Matters of life and death : making moral theory work in medical ethics and the law / David Orentlicher.

Format:

Book

Author/Creator:

Orentlicher, David, 1955-

Language:

English

Subjects (All):

Medical care--Law and legislation--United States.

Medical care.

Medical care--Law and legislation.

United States.

Medical ethics--United States.

Medical ethics.

Physical Description:

viii, 234 pages ; 24 cm

Place of Publication:

Princeton, N.J. : Princeton University Press, [2001]

Summary:

Philosophical debates over the fundamental principles that should guide life-and-death medical decisions usually occur at a considerable remove from the tough, real-world choices made in hospital rooms, courthouses, and legislatures. David Orentlicher seeks to change that, drawing on his extensive experience in both medicine and law to address the translation of moral principle into practice -- a move that itself generates important moral concerns.

Orendicher uses controversial life-and-death issues as case studies for evaluating three models for translating principle into practice. Physician-assisted suicide illustrates the application of "generally valid rules," a model that provides predictability and simplicity and, more importantly, avoids the personal biases that influence case-by-case judgments. The author then takes up the debate over forcing pregnant women to accept treatments to save their fetuses. He uses this issue to weigh the "avoidance of perverse incentives," an approach to translation that follows principles hesitantly for fear of generating unintended results. And third, Orentlicher considers the denial of life-sustaining treatment on grounds of medical futility in his evaluation of the "tragic choices" model, which hides difficult life-and-death choices in order to prevent paralyzing social conflict.

Matters of Life and Death is a rich and stimulating contribution to bioethics and law. It is the first book to examine closely the broad problems of translating principle into practice. And by analyzing specific controversies along the way, it develops original insights likely to provoke both moral philosophers and those working on thorny issues of life and death.

Contents:

Part 1 The Approach of Using Generally Valid Rules

2 The Importance of Generally Valid Rules in Implementing Moral Principle 11

3 The Absence of a Moral Distinction between Treatment Withdrawal and Assisted Suicide 24

4 The Distinction between Treatment Withdrawal and Assisted Suicide as a Generally Valid Way to Distinguish between Morally Justified and Morally Unjustified Deaths 53

Part 2 Avoiding Perverse Incentives

5 The Implications for Practice of a Policy's Perverse Incentives 83

6 Underlying Moral Principle Permits a Limited Legal Obligation for Pregnant Women to Accept Life-Saving Treatment for Their Fetuses 91

7 The Problems with a Legal Duty for Pregnant Women Because of Perverse Incentives 113

Part 3 The "Tragic Choices" Model

8 Avoiding Explicit Trade-offs through Implicit Choices 123

9 Limitations of the "Futility" Concept in Medical Treatment Decisions 132

10 Futility as a Way to Make "Tragic Choices" 153.

Notes:

Includes bibliographical references (pages [171]-224) and index.

ISBN:

0691089469

0691089477

OCLC:

46704057