Public Bioethics : Principles and Problems Principles and Problems

Abstract

Doing public bioethics involves analyzing and assessing actual and proposed public policies regarding biomedicine, healthcare, and public health. “Public bioethics” also refers to commissions, councils, task forces, and the like, that are governmentally established, sponsored, or funded for the purpose of deliberating collectively about bioethical issues, again with a primary goal of recommending public policies. Most chapters in this book grow out of, some reflect on, and all are profoundly shaped by the author’s experiences as a participant in several public bioethics bodies, especially at the national level in the United States. The processes of publicly deliberating in such bodies about bioethical issues and appropriate policies and of publicly justifying collective recommendations have profoundly shaped this book. After examining respect for autonomy—both thin and thick conceptions—and paternalistic policies and practices, as well as the tensions between particular case judgments and general principles and rules, this book next examines the appropriate role of religious convictions in public bioethics and in public policy and in conscientious claims to exemptions from expectations to provide certain health-related services. The third section of the book focuses on public policies and practices in organ transplantation, particularly difficulties in determining death, in obtaining first-person consent for deceased organ donation, and in fairly allocating donated organs. The final section maps the terrain of public health ethics, argues for a presumptivist approach to justifying public health interventions that infringe civil liberties, proposes a framework of triage for public health crises, and recasts John Stuart Mill’s misunderstood legacy for public health ethics.