Can the Hippocratic and Judeo-Christian traditions be synthesized with contemporary thought about practical reason, virtue and community to provide real-life answers to the dilemmas of healthcare today? Bishop Anthony Fisher discusses conscience, relationships and law in relation to the modern-day controversies surrounding stem cell research, abortion, transplants, artificial feeding and euthanasia, using case studies to offer insight and illumination. What emerges is a reason-based bioethics for the twenty-first century; a bioethics that treats faith and reason with equal seriousness, that shows the relevance of ancient wisdom to the complexities of modern healthcare scenarios and that offers new suggestions for social policy and regulation. Philosophical argument is complemented by Catholic theology and analysis of social and biomedical trends, to make this an auspicious example of a new generation of Catholic bioethical writing which has relevance for people of all faiths and none.

We who live in this post-modern late twentieth century culture are still children of dualism. For a variety of rather complex reasons we continue to split apart and treat as radical opposites body and spirit, medicine and religion, sacred and secular, private and public, love and justice, men and women. Though this is still our strong tendency, we are beginning to discover both the futility and the harm of such dualistic splitting. Peoples of many ancient cultures might smile at the belatedness of our discovery concerning the commonalities of medicine and religion. A cur sory glance back at ancient Egypt, Samaria, Babylonia, Persia, Greece, and Rome would disclose a common thread - the close union of religion and medicine. Both were centrally concerned with healing, health, and wholeness. The person was understood as a unity of body, mind, and spirit. The priest and the physician frequently were combined in the same individual. One of the important contributions of this significant volume of essays is the sustained attack upon dualism. From a variety of vantage points, virtually all of the authors unmask the varied manifestations of dualism in religion and medicine, urging a more holistic approach. Since the editor has provided an excellent summary of each article, I shall not attempt to comment on specific contributions. Rather, I wish to highlight three 1 broad themes which I find notable for theological ethics."

This volume offers a collection of writings on ethical issues regarding retarded persons. Because this important subject has been generally omitted from formal discussions of ethics, there is a great deal which needs to be addressed in a theoretical and critical way. Of course, many people have been very concerned with practical matters concerning the care of retarded persons such as what liberties, entitlements or advocacy they should have. Interestingly, because so much practical attention has been given to issues which are not discussed by ethical theorists, they offer a rare opportunity to evaluate ethical theories themselves. That is, certain theories which appear convincing on other subjects seem implausible when they are applied to reasoned and com pelling views we hold concerning retarded individuals. Our subject, then, has both practical and conceptual dimensions. More over, because it is one where pertinent information comes from many sources, contributors to this volume represent many fields, including philosophy, religion, history, law and medicine. We regret that it was not possible to include more points of view, like those of psychologists, sociologists, nurses and families. There is however, a good and longstanding literature on mental retardation from these perspectives."

This book arises from a two-fold conviction. The first is that autonomy, despite recent critiques about its importance in bioethics and philosophy of medicine, and the traditional resistance of medicine to its "intrusion" into the doctor-patient relation, is a fundamental building block of an individual's identity and mechanisms for dealing with illness, disease, and incapacity. As such it is an essential component in the health care professional's armamentarium employed to bring about healing. Furthennore, it functions in a similar way to assist the health professional in his or her relations to the sick and injured. The second conviction follows from the fITst. Autonomy is far more complex than appears from the philosophical use of the concept. In this conviction we join those who have criticized the over-reliance on autonomy in modem, secular bioethics originating in the United States, but gaining ascendancy in other cultures. This critique relies on appeals to the richer contexts of persons' lives. Elsewhere the contemporary critique of autonomy appears in a variety of alternative ethical models like narrative ethics, casuist ethics, and contextualism. Indeed, postmodern criticism of all bioethics argues that there is no defensible foundation for claims that one ought to respect autonomy or any other principle as a way of ensuring that one is ethical.

The Dutch experience has influenced the debate on euthanasia and death with dignity around the globe, especially with regard to whether physician-assisted suicide and euthanasia should be legitimized or legalized. A review of the literature reveals complex and often contradictory views about the Dutch experience. Some claim that the Netherlands offers a model for the world to follow; others believe that the Netherlands represents danger, rather than promise, and that the Dutch experience is the definitive answer regarding why we should not make active euthanasia and physician-assisted suicide part of our lives. Given these contradictory views, it has become clear that fieldwork is essential to developing a more informed opinion. Having investigated the Dutch experience for a number of years, and after thoroughly reading the vast literature published in English, I went to the Netherlands for one month in the summer of 1999 to get a feel for the local situation. I felt that this would provide the basis on which I could better interpret the findings of the available literature. I visited the major centers of medical ethics, as well as some research hospitals, and spoke with leading figures in the euthanasia policy and practice. The time spent was extremely beneficial and enriching. I followed in the footsteps of Carlos Gomez, who 1 published a book following one month of extensive research in the Netherlands.

The best things in my Ufe have come to me by accident and this book results from one such accident: my having the opportunity, out of the blue, to go to work as H. Tristram Engelhardt, Jr. 's, research assistant at the Institute for the Medical Humanities in the University of Texas Medi cal Branch at Galveston, Texas, in 1974, on the recommendation of our teacher at the University of Texas at Austin, Irwin C. Lieb. During that summer Tris "lent" me to Chester Bums, who has done important schol arly work over the years on the history of medical ethics. I was just finding out what bioethics was and Chester sent me to the rare book room of the Medical Branch Library to do some work on something called "medical deontology. " I discovered that this new field of bioethics had a history. This string of accidents continued, in 1975, when Warren Reich (who in 1979 made the excellent decisions to hire me to the faculty in bioethics at the Georgetown University School of Medicine and to persuade Andre Hellegers to appoint me to the Kennedy Institute of Ethics) took Tris Engelhardt's word for it that I could write on the history of modem medical ethics for Warren's major new project, the Encyclopedia of Bioethics. Warren then asked me to write on eighteenth-century British medical ethics."

This is an original contribution to the much debated area of the value that we should place on human life. With the euthanasia issue highlighted in the public arena this book argues for a non-absolutist highest value on life ethic and how that fits with society's current emphasis on individual autonomy. By the use of everyday examples the impact of placing a high value on life is explored. It will be useful for students of ethics, nursing and medicine and those engaged in the public debate on euthanasia.

This book contributes to an overall understanding of the nature and the impact of sexual boundary violations. By exploring an extreme human experience, childhood sexual abuse, the present study allows an insight into a hidden, silenced, and destructive aspect of human relations. It is the first of its kind to make comprehensible both the general path from violation to sickness, and the particular logic of assault embodiment. Due to its theoretical and methodological framework, the present study provides evidence that the embodiment of sexual violation experience is informed by situated logic and rationality. These, however, do not correspond to scientific logic and rationality. The universe of socio-culturally constituted meaning and that of scientifically constructed knowledge are shown to be incompatible. Subjectively informed violation embodiment is likely to be misinterpreted and consequently maltreated within the objectively grounded framework of current biomedical praxis. Consequently, victims of silenced sexual violence are revictimized by medicine.

PERSONHOOD AND HEALTH CARE This book arose as a result of a pre-conference devoted to the topic held June 28, 1999 in Paris, France. The pre-conference preceded the Annual Congress of the International Academy ofLaw and Mental Health. Other chapters were solicited after the conference in order to more completely explore the relation of personhood to health care. The pre conference was held in honor of Yves Pelicier who led so many of our French colleagues in medicine, philosophy, and ethics as Christian Herve notes in his Tribute. As health care is aimed at healing persons, it is important to realize how difficult it is to construct a theory of personhood for health care, and thus, a theory of how healing in health care comes about or ought to occur. The book is divided into four parts, Concepts of the Person, Theories of Personhood in Relation to Health Care and Bioethics, Person and Identity, and Personhood and Hs Relations. Each section explores a critical arena in constructing the relation of personhood to health care. Although no exploration ofthis nature can be exhaustive, every effort was made to present both conflicting and complementary views of personhood from within similar and different philosophical and religious traditions. PART ONE: CONCEPTS OF THE PERSON Tracing the origins of the concept of person from antiquity through present day, Jean Delemeau provides an historical sketch of the development of a wide range of meanings."

This book addresses well-known issues - the ethical, legal, and social implications of human genetics - but does so from an unusual perspective: the perspective of the scientific community itself. In distinction to what is common in the ELSI literature, the book also discusses bioethical method. A new kind of casuistry is developed on the basis of the empirical findings of cognitive semantics. It will be of interest to philosophers, bioethicists, geneticists, and policymakers.

The term bioethics' was coined in 1971, just as interest in the medical humanities claimed a prominent place in medical education. Out of this interest, a substantial area of research and scholarship took shape: the philosophy of medicine. This field has been directed to the epistemological, ontological, and value-theoretical issues occasioned by medicine and the biomedical sciences. Bioethics is nested in this field and can only be fully understood in terms of the foundational issues it addresses. This collection of essays in honor of Stuart F. Spicker, one of the individuals who gave shape to the philosophy of medicine, lays out the broad scope of concerns from the philosophy of embodiment, to issues of the role of ethics consultants, to concepts of disease, equity and the meaning of history.

This book is a part of the ongoing enterprise to understand the nature of human health and illness. This enterprise has expanded dramatically during the last decades. A great number of articles, as weIl as a fair number of monographs, on this topic have been published by renowned international publishers. In this discussion most participants share the idea that health is a partially normative concept, Le. that health is not a phe nomenon which can be wholly characterised in biological (or otherwise descriptive) terms. To ascribe health to a person is eo ipso, according to this line of thought, to as cribe a positively evaluated property to this person. Moreover, most debators share the idea that health is a holistic property, belonging to the person as a whole, whereas dis eases, injuries and defects are entities (or properties of entities) which can be very lim ited and and normally affect only a part of the individual. My own monograph belongs to this tradition. A feature of my position, which is not universally acknowledged in riyal theories, however, is my emphasis on the notion of ability as a fundament in the theory of health. In my formal characterisation of health I view it as astate of a person which is such that the person has the ability to fulfi1 his or her vital goals."

The editors have incurred many debts in preparing this book, and both etiquette and ethics would be contravened if they were not discharged here. Above all, we wish to thank the contributors for so cheerfully complying with our suggestions for preparing their papers for publication and efficiently meeting our schedules. It is thanks to their cooperation that this volume has appeared speedily and painlessly; their revisions have helped to give it internal coherence. This volume has emerged from papers delivered at a conference on the History of Medical Ethics, held at the Wellcome Institute for the History of Medicine, London, 1 December, 1989. We are most grateful to the Wellcome Trust for having underwritten the costs of the conference, and to Frieda Houser and Stephen Emberton whose organizational skills contributed so much to making it a smoothly-run and enjoyable day. In addition to the papers delivered at the conference, we are delighted to have secured further contributions from David Harley and Johanna Geyer-Kordesch. Our thanks to them for their eager help. From start to finish, we have received splendid encouragement from all those connected with the Philosophy and Medicine series, especially Professor Stuart Spicker, and Martin Scrivener at Kluwer Academic Publishers. Their enthusiasm has lightened our load, and expedited the editorial process.

K. Danner Clouser is one of the most important figures in establishing and shaping the fields of medical ethics, bioethics, and the philosophy of education in the second half of the twentieth century. Clouser challenged many established approaches to moral theory and offered innovative strategies for integrating the humanities into professional education, especially that of physicians and nurses. The contributions published in Building Bioethics: Conversations with Clouser and Friends on Medical Ethics are unique both in their devotion to a critical review of his contributions, and in bringing together internationally known figures in bioethics, medical ethics, and philosophy of medicine to comment upon Clouser's work. These leaders of the field include Tom Beauchamp, Daniel Callahan, James Childress, Nancy Dubler, H. Tristram Engelhardt, Al Jonsen, Loretta Kopelman, Larry McCullough, John Moskop, and Robert Veatch. This book merits special attention from those interested in bioethics, philosophy of medicine, medical ethics, philosophy, medical education, religious studies, and nursing education.

On May 13-15, 1982, some 50 scientists and scholars - physicians, philos ophers and social scientists - convened at Hasselby Castle in Stockholm for the first Nordic Symposium on the Philosophy of Medicine. The topics for the symposium included (1) the concepts of health and disease, (2) classification in medicine, and (3) causality and causal explanations in medicine. The majority of the participants were Scandinavian but the symposium was also able to welcome four distinguished guests from other parts of the world, Professors Stuart F. Spicker and H. Tristram Engelhardt, Jr., U.S.A., Dr Anne M. Fagot, France, and Dr Werner Morbach, West Germany. The latter represented Professor Kazem Sadegh-zadeh, who unfortunately was prevented from attending. One of the main purposes of this symposium was to bring together people in Scandinavia who at present work within the field of Philosophy of Medi cine. This group is still relatively small but is growing rapidly, and the scholarly activity has recently been notable. This fact is clearly demonstrated by the presentation of 'Philosophy of Medicine in Scandinavia' in the Appendix of this volume."

This volume introduces a new subseries of Philosophy and Medicine, Classics of Medical Ethics. The purpose of this new subseries is to bring out scholars' editions of major works in the history of medical ethics and philosophy of medicine. This new subseries will target for publication texts that are long out of print and difficult to access. Each volume will contain an introduction to the writings on medical ethics and philosophy of medicine produced by the original author. Each volume will also contain a guide to the primary and major secondary Hterature, to facilitate teaching and scholarship in bioethics, philosophy of medicine, and history of medicine. Texts will be presented in their origi nal style and will provide pagination of the original, so that citations can be made either to the original text or to the page numbers in these vol umes. Finally, each volume will be well indexed, again to facilitate teaching and research. Bioethics and philosophy of medicine - the former more so than the latter - have an insufficiently developed understanding of themselves as having a history. As a consequence, these fields lack the maturity that critical dialogue of the past with the present provides for other fields and disciplines of the humanities. To the extent that this problem is due to the fact that major primary historical sources are not readily available, this subseries will contribute to the further development and maturation of bioethics and philosophy of medicine as fields of the humanities."

debating (and possibly ratifying) the Convention at the national level 13]. The Convention identified basic principles necessary for the applica tion of medicine and the life sciences. It set out to protect the dignity and identity of all human beings: ''The interests and welfare of the human being shall prevail over the sole interest of society or science" (art. 2). It also requests that appropriate measures be taken to provide equitable access to healthcare of appropriate quality. The principle of respecting the free and informed consent of the person is clearly stressed. The issue of interventions on persons unable to provide an informed consent has been controversial for a long time; in the first draft, the exact formulation of the relevant article remained open. Now it states that interventions may be carried out on persons with impaired decision-making capacities, but only for their benefit, and only if minimal risks and minimal burdens are imposed. Consensus apparently exists over a broad range of issues. Privacy and free access to information are defined as rights, in article 10. Discrimination against a person on the basis of his or her genetic heritage is prohibited. Sex selection in medically assisted procreation is prohibited (except to avoid serious hereditary, sex-related diseases). Financial gain from using the human body and its parts is explicitly prohibited. The more controversial issues in bioethics are not addressed in this Convention, however. An exception is research on embryos in vitro."

Papers presented at a symposium on philosophy and medicine at the Institute for the Medical Humanities at the University of Texas Medical Branch in 1974 were published in the inaugural volume of this series. To help celebrate more than 20 years of extraordinary success with the series, another symposium was convened in Galveston in 1995. The convenors asked the participants these questions: In what ways and to what ends have academic humanists and medical scientists and practitioners become serious conversation partners in recent years? How have their dialogues been shaped by prevailing social views, political philosophies, academic habits, professional mores, and public pressures? What have been the key concepts and questions of these dialogues? Have the dialogues made any appreciable intellectual or social difference? Have they improved the care of the sick? Authors respond from a variety of theoretical perspectives in the humanities. They also articulate conceptions of philosophy of medicine and bioethics from various practice experiences, and bring critical attention to aspects of the contemporary health policy.

Besides offering a critical analysis of the WHO definition and a review of both ancient and contemporary conceptions of health, the cooperative effort of physicians and philosophers presented in this book works through the challenges which any definition of health faces, if it is to be both truly personalist, and at the same time operational.
The overall purpose of this book is to capture the essentials of human health and to propose the outlines for a personalist understanding of this concept, i.e., a conception that does justice to the personal nature of human beings by introducing dimensions that are essential to personal life and well-being, such as the realms of rationality, affectivity and freedom, the realms of meaning, values, morality, and spirituality, the realms of social and interpersonal relations.

Science, Technology, and the Art of Medicine contains papers by eminent scholars who discuss issues and concepts regarding the character of medicine. Special attention is given to the extent to which medicine is a science, art, and technology. Investigations are carried out with a particular focus on the nature of medical knowledge. Concepts of medical research, medical causality, intuition, and medical decision-making are examined in the light of medicine's revolutionary advances in the twentieth century. Past perspectives and present perplexities are also examined, bringing together a volume in the philosophy of medicine that treats a broad range of issues in medical epistemology and practise in a careful, critical fashion.

Positive conceptions of healthy aging are rightly displacing negative ageist perceptions of older members of our society. Nevertheless, at some stage, most elderly citizens will require some form of assistance from other members of society. When the body or mind begins to fail, a legitimate need for intervention and care will arise. This second volume on Aging discusses this theme.

Decisions at the End of Life is the last volume in a trilogy on Aging conceived for the International Library of Ethics, Law, and the New Medicine. Leading scholars from a range of disciplines examine some of the most emotive topics in the study of aging: assessing quality of life, improving end-of-life care, palliative care, euthanasia, and consent to research.

Nanobiotechnology is the convergence of existing and new biotechnology with the 1 ability to manipulate matter at or near the molecular level. This ability to manipulate matter on a scale of 100 nanometers (nm) or less is what constitutes the nanotechnology revolution occurring today, the potentially vast economic and social implications of which are yet to be fully understood (Royal Society, 2004). The most immediate way to understand the implications of nanobiotechnology for ethics is to consider the real life concerns of communities that are mobilizing within civil society. The conflicts and ethical debates surrounding nanotechnology will, almost by definition, emerge on the fault lines between different civil society actors, researchers and financial interests associated with nanobiotechnology, as well as (potentially) government regulators. These fault lines are all reflected within the concerns (as expressed d- cursively) of the communities mobilizing. This chapter will explore converging d- courses regarding converging technologies. Converging Technologies (CT) are already a familiar theme in the next gene- tion of biotechnology, nanotechnology, pharmacogenomics and proteomics research 2 and development. Nanobiotechnology means that previously separate disciplines (IT, physics, chemistry, and biology) are merging and converging to create new applications and even new life forms through converged technological platforms. Schummer (2004), and Glimell and Fogelberg (2003, p. 43), note the predominance of interdisciplinarity as a core theme of nano-discourse.