Wk3 Prenatal Testing Scenario and Reflection

Medical Ethics Accounts of

Ground-Breaking Cases EIGHTH EDITION

Gregory E. Pence University of Alabama at Birmingham

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MEDICAL ETHICS: ACCOUNTS OF GROUND-BREAKING CASES, EIGHTH EDITION

Published by McGraw-Hill Education, 2 Penn Plaza, New York, NY 10121. Copyright © 2017 by McGraw-Hill Education. All rights reserved. Printed in the United States of America. Previous editions © 2015, 2011, and 2008. No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written consent of McGraw-Hill Education, including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning. Wk3 Prenatal Testing Scenario and Reflection

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Library of Congress Cataloging-in-Publication Data

Names: Pence, Gregory E., author. Title: Medical ethics: accounts of ground-breaking cases / Gregory E. Pence,  University of Alabama at Birmingham. Other titles: Classic cases in medical ethics Description: Eighth edition. | New York, NY: MHE, [2017] | Audience: Age:  18+ | Editions 1-5 published under: Classis cases in medical ethics. |  Includes bibliographical references and index. Identifiers: LCCN 2016026704 | ISBN 9781259907944 (alk. paper) Subjects: LCSH: Medical ethics–Case studies. Classification: LCC R724 .P36 2017 | DDC 174/.2–dc23 LC record available at  https://lccn.loc.gov/2016026704

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iii

This new edition retains in-depth discussion of famous cases, while providing updated, detailed analysis of the issues those cases raise. Each chapter also focuses on a key question that could be debated in class.

Unique to this text is a single, authorial voice integrating description of the cases and their issues with historical overviews. The text is the only one that follows cases over decades to tell readers what did and, often, what did not, happen. Written by a professor who helped found bioethics and who has published in the field for 40 years, the text gives students a sense of mastery over this exciting, complex field. After they have read the book, I hope that students will feel that they have learned something important and that time studying the material has been well spent.

New to the 8th Edition New research was added to each chapter, and a new list of topics to debate was included on the inside cover of the book. Every chapter has been rewritten, tight- ened, and augmented; issues have been clarified. Highlights of the new edition are outlined here.

A NEW CHAPTER ON ALCOHOLISM (and addiction): Conflicting views on causes of alcoholism: Alcoholics Anonymous, neuroscience, Kant, genetics, social sciences, Fingarette. Focus on the famous case of Ernie Crowfeather.

A MAJOR NEW CASE: The Bucharest Early Intervention Project: Is it the Tuskegee Study of neuroscience? Research on vulnerable human populations?

A MAJOR NEW SECTON on research on people with schizophrenia, including cases of patients harmed by such research.

Discussion of Ebola and Zika virus in AIDS chapter: How it has resembled our responses to AIDS?

Discussion on CRISPR, the revolutionary method of changing genes that almost any geneticist can use to change a species and its progeny.

Update on the Patient Protection and Affordable Care Act: Why it’s working and what are its latest problems?

Preface

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iv Preface

Death and Dying: The case of Brittany Maynard; the case of Jahi McMath.

Comas: Update on cases of Terri Schiavo, Belgian coma patient Rom Houben, and minimally conscious states.

Abortion: Updates on death of Kenneth Edelin, declining numbers of abortion in America. New topics: Telemedicine and early-stage self-abortions, the Planned Parenthood video controversy, US Supreme Court decision limiting TRAP (Tar- geted Regulation of Abortion Providers) laws.

Assisted Reproduction: Updates on the Gosselins, McCaughey septuplets, IVF clinics, mistaken swaps of embryos, outsourced surrogates, and foreigners using American surrogates; a sperm donor meets eight of his children, right-to-life groups file in court to protect frozen embryos; state surrogacy laws, Snowflake (embryo adoption and its high costs), brighter chances for infertile women aged 30–40 of having IVF baby on late tries.

Stem Cells, Cloning, and Embyros: Updates on stem cells, battles over embryos among divorced couples and right-to-life friends, mitochondria-swapping to cure genetic disease (“a child with three parents”); hucksterism in selling stem- cell therapies; continuing problems in cloning primates.

Impaired Babies and Americans with Disabilities Act: Update on “Baby Jane Doe” Keri-Lynn, Marlise Munoz case; UAB’s controversial SUPPORT study on preemies, relevance to babies born with microcephaly from Zika virus.

Ethics of Research on Animals: Updates on the Great Ape Project, Edward Taub’s work, legal protection for chimpanzees in research.

Transplants and Organ Allocation: Updates on numbers, costs, and outcomes, especially for tracking bad outcomes of adult organ donors.

Genetics chapter: The pitfalls and promises of: personalized genetic testing and Big Data, CRISPR, and testing for diseases with no treatments.

Chapter on Enhancement: New emphasis on relation of enhancements to people with disabilities.

If you have suggestions for improvement, please email me at: pence@uab.edu.

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vii

Gregory E. Pence is professor and chair of the Department of Philosophy at the University of Alabama at Birmingham. Between 1977 and 2011, he taught medical ethics at the University of Alabama Medical School. He still directs its Early Medi- cal School Acceptance Program.

In 2006, and for achievement in medical ethics, Samford University awarded him a Pellegrino Medal. He testified about human cloning before committees of the U.S. Congress in 2001 and the California Senate in 2003.

He graduated cum laude in Philosophy with a B.A. from the College of William and Mary in 1970 and earned a Ph.D. from New York University in 1974, working mainly under the visiting professor, Peter Singer.

In 2010, his UAB team was national champion of the Intercollegiate Ethics Bowl. His teams won national championships of the Bioethics Bowl at Duke University in 2011 and Florida State University in 2015. At UAB, he has won both the Ingalls and President’s Awards for excellence in teaching.

• He has written six trade books, including Who’s Afraid of Human Cloning? (1998), Re-Creating Medicine: Ethical Issues at the Frontiers of Medicine (2000), Designer Food: Mutant Harvest or Breadbasket of the World? (2002), Cloning after Dolly: Who’s Still Afraid? (2004), How to Build a Better Human: An Eth- ical Blueprint (2012), and What We Talk about When We Talk about Clone Club: Bioethics and Philosophy in Orphan Black (2016). Wk3 Prenatal Testing Scenario and Reflection

• He has edited four books of general essays, Classic Works in Medical Ethics (1995), Flesh of My Flesh: The Ethics of Cloning Humans (1998), The Ethics of Food: A Reader for the Twenty-First Century (2002), and Brave New Bioethics (2004).

• He has published over 60 op-ed essays in national publications: two each in the New York Times, Los Angeles Times, Newsweek, and Chronicle of Higher Education; one each in the Los Angeles Times, Atlanta Journal-Constitution, and Philadelphia Inquirer; and 35 in the Sunday Birmingham News. His reader, Brave New Bioethics, collects these essays from 1974 to 2002.

• A full list of books by Gregory Pence is available through Connect.

About the Author

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viii

Several people helped in preparing the 8th edition of this text. Users of this text also improved the new edition with their suggestions and

corrections. In particular, Charles Cardwell, Pellissippi State Community College in Tennessee, and Jason Gray, who taught bioethics at UAB for two years, spotted many errors and made many helpful suggestions, as did my colleagues Josh May and Matt King. My research assistant Karan Jani wrote helpful summaries of the Bucharest Early Intervention Project and CRISPR. Lillian Chien provided amazing proofing at the last stage. Wk3 Prenatal Testing Scenario and Reflection

The ansrsource developmental editing, lead by Anne Sheroff and Reshmi Rajeesh were the perfect editors and helped me take this text to a higher level. I also appreciate the following reviewers for the eighth edition:

Brendan Shea, Rochester Community and Technical College, Minnesota Sarah Schrader, University of California, Santa Cruz, California

Acknowledgments

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Chapter 1 Good and Bad Ethical Reasoning; Moral Theories and Principles  1

Chapter 2 Requests to Die: Terminal and Nonterminal Patients  19

Chapter 3 Comas: Karen Quinlan, Nancy Cruzan, and Terri Schiavo  57

Chapter 4 Abortion: The Trial of Kenneth Edelin  84

Chapter 5 Assisted Reproduction, Multiple Gestations, Surrogacy, and Elderly Parents  109

Chapter 6 Embryos, Stem Cells, and Reproductive Cloning  132

Chapter 7 Impaired Babies and the Americans with Disabilities Act  157

Chapter 8 Medical Research on Animals  179

Chapter 9 Medical Research on Vulnerable Populations  196

Chapter 10 Ethical Issues in First-Time Organ Surgeries  221

Chapter 11 The God Committee  243

Chapter 12 Using One Baby for Another  264

Chapter 13 Ethical Issues in the Treatment of Intersex and Transgender Persons  284

Chapter 14 Involuntary Psychiatric Commitment and Research on People with Schizophrenia  299

Chapter 15 Ethical Issues in Pre-Symptomatic Testing for Genetic Disease: Nancy Wexler, Angelina Jolie, Diabetes and Alzheimer’s  325

Chapter 16 Ethical Issues in Stopping the Global Spread of Infectious Diseases: AIDS, Ebola, and Zika  346

Chapter 17 Ethical Issues of the Patient Protection and Affordable Care Act  367

Chapter 18 Ethical Issues in Medical Enhancement (and their effect on people with Disabilities)  392

Chapter 19 Ethical Issues in Treating Alcoholism  405

Brief Contents

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