Paul T. Menzel - Böcker

In the 21st century, people in the developed world are living longer. They hope they will have a healthy longer life and then die relatively quickly and peacefully. But frequently that does not happen. While people are living healthy a little longer, they tend to live sick for a lot longer. And at the end of being sick before dying, they and their families are frequently faced with daunting decisions about whether to continue life prolonging medical treatments or whether to find meaningful and forthright ways to die more easily and quickly. In this context, some people are searching for more and better options to hasten death. They may be experiencing unacceptable suffering in the present or may fear it in the near future. But they do not know the full range of options legally available to them. Voluntary stopping eating and drinking (VSED), though relatively unknown and poorly understood, is a widely available option for hastening death. VSED is legally permitted in places where medical assistance in dying (MAID) is not. And unlike U.S. jurisdictions where MAID is legally permitted, VSED is not limited to terminal illness or to those with current decision-making capacity. VSED is a compassionate option that respects patient choice. Despite its strongly misleading image of starvation, death by VSED is typically peaceful and meaningful when accompanied by adequate clinician and/or caregiver support. Moreover, the practice is not limited to avoiding unbearable suffering, but may also be used by those who are determined to avoid living with unacceptable deterioration such as severe dementia. But VSED is "not for everyone." This volume provides a realistic, appropriately critical, yet supportive assessment of the practice. Eight illustrative, previously unpublished real cases are included, receiving pragmatic analysis in each chapter. The volume's integrated, multi-professional, multi-disciplinary character makes it useful for a wide range of readers: patients considering present or future end-of-life options and their families, clinicians of all kinds, ethicists, lawyers, and institutional administrators. Appendices include recommended elements of an advance directive for stopping eating and drinking in one's future if and when decision making capacity is lost, and what to record as cause of death on the death certificates of those who hasten death by VSED.

In one form or another, health care is now being rationed; not every patient receives all that is possibly beneficial for him - sometimes with tragic consequences. Decisions to ration raise a classic dilemma: how can we treat an individual with dignity and genuine respect when he is being short-changed by an efficient policy that seems best overall?Strong Medicine argues that we can respect the individual, if those policies represent the hard trade-off preferences of patients controlling resources for their larger lives. Rationing is still strong medicine to swallow, but then it becomes what patients, as well as the doctor, ordered. Menzel develops this central idea and applies it to major issues of health policy and economics: the notion of pricing life, the long-run cost of prevention, measuring quality of life, imperilled newborns, adequate care for the poor, containing costs by market competition, malpractice suits, procuring organs for transplant, and dying expensively in old age. He provides a hard-hitting, critical philosophical discussion of these issues, in non-technical language accessible to a wide range of readers.

The questions and dilemmas of bioethics touch everyone. Should people who refuse to be vaccinated be treated for COVID-19, even if that displaces vaccinated patients with other serious conditions? What restrictions on abortion should there be, if any? Should women be paid to donate eggs? Bioethics: What Everyone Needs to Know ® discusses these and other similar questions facing the public today--as well as providing a way for thinking deeply about them.Steinbock and Menzel first examine major moral theories and how they can be used to analyze bioethical issues. They then provide historical background to the birth of bioethics and explain how it shifted from a paternalistic doctor knows best approach to respect for autonomy, a fundamental value in contemporary bioethics. Subsequent chapters cover advance directives, experimentation on human subjects, the definition of death, physician-assisted dying, abortion, disability, just healthcare systems, the allocation of scarce resources, pharmaceutical drug pricing, assisted reproductive technology, egg donation, surrogate motherhood, sex selection, and the genetic modification of humans. Race and gender are considered throughout, as are the ethical issues raised by pandemics. Steinbock and Menzel consider the controversial questions that surface in the public sphere, explaining the facts, and then evaluating different approaches to resolving them.

The questions and dilemmas of bioethics touch everyone. Should people who refuse to be vaccinated be treated for COVID-19, even if that displaces vaccinated patients with other serious conditions? What restrictions on abortion should there be, if any? Should women be paid to donate eggs? Bioethics: What Everyone Needs to Know ® discusses these and other similar questions facing the public today--as well as providing a way for thinking deeply about them.Steinbock and Menzel first examine major moral theories and how they can be used to analyze bioethical issues. They then provide historical background to the birth of bioethics and explain how it shifted from a paternalistic doctor knows best approach to respect for autonomy, a fundamental value in contemporary bioethics. Subsequent chapters cover advance directives, experimentation on human subjects, the definition of death, physician-assisted dying, abortion, disability, just healthcare systems, the allocation of scarce resources, pharmaceutical drug pricing, assisted reproductive technology, egg donation, surrogate motherhood, sex selection, and the genetic modification of humans. Race and gender are considered throughout, as are the ethical issues raised by pandemics. Steinbock and Menzel consider the controversial questions that surface in the public sphere, explaining the facts, and then evaluating different approaches to resolving them.