Bioethics developed as an academic and clinical discipline during the later part of the 20th century due to a variety of factors. Crucial to this development was the increased secularization of American culture as well as the dissolution of medicine as a quasi-guild with its own professional ethics. In the context of this moral vacuum, bioethics came into existence. Its raison d’être was opposition to the alleged paternalism of the medical community and traditional moral frameworks, yet at the same time it set itself up as a source of moral authority with respect to biomedical decision making. Bioethics serves as biopolitics in so far as it attempts to make determinations about how individuals ought to make medical decisions and then attempts to codify that in law. Progressivism and secularism are ultimately the ideology of bioethics.

This volume brings together a set of critical essays on the thought of Professor Doctor H. Tristram Engelhardt Junior, Co-Founding Editor of the Philosophy and Medicine book series. Amongst the founders of bioethics, Professor Engelhardt, Jr. looms large. Many of his books and articles have appeared in multiple languages, including Italian, Romanian, Portuguese, Spanish, and Chinese. The essays in this book focus critically on a wide swath of his work, in the process elucidating, critiquing, and/or commending the rigor and reach of his thought. This volume compasses analyses of many different aspects of Engelhardt's work, including social and political philosophy, biopolitics, the philosophy of medicine, and bioethics. It brings together internationally known scholars to assess key elements of Engelhardt's work.

Several studies have argued that there is a correlation between short stature and negative experiences and characteristics, such as social discrimination, economic disadvantage, health problems (especially for men). The idea that short men have a disadvantage in social interactions and in partner choices is also widespread in popular culture and common knowledge. It is now possible to use recombinant human growth hormone (hGH) to treat children with idiopathic short stature (ISS), namely children who are shorter than average for unknown medical reasons. Critics argue that there is a lack of evidence of both psychological distress caused by short stature and the efficacy of the treatment in increasing children’s well-being. This controversy is reflected in international drug evaluations: while the Food and Drug Administration (FDA) in the US granted marketing authorisation for hGH for children with ISS in 2003, the European Medicines Agency (EMA) refused it in 2007. The research presented here had two aims: first, to identify and analyse the norms, values and assumptions about short stature and the use of hGH treatment for children with ISS, found within sociocultural, philosophical and regulatory discussions of these, and within narrated lived experiences of short stature. Second, to critically and reflectively discuss how these analyses contribute to bioethical debates on the use of hGH treatment for children with ISS. It employs what it calls a critical paediatric bioethics theoretical approach, which deems as important to carefully analyse different reasoning, conceptualisations and arguments around the object of study, through a self-reflective analysis that is also sceptical about other forms of problematisation, and that combines philosophical analyses while being open to social implications and drawing upon empirical methods. The first article proposes a critical understanding of medicalisation as both a concept and a phenomenon, and explores what insights such critical understanding brings to ethical discussions about hGH for ISS. It argues that three main ethical issues concern the medicalisation of short stature: the downplayed role of the qualitative dimension of short stature, the justification of the treatment (as sometimes based on uncritically assumed social beliefs and unrealistic parental expectations), and possible misconduct of stakeholders. The second article examines the arguments for and against granting marketing authorisation of hGH treatment for the indication of ISS presented in selected FDA and EMA documents. It combines argumentative analysis with an approach to policy analysis called ‘what’s the problem represented to be’ and focuses on underlying assumptions and presuppositions about short stature and hGH treatment for ISS. It then discusses these arguments through the relational, experiential and cultural understandings of disability, and argues that the choice about whether to give hGH is not merely a choice based on efficacy and safety, but requires an examination of the values that we transmit by that choice. The third article examines how and why attendance to lived experiences of height is needed in bioethical and biomedical discussions of hGH treatment for children with ISS. It first describes what it defines as the ‘problem-oriented’ approach to the debate about hGH treatment for children with ISS. It then offers a sociophenomenological analysis of whether and, if so, when and how, height matters to the interviewed people in the Netherlands who are shorter than average without any known medical reasons. The sociophenomenological analysis shows the richness of meanings of lived experiences of short stature that cannot be captured by the problem-oriented approach, and suggests complementing clinical practices with narrative approaches. This research contributes to the ethical debate about using hGH for children with ISS, setting a critical gaze onto the social perception of short stature, highlighting some ethical challenges met by stakeholders involved at different levels (such as families, medical professionals and policy makers), and providing new insights into how to address these ethical issues. It is, therefore, of interest to stakeholders, bioethicists and lay people willing to explore alternative ways to address such bioethical dilemmas, and other paediatric interventions that aim to normalise children’s bodily characteristics.

Leading bioethicists from America, Asia and Europe discuss Jahr's visionary concept of an ethics of 'bios', integrating the ethics of land, community, health, and culture in light of global challenges in the 21st century.

In only four decades, bioethics has transformed from a fledgling field into a complex, rapidly expanding, multidisciplinary field of inquiry and practice. Its influence can be found not only in our intellectual and biomedical institutions, but also in almost every facet of our social, cultural, and political life. This volume maps the remarkable development of bioethics in American culture, uncovering the important historical factors that brought it into existence, analyzing its cultural, philosophical, and professional dimensions, and surveying its potential future trajectories. Bringing together a collection of original essays by seminal figures in the fields of medical ethics and bioethics, it addresses such questions as the following: - Are there precise moments, events, socio-political conditions, legal cases, and/or works of scholarship to which we can trace the emergence of bioethics as a field of inquiry in the United States? - What is the relationship between the historico-causal factors that gave birth to bioethics and the factors that sustain and encourage its continued development today? - Is it possible and/or useful to view the history of bioethics in discrete periods with well-defined boundaries? - If so, are there discernible forces that reveal why transitions occurred when they did? What are the key concepts that ultimately frame the field and how have they evolved and developed over time? - Is the field of bioethics in a period of transformation into biopolitics? Contributors include George Annas, Howard Brody, Eric J. Cassell, H. Tristram Engelhardt Jr., Edmund L. Erde, John Collins Harvey, Albert R. Jonsen, Loretta M. Kopelman, Laurence B. McCullough, Edmund D. Pellegrino, Warren T. Reich, Carson Strong, Robert M. Veatch, and Richard M. Zaner.

Before curing was a possibility, medicine was devoted to the relief of suffering. Attention to the relief of suffering often takes a back seat in modern biomedicine. This book seeks to place suffering at the center of biomedical attention, examining suffering in its biological, psychological, clinical, religious, and ethical dimensions.

This book argues that legal theory provides a jumping-off point for the study of controversial topics related to the work of Practicing Healthcare Ethicists (PHEs). Healthcare ethics consultation has had a place in healthcare for many decades yet the nature of the work is not well understood by many of its critics as well as its defenders. PHEs have been described as compromised and ineffectual, politicised and undemocratic, and their promise to offer sound advice has been deemed irredeemably incoherent in the context of value pluralism. Legal theorists have long attended to the relationship between law and morality, and the supposed tension between democracy and the role of an expert judiciary. An appreciation that these debates are not unique to the practice of healthcare ethics can help PHEs to engage critics with a renewed confidence and some fresh approaches to perennial, and hitherto unproductive, arguments. This book will be of great interest to practicing healthcare ethicists, as well as those who rely upon their services (healthcare professionals and healthcare leaders, patients, and their families) as well as academics working in the broader field of bioethics.

The moral theology of Hans G. Ulrich is presented here in English for the first time. These collected essays represent the culmination of a lifetime of reflection on Christian living from this German theologian in conversation with Luther, Bonhoeffer, and contemporary philosophers and theologians. Ulrich's ethics affirm the lively presence of the living work of God in orienting the daily life of Christians. This presence enables members of the Church to live as creatures trusting in God's promises, bearing witness in political and economic spheres, and trusting in life as a gift in response to bioethical issues. Ulrich's fresh take on living out of the promise of God yields further guidance on issues in international relations, economics, parenting, disability, and more.

This open access book about the Zadeh Project demonstrates and explores a core question in clinical ethics: how can ethics consultants be accountable in the face of a robust plurality of ethical standpoints, especially those that underwrite practices and methods for doing ethics consultation as well as those viewpoints and values encountered in daily clinical ethics practice? Underscoring this question is the recognition that the field of clinical ethics consultation has arrived at a crucial point in its maturation. Many efforts are underway to more formally “professionalize” the field, with most aimed toward stabilizing a specific set of institutional considerations. Stretched between these institutional and practical initiatives resides a crucial set of of ethical considerations, chief among them the meaning and scope of responsibility for clinical ethics consultants. Developed around a long-form case scenario, the Zadeh Project provides a multi-layered series of “peer-reviews”: critique of the actions of the case scenario’s ethics consultant; reflection on clinical ethics method; examination of the many ways that commitments to method and practice can, and do, intersect, overlap, and alter one another. The design and format of this book thus models a key element for clinical ethics practice: the need and ability to provide careful and thoughtful explanation of core moral considerations that emerge among diverse standpoints. Specifically designed for those studying to become and those who are ethics consultants, this book, with its innovative and multi-layered approach, allows readers to share a peer-review-like experience that shows accountability to be what it is, an ethical, not merely procedural or administrative, undertaking.

Reciprocity in Population Biobanks: Relational Autonomy and the Duty to Inform in the Genomic Era begins by discussing how current judicial interpretation keeps standard of disclosure at the core of genomic research. The book then outlines multiple limitations individualistic autonomy faces in the context of gene and population biobanks, including an analysis of the complexities of benefit considerations in the research setting. Second, the book explores how individualistic autonomy fails to acknowledge the multilateral relationships implicated in genomic research, including those that affect the broader research community, research participants' families, and the general public. In carrying out this analysis, this book pays special attention to alternative approaches and ways researchers, public health officials, and judicial bodies might interact in years to come. In other words, implementing an understanding of relational autonomy that acknowledges and sustains the multilateral relationships found in genomic research without compromising the rights of participants. In short, this book proposes a reconceived duty to inform for researchers and a new standard of disclosure that is more meaningful and impactful for research participants and researchers. - Examines the limitations individualistic autonomy faces in the context of gene and population biobanks - Proposes a reconceived duty to inform for researchers and a new standard of disclosure more meaningful to genomic research participants - Suggests ways researchers, public health officials, and judicial bodies might interact to drive genomic research while still protecting research participants