Do people of differing ethnicities, cultures, and races view medicine and bioethics differently? And, if they do, should they? Are doctors and researchers taking environmental perspectives into account when dealing with patients? If so, is it done effectively and properly? In "African American Bioethics", Lawrence J. Prograis Jr. and Edmund D. Pellegrino bring together medical practitioners, researchers, and theorists to assess one fundamental question: Is there a distinctive African American bioethics? The book's contributors resoundingly answer yes - yet their responses vary. They discuss the continuing African American experience with bioethics in the context of religion and tradition, work, health, and U.S. society at large - finding enough commonality to craft a deep and compelling case for locating a black bioethical framework within the broader practice, yet recognizing profound nuances within that framework. As a more recent addition to the study of bioethics, cultural considerations have been playing catch-up for nearly two decades. "African American Bioethics" does much to advance the field by exploring how medicine and ethics accommodate differing cultural and racial norms, suggesting profound implications for growing minority groups in the United States.

CATHOLIC PERSPECTIVES AND CONTEMPORARY MEDICAL MORALS A Catholic perspective on medical morals antedates the current world wide interest in medical and biomedical ethics by many centuries 5]. Discussions about the moral status of the fetus, abortion, contraception, and sterilization can be found in the writings of the Fathers and Doctors of the Church. Teachings on various aspects of medical morals were scattered throughout the penitential books of the early medieval church and later in more formal treatises when moral theology became recog nized as a distinct discipline. Still later, medical morality was incorpor ated into the many pastoral works on medicine. Finally, in the contemporary period, works that strictly focus on medical ethics are produced by Catholic moral theologians who have special interests in matters medical. Moreover, this long tradition of teaching has been put into practice in the medical moral directives governing the operation of hospitals under Catholic sponsorship. Catholic hospitals were monitored by Ethics Committees long before such committees were recommended by the New Jersey Court in the Karen Ann Quinlan case or by the President's Commission in 1983 ( 8, 9]). Underlying the Catholic moral tradition was the use of the casuistic method, which since the 17th and 18th centuries was employed by Catholic moralists to study and resolve concrete clinical ethical dilem mas. The history of casuistry is of renewed interest today when the case method has become so widely used in the current revival of interest in medical ethics ll]."

CATHOLIC PERSPECTIVES AND CONTEMPORARY MEDICAL MORALS A Catholic perspective on medical morals antedates the current world wide interest in medical and biomedical ethics by many centuries 5]. Discussions about the moral status of the fetus, abortion, contraception, and sterilization can be found in the writings of the Fathers and Doctors of the Church. Teachings on various aspects of medical morals were scattered throughout the penitential books of the early medieval church and later in more formal treatises when moral theology became recog nized as a distinct discipline. Still later, medical morality was incorpor ated into the many pastoral works on medicine. Finally, in the contemporary period, works that strictly focus on medical ethics are produced by Catholic moral theologians who have special interests in matters medical. Moreover, this long tradition of teaching has been put into practice in the medical moral directives governing the operation of hospitals under Catholic sponsorship. Catholic hospitals were monitored by Ethics Committees long before such committees were recommended by the New Jersey Court in the Karen Ann Quinlan case or by the President's Commission in 1983 ( 8, 9]). Underlying the Catholic moral tradition was the use of the casuistic method, which since the 17th and 18th centuries was employed by Catholic moralists to study and resolve concrete clinical ethical dilem mas. The history of casuistry is of renewed interest today when the case method has become so widely used in the current revival of interest in medical ethics ll]."

In the 1850s, "Drapetomania" was the medical term for a disease found among black slaves in the United States. The main symptom was a strange desire to run away from their masters. In earlier centuries gout was understood as a metabolic disease of the affluent, so much so that it became a badge of uppercrust honor -- and a medical excuse to avoid hard work. Today, is there such a thing as mental illness, or is mental illness just a myth? Is Alzheimer's really a disease? What is menopause -- a biological or a social construction?Historically one can see that health, disease, and illness are concepts that have been ever fluid. Modern science, sociology, philosophy, even society -- among other factors -- constantly have these issues under microscopes, learning more, defining and redefining ever more exactly. Yet often that scrutiny, instead of leading toward hard answers, only leads to more questions. Health, Disease, and Illness brings together a sterling list of classic and contemporary thinkers to examine the history, state, and future of ever-changing "concepts" in medicine. Divided into four parts -- Historical Discussions; Characterizing Health, Disease, and Illness; Clinical Applications of Health and Disease; and Normalcy, Genetic Disease, and Enhancement: The Future of the Concepts of Health and Disease -- the reader can see the evolutionary arc of medical concepts from the Greek physician Galen of Pergamum (ca. 150 ce) who proposed that "the best doctor is also a philosopher," to contemporary discussions of the genome and morality. The editors have recognized a crucial need for a deeper integration of medicine and philosophy with each other, particularly in an age of dynamicallychanging medical science -- and what it means, medically, philosophically, to be human.

Edmund D. Pellegrino has played a central role in shaping the fields of bioethics and the philosophy of medicine. His writings encompass original explorations of the healing relationship, the need to place humanism in the medical curriculum, the nature of the patient's good, and the importance of a virtue-based normative ethics for health care. In this anthology, H. Tristram Engelhardt, Jr., and Fabrice Jotterand have created a rich presentation of Pellegrino's thought and its development. Pellegrino's work has been dedicated to showing that bioethics must be understood in the context of medical humanities, and that medical humanities, in turn, must be understood in the context of the philosophy of medicine. Arguing that bioethics should not be restricted to topics such as abortion, third-party-assisted reproduction, physician-assisted suicide, or cloning, Pellegrino has instead stressed that such issues are shaped by foundational views regarding the nature of the physician-patient relationship and the goals of medicine, which are the proper focus of the philosophy of medicine.

This literally "refreshing" collection is based on the notion that the future of bioethics is inseparable from its past. Seminal works provide a unique and relatively unexplored vehicle for investigating not only where bioethics began, but where it may be going as well. In this volume, a number of the pioneers in bioethics - Tom Beauchamp, Lisa Sowle Cahill, James Childress, Charles E. Curran, Patricia King, H. Tristram Engelhardt, William F. May, Edmund D. Pellegrino, Warren Reich, Robert Veatch and LeRoy Walters - reflect on their early work and how they fit into the past and future of bioethics. Coming from many disciplines, generations, and perspectives, these trailblazing authors provide a broad overview of the history and current state of the field. Invaluable to anyone with a serious interest in the development and future of bioethics, at a time when new paths into medical questions are made almost daily, "The Story of Bioethics" is a Baedeker beyond compare.

Twenty leading experts in the bioethics debate here engage matters of dignity and dying from a Christian perspective. The book begins with essays by David Schiedermayer, Arlene Miller, and Gregory Waybright that root the book in the experience of dying itself. This is followed by contributions from Nigel Cameron, John Dunlop, Marsha Fowler, and Allen Verhey on the topics that provide the guiding vision for approaches to dignity and dying: autonomy, death, suffering, and faithfulness. Four of the most pressing end-of-life challenges-forgoing treatment, medical futility, definition of death, and assisted suicide/euthanasia-are then examined by John Kilner, Christopher Hook, Holly Vautier, and Edmund Pellegrino. The next section, with contributions from Ben Mitchell, Jerome Wernow, Arthur Dyck, and Henk Jochemsen, is devoted to investigations of key settings where people have wrestled with these challenges: Nazi Germany; Oregon; North American legal systems; and the Netherlands. Finally, the book concludes with discussions of five potentially constructive alternatives to the premature ending of life: hospice care (by Martha Twaddle); long-term care (by James Thobaben); wise advocacy (by James Reitman); parish nursing (by Norma Small); and congregational ministry (by Dennis Hollinger).

In this companion volume to their 1981 work, A Philosophical Basis of Medical Practice, Pellegrino and Thomasma examine the principle of beneficence and its role in the practice of medicine. Their analysis, which is grounded in a thorough-going philosophy of medicine, addresses a wide array of practical and ethical concerns that are a part of health care decision-making today. Among these issues are the withdrawing and withholding of nutrition and hydration, competency assessment, the requirements for valid surrogate decision-making, quality-of-life determinations, the allocation of scarce health care resources, medical gatekeeping, and for-profit medicine. The authors argue for the restoration of beneficence (re-interpreted as beneficence-in-trust) to its place as the fundamental principle of medical ethics. They maintain that to be guided by beneficence a physician must perform a right and good healing action which is consonant with the individual patient's values. In order to act in the patient's best interests, or the patient's good, the physician and patient must discern what that good is. This knowledge is gained only through a process of dialogue between patient and/or family and physician which respects and honors the patient's autonomous self-understanding and choice in the matter of treatment options. This emphasis on a dialogical discernment of the patient's good rejects the assumption long held in medicine that what is considered to be the medical good is necessarily the good for this patient. In viewing autonomy as a necessary condition of beneficence, the authors move beyond a trend in the medical ethics literature which identifies beneficence with paternalism. In their analysis of beneficence, the authors reject the current emphasis on rights- and duty-based ethical systems in favor of a virtue-based theory which is grounded in the physician-patient relationship. This book's provocative contributions to medical ethics will be of great interest not only to physicians and other health professionals, but also to ethicists, students, patients, families, and all others concerned with the relationship of professional to patient and patient to professional in health care today.

This collection of essays, commissioned by the President's Council on Bioethics, explores a fundamental concept crucial to today's discourse in law and ethics in general and in bioethics in particular. Since its formation in 2001, the council has frequently used the term "human dignity" in its discussions and reports. In this volume scholars from the fields of philosophy, medicine and medical ethics, law, political science, and public policy address the issue of what the concept of "human dignity" entails and its proper role in bioethical controversies. Human Dignity and Bioethics is an attempt to clarify a controversial concept, one that is a critical component in the decisions of policymakers. Contributors: Adam Schulman, F. Daniel Davis, Daniel C. Dennett, Robert P. Kraynak, Alfonso Gomez-Lobo, Patricia S. Churchland, Gilbert Meilaender, Holmes Rolston III, Charles Rubin, Nick Bostrom, Richard John Neuhaus, Peter Augustine Lawler, Diana Schaub, Leon R. Kass, Susan M. Shell, Martha Nussbaum, David Gelernter, Patrick Lee, Robert P. George, Paul Weithman, Daniel P. Sulmasy, O.F.M., Rebecca Dresser, and Edmund D. Pellegrino.

Drawing on multiple interconnected scriptural and spiritual sources, the Jewish tradition of ethical reflection is intricate and nuanced. This book presents scholarly Jewish perspectives on suffering, healing, life, and death, and it compares them with contemporary Christian and secular views.

The Jewish perspectives presented in this book are mainly those of orthodox scholars, with the responses representing primarily Christian-Catholic points of view. Readers unfamiliar with the Jewish tradition will find here a practical introduction to its major voices, from Spinoza to Jewish religious law. The contributors explore such issues as active and passive euthanasia, abortion, assisted reproduction, genetic screening, and health care delivery.

Offering a thoughtful and thought-provoking dialogue between Jewish and Christian scholars, Jewish and Catholic Bioethics is an important contribution to ecumenical understanding in the realm of health care.

Exploring the moral foundations of the healing relationship, Edmund D. Pellegrino and David C. Thomasma offer the health care professional a highly readable Christian philosophy of medicine. This book examines the influence religious beliefs have on the kind of person the health professional should be, on the health care policies a society should adopt, and on what constitutes healing in its fullest sense.

"Helping and Healing" looks at the ways a religious perspective shapes the healing relationship and the ethics of that relationship. Pellegrino and Thomasma seek to clarify the role of religious belief in health care by providing a moral basis for such commitment as well as a balancing role for reason. This book establishes a common ground for believers and skeptics alike in their dedication to relieve suffering by showing that helping and healing require an involvement in the religious values of patients. It clearly argues that religion provides crucial insights into medical practice and morality that cannot be ignored, even in our morally heterogeneous society.

Central to the authors' message is the concept of patients' vulnerabilities and the need to help them recover not only from the disease but also from an existential assault on their personhood. They then show how this understanding can move caregivers to view their professions as vocations and thereby change the nature of health care from a business to a community of healing.

Physicians, nurses, administrators, clergy, theologians, and other health professionals and church leaders will find this volume helpful for their own reflections on the role of religion in the health care ministry and for making a religious commitment integral to their professional lives.

Christian health care professionals in our secular and pluralistic society often face uncertainty about the place religious faith holds in today's medical practice. Through an examination of a virtue-based ethics, this book proposes a theological view of medical ethics that helps the Christian physician reconcile faith, reason, and professional duty. Edmund D. Pellegrino and David C. Thomasma trace the history of virtue in moral thought, and they examine current debate about a virtue ethic's place in contemporary bioethics. Their proposal balances theological ethics, based on the virtues of faith, hope, and charity, with contemporary medical ethics, based on the principles of beneficence, justice, and autonomy. The result is a theory of clinical ethics that centers on the virtue of charity and is manifest in practical moral decisions. Using Christian bioethical principles, the authors address today's divisive issues in medicine. For health care providers and all those involved in the fields of ethics and religion, this volume shows how faith and reason can combine to create the best possible healing relationship between health care professional and patient.

This book constructs a virtue-based ethics for medicine and health care. Beginning with the problem of relating virtues to principles, the authors develop a theory that this linkage lies in the goals of medicine and the nature of medical practice as a moral community. Specific virtues such as trust, compassion, prudence, justice, courage, temperance, and self-effacement are discussed in separate chapters. The book ends by examining how a virtue-based ethic of medicine makes a difference in analysing problems like caring for the poor, research on human subjects, whether the medical virtues can be taught in professional training, and how a refurbished philosophy of medicine can enhance medicine and health care in the future.

By analyzing the amalgam of Greek philosophy, Jewish and Christian teachings, and secular humanism that composes our dominant ethical system, the authors of this volume explore the question of whether or not Western and non-Western moral values can be commingled without bilateral loss of cultural integrity. They take as their philosophical point of departure the observation that both ethical relativism and ethical absolutism have become morally indefensible in the context of the multicultural American life, and they variously consider the need for an ethical middle ground.

The essays in "Ethics, Trust, and the Professions" probe the nature of the fiduciary relationship that binds client to lawyer, believer to minister, and patient to doctor. Angles of approach include history, sociology, philosophy, and culture, and their very multiplicity reveals how difficult we find it to formulate a code of ethics which will insure a relationship of trust between the professional and the public.