This volume developed from and around a series of six lectures sponsored by Rice University and the University of Texas Medical Branch at Galveston in the Fall of 1976. Though these lectures on the concepts of mental health, mental illness and personal responsibility, and the social treatment of the mentally ill were given to general audiences in Houston and Galveston, they were revised and expanded to produce six extensive formal essays by Dan Brock, Jules Coleman, Joseph Margolis, Michael Moore, Jerome Neu, and Rolf Sartorius. The five remaining contributions by Daniel Creson, Corinna Delkeskamp, Edmund Erde, James Speer, and Stephen Wear were in various ways engendered by the debates occasioned by the original six lectures. In fact, the majority of the last five contributions emerged from informal dis. cussions occasioned by the original lecture series. The result is an interlocking set of essays that address the law and public policy insofar as they bear on the treatment of the mentally ill, special atten. tion being given to the defmition of mental illness, generally and in the law, to the issues of the bearing of mental incompetence in cases of criminal and civil liability, and to the issue of involuntary commitment for the purpose of treatment or for institutional care. There is as well a critical defense of Thomas Szasz's radical proposal that mental illnesses are best understood as problems in living, not as diseases."

As the field of bioethics has matured, increasing attention is being paid to how bioethical issues are treated in different moral and religious traditions and in different regions of the world. It is often difficult, however, to obtain accurate information about these matters. The Bioethics Yearbook series provides interested parties with analyses of how such issues as new reproductive techniques, abortion, maternal-fetal conflicts, care of seriously ill newborns, consent, confidentiality, equitable access, cost-containment, withholding and withdrawing treatment, active euthanasia, the definition of death, and organ transplantation are being discussed in different religious traditions and regions. Volume Three discusses theological developments from 1990--1992 in Anglican, Baptist, Buddhist, Catholic, Continental Protestant, Eastern Orthodox, Hindu, Jewish, Latter-Day Saint, Lutheran, Methodist, Muslim, and Presbyterian traditions. Volume Four will continue coverage of official governmental and medical society policies on these topics throughout the world.

As the field of bioethics has matured, increasing attention is being paid to how bioethical issues are treated in different moral and religious traditions and in different parts of the world. It is often difficult, however, to get accurate information about these matters. The Bioethics Yearbook Series provides interested parties with analyses of how such issues as new reproductive techniques, abortion, maternal-fetal conflicts, care of seriously ill newborns, consent, confidentiality, equitable access, cost-containment, withdrawing treatment, active euthanasia, the definition of death, and organ transplantation are being discussed in these different traditions and different parts of the world. The first volume, and every second succeeding volume, will discuss developments in the Anglican, Baptist, Buddhist, Catholic, Eastern Orthodox, Hindu, Jewish, LDS, Lutheran, Methodist, Muslim, and Presbyterian Traditions. The second volume, and every second volume succeeding it, will discuss official governmental and medical society policies on these topics throughout the world.

principles. A second solution to this problem is to develop a scale for weighing the significance of the conflicting principles in a given case and for concluding which action should be adopted because it is supported by the weightier considerations in that case. Such a solution seems more realistic than the lexical ordering approach, but the development of such a scale is a problematic task. Still other, more complex solutions are possible. Which is the best solution to this problem of conflicting principles of bioethics? We need a moral theory to answer that question. This is the first reason for concluding that the principles of bioethics are not the true foundations of justified judgment in bioethics. What is the problem of the unclear scope and implications of the principles of bioethics and how can an appeal to moral theory help deal with that problem? The scope of a bioethical principle is the range of cases in which it applies. The implications of a bioethical principle are the conclusions to be derived from that principle in those cases in which it applies. It is clear from a review of the discussions in bioethics that there are major unclarities about the scope and implications of each of the principles. Consider, for example, the principle of autonomy.

B. Andrew Lustig, Baruch A. Brody, and Gerald P. McKenny Nearly every week the general public is treated to an announcement of another actual or potential "breakthrough" in biotechnology. Headlines trumpet advances in assisted reproduction, current or prospective experiments in cloning, and devel- ments in regenerative medicine, stem cell technologies, and tissue engineering. Scientific and popular accounts explore the perils and the possibilities of enhancing human capacities by computer-based, biomolecular, or mechanical means through advances in artificial intelligence, genetics, and nanotechnology. Reports abound concerning ever more sophisticated genetic techniques being introduced into ag- culture and animal husbandry, as well as efforts to enhance and protect biodiversity. Given the pace of such developments, many insightful commentators have proclaimed the 21st century as the "biotechnology century. " Despite a significant literature on the morality of these particular advances in biotechnology, deeper ethical analysis has often been lacking. Our preliminary review of that literature suggested that current discussions of normative issues in biotechnology have suffered from two major deficiencies. First, the discussions have been too often piecemeal in character, limited to after-the-fact analyses of particular issues that provoked the debate, and unconnected to larger concepts and themes. Second, a crucial missing element of those discussions has been the failure to reflect explicitly on the diverse disciplinary conceptions of nature and the natural that shape moral judgments about the legitimacy of specific forms of research and their applications.

B. Andrew Lustig, Baruch A. Brody, and Gerald P. McKenny In this second volume of the "Altering Nature" project, we situate specific religious and policy discussions of four broad areas of biotechnology within the context of our interdisciplinary research on concepts of nature and the natural in the first volume (Altering Nature, Concepts of Nature and the Natural in Biotechnology Debates). In the first volume, we invited five groups of scholars to explore the diverse conc- tions of nature and the natural that shape moral judgments about human alterations of nature, as especially exemplified by recent developments in biotechnology. A careful reading of such developments reveals that assessments of them-whether positive or negative-are often informed by different conceptual interpretations of nature and the natural, with differing implications for judgments about the app- priateness of particular alterations of nature. These varying interpretations of nature and the natural often result from the distinctive perspectives that characterize va- ous scholarly disciplines. Therefore, in an effort to explore the variety of meanings that attend discussions of the concepts of nature and the natural, the contributors to the first volume of Altering Nature addressed those concepts from five different disciplinary vantages. A first group of scholars analyzed a range of religious and spiritual perspectives on concepts of nature and the natural. Their research highlighted the thematic, h- torical, and methodological touchstones in those traditions that shape their persp- tives on nature.

As noted in Volume 1, the Yearbook series alternates between a biennial volume tracing recent theological discussions on topics in bioethics and a biennial volume tracing recent regional discussions in bioethics. Volume 2 provides for the first time a comprehensive single-volume summary of recent international and regional developments on specific topics in bioethics. To give uniformity to the discussions all authors were asked to report on the following topics: new reproductive technologies, abortion, maternal-fetal conflicts, case of severely disabled newborns, consent of treatment and experimentation, confidentiality, equitable access to health care, ethical concerns raised by cost-containment measures, decisions to withhold or withdraw life-sustaining treatment, active euthanasia, the definition of death, organ donation and transplantation. The internationally respected contributors report on the following 16 areas: the United States, Canada, Latin America, the United Kingdom and Ireland, France, the Netherlands, Germany/Austria/Switzerland, Eastern Europe, Spain/Portugal/Italy/Scandinavia, India, Southeast Asia, China, Japan, Australia/New Zealand, Council of Europe/EEC. The commentators draw on three sets of resources: Statutes, legislative proposals, and regulatory changes that directly influence, or have implications for, areas of bioethical concern; Case law and court judgments that shape, either decisively or suggestively, recent legal interpretations of particular issues of areas in bioethics; Formal statements of governmentally appointed commissions, advisory bodies, and representative professional groups, as well as less formal statements and recommendations of other organisations. In addition to providing timely summaries of recent developments, the volume offers rich and useful bibliographical references to a wide array of documents, many of which would be difficult for readers to learn about, given the lack of centralized international collection of such documents. The Yearbook should be widely consulted by all bioethicists, public policy analysts, lawyers and theologians.

As the field of bioethics has matured, increasing attention is being paid to how bioethical issues are treated in different moral and religious traditions and in different parts of the world. It is often difficult, however, to get accurate information about these matters. The Bioethics Yearbook Series provides interested parties with analyses of how such issues as new reproductive techniques, abortion, maternal-fetal conflicts, care of seriously ill newborns, consent, confidentiality, equitable access, cost-containment, withdrawing treatment, active euthanasia, the definition of death, and organ transplantation are being discussed in these different traditions and different parts of the world. The first volume, and every second succeeding volume, will discuss developments in the Anglican, Baptist, Buddhist, Catholic, Eastern Orthodox, Hindu, Jewish, LDS, Lutheran, Methodist, Muslim, and Presbyterian Traditions. The second volume, and every second volume succeeding it, will discuss official governmental and medical society policies on these topics throughout the world.

principles. A second solution to this problem is to develop a scale for weighing the significance of the conflicting principles in a given case and for concluding which action should be adopted because it is supported by the weightier considerations in that case. Such a solution seems more realistic than the lexical ordering approach, but the development of such a scale is a problematic task. Still other, more complex solutions are possible. Which is the best solution to this problem of conflicting principles of bioethics? We need a moral theory to answer that question. This is the first reason for concluding that the principles of bioethics are not the true foundations of justified judgment in bioethics. What is the problem of the unclear scope and implications of the principles of bioethics and how can an appeal to moral theory help deal with that problem? The scope of a bioethical principle is the range of cases in which it applies. The implications of a bioethical principle are the conclusions to be derived from that principle in those cases in which it applies. It is clear from a review of the discussions in bioethics that there are major unclarities about the scope and implications of each of the principles. Consider, for example, the principle of autonomy.

This volume developed from and around a series of six lectures sponsored by Rice University and the University of Texas Medical Branch at Galveston in the Fall of 1976. Though these lectures on the concepts of mental health, mental illness and personal responsibility, and the social treatment of the mentally ill were given to general audiences in Houston and Galveston, they were revised and expanded to produce six extensive formal essays by Dan Brock, Jules Coleman, Joseph Margolis, Michael Moore, Jerome Neu, and Rolf Sartorius. The five remaining contributions by Daniel Creson, Corinna Delkeskamp, Edmund Erde, James Speer, and Stephen Wear were in various ways engendered by the debates occasioned by the original six lectures. In fact, the majority of the last five contributions emerged from informal dis. cussions occasioned by the original lecture series. The result is an interlocking set of essays that address the law and public policy insofar as they bear on the treatment of the mentally ill, special atten. tion being given to the defmition of mental illness, generally and in the law, to the issues of the bearing of mental incompetence in cases of criminal and civil liability, and to the issue of involuntary commitment for the purpose of treatment or for institutional care. There is as well a critical defense of Thomas Szasz's radical proposal that mental illnesses are best understood as problems in living, not as diseases."

B. Andrew Lustig, Baruch A. Brody, and Gerald P. McKenny In this second volume of the "Altering Nature" project, we situate specific religious and policy discussions of four broad areas of biotechnology within the context of our interdisciplinary research on concepts of nature and the natural in the first volume (Altering Nature, Concepts of Nature and the Natural in Biotechnology Debates). In the first volume, we invited five groups of scholars to explore the diverse conc- tions of nature and the natural that shape moral judgments about human alterations of nature, as especially exemplified by recent developments in biotechnology. A careful reading of such developments reveals that assessments of them-whether positive or negative-are often informed by different conceptual interpretations of nature and the natural, with differing implications for judgments about the app- priateness of particular alterations of nature. These varying interpretations of nature and the natural often result from the distinctive perspectives that characterize va- ous scholarly disciplines. Therefore, in an effort to explore the variety of meanings that attend discussions of the concepts of nature and the natural, the contributors to the first volume of Altering Nature addressed those concepts from five different disciplinary vantages. A first group of scholars analyzed a range of religious and spiritual perspectives on concepts of nature and the natural. Their research highlighted the thematic, h- torical, and methodological touchstones in those traditions that shape their persp- tives on nature.

As noted in Volume 1, the Yearbook series alternates between a biennial volume tracing recent theological discussions on topics in bioethics and a biennial volume tracing recent regional discussions in bioethics. Volume 2 provides for the first time a comprehensive single-volume summary of recent international and regional developments on specific topics in bioethics. To give uniformity to the discussions all authors were asked to report on the following topics: new reproductive technologies, abortion, maternal-fetal conflicts, case of severely disabled newborns, consent of treatment and experimentation, confidentiality, equitable access to health care, ethical concerns raised by cost-containment measures, decisions to withhold or withdraw life-sustaining treatment, active euthanasia, the definition of death, organ donation and transplantation. The internationally respected contributors report on the following 16 areas: the United States, Canada, Latin America, the United Kingdom and Ireland, France, the Netherlands, Germany/Austria/Switzerland, Eastern Europe, Spain/Portugal/Italy/Scandinavia, India, Southeast Asia, China, Japan, Australia/New Zealand, Council of Europe/EEC. The commentators draw on three sets of resources: Statutes, legislative proposals, and regulatory changes that directly influence, or have implications for, areas of bioethical concern; Case law and court judgments that shape, either decisively or suggestively, recent legal interpretations of particular issues of areas in bioethics; Formal statements of governmentally appointed commissions, advisory bodies, and representative professional groups, as well as less formal statements and recommendations of other organisations. In addition to providing timely summaries of recent developments, the volume offers rich and useful bibliographical references to a wide array of documents, many of which would be difficult for readers to learn about, given the lack of centralized international collection of such documents. The Yearbook should be widely consulted by all bioethicists, public policy analysts, lawyers and theologians.

B. Andrew Lustig, Baruch A. Brody, and Gerald P. McKenny Nearly every week the general public is treated to an announcement of another actual or potential "breakthrough" in biotechnology. Headlines trumpet advances in assisted reproduction, current or prospective experiments in cloning, and devel- ments in regenerative medicine, stem cell technologies, and tissue engineering. Scientific and popular accounts explore the perils and the possibilities of enhancing human capacities by computer-based, biomolecular, or mechanical means through advances in artificial intelligence, genetics, and nanotechnology. Reports abound concerning ever more sophisticated genetic techniques being introduced into ag- culture and animal husbandry, as well as efforts to enhance and protect biodiversity. Given the pace of such developments, many insightful commentators have proclaimed the 21st century as the "biotechnology century. " Despite a significant literature on the morality of these particular advances in biotechnology, deeper ethical analysis has often been lacking. Our preliminary review of that literature suggested that current discussions of normative issues in biotechnology have suffered from two major deficiencies. First, the discussions have been too often piecemeal in character, limited to after-the-fact analyses of particular issues that provoked the debate, and unconnected to larger concepts and themes. Second, a crucial missing element of those discussions has been the failure to reflect explicitly on the diverse disciplinary conceptions of nature and the natural that shape moral judgments about the legitimacy of specific forms of research and their applications.

"Ethik und Affentliches Gesundheitswesen" wendet sich an alle mA1/4ndigen und an der Struktur und Ethik des Affentlichen Gesundheitswesens interessierten BA1/4rger, vor allem aber an Mediziner und Medizinpolitiker, GesundheitsAkonomen, Philosophen, Ethiker und Politiker und an die Vertreter der VerbAnde im Gesundheitswesen. Die BeitrAge dieses Buches leisten einen Beitrag zur aktuellen Diskussion A1/4ber die Kostenexplosion im Gesundheitswesen und seine notwendige Reform. Die ethischen Aspekte der PatientenmA1/4ndigkeit und der VorzA1/4ge einer marktwirtschaftlichen Reform werden besonders herausgestellt. Durch einen Vergleich mit den Gesundheitssystemen der USA, der UdSSR, Frankreichs und Englands gewinnt die gegenwArtige Diskussion in der Bundesrepublik an Konturen.