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| List of Cases | |
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| List of Tables | |
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| Preface | |
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| Introduction: Four Questions of Ethics | |
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| What Are the Source, Meaning, and Justification of Ethical Claims? | |
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| Distinguish between Evaluative Statements and Statements Presenting Nonevaluative Facts | |
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| Distinguish between Ethical and Nonethical Evaluations | |
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| Determine Who Ought to Decide | |
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| What Kinds of Acts Are Right? | |
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| Consequentialism | |
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| Deontological or "Duty-Based" Ethics | |
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| Other Issues of Normative Ethics | |
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| How Do Rules Apply to Specific Situations? | |
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| What Ought to Be Done in Specific Cases? | |
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| Notes | |
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| Ethics and Values in Medical Cases | |
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| A Model for Ethical Problem Solving | |
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| The Five-Step Model | |
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| Application of the Model | |
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| Respond to the Sense that Something Is Wrong | |
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| Gather Information | |
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| Identify the Ethical Problem/Moral Diagnosis | |
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| Seek a Resolution | |
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| Work with Others to Choose a Course of Action | |
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| Notes | |
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| Values in Health and Illness | |
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| Identifying Value Judgments in Medicine | |
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| Separating Ethical and Other Evaluations | |
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| Notes | |
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| What Is the Source of Moral Judgments? | |
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| Grounding Ethics in the Professional Code | |
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| Grounding Ethics in the Physician's Orders | |
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| Grounding Ethics in Institutional Policy | |
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| Grounding Ethics in the Patient's Values | |
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| Grounding Ethics in Religious or Philosophical Perspectives | |
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| Notes | |
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| Ethical Principles in Medical Ethics | |
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| Benefiting the Patient and Others: The Duty to Do Good and Avoid Harm | |
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| Benefiting the Patient | |
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| Health in Conflict with Other Goods | |
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| Conflicts among Health-Related Benefits | |
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| Relating Benefits and Harms | |
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| Benefits of Rules and Benefits in Specific Cases | |
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| Benefiting Society and Individuals Who Are Not Patients | |
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| Benefits to Society | |
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| Benefits to Specific Nonpatients | |
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| Benefits to the Profession | |
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| Benefit to the Health Professional and the Health Professional's Family | |
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| Notes | |
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| Justice: The Allocation of Health Resources | |
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| Justice among Patients | |
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| Justice between Patients and Others | |
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| Justice in Public Policy | |
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| Justice and Other Ethical Principles | |
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| Notes | |
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| Autonomy | |
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| Determining Whether a Patient Is Autonomous | |
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| External Constraints on Autonomy | |
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| Overriding the Choices of Autonomous Persons | |
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| Notes | |
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| Veracity: Honesty with Patients | |
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| The Condition of Doubt | |
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| Lying in Order to Benefit | |
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| Protecting the Patient by Lying | |
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| Protecting the Welfare of Others | |
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| Special Cases of Truth-Telling | |
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| Patients Who Do Not Want to Be Told | |
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| Family Members Who Insist the Patient Not Be Told | |
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| The Right of Access to Medical Records | |
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| Notes | |
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| Fidelity: Promise-Keeping, Loyalty to Patients, and Impaired Professionals | |
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| The Ethics of Promises: Explicit and Implicit | |
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| Fidelity and Conflicts of Interest | |
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| Incompetent and Dishonest Colleagues | |
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| Notes | |
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| Avoidance of Killing | |
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| Active Killing versus Letting Die | |
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| Withholding versus Withdrawing Treatment | |
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| Direct Versus Indirect Killing | |
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| Justifiable Omissions: The Problem of Nutrition and Hydration | |
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| Voluntary and Involuntary Killing | |
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| Killing as Punishment | |
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| Notes | |
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| Special Problem Areas | |
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| Abortion, Sterilization, and Contraception | |
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| Abortion | |
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| Abortion for Medical Problems of the Fetus | |
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| Abortion Following Sexual Assault | |
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| Abortion to Save the Life of the Pregnant Woman | |
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| Abortion and the Mentally Incapacitated Woman | |
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| Abortion for Socioeconomic Reasons | |
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| Sterilization | |
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| Contraception | |
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| Notes | |
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| Genetics, Birth, and the Biological Revolution | |
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| Genetic Counseling | |
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| Genetic Screening | |
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| In Vitro Fertilization and Surrogate Motherhood | |
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| Preimplantation Diagnosis | |
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| Gene Therapy | |
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| Notes | |
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| Mental Health and Behavior Control | |
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| The Concept of Mental Health | |
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| Mental Illness and Autonomous Behavior | |
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| Mental Illness and Third-Party Interests | |
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| Other Behavior-Controlling Therapies | |
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| Notes | |
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| Confidentiality: Ethical Disclosure of Medical Information | |
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| Breaking Confidence to Benefit the Patient | |
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| Breaking Confidence to Benefit Others | |
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| Breaking Confidence as Required by Law | |
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| Conflict between Confidentiality and Other Duties | |
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| Notes | |
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| Organ Transplants | |
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| Procuring Organs | |
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| Donation versus Salvaging | |
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| Diseased and Poor-Quality Organs | |
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| Donation after Cardiac Death | |
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| Preserving the Organs of the Dying | |
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| Socially Directed Organ Donation | |
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| Living Donor/Deceased Donor Organ Swaps | |
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| Children as Living Organ Sources | |
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| Allocating Organs | |
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| Maximizing Benefits and Distributing Organs Fairly | |
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| When Voluntary Risks Cause a Need for Organs | |
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| Multiple Organs and Special Priority for Special People | |
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| Notes | |
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| Health Insurance, Health System Planning, and Rationing | |
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| The Problem of Small, Incremental Benefits | |
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| Limits on Unproved Therapies | |
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| Marginally Beneficial, Expensive Therapy | |
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| Valued Care that Is Not Cost-worthy | |
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| Funding Care that Patients Have Refused | |
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| Pharmaceutical Manufacturers versus Insurers | |
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| Insurance and the Uninsured | |
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| Notes | |
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| Experimentation on Human Subjects | |
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| Calculating Risks and Benefits | |
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| Privacy and Confidentiality | |
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| Equity in Research | |
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| Conflicts of Interest in Research | |
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| Informed Consent in Research | |
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| Notes | |
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| Consent and the Right to Refuse Treatment | |
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| The Elements of a Consent | |
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| The Standards for Consent | |
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| Comprehension and Voluntariness | |
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| Notes | |
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| Death and Dying | |
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| The Definition of Death | |
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| Competent and Formerly Competent Patients | |
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| Never Competent Patients | |
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| Never Competent Persons without Available Family | |
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| Never Competent Persons with Available Family | |
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| Futile Care and Limits Based on the Interests of Others | |
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| Notes | |
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| Appendix: Codes of Ethics | |
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| The Hippocratic Oath | |
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| World Medical Association, Declaration of Geneva | |
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| The American Medical Association, Principles of Medical Ethics | |
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| Universal Declaration on Bioethics and Human Rights | |
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| Notes | |
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| Glossary | |
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| List of Cases from Public Sources | |
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| Index | |