Arthur L. Caplan

Thomas H. Murray

The fate of seriously ill newborns has captured the atten tion of the public, of national and state legislators, and of powerful interest groups. For the most part, the debate has been cast in the narrowest possible terms: "discrimination against the handicapped"; "physician authority"; "family autonomy." We believe that something much more profound is happening: the debate over the care of sick and dying babies appears to be both a manifestation of great changes in our feelings about infants, children, and families, and a reflection of deep and abiding attitudes toward the newborn, the handi capped, and perhaps other humans who are "less than" nor mal, rational adults. How could we cast some light on those feelings and attitudes that seemed to determine silently the course of the public debate? We chose to enlist the humanities-the dis players and critics of our cultural forms. Rather than closing down the public discussion, we wanted to open it up, to illuminate it with the light of history, religion, philosophy, literature, jurisprudence, and humanistically oriented sociol ogy. This book is a first effort to place the hotly contested Baby Doe debate into a broader cultural context.

Humanistic Dimensions of the Care of Imperiled Newborns

Which Babies Shall Live?

Willard Gaylin

Ruth Macklin

The place of drugs in American society is a problem more apt to evoke diatribe than dialog. With the support of the Na tional Science Foundation's program on Ethics and Values in Science and Technology, and the National Endowment for the Humanities' program on Science, Technology, and Human Values, * The Hastings Center was able to sponsor such dialog as part of a major research into the ethics of drug use that spanned two years. We assembled a Research Group from leaders in the scientific, medical, legal, and policy com munities, leavened with experts in applied ethics, and brought them together several times a year to discuss the moral, legal and social issues posed by nontherapeutic drug use. At times we also called on other experts when we needed certain issues clarified. We did not try to reach a consensus, yet several broad areas of agreement emerged: That our society's response to nontherapeutic drug use has been irrational and inconsistent; that our attempts at control have been clumsy and ill-informed; that many complex moral values are entwined in the debate and cannot be reduced to a simple conflict between individual liberty and state paternalism. Of course each paper should be read as the statement of that particular author or authors. The views expressed in this book do not necessarily represent the views of The Hastings Center, the National Science Foundation, or the National En dowment for the Humanities.

Ethics and Nontherapeutic Drug Use

Feeling Good and Doing Better

Voo Teck Chuan

This volume presents articles which focus on the ethical evaluation of performance-enhancing technologies in sport. The collection considers whether drug doping should be banned; the rationale of not banning ethically contested innovations such as hypoxic chambers; and the implications of the prospects of human genetic engineering for the notion of sport as a development of ’natural’ talent towards human excellence. The essays demonstrate the significance of the principles of preventing harm, ensuring fairness and preserving meaning to appraise whether a particular performance enhancer is acceptable in the context of sport. Selected essays on various forms of human enhancement outside of sport that highlight other principles and concepts are included for comparative purpose. Sport enhancement provides a useful starting point to work through the ethics of enhancement in other human practices and endeavors, and sport enhancement ethics should track broader bioethical debates on human enhancement. As a whole, the volume points to the need to consider the values and meanings that people seek in a given sphere of human activity and their associated principles to arrive at a morally grounded and reasonable approach to enhancement ethics.

The Ethics of Sports Technologies and Human Enhancement

"Why are some technologies such as fiberglass vaulting poles and hinged skates accepted in sport while performance-enhancing drugs are forbidden? Yes, performance-enhancing drugs are against the rules, but the people who play and govern sport create those rules; rules can be changed. Should we level the playing field by allowing all competitors to use drugs that allow them to run faster or longer, leap higher, or lift more? In this provocative exploration of what draws us to sport as participants and spectators, Good Sport argues that the values and meanings embedded within our games provide the guidance we need to make difficult decisions about fairness and performance-enhancing technologies. Good Sport reveals what we care about in sport. It describes how the reckless use of biomedical enhancements undermines those values. Implicit in sport's history, rules and practices are values and meanings that provide a sturdy foundation for an ethics of sport that celebrates natural talents and dedication. The way a sport adapts to innovations in equipment, tactics and players makes visible its values and meanings. Performance-enhancing drugs distort the connection between natural talents, the dedication to perfect those talents, and success in sport. Through understanding the fundamental role of values and meanings, we can see not just what we champion in the athletic arena but more broadly what we value in human achievement"--

Why Our Games Matter -- and how Doping Undermines Them

Good Sport

Robert F. Murray, Jr.

Mark A. Rothstein

"The volume deserves our serious attention. The authors have provided us an invaluable primer about the HGP and its implications for the future of American health care." -- Jurimetrics "This book does make a real contribution... in explaining why the genetics revolution holds so much promise and why it is so difficult to bring that promise to fruition." -- The Journal of Legal Medicine "... marked by a forward-looking, analytically and empirically grounded thematic coherence. The editors' carefully crafted template and contributions successfully focus and organize the material." -- Annals of Internal Medicine "Excellent" -- Canadian Medical Association Journal "The editors have done a very good job integrating the contents into a very useful and readable information source." -- Choice "... this highly focused book is a well-written, thoughtful, and insightful consideration of the HGP and is valuable reading for anyone concerned with the future of our country's medical infrastructure." -- Science Books & Films (**Highly recommended) "A distinguished group of scientists, lawyers, and scholars have written a coherent, readable account of the legal, medical, ethical, and policy issues many (if not all) of us will be wrestling with on both a personal and a public level, as a result of current genetic research." -- Library Journal "Each of the contributors is a distinguished authority on the topic. Ethicists, especially, will find well-developed presentation of issues, with exposition of the differing ethical assumptions in tension in the society debate." -- Doody's Health Sciences Book Review Home Page How will the science of gene mapping and gene manipulation affect health care? Leading scholars explore the clinical, ethical, legal, and policy implications of the Human Genome Project for the forms of health care, who delivers it, who receives it, and who pays for it.

Thomas H. Murray

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