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Biomedical subjects

T H Murray

Publications and source records attributed to T H Murray.

14 recordsLinked to original sources
PubMed1991

Ethical issues in human genome research.

In addition to provocative questions about science policy, research on the human genome will generate important ethical questions in at least three categories. First, the possibility of greatly increased genetic information about individuals and populations will require choices to be made about what that information should be and about who should control the generation and dissemination of genetic information. Presymptomatic testing, carrier screening, workplace genetic screening, and testing by insurance companies pose significant ethical problems. Second, the burgeoning ability to manipulate human genotypes and phenotypes raises a number of important ethical questions. Third, increasing knowledge about genetic contributions to ethically and politically significant traits and behaviors will challenge our self-understanding and social institutions.

Bioethics↗
PubMed1990

Human gene therapy, the public, and public policy.

The public's involvement in the debate over human gene therapy is used to illustrate two points. First, complex bioethical issues often come to the public's attention because of a scandal, in this case the Cline episode; enlightened discussion and public understanding are difficult to achieve under these conditions. Second, even with unfavorable circumstances at the outset, the debate can become channeled into politically responsible institutions which then can develop effective public policy. For gene therapy, four significant forums emerged: the President's Commission's Report Splicing Life, the 1982 Congressional Hearings, the OTA Report, and the RAC's Points to Consider document.

Advisory Committees↗
PubMed1987

Medical ethics, moral philosophy and moral tradition.

Medical ethics is commonly assumed to be a form of 'applied moral philosophy' in which practical moral judgments are deduced from moral theories. This account of the relationship between moral theory and moral judgment is inadequate in several reports. The deductivist approach often results in inadequate attention being given to social, historical and developmental contexts. It also fails to explain some common phenomena in practical moral reasoning. In contrast to the emphasis in deductivism, a case-centered or casuistic practical ethics insists on immersion in the particularities of cases and on interpretation of details in light of moral maxims and other mid-level forms of moral reasoning. Two features of casuistics that ought to be distinguished but frequently are not, are: (1) the emphasis on immersion and interpretation, and (2) a claim about the relation between moral judgment and moral theory as sources of moral knowledge. Once we consider case-centered moral judgments as sources of moral knowledge, we must also begin to look critically but open-mindedly to moral traditions which, upon examination, appear to be more dynamic and to have more reformist potential than is commonly assumed.

Cultural Diversity↗
PubMed1987

Gifts of the body and the needs of strangers.

Relationships governed by markets keep moral and social dimensions to a bare minimum. Gifts, by their open-endedness, defy such minimalization. Impersonal gifts such as blood or body parts or charity may not regulate relationships between specific individuals, but they serve other functions by regulating larger relationships and honoring important human values, precisely those threatened by massive and impersonal bureaucracies.

Biomedical Research↗
PubMed1987

Moral obligations to the not-yet born: the fetus as patient.

The fetus destined to be born rather than aborted has become increasingly an object of medical and moral concern. With considerable justification, women view this concern--which they share to a great degree--with suspicion that it will serve as a pretext for denying them social and economic equality with men. This article attempts to show that practical moral judgments about our obligations to not-yet-born children can be made without falling into the abyss of controversy surrounding abortion. By stressing the similarities in fathers' duties to their born children, we can also counter a measure of our historical propensity to view women's moral duties to their not-yet-born children as the overwhelmingly important feature of their moral lives, and resist the temptation to impose coercive public policies.

Abortion, Induced↗
PubMed1986

Divided loyalties for physicians: social context and moral problems.

An examination of the notion of divided loyalties dilemmas in medicine, situated within their social contexts, yields insight into the contemporary social and moral position of medicine in the United States. In a review of the literature, the author identifies four concepts important to gaining an understanding of the position that divided loyalties play in medicine and the physician-patient relationship. After describing some of the situations in which these dilemmas affect physicians' responses to patients' health care needs, interests, and choices, the author argues that divided loyalties dilemmas are not rare, and will probably increase with the changes in U.S. medicine. Candor and awareness of the importance of the public belief in physician loyalty are seen as necessary in preventing these changes from becoming destructive of the physician-patient relationship.

Behavior Control↗
PubMed1985

Why solutions continue to elude us.

Three issues addressed in Robert Weir's book Selective Nontreatment of Handicapped Newborns raise important questions about the social and political context of moral judgment, and the relation of moral judgment to moral theory. Arguments to the effect that infants are not moral "persons" as we normally understand the concept of personhood, illuminate the dialectical relationship between sound, confident moral judgments and moral theories. The way we describe and label decisions to offer or not to offer particular treatments to specific individuals has political and moral consequences. In general, we should opt for descriptions that display, rather than conceal, the problematic and controversial aspects of our decisions. The active killing of patients can only be defended from the narrowest viewpoint of minimizing that individual's suffering. It ignores the requirements made of other moral actors, and it fails to acknowledge a number of important facts about social institutions. Workable solutions must be attentive to the political and social context of moral dilemmas.

Persons with Disabilities↗
PubMedDate not supplied

Genetics and the moral mission of health insurance.

Deciding whether genetic differences among individuals are morally relevant to health insurance requires us to ask, What kind of good is health care? and, What principles should govern its distribution? There are good reasons to doubt that "actuarial fairness" is an adequate description of genuine fairness in health insurance.

Actuarial Analysis↗
PubMedDate not supplied

Doctors, drug companies, and gifts.

Doctors often accept gifts from drug companies. We analyze this practice and conclude that accepting a gift has complex practical and ethical repercussions. Gifts cost patients money, and they may change society's perception of the profession as serving the best interest of patients. Also, accepting a gift establishes a relationship between the physician and the drug company that obliges a response from the physician. Accepting gifts and the resulting relationship have ethical implications as well. First, the use of patients' money to pay for gifts can be unjust. Second, the fiduciary relationship between physician and patient may be threatened if prescribing practices are affected (as intended by the drug company). Third, physicians' characters may be altered by a practice that fosters self-interest at patients' expense. We discuss the need for guidelines for the profession to help physicians promote their patients' well-being.

Drug Industry↗