Biomedical Ethics: A Canadian Focus offers a detailed, engaging examination of issues and debates encompassing biomedical ethics. Using many Canadian cases and examples, ethical issues are explored in the context of our health care system. Debates include patient autonomy, confidentiality, morality, and genetic engineering, as well other topics related to modern health care. Over one hundred renowned case studies and articles are included, ranging from early eugenics programs to modern genetic testing, giving students valuable insights into biomedical ethics in Canada.

Preface 1. Morality and Ethics 1.1 Introduction 1.2 Morality and Ethics 1.3 Moral Theories 2. Patient Self-Determination 2.1 Introduction 2.2 Who Decides for the Patient? Autonomy, Competence, and Paternalism Standards of Competence, Allen E. Buchanan and Dan W. Brock Involving Children in Medical Decisions, Christine Harrison, Nuala P. Kenny, Mona Sidarous, and Mary Rowel Advance Directives for Resuscitation and Other Life-Saving or -Sustaining Measures, Canadian Medical Association A Relational Approach to Autonomy in Health Care, Susan Sherwin 2.3 Differing Opinions of Patient Best Interest Quality Care and the Wounds of Diversity, Kenneth Kipnis Ethical Relativism in a Multicultural Society, Ruth Macklin 2.4 Individual Interests versus Family Interests What About the Family?, John Hardwig Patient Choices, Family Interests, and Physician Obligations, Thomas A. Mappes and Jane S. Zembaty 2.5 Cases Case 1: Scott Starson: Refusing Treatment While Incompetent Case 2: No Chemotherapy for Anael: Surrogate Refusal of Treatment for a Minor Child Case 3: Do Everything for Mom Case 4: A Teen's Secret Decision to Abort Case 5: Current Wishes Conflict with Prior Instructions 2.6 Study Questions 2.7 Suggested Further Reading 3. Management of Medical Information 3.1 Introduction 3.2 Privacy and Confidentiality Privacy: Human Rights, Public Policy, and Law, Canadian HIV/AIDS Legal Network Confidentiality in Medicine-A Decrepit Concept, Mark Siegler Genetic Privacy, Lawrence O. Gostin 3.3 Truth Telling On Telling Truth to Patients, Mack Lipkin Telling the Truth to Patients: A Clinical Ethics Exploration, David C. Thomasma 3.4 Informed Consent The Concept of Informed Consent, Ruth R. Faden and Tom L. Beauchamp Consent, Coercion, and Conflicts of Rights, Ruth Macklin Transparency: Informed Consent in Primary Care, Howard Brody Culture, Power, and Informed Consent: The Impact of Aboriginal Health Interpreters on Decision Making, Joseph Kaufert and John O'Neil 3.5 Cases Case 1: Please Don't Tell!: A Case about HIV and Confidentiality, Leonard Fleck and Marcia Angell Case 2: John Reibl: Information Disclosure, Comprehension, and Informed Consent Case 3: Do Patients Have a Right to the Information in Their Medical Files? Canadian Supreme Court Case of McInerney v. Macdonald (1992) Case 4: Breach of Lawyer-Client Confidentiality Appropriate When Poses Public Danger: Candian Supreme Court Case of Smith v. Jones (1999) Case 5: Refusal to Consent to DNR for Minor Child: Manitoba Court of Appeal Case Child and Family Services of Central Manitoba v. R.L. 3.6 Study Questions 3.7 Suggested Further Reading 4. End-of-Life Decision Making 4.1 Introduction 4.2 Refusal or Withdrawal of Treatment, Medical Futility, and Terminal Sedation Withholding and Withdrawal of Potentially Life-Sustaining Treatment, Health Law Institute Patient Refusal of Hydration and Nutrition: An Alternative to Physician-Assisted Suicide or Voluntary Active Euthanasia, James L. Bernat, Bernard Gert, and R. Peter Mogielnicki Medical Futility: A Conceptual and Ethical Analysis, Mark R. Wicclair Medical Ethics and Double Effect: The Case of Terminal Sedation, Joseph Boyle 4.3 Voluntary Active Euthanasia and Physician-Assisted Suicide Bioethics for Clinicians: Euthanasia and Assisted Suicide, James V. Lavery, Bernard M. Dickens, Joseph M. Boyle, and Peter A. Singer Active and Passive Euthanasia, James Rachels Voluntary Active Euthanasia, Dan W. Brock When Self-Determination Runs Amok, Daniel Callahan Gender, Feminism, and Death: Physician-Assisted Suicide and Euthanasia, Susan Wolf 4.4 Rights to Die and Duties to Die Is There a Right to Die?, Leon R. Kass Is There a Duty to Die?, John Hardwig 4.5 Cases Case 1: Sue Rodriguez: Physician-Assisted Suicide Case 2: Dr Nancy Morrison: (Non)Voluntary Active Euthanasia of an Adult Case 3: Tracy Latimer: Nonvoluntary Active Euthanasia of a Minor Case 4: Mr. McCullough: Recommending Voluntary Passive Euthanasia Case 5: Elizabeth and Eric MacDonald: Assisted Suicide 4.6 Study Questions 4.7 Suggested Further Reading 5. Moral Status of the Human Fetus and Infant 5.1 Introduction 5.2 Positions on Fetal Moral Status: Conservative, Liberal, and Moderate Reproductive Technologies: Royal Commission Final Report, Nancy Miller Chenier Why Abortion Is Immoral, Don Marquis On the Moral and Legal Status of Abortion, Mary Anne Warren A Defense of Abortion, Judith Jarvis Thomson Abortion Through a Feminist Ethics Lens, Susan Sherwin 5.3 Declining Treatment during Pregnancy and Immediately after Birth A Pregnant Woman's Decision to Decline Treatment: How Should the Law Respond?, John Seymour Decisions Regarding Disabled Newborns, Mary B. Mahowald 5.4 Cases Case 1: Prenatal Diagnosis and Abortion or Infanticide through Declining Treatment Case 2: Failed Abortion and Offer of Third-Trimester Abortion Case 3: Abortion of Suspected Female Fetus Case 4: Ms G. and Refusal of Treatment While Pregnant Case 5: Endangering Behaviour in a Pregnant Woman 5.5 Study Questions 5.6 Suggested Further Reading 6. Genetic Technology Use 6.1 Introduction 6.2 Eugenics Eugenics: Some Lessons from the Nazi Experience, Jonathan Glover Sterilizing the 'Feeble-Minded': Eugenics in Alberta, Canada, 1929-72, Jana Grekul, Harvey Krahn, and Dave Odynak Population Policy and Eugenics in China, Veronica Pearson 6.3 Cloning and Stem Cell Usage Cloning of Human Beings, Leon R. Kass A Rose Is a Rose, but Clones Will Differ, John Russell and Andrew Irvine Creating and Sacrificing Embryos for Stem Cells, K. Devolder 6.4 Genetic Treatment and Enhancement Genetic Enhancement, Walter Glannon Genetic Engineering, Dan W. Brock The Inevitability of Genetic Enhancement, Francois Baylis and Jason Scott Robert 6.5 Genetic Testing Implications of Prenatal Diagnosis for the Human Right to Life, Leon R. Kass Genetics and Reproductive Risk: Can Having Children Be Immoral?, Laura M. Purdy Prenatal Genetic Testing and Screening: Constructing Needs and Reinforcing Inequities, Abby Lippman 6.6 Cases Case 1: Leilani Muir versus the Philosopher King: Eugenics on Trial in Alberta, Douglas Wahlsten Case 2: Changing Socially-Undesirable Characteristics Case 3: Predictive Testing for Criminal Behaviour: Genes and Environment Case 4: Testing for Late-Onset Genetic Disorders in Children 6.7 Study Questions 6.8 Suggested Further Reading 7. Access to Health Care 7.1 Introduction 7.2 Macroallocation: Is There a Right to Health Care? The Right to a Decent Minimum of Health Care, Allen E. Buchanan Managing Care the Canadian Way, Pat Armstrong Restoring the Status of an Icon: A Talk with Canada's Minister of Health, John K. Inglehart Sustaining Medicare: The Commission on the Future of Health Care in Canada, Ray Romanow Autonomy, Equality, and a Just Health Care System, Kai Nielson 7.3 Cases Case 1: Belinda Stronach Travels to California for Health Care Case 2: BC Physicians 'Cherry-Picking' Patients for Ease of Care, Refusing Those in Need Case 3: Refusal of Life-Saving Treatment Case 4: Universal Care: Less Time, Less Efficacy Case 5: Multiple Transplants 7.4 Study Questions 7.5 Suggested Further Reading 8. Allocation of Scarce Medical Resources 8.1 Introduction 8.2 Microallocation: The Necessity of Rationing The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ Transplantation, George J. Annas The Allocation of Exotic Medical Life-Saving Therapy, Nicholas P. Rescher Allocating Resources to the Elderly, Daniel Callahan Voluntary Risks to Health: The Ethical Issues, Robert Veatch 8.3 Increasing Resources through Commodification The Commodification of Medical and Health Care: The Moral Consequences of a Paradigm Shift from a Professional to a Market Ethic, Edmund D. Pellegrino Join the Club: A Modest Proposal to Increase Availability of Donor Organs, Rupert Jarvis Human Organs, Scarcities, and Sale: Morality Revisited, R R. Kishore Keeping an Eye on the Global Traffic in Human Organs, Nancy Scheper-Hughes Debate over Online Recruitment of Organ Donors, Wayne Kondro 8.4 Cases Case 1: No Lungs for Linda Case 2: Rationing Services to an Elder Who Is Responsible for His Medical Condition Case 3: Buying a Kidney in India but Requesting Canadian After-Care 8.5 Study Questions 8.6 Suggested Further Reading 9. Research With Humans 9.1 Introduction 9.2 The Dark History of Human Research The Tuskegee Study, Gregory E. Pence Dr Ewen Cameron, Colin A. Ross Biomedical Conflicts of Interest: A Defence of the Sequestration Thesis-Learning from the Cases of Nancy Olivieri and David Healy, Arthur Schafer Dancing with the Porcupine: Rules for Governing the University-Industry Relationship, Stephen Lewis, Patricia Baird, Robert G. Evans, William A. Ghali, Charles J. Wright, Elaine Gibson, and Francoise Baylis 9.3 Codes and Guidelines The Nuremburg Code, Nuremburg Military Tribunal Declaration of Helsinki, World Medical Association Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans, Canadian Institutes of Health Research 9.4 Use of Children and Noncompetent Patients in Research Ethical and Human-Rights Issues in Research on Mental Disorders That May Affect Decision-Making Capacity, Alexander M. Capron The Child as Research Subject, Lainie Freidman Ross Baby Fae: The 'Anything Goes' School of Human Experimentation, George J. Annas 9.5 Cases Case 1: Stanley Milgram: Lies and Invalid Consent a Necessary Part of the Research Case 2: Mr Halushka: Human Research and Harm to Participants Case 3: Nonclinical Research on Alzheimer's Patients 9.6 Study Questions 9.7 Suggested Further Reading Glossary Bibliography

"The combination of classic and contemporary articles and cases strikes a good balance between theoretical and practical aspects of the issues addressed in each chapter. This, in addition to the comprehensive coverage of philosophical, legal, medical and multicultural dimensions of the field, captures the debates in biomedical ethics in a way that will stimulate and engage readers. An excellent text." --Walter Glannon, Canada Research Chair in Medical Bioethics and Ethical Theory, University of Calgary