Nancy M. P. King

Bioethics needs an expanded moral vision. Born in the ferment of the 1970s, the field responded to rapid developments in biomedical technology and injustices in clinical care and research. Since then, bioethics has predominantly focused on respect for autonomy, beneficence and nonmaleficence, and the zero-sum "lifeboat" ethics of distributive justice, applying these principles almost exclusively within the walls of medical institutions. It is now time for bioethics to take full account of the problems of health disparities and structural injustice that are made newly urgent by the COVID-19 pandemic and the effects of climate change. This book shows why and how the field must embrace a broader and more meaningful view of justice, principally by incorporating the tools and insights of the social sciences, epidemiology, and public health. Nancy M. P. King, Gail E. Henderson, and Larry R. Churchill make the case for a more social understanding and application of justice, a deeper humility in assessing expertise in bioethics consulting, a broader and more relevant research agenda, and greater appreciation of the profound health implications of global warming.

Bioethics needs an expanded moral vision. Born in the ferment of the 1970s, the field responded to rapid developments in biomedical technology and injustices in clinical care and research. Since then, bioethics has predominantly focused on respect for autonomy, beneficence and nonmaleficence, and the zero-sum "lifeboat" ethics of distributive justice, applying these principles almost exclusively within the walls of medical institutions. It is now time for bioethics to take full account of the problems of health disparities and structural injustice that are made newly urgent by the COVID-19 pandemic and the effects of climate change. This book shows why and how the field must embrace a broader and more meaningful view of justice, principally by incorporating the tools and insights of the social sciences, epidemiology, and public health. Nancy M. P. King, Gail E. Henderson, and Larry R. Churchill make the case for a more social understanding and application of justice, a deeper humility in assessing expertise in bioethics consulting, a broader and more relevant research agenda, and greater appreciation of the profound health implications of global warming.

Advance directives - such as living wills and health care proxies - are documents intended to declare and preserve the health care choices of patients if they become unable to make their own decisions. This book provides a comprehensive overview of advance directives and clear, practical directions for writing and interpreting them. Nancy M.P. King provides a legal, philosophical, and historical analysis of the moral and legal force of advance directives. She explains the types and models of advance directives currently in use and offers guidelines for individuals seeking to write, read, and use directives to promote individuals' health care choices within the laws of their own states. King emphasizes that advance directives are not orders given by patients to their doctors; instead, they are documents that invite conversation between doctors and patients about health care decisions of great importance. The purpose of advance directives is to support patients' health care choices, and the book promotes a thoughtful use of advance directives that is best calculated to achieve that purpose, whatever form individual advance directives may take. This new edition has been updated to reflect the many changes in advance directive statutes since 1991, including expanded discussions of health care proxy statutes, the impact of the Patient Self-Determination Act and the Supreme Court's Cruzan decision. King also has extended her analysis of the implications for advance directives of managed care, resource allocation, resource scarcity, and the debate over futile treatment at the end of life. "Making Sense of Advance Directives" is a valuable handbook for patients, health care providers and administrators, patient counselors, lawyers, policymakers, and any individual interested in advance directives.

This is a handbook of ethics for a diverse audience of health care providers. Its subject is the moral and legal force of 'advance directives', which are documents, intended to declare and preserve the values, choices, and preferences of patients in the event that they become unable to make decisions about their own health care. The posture of the work is one of strong support for patients' individual health care choices, and encouragement of thoughtful use of advance directives to that end. The work presents a historical and conceptual examination of the patient's role in medical decision-making and the refusal of treatment, with special attention to the problems of advance decision-making. It examines the types and models of advance directives currently in common use and gives suggestions both about helping patients to write directives and about interpreting and making use of directives prepared by patients and encountered by clinicians. Finally, the implications of the suggested policy are examined in light of growing concerns about the scarcity of funds and resources for health care.