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Prenatal Testing and Disability Rights
Erik Parens and Adrienne Asch, Editors
Georgetown University Press, 2000

As prenatal tests proliferate, the medical and broader communities perceive that such testing is a logical extension of good prenatal care—it helps parents have healthy babies. But prenatal tests have been criticized by the disability rights community, which contends that advances in science should be directed at improving their lives, not preventing them. Used primarily to decide to abort a fetus that would have been born with mental or physical impairments, prenatal tests arguably reinforce discrimination against and misconceptions about people with disabilities.

In these essays, people on both sides of the issue engage in an honest and occasionally painful debate about prenatal testing and selective abortion. The contributors include both people who live with and people who theorize about disabilities, scholars from the social sciences and humanities, medical geneticists, genetic counselors, physicians, and lawyers. Although the essayists don't arrive at a consensus over the disability community's objections to prenatal testing and its consequences, they do offer recommendations for ameliorating some of the problems associated with the practice.

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Rationing Sanity
Ethical Issues in Managed Mental Health Care
James Lindemann Nelson, Editor
Georgetown University Press, 2003

Mental illness is the poor, and somehow "damaged," cousin to physical ailments in the eyes of too many in our society. Compare the difference in how people would respond to someone who had fallen and broken their leg on the street, to how most react to those mentally ill among us, on those same streets, who spend their winters on steam grates and forage for food in dumpsters. Rationing Sanity is a provocative analysis of the mental health care system in the United States, dealing with issues of justice and access to mental health care.

How should a decent society, affluent but facing many serious calls on its resources, best care for citizens afflicted with severe and persistent mental illnesses? James Lindemann Nelson brings together, for the first time, scholars of the ethics of mental health care and top managed care policy analysts to address this crucial problem. Rationing Sanity integrates those perspectives with the thoughtful practice-based experience of physicians well versed in the actual care of people with emotional and behavioral problems. Over a period of years, the contributors met face-to-face to engage each other on the ethics of managed mental health care—the result is a unique, collaborative effort that provides a wealth of important new insights on not only how Americans can readjust their attitudes toward the mentally ill—but also how we may find more just and humane treatment for those afflicted.

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Slow Cures and Bad Philosophers
Essays on Wittgenstein, Medicine, and Bioethics
Carl Elliott, ed.
Duke University Press, 2001
Slow Cures and Bad Philosophers uses insights from the philosophy of Ludwig Wittgenstein to rethink bioethics. Although Wittgenstein produced little formal writing on ethics, this volume shows that, in fact, ethical issues permeate the entirety of his work. The scholars whom Carl Elliott has assembled in this volume pay particular attention to Wittgenstein’s concern with the thick context of moral problems, his suspicion of theory, and his belief in description as the real aim of philosophy. Their aim is not to examine Wittgenstein’s personal moral convictions but rather to explore how a deep engagement with his work can illuminate some of the problems that medicine and biological science present.
As Elliott explains in his introduction, Wittgenstein’s philosophy runs against the grain of most contemporary bioethics scholarship, which all too often ignores the context in which moral problems are situated and pays little attention to narrative, ethnography, and clinical case studies in rendering bioethical judgments. Such anonymous, impersonal, rule-writing directives in which health care workers are advised how to behave is what this volume intends to counteract. Instead, contributors stress the value of focusing on the concrete particulars of moral problems and write in the spirit of Wittgenstein’s belief that philosophy should be useful. Specific topics include the concept of “good dying,” the nature of clinical decision making, the treatment of neurologically damaged patients, the moral treatment of animals, and the challenges of moral particularism.
Inspired by a philosopher who deplored “professional philosophy,” this work brings some startling insights and clarifications to contemporary ethical problems posed by the realities of modern medicine.

Contributors. Larry Churchill, David DeGrazia, Cora Diamond, James Edwards, Carl Elliott, Grant Gillett, Paul Johnston, Margaret Olivia Little, James Lindemann Nelson, Knut Erik Tranoy

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