthanasia.

Neglected diseases are severe conditions that mainly affect the world's poorest people. Those suffering from neglected diseases are mostly suffering from tropical infections that have failed to receive priority in pharmaceutical research and development programs, as well as in public health policies aimed at improving availability and access to preventive, diagnostic and curative medicine. The World Health Organization has issued a number of documents directing attention to the plight affecting one third of the world's population, assisted by active support from (...) private organizations, notably the Bill and Melissa Gates Foundation, but the overall situation remains dismal. In the wake of major socioeconomic processes including globalization, steadily growing economic disparity, healthcare inequality, the instability created by rogue states and terrorism, as well as massive migration, and epidemic outbreaks, the features of neglected diseases have been changing. Neglected populations affected by tropical diseases are suffering increasingly from non-infectious degenerative conditions and disabilities due to untreated chronic maladies. Pockets of poverty and neglect can also be detected in high-income countries, contributing to the emergence of new diseases and the reemergence of infections believed to be disappearing such as tuberculosis and the measles. Included in the issues of neglect are rare diseases, mostly of genetic origin, affecting a small number of patients that suffer from multiple life-shortening functional impairment and organ defects. Effective medicines are extremely expensive, allegedly because research and development of appropriate drugs is resources and time consuming, requiring exorbitant prices to recoup investment from a small number of consumers. Bioethics has been tardy in addressing the suffering and destitution of neglected and rare diseases. Convinced that permanently repeated denunciations blunt the sensitivity towards suffering, whereas statistics are bloodless and unable to elicit commitment, this book attempts to explore a different strategy. In an upstream approach, bioethics needs to engage in ethnographic fieldwork that confronts and shares the context in which people suffer, vividly presenting what epidemiological research has blunted into statistical data. Additionally, a downstream approach is suggested, requiring bioethics to vigorously and openly denounce unethical biomedical and pharmaceutical research, misdeeds in registration and marketing of drugs, and misalignment of policies with the unmet healthcare needs of the destitute. More than being critical observers, bioethicists ought to shed lurking conflicts of interests and seek active participation in planning research and public healthcare practices aimed at improving the lives of medically neglected populations. (shrink)

Metaphors used to describe new technologies mediate public understanding of the innovations. Analyzing the linguistic, rhetorical, and affective aspects of these metaphors opens the range of issues available for bioethical scrutiny and increases public accountability. This article shows how such a multidisciplinary approach can be useful by looking at a set of texts about one issue, the use of a newly developed technique for genetic modification, CRISPRcas9.

With the growth of neuroscience research, new neuroscience and society (NeuroX) fields like neuroethics, neurolaw, neuroarchitecture, neuroeconomics, and many more have emerged. In this article we report on lessons learned about mentoring students in the interdisciplinary space of neuroscience and society. We draw on our experiences with the recently launched Dana Foundation Career Network in Neuroscience & Society. This resource supports educators and practitioners mentoring students aiming to apply neuroscience in diverse fields beyond medicine and biomedical science. Through our programming, (...) we identified three key lessons: (1) students are interested in exploring a wide range of neuroscience and society intersections; (2) outreach to underserved institutions generates avenues for students to join NeuroX conversations; and (3) by offering free access to online NeuroX resources and a network of subject-matter experts, the Career Network joins many partners helping to bridge the gap between neuroscience and society. (shrink)

An understanding of the ethical implications of their work is now essential for all scientists. This accessible textbook clearly explains bioethical theories and their philosophical foundations to science students, enabling them to confidently take part in the key ethical debates of biotechnology. Over 200 activities introduce topics for personal reflection and discussion points encourage students to think for themselves and build their own arguments. Highlighting the potential pitfalls for those new to bioethics, each chapter features boxes providing factual (...) information and outlining the philosophical background. Accompanying online podcasts by the author (two of whose podcasts on iTunesU have attracted over 3 million downloads) explain points that might be difficult for beginners. Detailed case studies provide an insight into real-life examples of bioethical problems. Within-chapter essay questions and quizzes, along with end-of-chapter review questions, allow students to check their understanding and encourage broader thinking about the topics discussed. (shrink)

This discussion paper considers how seldom recognised theories influence clinical ethics committees. A companion paper examined four major theories in social science: positivism, interpretivism, critical theory and functionalism, which can encourage legalistic ethics theories or practical living bioethics, which aims for theory–practice congruence. This paper develops the legalistic or living bioethics themes by relating the four theories to clinical ethics committee members’ reported aims and practices and approaches towards efficiency, power, intimidation, justice, equality and children’s interests and rights. (...) Different approaches to framing ethical questions are also considered. Being aware of the four theories’ influence can help when seeking to understand and possibly change clinical ethics committee routines. The paper is not a research report but is informed by a recent study in two London paediatric cardiac units. Forty-five practitioners and related experts were interviewed, including eight members of ethics committees, about the work of informing, preparing and supporting families during the extended process of consent to children’s elective heart surgery. The mosaic of multidisciplinary teamwork is reported in a series of papers about each profession, including this one on bioethics and law and clinical ethics committees’ influence on clinical practice. The qualitative social research was funded by the British Heart Foundation, in order that more may be known about the perioperative views and needs of all concerned. Questions included how disputes can be avoided, how high ethical standards and respectful cooperation between staff and families can be encouraged, and how minors’ consent or refusal may be respected, with the support of clinical ethics committees. (shrink)

In March 1997, 60 Minutes, a nationally syndicated news magazine program, featured a story in which it was claimed that The Cleveland Clinic Foundation had in place a non-heart-beating donor protocol that involved killing patients for their organs. These charges were brought by a philosopher from a local university. A student who worked at LifeBanc, the northeastern Ohio organ procurement agency where the organ donation protocol originated, was given the protocol by LifeBanc with the understanding that it was to be (...) used in class; the student and professor charged that the protocol involved killing patients for their organs. These claims were advanced without noting that the protocol was a draft that was being reviewed and revised and had not been implemented. (shrink)

Recent approaches in the medical and social sciences have begun to lay stress on “plasticity” as a key feature of human physiological experiences. Plasticity helps to account for significant differences within and between populations, particularly in relation to variations in basic physiological processes, such as brain development, and, in the context of this article, daily sleep needs. This article proposes a novel basis for the redevelopment of institutions in accordance with growing awareness of human variation in physiological needs, and articulates (...) a theory of multibiologism. This approach seeks to expand the range of “normal” physiological experiences to respond to human plasticity, but also to move beyond critiques of medical practice that see medicine as simply responding to capitalist demands through the medicalization of “natural” processes. Instead, by focusing on how the institutions of U.S. everyday life—work, family, and school—structure the lives of individuals and produce certain forms of sleep as pathological, this article proposes that minor alterations in institutions could result in less pathologization for individuals and communities. Multibiologism provides a foundation for shared priorities in the social sciences, in bioethics, and in medical practice, and may lay the groundwork for emergent collaborations in institutional reform. (shrink)

ABSTRACT:This essay explores how bioethics as a field, rather than as a collection of individual efforts by bioethicists working within it, can inform deliberation on matters of bioethical import that, for better or worse, are in the hands of civic processes. It is motivated by the repeal of a constitutional protection of abortion access in the Supreme Court Dobbs v. Jackson Women's Health Organization decision, which effectively returned abortion regulations to states rather than setting a baseline federal protection of (...) abortion access up to fetal viability. Given the outsized role of local legislators in shaping health-care policy through legislation, about abortion as well as other health topics, the author proposes foundational bioethical education for legislators and considers two potential models for such education: one that operates on a clinical ethics consultation model, and one that mirrors bioethical coursework taught in traditional academic settings but modified for a legislator audience. Although both models present notable challenges requiring further conceptualization and problem-solving, overcoming these hurdles would enable bioethics to provide a service to civic learning and placemaking that would complement advocacy or lobbying efforts by individual bioethicists. (shrink)

This book offers new essays exploring concepts and applications of nonideal theory in bioethics. Nonideal theory refers to an analytic approach to moral and political philosophy (especially in relation to justice), according to which we should not assume that there will be perfect compliance with principles, that there will be favorable circumstances for just institutions and right action, or that reasoners are capable of being impartial. Nonideal theory takes the world as it actually is, in all of its imperfections. (...) Bioethicists have called for greater attention to how nonideal theory can serve as a guide in the messy realities they face daily. Although many bioethicists implicitly assume nonideal theory in their work, there is the need for more explicit engagement with this theoretical outlook. A nonideal approach to bioethics would start by examining the sociopolitical realities of healthcare and the embeddedness of moral actors in those realities. How are bioethicists to navigate systemic injustices when completing research, giving guidance for patient care, and contributing to medical and public health policies? When there are no good options and when moral agents are enmeshed in their sociopolitical viewpoints, how should moral theorizing proceed? What do bioethical issues and principles look like from the perspective of historically marginalized persons? These are just a few of the questions that motivate nonideal theory within bioethics. This book begins in Part I with an overview of the foundational tenets of nonideal theory, what nonideal theory can offer bioethics, and why it may be preferable to ideal theory in addressing moral dilemmas in the clinic and beyond. In Part II, authors discuss applications of nonideal theory in many areas of bioethics, including reflections on environmental harms, racism and minority health, healthcare injustices during incarceration and detention, and other vulnerabilities experienced by patients from clinical and public health perspectives. The chapters within each section demonstrate the breadth in scope that nonideal theory encompasses, bringing together diverse theorists and approaches into one collection. (shrink)

In recent years there has been growing scholarly interest in the relationship between bioethics and human rights. The majority of this work has proposed that the normative and institutional frameworks of human rights can usefully be employed to address those bioethical controversies that have a global reach: in particular, to the genetic modification of human beings, and to the issue of access to healthcare. In response, a number of critics have urged for a degree of caution about applying human (...) rights to such controversies. In particular, they have claimed that human rights have unresolved distributive and foundational problems. Interestingly, however, some of these critics have gone on to suggest that it might be possible to draw on certain bioethical insights to remedy these problems with human rights. This paper evaluates these recent attempts to apply insights from bioethics to the theory and practice of human rights. It argues that while these insights do not constitute an entirely new and original contribution to human rights thinking, they do force human rights scholars and campaigners to reflect on some key issues. First of all, they force us to question the prevalent idea that human rights are always ‘inviolable trumps’. Secondly, they demand that we pay close attention to the ‘fairness’ of the institutions we charge with determining our concrete rights. And finally, and perhaps most radically, these insights challenge the notion that human rights are held exclusively by members of the human species. (shrink)

This bold and lively essay is one of those rarest of intellectual achievements, a big small book. In its short length are condensed enormous erudition and impressive analytical scope. With verve and self-assurance, it addresses a broad, central question: How can we improve our understanding of the large-scale processes and structures that transformed the world of the nineteenth century and are transforming our world today? Tilly contends that twentieth-century social theories have been encumbered by a nineteenth century heritage of “pernicious (...) postulates.” He subjects each misleading belief to rigorous criticism, challenging many standard social science paradigms and methodologies. As an alternative to those timeless, placeless models of social change and organization, Tilly argues convincingly for a program of concrete, historically grounded analysis and systematic comparison. To illustrate the strategies available for such research, Tilly assesses the works of several major practitioners of comparative historical analysis, making skillful use of this selective review to offer his own speculative, often unconventional accounts of our recent past. Historically oriented social scientists will welcome this provocative essay and its wide-ranging agenda for comparative historical research. Other social scientists, their graduate and undergraduate students, and even the interested general reader will find this new work by a major scholar stimulating and eminently readable. This is the second of five volumes commissioned by the Russell Sage Foundation to mark its seventy-fifth anniversary. "In this short, brilliant book Tilly suggests a way to think about theories of historical social change....This book should find attentive readers both in undergraduate courses and in graduate seminars. It should also find appreciative readers, for Tilly is a writer as well as a scholar." —Choice. (shrink)

This article argues that Robert Nozick's Anarchy, State, and Utopia has been widely misread as a crude defense of the inequalities of contemporary capitalist societies. Nozick's book was in fact a work of ideal theory that proposed an account of the emergence of the state as a new moral foundation for liberal thought and practice. Nozick believed a justification of the state derived from a hypothetical account of its emergence without violating anyone's rights was more plausible than the standard liberal (...) claim that the legitimacy of the state followed from the hypothetical consent of the governed. An appreciation of the purpose and success of Nozick's account of the emergence of the state challenges established interpretations of his book as an inherently flawed, if at times ingenious, conservative political tract. (shrink)

Many Christian scholars, if not all of them, consider Genesis to be foundational texts of the Bible and the spring for all the other doctrines of the Scripture. Therefore, I'm considering the attempt to search and find arguments for cell therapy ethical issues in the fundamental text of Genesis as a challenging and educative task. Moreover, this could be the first step in analyzing the relationships between Christian religions and bioethics, in terms of finding reasonable decisions for ethical challenges, (...) raised by the current biomedical research. As for many other dilemmas of humanity, we have to recall the text of Genesis for analyzing the goodness or evilness of our actions in translational medicine, even though that is not the only way to get a reasonable ethical decision. My contribution is an essay that is trying to correlate the Genesis lessons with the needed arguments in deciding what could be good and what could be evil in the stem cell research, according to the religious convictions. The biggest challenges of biomedical research for Christian religions were due to the human cloning issue, made possible by the somatic cell nuclear transfer, but those challenges update the older debates on birth control pill, technologically assisted reproduction, or gene therapy. Issues related to in vitro fertilization, gene enhancement and gene therapy, human cell cloning, embryonic stem cell using, and chimera cell obtaining for research are being considered and related to the putative arguments extracted from the book of Genesis, describing the origins. As a matter of fact, I may conclude that the single way to reach a reasonable ethical decision in our society is to intersect ethics, science and theology and to engage large debates involving scientists, theologians, civil society representatives, ethicists (experts in applied ethics) and moral philosophers, having the two latest professionals as referees. (shrink)

ABSTRACT:Many of humanity's most serious problems are global, intergenerational, and ecological, yet current institutions are poorly placed to confront such problems. In part, this institutional challenge reflects difficulties with our basic concepts and theories. Bioethics is a central area where such questions arise. Although some have argued for an environmentalized bioethics since its inception, biomedicine has thus far failed to embrace the challenge, and some accuse most bioethicists of being "asleep at the wheel" (Schenck and Churchill 2021). This (...) paper discusses the basic ethical challenge, offers the "perfect moral storm" analysis, and explores one promising new concept for bioethics, planetary health, in light of that analysis. Drawing on the foundational report of the Rockefeller Foundation–Lancet Commission (Whitmee et al. 2015) and using climate change as the example, the author argues that planetary health has significant strengths but also some weaknesses, and that identifying both is helpful in charting a path forward for environmentalized bioethics. (shrink)

This is a collection of 15 papers from “philosophers, social scientists, and academic lawyers” concerned with “the field of bioethics itself”, “bioethics’s role in contemporary society”, and “specific issues”, including some—such as the role of the pharmaceuticals—not often addressed in such collections. They have all been commissioned for the volume either by or through the Social Philosophy and Policy Foundation, located in the USA, on whose behalf Cambridge University Press has published it in the UK. Perhaps, then, it (...) is not surprising that it …. (shrink)

We concur with Baum and colleagues (2009) on the importance of pandemic planners taking explicit steps to employ public engagement methodologies. Thus far, as Baum and colleagues note, there have b...

This book review essay points to some of the more novel and controversial contributions of A Theory of Bioethics, by Joseph Millum and David DeGrazia (Cambridge University Press, 2021), such as their account of moral status. With a remarkable breadth of topics, the book is characterized by philosophical care and nuance and by spelling out the implications of the authors’ theorizing for real‐world, pressing questions, for instance, about the implications of Millum and DeGrazia's theoretical work on moral status for (...) embryo research, animal research with mice and apes, and human‐brain organoids. (shrink)

The call has been made for global bioethics. In an age of pandemics, international drug trials, and genetic technology, health has gone global, and bioethics must follow suit. George Annas is one among a number of thinkers to recommend that bioethics expand beyond its traditional domain of patient–physician interactions to encompass a broader range of health-related matters. Medicine, Annas argues, must “develop a global language and a global strategy that can help to improve the health of all (...) of the world's citizens.” Individual countries cannot address global health issues, and culturally specific principles are inadequate for addressing global bioethics concerns. We will need a language and moral framework grounded in a foundation of universally shared, transcultural judgments about humankind that will also recognize moral pluralism. The claim has been made that such a foundation already exists in human rights, and that human rights should, therefore, be the new lingua franca of bioethics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics ConsultationPat Milmoe McCarrick (bio)(John La Puma, M.D., from the Department of Medicine at Lutheran General Hospital in Chicago, contacted the National Reference Center for Bioethics Literature and suggested bioethics consultation as a topic for the Scope Note Series. He provided an extensive list of citations about ethics consultations collected by him and by David Schiedermayer, M.D., for their new book Ethics Consultation: A Practical Guide.)In (...) Ethics Consultation in Health Care, editors John Fletcher, Norman Quist, and Albert R. Jonsen (I, 1989) define ethics consultation as "the provision of specialized help in identifying, analyzing, and resolving ethical problems that arise in clinical care. In medical ethics the area of consultation has grown rapidly since 1978 when Edmund D. Pellegrino (II, 1978) noted, "we cannot separate technical-moral decisions from the philosophic principles we use to justify them. Medicine and ethics must be engaged with each other at every level."In 1980 Albert Jonsen raised the question of whether an ethicist could be a consultant and said that the ethicist as consultant is a casuist, one whose moral reasoning is based on a system of reasoning that is applied to particular cases. He describes historical casuistry in Western culture, comparing it to modern moral philosophy, and suggests that a "new casuistry seems timely" for ethics consultation (II, Jonsen 1980). By 1984 ethicist Ruth Purtilo recorded her thoughts following an ethics consultation. She raised questions about the ethicist's place on a hospital staff and how to make that role appropriate and beneficial to all concerned, saying that "the ethicist retreats after the consultation; under no circumstances would the outcome of an ethics consultation be that the ethicist became the primary care giver or assumed ongoing responsibility for the clinical management of a case" (II, Purtilo 1984). Nevertheless, in 1992 two physician-ethicists who had been called as ethics consultants for a patient who had requested that he be removed from his ventilator reported that they became the persons who turned off the ventilator and administered the drugs that eased his dying (II, Edwards and Tolle 1992).In recognition of the growing number of persons identifying themselves as [End Page 433] consultants, the Society for Bioethics Consultation was founded in October 1985 as a professional society of persons engaged in bioethics consultation. It encourages and supports consultation, assists in establishing clinical education programs, and raises funds for consultation education. Although the Society has no permanent office, the president (currently, George Kanoti in the Cleveland Clinic Foundation's Bioethics Department) conducts its work and plans an annual meeting.The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) established new criteria concerning ethics in its 1992 Manual (III, JCAHO 1992) and in a special issue of QRB devoted to ethics consultation (I, Defining Quality 1992). These publications undoubtedly have contributed to the increased use of experts in medical ethics. The Manual notes that all organizations seeking accreditation should have some sort of "mechanism for the consideration of ethical issues arising in the care of patients and to provide education to care givers and patients on ethical issues in health care." A health care institution's eligibility for JCAHO accreditation, which is required for federal reimbursement, requires adherence to this specification (III, JCAHO 1992).The new International Directory of Bioethics Organizations provides an index of 129 different groups that indicated to the authors that they offer bioethics consultations. Of these, 83 are in the United States and 46 are in other countries. The ethics consultants included in the directory encompass a broad group of professionals who will assist patients, families, and primary care medical staff in finding solutions to ethical dilemmas resulting from use of new technologies or new treatments in health care. Consultants often come from the health fields: physicians, nurses, and other health personnel, but other professionals are also active as ethics consultants. Lawyers, pastoral counselors, philosophers, and social workers also offer bioethics consultation services (III, Nolen and Coutts 1993).Drs. Siegler, Pellegrino, and Singer wrote in 1990 that "Physician-ethicists and professional ethicists will continue to work side by side in the future. One is not likely to replace the other, nor is this desirable, because... (shrink)

Abstract:Increasing attention to climate change and health has re-centered environmental ethics on the medical industry and biomedical ethics on the environment. Yet, without a belief in climate change, there is little reason for sustainability in medicine. In the United States, about one-quarter of all adults self-identify as Evangelical Christians, with a sizable subset of "climate change deniers." In order for millions of Evangelicals to be persuaded about the importance of sustainability in medicine, there must be a theological justification. This article (...) will lay the foundation for an Evangelical environmental bioethic. I will first provide a brief history of environmental bioethics. Then, Christian theology will be introduced. In the following section, the work of Richard Bauckham—as a representative of Evangelical ecological theology—will be explored. His scholarship on biblical limitation can form the basis of an Evangelical environmental bioethic. The views and actions of American Evangelicals demands special attention, not only because of their number, but also because of their influence in one of the most environmentally noxious countries in the world. (shrink)

This issue of Christian Bioethics explores foundational debates regarding the orientation and application of Christian bioethics. Should Christian bioethics be approached as essentially a human activity, grounded in scholarly study of theological arguments and religious virtues, oriented toward practical social ends, or should Christian bioethics be recognized as the result of properly oriented prayer, fasting, and asceticism leading to an encounter with God? The gulf between these two general perspectives—the creation of immanent human goods versus submission (...) to a fully transcendent God—is significant and, as ongoing debate in Christian Bioethics: Non-Ecumenical Studies in Medical Morality over the past nearly three decades has made clear, the implications are both intellectually engaging and spiritually profound. (shrink)