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From page 521...
... Index A Abortion, 47, 172 as bioethics topic, 187-188 fetal research and, 97, 98, 138, 173, 481, 482-483, 484, 496-497 nn.3738 French debate, 488 grassroots movements, 8, 138-139 legal environment, 106, 107, 341342, 344 in National Commission deliberations, 267 political conflicts over, 94, 353, 477478 women's movement and, 50, 52 Abram, Morris B., 246-247, 269 Academic-industry collaboration, 2, 3, 27, 39-41 benefits of, 60-61 ELSI Working Group on, 441-442 Access to care, 3, 359 antipoverty programs and, 48 hospital resources and, 37 insurance trends in, 37-38, 57 new medical technology and, 38-39 521 President's Commission on, 92, 93, 101, 102, 162, 266, 289 social justice issues in, 247-248, 350 Accountability in health care, 35-36 in policymaking, 337 of science, 79-80 in science research, 62 Accreditation, 7, 125, 181, 412413 ACT-UP. See AIDS Coalition to Unleash Power Action-forcing power of national commissions, 91, 101, 174, 191 of supra-agency ethics commission, 21-22, 191 Adams, Arlin, 482 Advance directives, 100, 105, 163, 309, 313,317,318,322,324,412 legal conceptualizations, 343 Advisory Committee on Human Radiation Experiments, 33-34 African Americans, 48-49, 139-140, 141, 156 Agency for Health Care Policy and Research, 120-121
From page 522...
... refusal of treatment, 309, 315 Association of American Medical Colleges (AAMC) , 81, 83 Association of State and Territorial Health Officials, 464-465 Augenstein, Leroy, 69 Australia, 109, 110 B Baby Doe issues, 102, 119, 121, 318319, 411 Baby M case, 100 Barnes, Barry, 394-395 Bauer, Gary, 481, 482 Bayer, Ronald, 247 Bayh-Dole Patent and Trademark Laws Amendment Act, 59 Beckwith, Jonathan, 438-439 Beecher, Henry, 32 Beneficence, 91 Bentham, Jeremy, 206 Bernard, Claude, 30 Bernard, Jean, 491, 492 Beta-thalassemia, 140 Bioethics academic development, 67-70 centers for study of, 8, 69, 131-133 complexity of moral decision making in, 252 conceptual evolution, 4, 176 core issues, 358, 359 current deliberations, 73, 168 as government domain, 5-6 multidisciplinary investigations, 7475 as philosophic discipline, 70-73
From page 523...
... Supreme Court, 342, 425 Boyle, Robert, 397, 398 Breast cancer, 51 British Medical Association, 113 Brody, Baruch, 247-248 Brooklyn Jewish Chronic Disease Hospital, 32 Bush administration, 348, 352, 445, 477, 483, 485 Bypass surgery, 15, 170 C Califano, Joseph, 94, 95 California, 313, 314, 480 Natural Death Act, 105, 313 Calvin, John, 370 Canada, 110, 115, 428 n.3, 485486 Cancer, 480 research, 63, 96 Canterbury v. Spence, 34 Capron, Alexander, 269 Cardiopulmonary resuscitation, 324325 Carter administration, 135, 269, 300, 306 n.4 523 Centers for Disease Control, 94 in AIDS/HIV research, 459, 460, 461, 467 Changeux, Pierre, 491-492 Civil rights movement, 4, 48 Clinical practice guidelines, 116 artificial nutrition and hydration, 121-122 problems of, 120-121 for seriously ill newborns, 121, 411 Clinton administration, 8, 27, 33-34, 58, 62, 157, 173, 353, 485 Cloning, 14-15 Closed meetings, 11-12, 156-159, 171, 299 in hospital ethics committee deliberations, 416 Cobbs v.
From page 524...
... closed meetings, 156-159, 171, 299, 416 overlapping consensus in, 243-244 policy/practice impact, 304-305 in policymaking, 1-2, 216-217 populist model, 110-112 potential negative outcomes of, 14, 164-167 prestige factors, 305 n.3 private model, 112-113 problems of process, 256-257 professional dominance of, 114 professional ethicists in, 222-223 in professional scientific societies, 78 public access, 114 public education role, 111, 217 report-writing style, 12, 159 role of, 261 role of consensus in, 252-253 single-interest advocacy in, 14, 164165, 475 sponsorship, 114, 299 staff structure, 115, 302-303, 306 n.6 state-sponsored, 6, 19, 99-100, 184185 supra-agency national organization, 15-16, 19-23 trade-offs in design/activities of, 301 See also Evaluation of commissions; Mechanisms of ethical decision making; Membership of commissions; specific commission Community-based organizations, 8-9, 137, 139-141, 143-144 Compromise, 161, 232, 244-245, 258 n.4, 475 See also Consensus Confidentiality, 97 AIDS/HIV and, 458, 459463, 464, 465, 466 American Medical Association on, 117 in genetic research, 440, 450, 451 in hospital ethics committee deliberations, 416 in human subjects research, 123 legal basis of medical privacy, 341, 342 National Commission on, 284 President's Commission on, 92, 93, 266 supra-agency commission on, 186 Congress, U.S. bioethics advisory boards, 6 ELSI Working Group and, 445-447 legislative authority, 34~346 Office of Technology Assessment, 130, 346-347 political functioning, 45-46 in regulation of scientific research, 33, 40, 62, 78, 9~94 supra-agency national commission and, 189, 190 Conroy case, 99, 122 Consensus, 13, 102, 151 in AIDS/HIV research design, 47 471 in bioethics commissions, 252-253, 257-258 closed meetings and, 157-159 complete form, 242-243
From page 525...
... Merrell Dow Pharmaceuticals, 76, 80, 340 Death, definition of, 79, 322 moral values in, 372, 373 President's Commission on, 92, 93, 101, 151-152, 164, 216, 266, 286, 306 n.12 public education on, 111 state ethics commissions on, 6, 99, 100, 105, 184, 185, 322 Declaration of Helsinki, 31 Deductive reasoning, in moral justification, 223-226, 229, 231, 232 Deinstitutionalization, 343-344 Democratic process American tradition, 43-44, 335-336 in bioethics forums, 11-12, 77, 155159 .
From page 526...
... Working Group, ix, x, 6, 74 on Americans with Disabilities Act, 442, 447, 452, 453 budget, 437 bureaucratic status, 438, 446, 453454 cystic fibrosis screening program, 447-449 development of, 437438 on family genetic research, 450 genetic research bioethics prior to, 434436 grants program, 443445, 447 on insurance issues, 450452 membership, 97, 438439, 442, 512 .
From page 527...
... refusal of treatment, 309 Evaluation of commissions citations to National Commission as criterion for, 270-274 citations to President's Commission as criterion for, 270-272, 274-276 comparative, on life-prolonging medical treatment, 307-308 consensus as criterion for, 13, 160162, 257-258 criteria, 9-14, 114-115, 152-153, 171174, 262-263 as educational mechanisms, 152 hospital ethics committees, 427428 institutional review boards, 17-18, 125, 181-182 legal influence as criterion for, 13 methodology for, 269-270, 276-280 obstacles to, 150-152, 166, 171-173 by participants, 27~280 policy influence as criterion for, 152, 280, 304-305 Expert witnesses, 76, 80,118, 340-341 Experts in ethics qualifications, 10 resources of science and law in, 7677 F Facts, 80 Faden, Ruth, 467, 468 Federal Coordinating Committee on Science and Technology, 442 Federal government absence of bioethics review in, 11 117, 118, 168, 173 bioethics advisory bodies, 6, 94-99, 186 biomedical research funding, 58-59 executive branch in policymaking, 351-353 on fetal tissue research, 481484, 485 527 genetic testing issues in, 175 in health care policymaking, 335-336 health insurance programs, 54-55 human research regulation, 7, 31, 32-34, 89 legislative authority, 345-346 in new medical technology development, 38-39 political process, 4546 recommendations for, 19, 186 in scientific research, 61-63 See also Congress, U.S.; specific agency Federal Technology Transfer Act, 59 Feminist philosophy, 73, 79, 165 Fetal disorders, viii Fetal protection laws, 337 Fetal tissue research, 168, 306 n.4 abortion and, 97, 98, 138, 162, 173, 481, 482483, 484, 496497 nn.3738 bioethics commissions on, 481486 Biomedical Ethics Board on, 94 in Canada, 485-486 contributions of, 480, 486 ethics issues in, 482483 federal guidelines, 481 French bioethics commission, 479, 486493 funding for, 481, 485 HARP on, 6, 97-99, 172, 173, 191, 482484, 495 n.26 moral arguments in, 244 National Commission on, 283 political context of policy debate, 353, 479, 480, 495 n.29 professional societies on, 484-485 state regulations, 480-481 supra-agency commission on, 186 transplantation, 97-99 Fialuridine, 124 Firth, R., 71 Fletcher, Joseph, 34, 69 Florida, 315 Food and Drug Administration, 17, 40, 51, 53, 182, 468 Foundationalist beliefs, 225-226, 232, 239 n.6 Fox, Renee, 82 France, 112, 114, 478479, 486-493
From page 528...
... See Congress, U.S.; Federal government; Policymaking; State governments Grant applications ELSI program, 443-445, 447 INDEX ethical implications reviewed in, 16 federal ethics board for review of, 477 at National Institutes of Health, 443 reductionism in review process, 443 trends, 40 Grassroots organizations, 5, 8-9, 87, 88, 165 bioethics deliberation in, 136-139 in policymaking, 43-44, 46, 178 in state policymaking, 185 Griswold v. Connecticut, 105-106, 341 Groupthink, 256-257 GustaLson, James, 69 H Harris, Patricia, 95 Hastings Center, 8, 69, 132-133, 410, 461463, 466 Health, Education, and Welfare, Department of, 6, 32, 33, 90, 91, 93, 94-95 Health and Human Services, Department of, 118, 173, 341, 351, 445446, 453-454, 477 Human Fetal Tissue Transplantation Research Panel, 97-99 recommendations for, 19, 22, 186, 192 Health care agent, 325-326 Health Care Financing Agency, 175 Health care professionals bioethicists, 68 conscientious objection to lifeprolonging therapy decisions, 328, 331 ethics training for, 18, 81-84,182-183 with HIV, 349 n., 350 humanistic training for, 82 status of, 35, 55 training in technology vs.
From page 529...
... See AIDS/H~ Hobbes, Thomas, 203-204, 205,210, 211 Hospital ethics committees, 3, 5, 77 administrative structure, 419 consensus-making in moral decisions, 248 consultative process, 415418 cost containment issues, 42~427 disagreement with decisions of, 417418 documentation, 417, 419 educational role, 414-415 effectiveness of, 127 evolution of, 125-126, 325, 327-328, 409412 future of, 127 genetic testing issues, 175 guidelines for, 119 leadership, 419420 legal liability, 425426 in long-term care settings, 424-425 membership, 126, 420423 networks, 126-127, 423-424 performance evaluation of, 427-428 prevalence, 413 professional ethicists in, 422423 recommendations for, 17, 180-181 role of, 7, 126-127, 181, 411, 41~418 standard of care issues, 426 Hospitals, 178 financial management in, 37 in life-prolonging treatment decisions, 308, 311 spending in, 58 trends, 55-57 Human Fetal Tissue Transplantation Research Panel (Ht'l~l'RP)
From page 530...
... ~ . minorities as, o1 National Commission on, 216, 266, 284 President's Commission on, 289, 290 regulations for protection of, 2, 3134, 91, 172, 174 risk assessment, 123 subject truthfulness, 471472 vulnerable populations, 123 women as, 51, 129 Human rights, 339 AIDS/HIV issues, 459460, 466 antidiscrimination legislation, 348349 in legal health care decisions, 345 tuberculosis control and, 472473, 474 Hume, David, 203, 205-206 I Idaho, 313, 314 Ideal Observer theory, 71 Immunizations, 15, 170 Impartiality in ethics commissions, 102, 156 as moral philosophical concept, 208-209 INDEX in policymaking, 337 In vitro fertilization, 15, 116-117, 170, 490 government oversight, 94, 95, 173 research funding, 118 Individual interest in American social tradition, 34, 4344 collective self-interest and, 203-205 in construction of moral belief, 202, 203 in ethical debate, 29 impartial resolution of conflicts in, models of, 208-209 in moral system, 233 in natural rights formulation, 205, 206 public interest vs., viii, 213 public interest vs., in research protocols, 470 in reproductive decisions, 105-106 in universalizability formulation of morals, 207, 208, 213 in utilitarian philosophy, 205-207, 208, 211 Infectious disease classification of, as policy issue, 336337 state responsibility, 19, 184 tuberculosis, 472474 Informed consent, 2, 119 conceptual development in health care, 34-36 as HIV issue, 458 in human subject research, 31 .
From page 531...
... Everett, 53 Krim, Mathilde, 461 L Leake, Chauncey, 68-69 Legal system, 5 accountability of science in, 79-80 advance directives in, 343 antidiscrimination legislation, 348349 care for severely impaired newborns in, 411 cites to National Commission, 272273 cites to President's Commission, 274 context of ethics commissions in, 220 definition of death in, 102 in do not resuscitate guidelines, 324 documentation of hospital ethics committee proceedings, 417 establishment of hospital ethics committees, 412 as ethical decision-making mechanism, 6, 104-107, 171 evaluation of ethics advisories in, 13 fetal protection laws, 337 forms of public discourse and, 7~77 in health policy formulation, 339-345 informed consent concept in, 34-35 liability of hospital ethics committees, 425426 life-prolonging treatment decisions, 121-122, 308, 313-316, 342 malpractice claims, 38 mental health policy in, 343, 344-345
From page 532...
... . patient competency in c Recision making, 308, 309, 313, 315-316, 322, 329-330 patient's perspective in, 308, 312, 317 for persistent vegetative state patients, 320 practitioner guidelines, 118, 119 INDEX President's Commission on, 101-102, 307, 308, 310-311, 313, 31~322 refusal of, euthanasia vs., 309, 314, 319 refusal of, suicide vs., 309, 314, 315, 319 right to refuse, 36, 308, 342 for seriously ill newborns, 121, 318319, 411 state regulation of, 18, 172, 184 supra-agency commission on, 186 surrogate decision making, 309, 313, 314, 315, 316, 318-319, 324, 325-326 withdrawal of, x, 105, 313-322, 342343 Living wills, 309, 314, 317, 318, 326 Lobbying, 346, 347-348 Locke, John, 203, 204-205, 206, 208, 393, 397 Long-term care facilities, 424-425 Lowe, Charles U., 267-268 M Majority rule, 245-246 Malpractice, 38, 118 hospital ethics committees and, 425426 Managed competition, 55, 57 Maryland, 412, 413, 425 Massachusetts, 315-316, 317 McCann v.
From page 533...
... moral differences, 227-228 dimensions of religious belief, 359360, 370-371 epistemological methodologies in, 203 as epistemological subject, 201-202 expertise in, 222 foundational beliefs in, 225-226, 232, 239 n.6 generalizability of, 231, 233 goals of, 211-212, 213 good and evil in, 361-363, 379 guidance for conduct, 368-370, 373 human agency formulations in, 375376 in human embryo research debate, 244-245 identification of, in ethics commission justifications, 234235
From page 534...
... , viii, 33, 157 accomplishments of, 70, 102, 163, 171, 172, 174, 269, 297 action-forcing power, 91, 101, 174, 191 assessing effectiveness of, method for, 269-270 bureaucratic location, 267-268, 299 citations to, 269, 270-274 consensus in, 243 evaluation by participants, 276-285, 291-293 on fetal research, 481 mandate, 90, 101, 266, 285, 505 membership, 90-91, 100-101, 265, 267, 505 origins of, 2, 6, 90, 481 on patient rights, 36 policy influence, 280-283, 29~295, 304 President's Commission and, 100102, 263-265, 266-267, 294-296 products of, 91-92, 101-102, 262, 506 role of, 70, 101, 216 staff role, 302 structural factors in performance of, 103, 267-268, 269, 293, 296-297, 299 National Council of Churches, 135 National Heart Institute, 89-90 National Institutes of Health, 129, 353 bioethics advisory bodies, 6 in biomedical research funding, 38, 39, 48, 62 genome research, 437438 grants management in, 40, 62, 443 human research guidelines, 31, 51
From page 535...
... Axelrod, 336 New York State Task Force on Life and the Law, x, 19, 99, 157, 162, 163, 171, 172 on advance directives, 163 closed meetings of, 157, 171 on do not resuscitate orders, 323325, 328-330 on hospital ethics committees, 327328 535 on life-sustaining medical treatment, 172, 307, 308, 322-332 mandate, 6, 99, 323, 516 on medical staff conscientious objection, 327-328 membership, 516-517 origins, 99, 322 reports, 99, 172, 517 on surrogate decision making, 325331 on surrogate parenting, 162 Newton, Isaac, 398-399 Noninvasive assessment, 30-31, 57 Norplant, 156 North Carolina, 313, 314 Nuffield Foundation Council on Bioethics, 113 Nuremberg Code, 2, 31, 89 Nurses/nursing, 82, 416, 421 o Office of Science and Technology Policy, 22, 192 Office of Technology Assessment bioethics deliberations in, 7, 127, 130-131 on cystic fibrosis screening, 449 in evaluation of bioethics commissions, 171 on genetic research, 176, 435, 442 political process and, 131 recommendations for, 17, 181, 192 role of, 130, 261, 346-347 structure, 130 Oklahoma, 480 Oregon, 141-143, 185 right to refuse life-prolonging treatment in, 313, 314 Organ transplantation, 99, 184 Outcomes research, 36 Outpatient care, 57 p Pan American Health Organization, 109 Parkinson's disease, 480, 481
From page 536...
... , 314, 316, 318, 320 Personhood issues, 320 Pharmaceutical industry AIDS treatments, 53, 138, 470472 contraception research, 138-139 new product development, 59-60 physicians and, 119 women's movement and, 51 Philanthropy, 37 Physicians disagreement with hospital ethics committee, 417418 hospital ethics committee consultations, 415417 as hospital ethics committee members, 420421 malpractice risk management, 38 pharmaceutical industry relations, 119 training of, recommendations for, 18, 182-183 See also Health care professionals Planned Parenthood of Southeastern INDEX Pennsylvania v. Casey, 106, 341342 Policymaking abortion deliberations, 187-188, 477478 AIDS issues, 458459, 474475 American tradition, 43-44 bioethical philosophy in, 72-73 bioethicist-activist collaborations, 475 classification of disease in, 336-337 diversity of views in, 332, 454 ELSI program in, 442, 445447, 451452, 453454 ethical decision making in, viii, 218222, 239 ethical issues as subjects of, 5-6 as evaluation criteria for bioethics bodies, 152, 280, 304-305 evaluation of advisory reports in, 914 evaluation of proposals, 338-339 executive branch in, 351-353 expert ethics advisors in, 8, 67-68 fetal tissue research in, political context of, 479, 480 forums for ethical debate, 5 framework for, 336-339 French bioethics commissions in, 478479, 486493 gay and lesbian issues in, 53 genetic research in, 434437 as goal of bioethics commissions, 12, 216-217 grassroots movements in, 8-9 in health care, 335-336 HIV screening, 463466 human rights considerations in, 339 impartiality in, 29, 71 information-gathering for, 337-338, 347, 351 interest group lobbying in, 346, 347348, 351 judiciary in, 339-345 legislature's role in, 345-351 long-term perspective in, 348 minorities in, 48-50 moral conceptualizations in, 210, 212-213
From page 537...
... INDEX moral philosophy in context of, 201, 210, 212-213 multilevel approach, 15-16, 174-176, 177-178 national bioethics commissions in, 115 National Commission influence, 280-283 nongovernmental participants in, 16-18, 178-183 overlapping moral consensus, 237238 participants in, 336 political process and, 45-46, 346, 347 President's Commission influence, 286, 289 professional organizations in, 116 public participation in, 337 religious groups in, 44, 46-48 research funding, 62, 444-445 research grant review process and, 443, 444-445, 449 restrictions on reasons for justification, 237-238 right to die legislation, 343 role of consensus in, 217 role of New York State Task Force on Life and the Law in, 323 single-interest advocacy in, 14, 156, 164-165, 475 systems of moral justification in, 223-228 value of commission consensus in, 247 women's movement in, 50 Power of attorney, 317, 318, 326 Preexisting conditions, 38, 54 Prenatal diagnosis, 489 Presbyterian Church, 8, 134 President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (President's Commission) , viii, ix, x, 73, 107, 157, 171 on access to care, 162 action-forcing power, 101, 191 on assisted suicide/euthanasia, 319320 autonomy of, 103, 299 537 citations to, 269, 270-272, 274-276 consensus in, 246-247 context in evaluation of, 309 criticisms of, 286, 289 on defining death, 101, 151-152, 164, 216, 306 n.l2 effectiveness of, 174, 216-217, 269270, 272, 297-299 evaluation by members of, 276-280, 285-291, 293-294, 306 n.ll evaluation of, method for, 269-270 factors for success in, 293-294, 295296 funding of, 92-93 on genetic research, 152, 435-436 on hospital ethics committees, 410411, 417 ideological conflicts, 293, 300-301, 306 n.4 leadership, 268-269 on life-sustaining procedures, 307, 308, 310-311, 313, 316-322 mandate, 101, 266, 310, 507 membership, 92, 100-101, 268, 269, 507-508 National Commission and, 100-102, 263-265, 266-267, 29~296 openness of, 443 origins of, 92 on patient rights, 36, 105, 162 policy influence, 286, 289, 295, 304 products of, 93, 101-102, 153, 262, 269, 509 public education efforts, 163 role of, 3, 6, 92, 101 social justice issues in, 247-248 staff functioning, 302-303, 306 n.6 structure of, 92-93, 265, 299 Prisons/prisoners, 90, 91, 209, 283, 284 Professional organizations/societies bioethics commissions in, 7, 115-122 ethical decision-making guidelines, 7,82 on fetal tissue research, 484-485 international, 109 patient advocacy by, 180 public interest in, 1~17 recommendations for, 17, 179-180 in sciences, 397
From page 538...
... See Health care resource allocation Rawls, John, 208, 220, 229, 232, 238, 243 Reagan administration, 53, 173, 293, 294, 299, 300, 306 n.4, 352, 353, 477, 481, 482 Recombinant DNA Advisory Committee, 6, 95-96, 175, 289, 435, 436, 510-511 Recombinant DNA research, 59, 78 concerns in, 95, 435 government oversight, 95-96 Recombinant DNA technology, 59 Relativism, 236-237, 384 Religious communities in bioethical discussion, 4-5, 8 bioethics deliberations in, 134-135 child abuse exemptions, 119 community relationships, 363-366 dimensions of belief, 359-360, 370371 hospital ethics committees and' 422 interfaith, 135 on life-prolonging therapy, 322-323, 328 patterns of participation, 382-383 in policymaking, 44, 46-48 priestly religion, 381-382 prohibitions against life-saving medical procedures in, 248 in public discourse, 74-75 in state bioethics commissions, 99 See also Theological thought
From page 539...
... Perlmutter, 314, 315 Sandoz Pharmaceutical Corporation, 40 Schwitalla, Alfred, 31 Scientific community advisers to Congress, 346-347 in bioethical decision making, 5, 7576, 78-79, 80 credibility of, 389-392 ethical intuition in, 77-79 539 ethical sense in, 388-389 ethics advisory bodies in, 7 executive branch advisers, 351, 352 French, 479 integrity of members of, 396-398 legal accountability, 79-80 moral authority of, 403-405 policing of, 401403 social authority of, 79-80 special insight of, 75, 78-79 virtuousness of, 398400 Scientific method credibility of, in public opinion, 392 as discursive model, 76-77 embedded values in, 79 ethical nature of, 75 facts in, 80 legal process and, 76 moral knowledge vs. factual knowledge, 202-203, 388-389 in style of public discourse, 76-77 trust-dependency in, 393-396 Scripps Research Institute, 40 Self-help movements in health care, 136, 137 women's, 51 Shapiro, Harold, 61 Sickle cell anemia, 48, 49, 139-140, 141 Silicone breast implants, 51 Sinsheimer, Robert, 78 Situational analysis, 372-373, 376 Small Business Patent Procedure Act, 59 Smoking, 139 Social workers, 421 Society for Health and Human Values, 81 Sociology, 400 Sources of ethical dilemmas anticipating, 168-169 cumulative effects, ix, 15, 170 in current environment, 2-3, 168 definitional issues, 27-29 evolution of, 1, 3-4, 27 Specialization in medicine, 3, 34, 35, 37, 56 Sperry, Williard, 69 Spina bifida, 319
From page 540...
... 540 Sing, In re, 314, 316 State governments abortion regulation, 106, 342 bioethics advisory bodies, 6, 99-100 bioethics commissions, 99-100 constitutional authority, 346 death and dying legislation, 105, 313-316 executive branch in policymaking, 351-353 fetal tissue research regulation, 480481 genetic testing regulation, 175 in health care policymaking, 335-336 national commission findings and, 103, 185 political process, 45 President's Commission influence, 272, 286 recommendations for, 18-19, 176177, 183-185 See also specific states Sterilization, 118 Stevenson-Wydler Act, 59 Storar, In re, 314, 316, 317 Superintendent of Belch~town Hospital v. Saikewicz, 314, 315-316 Supra-agency ethics commission action-forcing powers, 21-22, 191 advantages of, 20, 187 advisory role, 21-22, 190-191 appointment process, 21, 189-190 dissemination of findings, 190-191 duration, 20, 22, 192 educational role, 21 external advisory committee for, 23 funding and staff, 22, 191 government sponsorship, 189 interim operations, 23, 192-193 mandate, 20-21, 18~188 membership structure, 21, 22, 189 models for, 15 in multitiered system, 15-16, 17 175 public participation, 190 recommendations for, 19-23, 186193 resources for, 22 INDEX Surrogate decision making in absence of patient guidance, 326327 best interest standard, 315, 324, 326, 327 documentation for, 329 health care agent for, 32~326 in home care, 329 for incompetent patients, 313, 318319 legal environment, 342 legal instruments in, 326 New York State Task Force, 99, 324 parents in, 315 state statutes, 313, 314, 316 substituted judgment standard, 309, 315, 316, 324, 326, 327 Surrogate parenting, 99, 100, 106, 118, 162, 342 practitioner guidelines, 120 Swine flu vaccine, 306 n.8 T Tay~achs disease, 140-141 Technology transfer genetic science, 4041 legislation, 59 university-industry collaborations and, 61 Teel, Karen, 409410 Terminally ill patients, 94, 99, 119, 266 artificial nutrition and hydration guidelines, 121-122, 309, 314 do not resuscitate orders, 163-164, 323-325, 328-330 legal guidelines for treatment decisions, 342-343 as research subjects, 124, 469470 See also Life-sustaining procedures/ technologies Testart, Jacques, 490 Texas, 313, 314 Theological thought basic questions in, 385 n.3 in bioethics, 73-74, 134, 38~385 concept of human loyalties in, 377379
From page 541...
... Vesey, 34 Windom, Robert, 97 Wise, Bob, 445446 Wolf, Susan M., 246-247 Women's health issues, 50-52, 79, 129 Working Group on HIV Testing of Pregnant Women and Newborns, 467-468 Workplace drug testing in, 112 genetic research implications, 97 genetic testing in, 440 health care insurance in, 54 World Council of Churches, 135 World Health Organization, 108 World Parliament of Religions, 135 Wyngaarden, James, 97, 438 y Yesley, Michael, 268


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