| Preface |
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xv | |
| Acknowledgments |
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xix | |
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1 What Are the Philosophical Foundations of Bioethics? |
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1 | (17) |
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What is "normative ethics"? |
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1 | (3) |
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What are some important moral theories for bioethics? |
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4 | (1) |
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How does utilitarian reasoning work? |
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5 | (5) |
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What principles are featured in Kantian ethics? |
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10 | (2) |
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What does Natural Law ethics contribute to bioethics? |
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12 | (3) |
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What is the "principles approach" to bioethics? |
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15 | (2) |
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17 | (1) |
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2 How Has the Shift from Paternalism to Autonomy Shaped Bioethics? |
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18 | (22) |
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What is paternalism in general? |
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18 | (3) |
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How do strong and weak paternalism differ? |
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21 | (2) |
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What is medical paternalism? |
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23 | (1) |
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What does autonomy mean in bioethics? |
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24 | (1) |
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What is informed consent? |
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25 | (2) |
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What was the significance of the Belmont Report? |
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27 | (1) |
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What historical forces led to the rejection of medical paternalism? |
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28 | (1) |
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Do the effects of serious illness justify medical paternalism? |
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29 | (1) |
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Do irrational choices justify medical paternalism? |
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29 | (1) |
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Does respect for cultural differences justify deception? |
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30 | (1) |
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How should doctors give bad news to patients? |
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31 | (2) |
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Is deception justified in some "hard cases"? |
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33 | (2) |
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How should bioethicists and healthcare professionals address racism? |
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35 | (4) |
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39 | (1) |
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3 Do Advance Directives Protect Patient Autonomy? |
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40 | (17) |
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What is an advance directive for medical care? |
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40 | (2) |
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What constitutes a relevant change of mind? |
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42 | (3) |
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What is the "then-self/now-self" problem? |
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45 | (2) |
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How have defenders of advance directives responded to this problem? |
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47 | (3) |
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Can advance directives accommodate the then-self/now-self problem? |
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50 | (3) |
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What communication challenges limit the use of advance directives? |
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53 | (2) |
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55 | (2) |
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4 When Is Experimentation on Human Subjects Unethical? |
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57 | (20) |
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What principles for ethical research emerged in the Nuremberg Code? |
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57 | (2) |
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What notable experiments influenced the development of medical research ethics? |
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59 | (5) |
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Are randomized clinical trials ethically questionable? |
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64 | (4) |
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When do placebo-control trials violate basic principles of medical ethics? |
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68 | (2) |
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How do international contexts affect the ethics of trials? |
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70 | (1) |
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When are "challenge" trials for new vaccines acceptable? |
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71 | (3) |
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When do exclusions and priorities unjustly affect disadvantaged groups? |
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74 | (1) |
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75 | (2) |
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5 How Should Death Be Defined and Determined? |
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77 | (17) |
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77 | (1) |
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78 | (1) |
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Are neurological criteria a better indicator of death? |
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79 | (1) |
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What are the practical advantages of neurological criteria? |
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80 | (1) |
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Are there scientific arguments in favor of brain death? |
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81 | (1) |
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What are the arguments against brain death? |
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82 | (1) |
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What is the significance of the case of Jahi McMath? |
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83 | (3) |
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What would happen if we gave up brain death? |
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86 | (2) |
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Should a higher-brain standard be adopted? |
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88 | (2) |
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Is death an event or a process--and does it matter? |
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90 | (1) |
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91 | (3) |
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6 Is Physician-Assisted Dying an Ethical Choice? |
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94 | (19) |
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94 | (1) |
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What is the difference between voluntary and nonvoluntary euthanasia? |
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95 | (1) |
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What was the Nazi "euthanasia" program? |
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96 | (1) |
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What is self-administered physician-assisted dying? |
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97 | (3) |
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What is the equal protection argument for PAD? |
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100 | (1) |
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Where is self-administered PAD legal in the United States? |
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101 | (1) |
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What is the legal status of PAD elsewhere in the world? |
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102 | (1) |
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What are the moral arguments in favor of PAD? |
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103 | (1) |
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Whatare the moral arguments against PAD? |
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104 | (2) |
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Is PAD inconsistent with the physician's role? |
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106 | (1) |
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Would legalizing PAD undermine palliative care? |
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106 | (1) |
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Does legalizing PAD create a slippery slope? |
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107 | (2) |
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Is there really a need for PAD? |
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109 | (2) |
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111 | (2) |
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7 Is Abortion an Ethical Choice? |
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113 | (22) |
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What is the conservative view of the moral status of the unborn? |
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114 | (1) |
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Why do moderate conservatives think human life begins after conception? |
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115 | (1) |
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Is abortion always wrong for conservatives? |
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116 | (2) |
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What is the liberal view of the moral status of the unborn? |
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118 | (2) |
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What is the potentiality principle? |
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120 | (1) |
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Does the person view justify infanticide? |
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121 | (2) |
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How does the "future-like-ours" theory offer a new approach to abortion? |
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123 | (1) |
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How does the embodied minds view affect the debate? |
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124 | (2) |
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What are the implications of the interest view for abortion? |
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126 | (1) |
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How does the interest view support a gradualist approach? |
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127 | (2) |
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What about late abortions? |
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129 | (1) |
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What role does the nght to bodily self-determination play? |
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130 | (3) |
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133 | (2) |
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8 What Are the Implications of the Disability Critique? |
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135 | (15) |
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What is prenatal testing? |
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136 | (1) |
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What is preimplantation genetic testing? |
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137 | (1) |
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What is the purpose of FT and PGT? |
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138 | (3) |
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What is the DCs objection to selective abortion? |
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141 | (2) |
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What responses can be made to the DC? |
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143 | (2) |
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Can prenatal testing be regarded as a preventive measure? |
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145 | (1) |
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Does the choice of selective abortion display a bad parental attitude? |
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145 | (3) |
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148 | (2) |
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9 What Ethical Issues Are Raised by Assisted Reproductive Technology? |
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150 | (28) |
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How is infertility defined, and what are its causes? |
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150 | (1) |
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What medical procedures are used to treat infertility? |
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151 | (2) |
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What ethical arguments favor ART? |
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153 | (1) |
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Is adoption a better alternative than ART? |
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154 | (3) |
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What are the health risks of IVF to women? |
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157 | (1) |
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What are the health risks to offspring? |
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158 | (2) |
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Are the offspring at risk of psychological harm? |
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160 | (1) |
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161 | (2) |
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Is using ART to create nontraditional families ethically acceptable? |
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163 | (1) |
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Does paying gamete donors or gestational carriers commodity reproduction? |
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164 | (3) |
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Does payment exploit egg donors? |
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167 | (2) |
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Does payment exploit gestational carriers? |
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169 | (3) |
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Is the use of ART for medical sex selection ethical? |
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172 | (1) |
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What arguments support the use of ART for nonmedical sex selection? |
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173 | (1) |
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What are the arguments against nonmedical sex selection? |
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173 | (3) |
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176 | (2) |
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10 What Is Required for a Healthcare System to Be Just? |
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178 | (23) |
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What questions of justice arise in comparing healthcare systems? |
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178 | (2) |
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How do utilitarian views of justice apply to healthcare systems? |
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180 | (2) |
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What does an egalitarian view of justice require? |
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182 | (3) |
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What does libertarian justice imply for choice of a healthcare system? |
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185 | (2) |
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How do "market failure" and "cost-shifting" affect health insurance? |
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187 | (2) |
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What is unfair "free-riding"? |
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189 | (2) |
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To what extent does free-riding affect arguments about insurance? |
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191 | (2) |
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Why is insurance dangerous, and how can that danger be addressed? |
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193 | (2) |
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What role does "public health" play in a just system? |
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195 | (2) |
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Can common ground be found in debates about healthcare systems? |
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197 | (2) |
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199 | (2) |
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11 How Can Scarce Resources Be Allocated Justly? |
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201 | (22) |
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Who should have priority for life-saving organ transplants? |
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202 | (2) |
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In a pandemic, who should get care first? |
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204 | (3) |
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Should past behavior affect priority for care? |
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207 | (2) |
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Should priorities be adjusted for structural inequities of health? |
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209 | (1) |
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What priority, if any, should treatment have over prevention? |
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210 | (3) |
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What should be included in the basic minimum available to everyone? |
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213 | (2) |
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What is a "quality-adjusted life year"? |
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215 | (2) |
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Is it ethical to use QALYs to allocate healthcare resources? |
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217 | (3) |
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Do "reference point" effects justify extra value at the end of life? |
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220 | (2) |
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222 | (1) |
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12 What Is a Justified Price for Pharmaceutical Drugs? |
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223 | (19) |
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What is an ethically justified price? |
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223 | (2) |
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What costs of research and development justify price? |
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225 | (3) |
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Is market competition a good determinant of drug price? |
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228 | (3) |
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What makes it difficult to discern the true effectiveness of a drug? |
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231 | (2) |
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Should "value-basedpricing" be used to determine price? |
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233 | (4) |
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What reforms are needed in markets and regulation? |
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237 | (2) |
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Is patent protection compatible with global justice? |
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239 | (2) |
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241 | (1) |
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13 Is It Ethical to Genetically Modify Humans? |
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242 | (25) |
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243 | (1) |
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244 | (2) |
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What safety concerns does CRISPR raise? |
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246 | (1) |
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Who was He Jiankui, and what did he do? |
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247 | (1) |
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What was unethical about what He Jiankui did? |
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248 | (2) |
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Can genetic modification of embryos to prevent disease be justified? |
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250 | (1) |
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251 | (2) |
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Does enhancement threaten authenticity? |
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253 | (1) |
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Does enhancement violate autonomy? |
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253 | (1) |
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Might enhancement be damaging to parent-child relationships? |
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254 | (2) |
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Are genes more deterministic than environmental influences? |
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256 | (2) |
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Is gene therapy worth the cost? |
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258 | (1) |
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Is genetic enhancement incompatible with social justice? |
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259 | (1) |
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Should we alter human evolution? |
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260 | (5) |
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265 | (2) |
| Notes |
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267 | (24) |
| Further Reading |
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291 | (8) |
| Index |
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299 | |
