A pioneer in the theory of pluralistic casuistry, the idea that there are almost as many facets to moral choices as there are cases that call for choices, Baruch Brody takes issue with conventional bioethical wisdom and challenges the rigid principalism of contemporary bioethics. His views have been seen as controversial, but they are firmly held, and convincingly argued—all of which have led him to be one of the most widely discussed and highly admired bioethicists of our time. He argues for the fundamental distinction between active and passive euthanasia, for a need to reconceptualize approaches to brain death, and for the right of providers to unilaterally discontinue life support. He shows support for the waiving of the requirement of informed consent for some research, for the widespread use of animals in research, and for the use of placebos in many international clinical trials.
When it comes to morality as it is practiced in medicine, Brody makes clear that the ethical issues are never as simple as black and white—that there are myriad factors and fine nuances that can and should challenge decision making as it is commonly practiced in difficult medical cases. In this collection, delving thoughtfully and systematically into methodology, research ethics, clinical ethics, and Jewish medical ethics, he tackles thorny life-and-death questions head-on and fearlessly. He casts a light into all the corners of end-of-life decisions—a field in which he has exemplary credentials—while illuminating a new understanding of morality and ethics.
The introduction outlines Brody's approach, defines the terminology used, and contrasts his ethical positions with much of the competing literature. Taking Issue will be invaluable to students and scholars in medical ethics, bioethics, and philosophy of medicine.
Table of Contents
Introduction
Part I. Methodology
1. Pluralistic Moral Theory
2. Intuitions and Objective Moral Knowledge
3. Assessing Empirical Research in Bioethics
Part II. Research Ethics
4. Research Ethics: International Perspectives
5. The Ethics of Controlled Clinical Trials
6. In Cases of Emergency, No Need for Consent
7. Making Informed Consent Meaningful
8. When Are Placebo Controlled Trials No Longer Appropriate?
9. Ethical Issues in Clinical Trials in Developing Countries
10. The New Declaration of Helsinki May Be Dangerous to the Health of Developing Countries
11. Defending Animal Research: An International Perspective
Part III. Clinical Ethics
12. Withdrawl of Treatment versus Killing of Patients
13. Special Ethical Issues in the Management of Persistent Vegetative State (PVS) Patients
14. The Role of Futility in Health Care Reform
15. How Much of the Brain Must Be Dead?
Part IV. Jewish Medical Ethics
16. Jewish Reflections on Life and Death Decision Making
17. A Historical Introduction to Jewish Casuistry on Suicide and Euthanasia
18. The Use of Halakhik Material in Discussions of Medical Ethics
Index
Reviews
"Dr. Brody has crafted a set of lucid and compelling arguments for the utility and integrity of moral pluralism. His collected essays challenge the ethics orthodoxy to submit conventional views to a fresh analysis."—Nancy Neveloff Dubler, LLB, director, Division of Bioethics, Department of Epidemiology and Social Medicine, Montefiore Medical Center and professor of bioethics, Albert Einstein College of Medicine
About the Author
Baruch A. Brody is the Leon Jaworski Professor of Biomedical Ethics and director of the Center for Medical Ethics and Health Policy at Baylor College of Medicine. He is also a professor of philosophy at Rice University and director of the Ethics program at The Methodist Hospital in Houston. He is the author of The Ethics of Biomedical Research: An International Perspective and Life and Death Decision Making.
