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Page i

Medical Ethics
Accounts of
Ground-Breaking Cases

NINTH EDITION

Gregory E. Pence

University of Alabama at Birmingham

Logo: McGraw-Hill Education

Page ii

Logo: McGraw-Hill Education

MEDICAL ETHICS: ACCOUNTS OF GROUND-BREAKING CASES,

NINTH EDITION

Published by McGraw Hill LLC, 1325 Avenue of the Americas, New York,
NY 10121. Copyright © 2021 by McGraw-Hill LLC. All rights reserved.
Printed in the United States of America. Previous editions © 2017, 2015,
and 2011. 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 LLC, including, but not
limited to, in any network or other electronic storage or transmission, or
broadcast for distance learning.

Some ancillaries, including electronic and print components, may not be

available to customers outside the United States.

This book is printed on acid-free paper.

1 2 3 4 5 6 7 8 9 LCR 24 23 22 21 20

ISBN 978-1-260-24104-4 (bound edition)

MHID 1-260-24104-1 (bound edition)

ISBN 978-1-260-80783-7 (loose-leaf edition)

MHID 1-260-80783-5 (loose-leaf edition)

Product Developer: Alex Preiss

Marketing Manager: Nancy Baudean

Content Project Managers: Danielle Clement, Katie Reuter

Buyer: Susan K. Culbertson

 Design: Beth Blech

Content Licensing Specialist: Sarah Flynn

Cover Image: ©pixologicstudio/Getty Images

Compositor: SPi Global

All credits appearing on page or at the end of the book are considered to be
an extension of the copyright page.

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.

Description: Ninth edition. | New York : McGraw-Hill Education, [2021] |

Includes bibliographical references and index. | Audience: Ages 18+

Identifiers: LCCN 2019058441 (print) | LCCN 2019058442 (ebook) | ISBN

9781260241044 (paperback) | ISBN 9781260807943 (ebook)

Subjects: LCSH: Medical ethics–Case studies.

Classification: LCC R724 .P36 2021 (print) | LCC R724 (ebook) | DDC
174.2–dc23

LC record available at https://lccn.loc.gov/2019058441

LC ebook record available at https://lccn.loc.gov/2019058442

The Internet addresses listed in the text were accurate at the time of
publication. The inclusion of a website does not indicate an endorsement by
the authors or McGraw-Hill LLC, and McGraw-Hill LLC does not
guarantee the accuracy of the information presented at these sites.

mheducation.com/highered
Page iii

Preface
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 nearly 50 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 9th Edition

The most important change is that each chapter now has 3–4 links to online
videos dramatizing the cases and issues of each chapter. All of these are
free and in the public domain. Especially great are the Retro Reports co-
sponsored by the New York Times, for example, on the case of Teri Schiavo
or history of assisted reproduction. In the e-book, students can click on the
links and directly see the key figures in the case.

A NEW CHAPTER on Ethical Issues in Weight Management, focusing on

the show “The Biggest Loser,” discusses fat shaming, personal
responsibility for weight, bariatric surgery, taxes on sodas, unrealistic ideals
about weight, anorexia, and the global epidemic of obesity.

A new half chapter on the OPIOD EPIDEMIC has been added to the
previous chapter on ethical issues in treating ALCOHOLISM, with
perspectives from neuroscience, Narcotics Anonymous, genetics, Social
Justice (Rawls), and Kant.
Death and Dying: Inclusion of case of Dax Cowart and his obituary;
overview of 25 years of right-to-die legislation in federal courts and new
laws in Vermont, California, et al. Cases of children in comas: Jahi McMath
and Marlise Munoz.

Comas: Update on care for patients in minimally conscious states as a new

kind of right.

Abortion: Abortion and the Trump presidency and Supreme Court; updates
on declining numbers of abortion in America; OTC emergency
contraception for teenagers; more on telemedicine and self-induced, early-
stage self-abortions; success of TRAP (Targeted Regulation of Abortion
Providers) laws.

Assisted Reproduction: Surprising updates on the Gosselins and eight kids

of the Octomom. Several clinics charged with lying to customers about
characteristics of sperm donors; more physicians at such clinics using their
own sperm. Implanting “mosaic” embryos as a last resort for women in
their 40s.

Page iv

Stem Cells, Cloning, and Embryos: Updates on the proliferation of sham

stem-cell clinics across America and their false, outrageous claims. Huge
controversy over legal damages to couples from embryos lost at the
Cleveland Clinic and at clinic in California.

Impaired Babies chapter: The case in Britain of Charlie Gard.

Animals chapter: Worries about chimeras; the end of use of chimpanzees in

research in America.

Intersex chapter: The Case of Andraya Yearwood, a male who identifies as

a girl in Connecticut and who won the state championship there in his/her
first official race.

Involuntary commitment chapter (Joyce Brown): Update on how Kendra’s

Law is, and is not, working; more on NIMBY.
In the chapter on first-time surgeries, new information about Barnard’s first
heart transplant. New issues about LVAD’s as final destinations.

God Committee and organ donation chapter: new issues in using organs
infected with hepatitis C and HIV; new data on long-term health of
voluntary, adult donors.

In the chapter on the Tuskegee Syphilis Study, new case of the Radium
Girls.

Updates on Ebola and Zika virus in the AIDS chapter. Zika’s effects in
Brazil.

Update on the Patient Protection and Affordable Care Act: How it survived
two attempts to unravel it. Discussion of the public option.

Update on the pitfalls and promises of Personalized Genomic Testing and

Big Data, especially problems of testing and getting unwelcome news,
forming a sick identity. Problems of ancestry testing and indirectly testing
members of one’s family without their consent. Discussion on CRISPR, the
revolutionary method of changing genes that almost any geneticist can use
to change a species and its progeny. Discussion of mitochondrial donation,
embryo repair, and All of US program of NIH.

Enhancement chapter: updates on cheating by athletes worldwide, updates

on doping.
Page v

About the Author

Gregory E. Pence is professor in 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 Medical 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.
In 2019, UAB awarded him its Ireland Prize for Scholarly Distinction, its
highest academic prize.

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, at Florida State University in 2015 and at South
Alabama in 2019. 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 Ethical Blueprint
(2012), What We Talk about When We Talk about Clone Club:
Bioethics and Philosophy in Orphan Black (2016), and Overcoming
Addiction: Seven Imperfect Solutions and the End of America's
Greatest Epidemic (2020).
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.

Page vi

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Page vii
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