Risk and luck in medical ethics / Donna Dickenson.

Format:

Book

Author/Creator:

Dickenson, Donna.

Language:

English

Subjects (All):

Medical ethics.

Risk.

Fortune.

Uncertainty.

Ethics, Medical.

Bioethical Issues.

Medical Subjects:

Ethics, Medical.

Bioethical Issues.

Risk.

Uncertainty.

Physical Description:

x, 269 pages ; 24 cm

Other Title:

Previous ed. entitled: Moral luck in medical ethics and practical politics

Place of Publication:

Cambridge, UK : Polity ; Malden, MA : Blackwell, 2003.

Summary:

Ethics is commonly assumed to be the one realm in which luck and risk do not intrude. It has been said that 'While one can be lucky in one's business, in one's married life, and in one's health, one cannot, so it is commonly assumed, be subject to luck as far as one's moral worth is concerned.' But although we do not normally hold people responsible for outcomes beyond their control, a serious examination of the role of luck and risk may lead us to conclude that very few outcomes are really within people's control. This is the paradox of 'moral luck'. Risk and Luck in Medical Ethics examines the 'moral luck' paradox in greater detail, relating it to Kantian, consequentialist, and virtue-based approaches to ethics. This revised edition applies the paradoxes of risk and luck to medical ethics, including timely discussion of risk and luck in the allocation of scarce health care resources, informed consent to treatment, decisions about withholding life-sustaining treatment, psychiatry, reproductive ethics, genetic testing, and medical research and evidence-based medicine. The book concludes with an examination of the relevance of risk and luck in a medical context to the study of global ethics. If risk and luck are taken seriously, it would seem to follow that we cannot develop any definite moral standards at all, that we are doomed to moral relativism. However, Dickenson offers strong counter-arguments to this view that enable us to think in terms of universal standards for judging ethical systems. This claim has direct practical relevance for practitioners as well as philosophers.

Contents:

1 Ethics versus Luck? 1

The myriad forms of luck 1

A preliminary typology of luck 4

Outcome luck: further considerations 7

Moral luck: how serious and genuine is the paradox? 11

Judgement from hindsight: Gauguin and Anna Karenina 14

Escaping from the paradox 19

2 The Fragility of Virtue and the Robust Health of Kantianism 24

Moral luck and virtue 24

The fragility of goodness 29

Kantianism and moral luck 33

3 Utilitarianism and Luck in Outcomes 46

Actual consequences 48

Potential consequences 52

Remorse and regret 59

4 Risk and Consent 65

The law of consent: prudent patient versus reasonable doctor 66

Remorse, responsibility and consent 71

Rationality and risk 73

How much is the doctor responsible for? 76

5 Death and Dying 86

Withdrawal of life-sustaining treatment and assisted suicide 87

Advance directives 95

6 Moral Luck and the Allocation of Health Care Resources 104

The 'micro' level 105

Knowing our limits: the 'macro' level 115

7 Reproductive Ethics: What Risks Can Women be Asked to Bear? 124

Risk, contract and 'surrogacy' 124

Therapeutic and human cloning 137

8 Psychiatry and Risk 144

Risk and dangerousness: luck in outcomes 144

Luck in character 159

9 Luck, Genetics and Moral Character 167

Are genes us? 168

Genetics and luck in decisions to be faced 170

Genetics and luck in antecedent circumstances 174

Gauguin revisited: character, genetics and moral luck 181

10 Moral Luck and Global Ethics 187

Towards justice and virtue: O'Neill's account 197

Nussbaum and the capabilities approach 203

The final synthesis: feminism, global ethics and moral luck 206.

Notes:

Rev. ed. of: Moral luck in medical ethics and practical politics, c1991.

Includes bibliographical references (pages [241]-261) and index.

ISBN:

0745621457

0745621465

OCLC:

49285328