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Bioethics in a Liberal Society

The Political Framework of Bioethics Decision Making

Thomas May

Publication Year: 2002

Issues concerning patients' rights are at the center of bioethics, but the political basis for these rights has rarely been examined. In Bioethics in a Liberal Society: The Political Framework of Bioethics Decision Making, Thomas May offers a compelling analysis of how the political context of liberal constitutional democracy shapes the rights and obligations of both patients and health care professionals. May focuses on how a key feature of liberal society—namely, an individual's right to make independent decisions—has an impact on the most important relational facets of health care, such as patients' autonomy and professionals' rights of conscience. Although a liberal political framework protects individual judgments, May asserts that this right is based on the assumption of an individual's competency to make sound decisions. May uses case studies to examine society's approach to medical decision making when, for reasons ranging from age to severe mental disorder, a person lacks sufficient competency to make independent and fully informed choices. To protect the autonomy of these vulnerable patients, May emphasizes the need for health care ethics committees and ethics consultants to help guide the decision-making process in clinical settings. Bioethics in a Liberal Society is essential reading for all those interested in understanding how bioethics is practiced within our society.

Published by: The Johns Hopkins University Press

Title Page, Copyright

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Contents

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pp. v-vi

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Preface

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pp. vii-x

Throughout this book, I examine the rights and obligations that result from a liberal society’s attempt to “balance” the autonomy of different individuals interacting in a common social setting. Along the way, I explore how a liberal perspective on autonomy and patient rights should shape our understanding of competency, ...

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Acknowledgments

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pp. xi-xii

Many people contributed to the completion of this project. I would like to thank in particular Mark Aulisio, Jana Craig, and John Tomkowiak for comments and discussions that greatly improved the arguments in this book, and Laura Dillon and LaVar Matthews for their help in preparing the manuscript. ...

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1. Introduction: The Liberal Framework

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pp. 1-10

Developments in medical technology offer tremendous advantages in many very important areas of life. But in making available treatment options that did not previously exist, these developments can infringe on other very important areas of life in ways once unfathomable. ...

I. Patient Autonomy

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2. Patient Autonomy and Informed Consent

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pp. 13-31

Any discussion of bioethics in the context of a liberal constitutional political framework must begin with an examination of patient autonomy and informed consent. Health care touches on value questions that are taken to be among the most important and profound in a person’s life. ...

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3. Patient Responsibility for Decision Making

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pp. 32-53

Many of the most important advancements in providing humane and responsible health care in recent decades can be traced to an increased emphasis that has been placed on patient autonomy. As might be expected, the greater focus on informed consent has been accompanied by a set of problematic cases. ...

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4. Advance Directives: Extending Autonomy for Patients

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pp. 54-78

Although a competent patient has the right to refuse treatment necessary to sustain life, for many end-of-life decisions we lack direct access to the wishes of a competent patient. Some treatment decisions near the end of life involve patients with severely diminished mental capacity (e.g., those with Alzheimer disease), ...

II. Professional Rights of Conscience

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5. Beneficence, Abandonment, and the Duty to Treat

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pp. 81-97

The practice of health care, with its long history of paternalism (in which the physician acted as sole arbiter in health care decisions), has only recently begun to recognize the important role of patient autonomy. Health care providers bring to the provider-patient relationship substantive moral beliefs of their own. ...

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6. Rights of Conscience in the Physician-Patient Relationship

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pp. 98-114

Professional life in a liberal constitutional society involves a balancing of values between professional and client. This is commonly accomplished through negotiation, but in some areas of life the values in question are so fundamental and important that negotiated compromise is difficult, if not impossible. ...

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7. Conclusion: Health Care Ethics Committees and Consultants in a Liberal Framework

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pp. 115-126

Throughout, I have focused on the implications of a liberal political and social context for bioethics decision making. Protecting an individual’s right to frame the values that guide her life is, as we have seen, a fundamental concern of our liberal society. Now I will examine how the concern to respect patient autonomy ...

References

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pp. 127-132

Index

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pp. 133-135


E-ISBN-13: 9780801876486
E-ISBN-10: 0801876486
Print-ISBN-13: 9780801892820
Print-ISBN-10: 0801892821

Page Count: 152
Publication Year: 2002