The fate of seriously ill newborns has captured the atten tion of the public, of national and state legislators, and of powerful interest groups. For the most part, the debate has been cast in the narrowest possible terms: "discrimination against the handicapped"; "physician authority"; "family autonomy." We believe that something much more profound is happening: the debate over the care of sick and dying babies appears to be both a manifestation of great changes in our feelings about infants, children, and families, and a reflection of deep and abiding attitudes toward the newborn, the handi capped, and perhaps other humans who are "less than" nor mal, rational adults. How could we cast some light on those feelings and attitudes that seemed to determine silently the course of the public debate? We chose to enlist the humanities-the dis players and critics of our cultural forms. Rather than closing down the public discussion, we wanted to open it up, to illuminate it with the light of history, religion, philosophy, literature, jurisprudence, and humanistically oriented sociol ogy. This book is a first effort to place the hotly contested Baby Doe debate into a broader cultural context."

The place of drugs in American society is a problem more apt to evoke diatribe than dialog. With the support of the Na tional Science Foundation's program on Ethics and Values in Science and Technology, and the National Endowment for the Humanities' program on Science, Technology, and Human Values, * The Hastings Center was able to sponsor such dialog as part of a major research into the ethics of drug use that spanned two years. We assembled a Research Group from leaders in the scientific, medical, legal, and policy com munities, leavened with experts in applied ethics, and brought them together several times a year to discuss the moral, legal and social issues posed by nontherapeutic drug use. At times we also called on other experts when we needed certain issues clarified. We did not try to reach a consensus, yet several broad areas of agreement emerged: That our society's response to nontherapeutic drug use has been irrational and inconsistent; that our attempts at control have been clumsy and ill-informed; that many complex moral values are entwined in the debate and cannot be reduced to a simple conflict between individual liberty and state paternalism. Of course each paper should be read as the statement of that particular author or authors. The views expressed in this book do not necessarily represent the views of The Hastings Center, the National Science Foundation, or the National En dowment for the Humanities."

In a provocative analysis of sport ethics and human values, Genetically Modified Athletes imagines the brave new world of sport. The internationally acclaimed book examines this issue at a crucial time in its theorisation, questioning the very cornerstone of sporting and medical ethics, asking whether sporting authorities can, or even should, protect sport from genetic modification. This book brings together sport studies and bioethics to challenge our understanding of the values that define sport. We already allow that athletes can optimise their performance by the use of technologies; without wishing to assert that 'anything goes' in sports performance enhancement, Andy Miah argues that simply being human matters in sport and that genetic modification does not have to challenge this capacity. Genetically Modifies Athletes includes examination of: * the concept of 'good sport' and the definition of cheating * the doped athlete - should we be more sympathetic? * the role of the medical industry * the usefulness (or not) of the terms 'doping' and 'anti-doping'. An important and growing field of interest, this book should be read by students, academics and practitioners.

In a provocative analysis of sport ethics and human values, Genetically Modified Athletes imagines the brave new world of sport. The internationally acclaimed book examines this issue at a crucial time in its theorisation, questioning the very cornerstone of sporting and medical ethics, asking whether sporting authorities can, or even should, protect sport from genetic modification. This book brings together sport studies and bioethics to challenge our understanding of the values that define sport. We already allow that athletes can optimise their performance by the use of technologies; without wishing to assert that 'anything goes' in sports performance enhancement, Andy Miah argues that simply being human matters in sport and that genetic modification does not have to challenge this capacity. Genetically Modifies Athletes includes examination of: * the concept of 'good sport' and the definition of cheating * the doped athlete - should we be more sympathetic? * the role of the medical industry * the usefulness (or not) of the terms 'doping' and 'anti-doping'. An important and growing field of interest, this book should be read by students, academics and practitioners.

This volume presents articles which focus on the ethical evaluation of performance-enhancing technologies in sport. The collection considers whether drug doping should be banned; the rationale of not banning ethically contested innovations such as hypoxic chambers; and the implications of the prospects of human genetic engineering for the notion of sport as a development of 'natural' talent towards human excellence. The essays demonstrate the significance of the principles of preventing harm, ensuring fairness and preserving meaning to appraise whether a particular performance enhancer is acceptable in the context of sport. Selected essays on various forms of human enhancement outside of sport that highlight other principles and concepts are included for comparative purpose. Sport enhancement provides a useful starting point to work through the ethics of enhancement in other human practices and endeavors, and sport enhancement ethics should track broader bioethical debates on human enhancement. As a whole, the volume points to the need to consider the values and meanings that people seek in a given sphere of human activity and their associated principles to arrive at a morally grounded and reasonable approach to enhancement ethics.

The place of drugs in American society is a problem more apt to evoke diatribe than dialog. With the support of the Na tional Science Foundation's program on Ethics and Values in Science and Technology, and the National Endowment for the Humanities' program on Science, Technology, and Human Values, * The Hastings Center was able to sponsor such dialog as part of a major research into the ethics of drug use that spanned two years. We assembled a Research Group from leaders in the scientific, medical, legal, and policy com munities, leavened with experts in applied ethics, and brought them together several times a year to discuss the moral, legal and social issues posed by nontherapeutic drug use. At times we also called on other experts when we needed certain issues clarified. We did not try to reach a consensus, yet several broad areas of agreement emerged: That our society's response to nontherapeutic drug use has been irrational and inconsistent; that our attempts at control have been clumsy and ill-informed; that many complex moral values are entwined in the debate and cannot be reduced to a simple conflict between individual liberty and state paternalism. Of course each paper should be read as the statement of that particular author or authors. The views expressed in this book do not necessarily represent the views of The Hastings Center, the National Science Foundation, or the National En dowment for the Humanities."

The fate of seriously ill newborns has captured the atten tion of the public, of national and state legislators, and of powerful interest groups. For the most part, the debate has been cast in the narrowest possible terms: "discrimination against the handicapped"; "physician authority"; "family autonomy." We believe that something much more profound is happening: the debate over the care of sick and dying babies appears to be both a manifestation of great changes in our feelings about infants, children, and families, and a reflection of deep and abiding attitudes toward the newborn, the handi capped, and perhaps other humans who are "less than" nor mal, rational adults. How could we cast some light on those feelings and attitudes that seemed to determine silently the course of the public debate? We chose to enlist the humanities-the dis players and critics of our cultural forms. Rather than closing down the public discussion, we wanted to open it up, to illuminate it with the light of history, religion, philosophy, literature, jurisprudence, and humanistically oriented sociol ogy. This book is a first effort to place the hotly contested Baby Doe debate into a broader cultural context."

Why are fiberglass vaulting poles and hinged skates accepted in sport - while performance-enhancing drugs are forbidden? Are the rules that forbid them arbitrary? Should we level the playing field by allowing all competitors to use drugs that allow them to run faster or longer, leap higher, or lift more? In this provocative exploration of what draws us to sport as participants and spectators, Thomas Murray argues that the values and meanings embedded within our games provide the guidance we need to make difficult decisions about fairness and performance-enhancing technologies. Good Sport reveals what we really care about in sport and how the reckless use of biomedical enhancements undermines those values. Implicit in sports history, rules, and practices are values that provide a sturdy foundation for an ethics of sport that celebrates natural talents and dedication. You see these values when the Paralympics creates multiple level playing fields among athletes with different kinds of impairments. They appear again in sports struggles to be fair to all when an extraordinary woman athlete emerges who appears to possess a mans hormone profile and muscles. They are threatened when the effort to assure athletes a fair chance to win without doping is subverted by cheating or by corruption, as in the case of Russias state-supported doping operation. Performance-enhancing drugs distort the connection between natural talents, the dedication to perfect those talents, and success in sport. Explaining the fundamental role of values and meanings, Good Sport reveals not just what we champion in the athletic arena but also, more broadly, what we value in human achievement.

As the population ages and the health care system focuses on cost-containment, family caregivers have become the frontline providers of most long-term and chronic care. Patient care at home falls mainly on untrained and unprepared family members, who struggle to adjust to the new roles, responsibilities, and expenses. Because the culture of family caregivers-their values, priorities, and relationships to the patient-often differs markedly from that of professionals, the result can be conflict and misunderstanding. In The Cultures of Caregiving, Carol Levine and Thomas Murray bring together accomplished physicians, nurses, social workers, and policy experts to examine the differences and conflicts (and sometimes common ground) between family caregivers and health care professionals-and to suggest ways to improve the situation. Topics addressed include family caregivers and the health care system; cultural diversity and family caregiving; the changing relationship between nurses, home care aides, and families; long-term health care policy; images of family caregivers in film; and the ethical dimensions of professional and family responsibilities. The Cultures of Caregiving provides needed answers in the contemporary crisis of family caregiving for a readership of professionals and students in medical ethics, health policy, and such fields as primary care, geriatrics, oncology, nursing, and social work. Contributors: Donna Jean Appell, R.N., Project DOCC: Delivery of Chronic Care; Jeffrey Blustein, Ph.D., Albert Einstein College of Medicine and Barnard College; Judith Feder, Ph.D., Georgetown University; Gladys Gonzalaz-Ramos, M.S.W., Ph.D., New York University School of Social Work and NYU Medical School; David A. Gould, Ph.D., United Hospital Fund in New York City; Eileen Hanley, R.N., M.B.A., St. Vincent's Hospital Manhattan / Saint Vincent Catholic Medical Centers, New York City; Maggie Hoffman, Project DOCC: Delivery of Chronic Care; Alexis Kuerbis, C.S.W., Mount Sinai Medical Center; Carol Levine, M.A., United Hospital Fund, in New York City; Jerome K. Lowenstein, M.D., New York University Medical Center; Mathy Mezey, R.N., Ed.D., New York University; Thomas H. Murray, Ph.D., The Hastings Center, Garrison, New York; Judah L. Ronch, Ph.D., LifeSpan DevelopMental Systems; Sheila M. Rothman, Ph.D., Columbia University Mailman School of Public Health; Rick Surpin, Independence Care System.

Thomas Murray's graceful and humane book illuminates one of the most morally complex areas of everyday life: the relationship between parents and children. What do children mean to their parents, and how far do parental obligations go? What, from the beginning of life to its end, is the worth of a child? Ethicist Murray leaves the rarefied air of abstract moral philosophy in order to reflect on the moral perplexities of ordinary life and ordinary people. Observing that abstract moral terms such as altruism and selfishness can be buried in the everyday doings of families, he maintains that ethical theory needs a richer description than it now has of the moral life of parents and children. How far should adults go in their quest for children? What options are available to women who do not want to bear a child now? Should couples be allowed to reject a child because of genetic disability or 'wrong' gender? How can we weigh the competing claims of the genetic and the rearing parents to a particular child? "The Worth of a Child" couples impressive learning with a conversational style. Only by getting down to cases, Murray insists, can we reach moral conclusions that are unsentimental, far-sighted, and just. In an era of intense public and private acrimony about the place and meaning of 'family values', his practical wisdom about extraordinary difficult moral issues offers compelling reading for both experienced and prospective parents, as well as for ethicists, social and behavioral scientists, and legal theorists.

"The volume deserves our serious attention. The authors have provided us an invaluable primer about the HGP and its implications for the future of American health care." Jurimetrics

"This book does make a real contribution... in explaining why the genetics
revolution holds so much promise and why it is so difficult to bring that promise to fruition." The Journal of Legal Medicine

..". marked by a forward-looking, analytically and empirically grounded thematic coherence. The editors carefully crafted template and contributions successfully focus and organize the material." Annals of Internal Medicine

"Excellent" Canadian Medical Association Journal

"The editors have done a very good job integrating the contents into a very useful and readable information source." Choice

..". this highly focused book is a well-written, thoughtful, and insightful consideration of the HGP and is valuable reading for anyone concerned with the future of our country's medical infrastructure." Science Books & Films (**Highly recommended)

"A distinguished group of scientists, lawyers, and scholars have written a coherent, readable account of the legal, medical, ethical, and policy issues many (if not all) of us will be wrestling with on both a personal and a public level, as a result of current genetic research." Library Journal

"Each of the contributors is a distinguished authority on the topic. Ethicists, especially, will find well-developed presentation of issues, with exposition of the differing ethical assumptions in tension in the society debate." Doody s Health Sciences Book Review Home Page

How will the science of gene mapping and gene manipulation affect health care? Leading scholars explore the clinical, ethical, legal, and policy implications of the Human Genome Project for the forms of health care, who delivers it, who receives it, and who pays for it."

A range of views on the morality of synthetic biology and its place in public policy and political discourse. Synthetic biology, which aims to design and build organisms that serve human needs, has potential applications that range from producing biofuels to programming human behavior. The emergence of this new form of biotechnology, however, raises a variety of ethical questions-first and foremost, whether synthetic biology is intrinsically troubling in moral terms. Is it an egregious example of scientists "playing God"? Synthetic Biology and Morality takes on this threshold ethical question, as well as others that follow, offering a range of philosophical and political perspectives on the power of synthetic biology. The contributors consider the basic question of the ethics of making new organisms, with essays that lay out the conceptual terrain and offer opposing views of the intrinsic moral concerns; discuss the possibility that synthetic organisms are inherently valuable; and address whether, and how, moral objections to synthetic biology could be relevant to policy making and political discourse. Variations of these questions have been raised before, in debates over other biotechnologies, but, as this book shows, they take on novel and illuminating form when considered in the context of synthetic biology. Contributors John Basl, Mark A. Bedau, Joachim Boldt, John H. Evans, Bruce Jennings, Gregory E. Kaebnick, Ben Larson, Andrew Lustig, Jon Mandle, Thomas H. Murray, Christopher J. Preston, Ronald Sandler