In the quarter century since the landmark Karen Ann Quinlan case, an ethical, legal, and societal consensus supporting patients' rights to refuse life-sustaining treatment has become a cornerstone of bioethics. Patients now legally can write advance directives to govern their treatment decisions at a time of future incapacity, yet in clinical practice their wishes often are ignored.
Examining the tension between incompetent patients' prior wishes and their current best interests as well as other challenges to advance directives, Robert S. Olick offers a comprehensive argument for favoring advance instructions during the dying process. He clarifies widespread confusion about the moral and legal weight of advance directives, and he prescribes changes in law, policy, and practice that would not only ensure that directives count in the care of the dying but also would define narrow instances when directives should not be followed. Olick also presents and develops an original theory of prospective autonomy that recasts and strengthens patient and family control.
While focusing largely on philosophical issues the book devotes substantial attention to legal and policy questions and includes case studies throughout. An important resource for medical ethicists, lawyers, physicians, nurses, health care professionals, and patients' rights advocates, it champions the practical, ethical, and humane duty of taking advance directives seriously where it matters most-at the bedside of dying patients.
A pioneer in the theory of pluralistic casuistry, the idea that there are almost as many facets to moral choices as there are cases that call for choices, Baruch Brody takes issue with conventional bioethical wisdom and challenges the rigid principalism of contemporary bioethics. His views have been seen as controversial, but they are firmly held, and convincingly argued—all of which have led him to be one of the most widely discussed and highly admired bioethicists of our time. He argues for the fundamental distinction between active and passive euthanasia, for a need to reconceptualize approaches to brain death, and for the right of providers to unilaterally discontinue life support. He shows support for the waiving of the requirement of informed consent for some research, for the widespread use of animals in research, and for the use of placebos in many international clinical trials.
When it comes to morality as it is practiced in medicine, Brody makes clear that the ethical issues are never as simple as black and white—that there are myriad factors and fine nuances that can and should challenge decision making as it is commonly practiced in difficult medical cases. In this collection, delving thoughtfully and systematically into methodology, research ethics, clinical ethics, and Jewish medical ethics, he tackles thorny life-and-death questions head-on and fearlessly. He casts a light into all the corners of end-of-life decisions—a field in which he has exemplary credentials—while illuminating a new understanding of morality and ethics.
The introduction outlines Brody's approach, defines the terminology used, and contrasts his ethical positions with much of the competing literature. Taking Issue will be invaluable to students and scholars in medical ethics, bioethics, and philosophy of medicine.
Modern Japan offers us a view of a highly developed society with its own internal logic. Eiko Ikegami makes this logic accessible to us through a sweeping investigation into the roots of Japanese organizational structures. She accomplishes this by focusing on the diverse roles that the samurai have played in Japanese history. From their rise in ancient Japan, through their dominance as warrior lords in the medieval period, and their subsequent transformation to quasi-bureaucrats at the beginning of the Tokugawa era, the samurai held center stage in Japan until their abolishment after the opening up of Japan in the mid-nineteenth century.
This book demonstrates how Japan’s so-called harmonious collective culture is paradoxically connected with a history of conflict. Ikegami contends that contemporary Japanese culture is based upon two remarkably complementary ingredients, honorable competition and honorable collaboration. The historical roots of this situation can be found in the process of state formation, along very different lines from that seen in Europe at around the same time. The solution that emerged out of the turbulent beginnings of the Tokugawa state was a transformation of the samurai into a hereditary class of vassal-bureaucrats, a solution that would have many unexpected ramifications for subsequent centuries.
Ikegami’s approach, while sociological, draws on anthropological and historical methods to provide an answer to the question of how the Japanese managed to achieve modernity without traveling the route taken by Western countries. The result is a work of enormous depth and sensitivity that will facilitate a better understanding of, and appreciation for, Japanese society.
Since the end of World War II, runaway fears of Soviet imperialism, global terrorism, and anarchy have tended to drive American foreign policy toward an imperial agenda. At the same time, uncurbed appetites have wasted the environment and driven the country’s market economy into the ditch. How can we best sustain our identity as a people and resist the distortions of our current anxieties and appetites?
Ethicist William F. May draws on America’s religious and political history and examines two concepts at play in the founding of the country—contractual and covenantal. He contends that the biblical idea of a covenant offers a more promising way than the language of contract, grounded in self-interest alone, to contain our runaway anxieties and appetites. A covenantal sensibility affirms, “We the people (not simply, We the individuals, or We the interest groups) of the United States.” It presupposes a history of mutual giving and receiving and of bearing with one another that undergirds all the traffic in buying and selling, arguing and negotiating, that obtain in the rough terrain of politics. May closes with an account of the covenantal agenda ahead, and concludes with the vexing issue of immigrants and undocumented workers that has singularly tested the covenant of this immigrant nation.
The field of bioethics was deeply influenced by religious thinkers as it emerged in the 1960s and early 1970s. Since that time, however, a seemingly neutral political liberalism has pervaded the public sphere, resulting in a deep suspicion of those bringing religious values to bear on questions of bioethics and public policy.
As a theological ethicist and progressive Catholic, Lisa Sowle Cahill does not want to cede the "religious perspective" to fundamentalists and the pro-life movement, nor does she want to submit to the gospel of a political liberalism that champions individual autonomy as holy writ. In Theological Bioethics, Cahill calls for progressive religious thinkers and believers to join in the effort to reclaim the best of their traditions through jointly engaging political forces at both community and national levels.
In Cahill's eyes, just access to health care must be the number one priority for this type of "participatory bioethics." She describes a new understanding of theological bioethics that must go beyond decrying injustice, beyond opposing social practices that commercialize human beings, beyond painting a vision of a more egalitarian future. Such a participatory bioethics, she argues, must also take account of and take part in a global social network of mobilization for change; it must seek out those in solidarity, those involved in a common calling to create a more just social, political, and economic system.
During the past two decades Cahill has made profound contributions to theological ethics and bioethics. This is a magisterial and programmatic statement that will alter how the religiously inclined understand their role in the great bioethics debates of today and tomorrow that yearn for clear thinking and prophetic wisdom.
What are human rights? Can theology acknowledge human rights discourse? Is theological engagement with human rights justified? What place should this discourse occupy within ethics?
Ethna Regan seeks to answer these questions about human rights, Christian theology, and philosophical ethics. The main purpose of this book is to justify and explore theological engagement with human rights. Regan illustrates how that engagement is both ecumenical and diverse, citing the emerging engagement with human rights discourse by evangelical theologians in response to the War on Terror. The book examines where the themes and concerns of key modern theologians—Karl Rahner, J. B. Metz, Jon Sobrino, and Ignacio Ellacuría—converge with the themes and concerns of those committed to the advancement of human rights. Regan also critically engages with the “disdain” for rights discourse that is found in the postliberal critiques of John Milbank and Stanley Hauerwas.
This interdisciplinary volume will be of interest to students and scholars in the fields of systematic theology, theological ethics, human rights, religion and politics, and political theory.
Freedom is a fundamental Christian theological category, as much a challenge to construct a new way of seeing oneself and others as it is an announcement of what Christ has already done for us in his death and resurrection. Liberation theology is, most simply, the effort to spell out what such freedom means for Christians in the twentieth and twenty-first centuries.
This book has as its principle premise the conviction that if we are to construct a North American liberation theology we must begin listening to and understanding Latin American theology not so much as a model to be slavishly followed but as a challenge to our own cultural, political, and even religious assumptions. The focus thus is not so much on the theoretical meaning of Christian freedom but on its practice, and more exactly its praxis, that is to say the dialectic between theory and practice.
After focusing on the creation and development of liberating theological methods and sources and, above all, the revitalization and renewal of structures that will contribute to the development of a liberated and liberating church, Fr. Hennelly ends with an analysis of the most recent and the most important vatican document on liberation theology, The Instruction of Christian Freedom and Liberation, which he sees as an acknowledgement by the universal church that the theme of liberation is central to the meaning of Christian theology.
The first examination of predictive technology from the perspective of Catholic theology
Probabilistic predictions of future risk govern much of society. In business and politics alike, institutional structures manage risk by controlling the behavior of consumers and citizens. New technologies comb through past data to predict and shape future action. Choosing between possible future paths can cause anxiety as every decision becomes a calculation to achieve the most optimal outcome.
Tomorrow’s Troubles is the first book to use virtue ethics to analyze these pressing issues. Paul Scherz uses a theological analysis of risk and practical reason to show how risk-based decision theory reorients our relationships to the future through knowledge of possible dangers and foregone opportunities—and fosters a deceptive hope for total security. Scherz presents this view of temporality as problematic because it encourages a desire for stability through one’s own efforts instead of reliance on God. He also argues that the largest problem with predictive models is that they do not address individual reason and free will. Instead of dwelling on a future, we cannot control, we can use our past experiences and the Christian tradition to focus on discerning God’s will in the present.
Tomorrow’s Troubles offers a thoughtful new framework that will help Christians benefit from the positive aspects of predictive technologies while recognizing God’s role in our lives and our futures.
Torture doctors invent and oversee techniques to inflict pain and suffering without leaving scars. Their knowledge of the body and its breaking points and their credible authority over death certificates and medical records make them powerful and elusive perpetrators of the crime of torture. In The Torture Doctors, Steven H. Miles fearlessly explores who these physicians are, what they do, how they escape justice, and what can be done to hold them accountable.
At least one hundred countries employ torture doctors, including both dictatorships and democracies. While torture doctors mostly act with impunity—protected by governments, medical associations, and licensing boards—Miles shows that a movement has begun to hold these doctors accountable and to return them to their proper role as promoters of health and human rights. Miles’s groundbreaking portrayal exposes the thinking and psychology of these doctors, and his investigation points to how the international human rights community and the medical community can come together to end these atrocities.
Rescued in 1972 from a storeroom in which rats and seeping water had severely damaged the fifty-year-old manuscript, this text is the earliest major work (1919-1921) of the great Russian philosopher M. M. Bakhtin. Toward a Philosophy of the Act contains the first occurrences of themes that occupied Bakhtin throughout his long career. The topics of authoring, responsibility, self and other, the moral significance of "outsideness," participatory thinking, the implications for the individual subject of having "no-alibi in existence," the difference between the world as experienced in actions and the world as represented in discourse—all are broached here in the heat of discovery. This is the "heart of the heart" of Bakhtin, the center of the dialogue between being and language, the world and mind, "the given" and "the created" that forms the core of Bakhtin's distinctive dialogism.
A special feature of this work is Bakhtin's struggle with the philosophy of Immanuel Kant. Put very simply, this text is an attempt to go beyond Kant's formulation of the ethical imperative. mci will be important for scholars across the humanities as they grapple with the increasingly vexed relationship between aesthetics and ethics.
The highly engaging introduction to thinking like an economist, updated for a new generation of readers.
When economists wrestle with any social issue—be it unemployment, inflation, healthcare, or crime and punishment—they do so impersonally. The big question for them is: what are the costs and benefits, or trade-offs, of the solutions to such matters? These trade-offs constitute the core of how economists see the world—and make the policies that govern it.
Trade-Offs is an introduction to the economic approach of analyzing controversial policy issues. A useful introduction to the various factors that inform public opinion and policymaking, Trade-Offs is composed of case studies on topics drawn from across contemporary law and society.
Intellectually stimulating yet accessible and entertaining, Trade-Offs will be appreciated by students of economics, public policy, health administration, political science, and law, as well as by anyone following current social policy debates.
The first book to argue for the concept of tragic dilemmas in Christian ethics
Moral dilemmas arise when individuals are unable to fulfill all of their ethical obligations. Tragic dilemmas are moral dilemmas that involve great tragedy. The existence of moral and tragic dilemmas is debated in philosophy and often dismissed in theology based on the notion that there are effective strategies that completely solve hard ethical situations. Yet cases from real-life events in war and bioethics offer compelling evidence for the existence of tragic dilemmas.
In Tragic Dilemmas in Christian Ethics, Jackson-Meyer expertly explores the thought of Augustine and Aquinas to show the limits of their treatment of hard cases, as well as where their thought can be built on and expanded in relation to tragic dilemmas. She recognizes and develops a new theological understanding of tragic dilemmas rooted in moral philosophy, contemporary case studies, and psychological literature on moral injury. Jackson-Meyer argues that in tragic dilemmas moral agents choose between conflicting nonnegotiable moral obligations rooted in Christian commitments to protect human life and the vulnerable. Personal culpability is mitigated due to constrained situations and society is also culpable when tragic dilemmas are a result of structural sin. In response, Jackson-Meyer implores Christian communities to offer individual and communal healing after tragic dilemmas and to acknowledge their own participation in injustice.
Tragic Dilemmas in Christian Ethics offers practical strategies that Christian communities can use to provide healing to those who have acted in tragic dilemmas and to transform the unjust structures that often cause these tragedies.
Tragic Effects: Ethics and Tragedy in the Age of Translation confronts the peculiar fascination with Greek tragedy as it shapes the German intellectual tradition, with particular focus on the often controversial practice of translating the Greeks. Whereas the tradition of emulating classical ideals in German intellectual life has generally emerged from the impulse to identify with models, the challenge of translating the Greeks underscores the linguistic and historical discontinuities inherent in the recourse to ancient material and inscribes that experience of disruption as fundamental to modernity.
Friedrich Hölderlin’s translations are a case in point. Regarded in his own time as the work of a madman, his renditions of Sophoclean tragedy intensify dramatic effect with the unsettling experience of familiar language slipping its moorings. His attention to marking the distances between ancient source text and modern translation has granted his Oedipus and Antigone a distinct longevity as objects of discussion, adaptation, and even retranslation. Cited by Walter Benjamin, Martin Heidegger, Bertolt Brecht, and others, Hölderlin’s Sophocles project follows a path both marked by various contexts and tinged by persistent quandaries of untranslatability.
Tragedy has long functioned as a cornerstone for questions about ethical life. By placing emphasis on processes of translation and adaptation, however, Tragic Effects approaches the question of ethics from a perspective informed by recent discourse in translation studies. Reconstructing an ancient text in this context requires negotiating the difficult tension between comprehending the distant past and preserving its radical singularity.
The timeless human desire to be more beautiful, intelligent, healthy, athletic, or young has given rise in our time to technologies of human enhancement. Athletes use drugs to increase their strength or stamina; cosmetic surgery is widely used to improve physical appearance; millions of men take drugs like Viagra to enhance sexual performance. And today researchers are exploring technologies such as cell regeneration and implantable devices that interact directly with the brain. Some condemn these developments as a new kind of cheating—not just in sports but in life itself—promising rewards without effort and depriving us most of all of what it means to be authentic human beings. “Transhumanists,” on the other hand, reject what they see as a rationalizing of human limits, as if being human means being content forever with underachieving bodies and brains. To be human, they insist, is to be restless with possibilities, always eager to transcend biological limits.
As the debate grows in urgency, how should theology respond? Christian theologians recognize truth on both sides of the argument, pointing out how the yearnings of the transhumanists—if not their technological methods—find deep affinities in Christian belief. In this volume, Ronald Cole-Turner has joined seasoned scholars and younger, emerging voices together to bring fresh insight into the technologies that are already reshaping the future of Christian life and hope.
Three decades after the first heart transplant surgery stunned the world, organs including eyes, lungs, livers, kidneys, and hearts are transplanted every day. But despite its increasingly routine nature-or perhaps because of it-transplantation offers enormous ethical challenges. A medical ethicist who has been involved in the organ transplant debate for many years, Robert M. Veatch explores a variety of questions that continue to vex the transplantation community, offering his own solutions in many cases.
Ranging from the most fundamental questions to recently emerging issues, Transplantation Ethics is the first complete and systematic account of the ethical and policy controversies surrounding organ transplants. Veatch structures his discussion around three major topics: the definition of death, the procurement of organs, and the allocation of organs. He lobbies for an allocation system-administered by nonphysicians-that considers both efficiency and equity, that takes into consideration the patient's age and previous transplant history, and that operates on a national rather than a regional level.
Rich with case studies and written in an accessible style, this comprehensive reference is intended for a broad cross section of people interested in the ethics of transplantation from either the medical or public policy perspective: patients and their relatives, transplantation professionals, other health care professionals and administrators, social workers, members of organ procurement organizations, and government officials involved in the regulation of transplants.
Although the history of organ transplant has its roots in ancient Christian mythology, it is only in the past fifty years that body parts from a dead person have successfully been procured and transplanted into a living person. After fourteen years, the three main issues that Robert Veatch first outlined in his seminal study Transplantation Ethics still remain: deciding when human beings are dead; deciding when it is ethical to procure organs; and deciding how to allocate organs, once procured.
However, much has changed. Enormous strides have been made in immunosuppression. Alternatives to the donation model are debated much more openly—living donors are used more widely and hand and face transplants have become more common, raising issues of personal identity. In this second edition of Transplantation Ethics, coauthored by Lainie F. Ross, transplant professionals and advocates will find a comprehensive update of this critical work on transplantation policies.
Drawing on his own experience, and on literature, philosophy, and medicine, Daniel Callahan offers great insight into how to deal with the rewards of modern medicine without upsetting our perception of death. He examines how we view death and the care of the critically ill or dying, and he suggests ways of understanding death that can lead to a peaceful acceptance. Callahan's thoughtful perspective notably enhances the legal and moral discussions about end-of-life issues.
Originally published in 1993 by Simon and Schuster.
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