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Society's Choices: Social and Ethical Decision Making in Biomedicine
Content
EXECUTIVE SUMMARY
1
PART I
1
INTRODUCTION
27
Defining ''Ethical" Issues,
27
Sources of Ethical Issues in Biomedicine,
30
2
THE SOCIAL CONTEXT OF BIOETHICAL PROBLEM SOLVING
43
The American Character,
43
Actors Shaping the Social Context for Bioethics,
48
Health Care and Science: Shaping the Social Context for Bioethics,
53
3
SYSTEMATIC APPROACHES TO BIOETHICS
67
Academic Bioethics,
67
Scientists and Other Technical Experts,
75
Health Care Professional Education,
80
4
THE SPECTRUM OF SOCIETAL RESPONSES
87
Political and Legal Mechanisms,
89
Professional and Institutional Mechanisms,
115
Individual and Community Responses,
136
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Society's Choices: Social and Ethical Decision Making in Biomedicine
5
CRITERIA FOR SUCCESS
150
Intellectual Integrity
153
Sensitivity To Democratic Values,
155
Effectiveness
159
6
CONCLUSIONS AND RECOMMENDATIONS
168
Interpreting the Committee's Charge,
168
Criteria for Evaluation,
171
A Multilevel Approach to Bioethics Deliberation,
174
Recommendations,
176
PART II
COMMISSIONED PAPERS
Moral Epistemology
Thomas Nagel
201
Public Moral Discourse
Dan W. Brock
215
The Value of Consensus
Martin Benjamin
241
Bioethics Commissions: What Can We Learn from Past Successes and Failures?
Bradford H. Gray
261
Limiting Life-Prolonging Medical Treatment: A Comparative Analysis of the President's Commission and the New York State Task Force
Baruch A. Brody
307
The Formulation of Health Policy by the Three Branches of Government
Lawrence Gostin
335
The Role of Religious Participation and Religious Belief in Biomedical Decision Making
Charles M. Swezey
358
Trust, Honesty, and the Authority of Science
Steven Shapin
388
Institutional Ethics Committees: Local Perspectives on Ethical Issues in Medicine
Elizabeth Heitman
409
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Society's Choices: Social and Ethical Decision Making in Biomedicine
The Ethical, Legal, and Social Implications Program of the National Center for Human Genome Research: A Missed Opportunity?
Kathi E. Hanna
432
AIDS, Ethics, and Activism: Institutional Encounters in the Epidemic's First Decade
Ronald Bayer
458
"La Pénible Valse Hésitation"1: Fetal Tissue Research Review and the Use of Bioethics Commissions in France and the United States
R. Alta Charo
477
APPENDIX PAST COMMISSIONS AND ADVISORY BOARDS
503
INDEX
521
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Society's Choices: Social and Ethical Decision Making in Biomedicine
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Society's Choices: Social and Ethical Decision Making in Biomedicine
SOCIETY'S CHOICES
Social and Ethical Decision Making in Biomedicine
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Society's Choices: Social and Ethical Decision Making in Biomedicine
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