My goal for this book is to provide an engaging and concise introduction to the expanding field of health care ethics. The volume is designed to be accessible to university undergraduates, but detailed enough for graduate and professional school students and health care professionals in practice. Because it is an introduction to health care ethics, I have avoided stating and defending my own position on controversial moral issues and complex case examples. Rather, I have attempted to provide essential conceptual and factual information about the issues discussed, a fair statement of commonly held positions, and a review of central moral arguments. This approach, I hope, will enable readers to understand why the issues and cases are challenging, to engage in careful moral reasoning and deliberation about them, and to formulate and defend their own conclusions.
The book is divided into four parts. The five chapters of Part I offer basic information about health care ethics. These chapters provide an account of the role of ethics in health care, a brief history of health care ethics and clinical ethics consultation in the United States, a review of leading methods of moral reasoning in health care, and an examination of the relationships between law and ethics and between culture and ethics in health care. Part II examines the moral foundations of the therapeutic relationship between patients and health care professionals. Each of the six chapters in this part focuses on a central moral feature of that relationship, including privacy and confidentiality, truthfulness, informed consent to treatment, surrogate decision-making for patients who lack decision-making capacity, respect for professional boundaries, and responsible stewardship of health care resources. Part III is devoted to ethical issues in health care at the beginning and at the end of life. The seven chapters in this part explore the topics of assisted reproductive technologies, abortion, maternal-fetal conflict, advance care planning and advance directives, moral conflicts in end-of-life care, medical futility, and aid in dying. The three chapters of Part IV examine three additional areas of major interest and attention in health care ethics: biomedical research on human subjects, human genetics, and organ transplantation. Each of the four parts of the book begins with a brief introduction that includes a summary of the content of its individual chapters.