Against Bioethics (Basic Bioethics) [Hardcover]

Jonathan Baron (Author)

Book Description

Series: Basic Bioethics | Publication Date: February 17, 2006

Governments, health professionals, patients, research institutions, and research subjects look to bioethicists for guidance in making important decisions about medical treatment and research. And yet, argues Jonathan Baron in Against Bioethics, applied bioethics lacks the authority of a coherent guiding theory and is based largely on intuitive judgments. Baron proposes an alternative, arguing that bioethics could have a coherent theory based on utilitarianism and decision analysis. Utilitarianism holds that the best option is the one that does the most expected good. Decision analysis provides a way of thinking about the risks and trade-offs of specific options. Like economics, utilitarian decision analysis makes predictions of expected good in complex situations, using data when possible, and focusing human judgment on the issues relevant to consequences. With such a guiding theory, bioethics would never yield decisions that clearly go against the expected good of those involved, as some do now.Baron discusses issues in bioethics that can be illuminated by such analysis, including "enhancements" to nature in the form of genetics, drugs, and mind control; reproduction; death and end-of-life issues, including advance directives, euthanasia, and organ donation; coercion and consent; conflict of interest and the reform of internal review boards; and drug research. Although Baron opposes current practice in bioethics, he argues that by combining utilitarianism and decision analysis, bioethics can achieve its aims of providing authoritative guidance in resolving thorny medical and ethical issues.

Editorial Reviews

Review

"Baron's diagnosis is correct: much is lacking in how bioethics has been translated into policy and practice. His proposed therapy, greater reliance on utilitarianism and decision theory, may not be a complete answer, but it moves the field in the right direction. Baron's critique, and his proposed solutions, deserve a wide readership."--Barbara A. Koenig, Professor of Medicine, Mayo College of Medicine

" Against Bioethics is a well-written, lucid, nontechnical exposition of how utilitarianism and its technical cousin, decision analysis, can be applied to a variety of bioethical problems including assisted suicide, informed consent, and the justifications for "going against nature" (a particularly intriguing chapter on genetic engineering and stem cell research). For the most part, the book avoids the computational complexities that have limited the audience for a decision-analytic view of these problems. Instead, it focuses on the philosophical principles at stake and works out their implications for action. Its critique of specific solutions recommended by applied bioethicists deserves serious consideration." Arthur Elstein , Professor Emeritus of Medical Education, University of Illinois at Chicago, past president, Society for Medical Decision Making

"*Against Bioethics* is a well-written, lucid, nontechnical exposition of how utilitarianism and its technical cousin, decision analysis, can be applied to a variety of bioethical problems including assisted suicide, informed consent, and the justifications for 'going against nature' (a particularly intriguing chapter on genetic engineering and stem cell research). For the most part, the book avoids the computational complexities that have limited the audience for a decision-analytic view of these problems. Instead, it focuses on the philosophical principles at stake and works out their implications for action. Its critique of specific solutions recommended by applied bioethicists deserves serious consideration."--Arthur Elstein, Professor Emeritus of Medical Education, University of Illinois at Chicago, past president, Society for Medical Decision Making

About the Author

Jonathan Baron is Professor of Psychology at the University of Pennsylvania. He is the author of Morality and Rational Choice, Thinking and Deciding, Judgment Misguided: Intuition and Error in Public Decision Making, and other books.

Product Details

• Hardcover: 248 pages
• Publisher: The MIT Press; 1 edition (February 17, 2006)
• Language: English
• ISBN-10: 0262025965
• ISBN-13: 978-0262025966
• Product Dimensions: 9.3 x 6.2 x 0.7 inches
• Shipping Weight: 1 pounds (View shipping rates and policies)
• Average Customer Review: 5.0 out of 5 stars  See all reviews (1 customer review)
• Amazon Best Sellers Rank: #1,733,138 in Books (See Top 100 in Books)

More About the Author

See my web page at
http://www.sas.upenn.edu/~baron

I have to make this longer, so I'm adding padding.

Customer Reviews

Most Helpful Customer Reviews

3 of 3 people found the following review helpful:

5.0 out of 5 stars Excellent study of the basis of medical ethics, November 12, 2007

By 

William Podmore (London United Kingdom) - See all my reviews
(REAL NAME)   

This review is from: Against Bioethics (Basic Bioethics) (Paperback)

Having worked on the Ethics Committee of the Hospital of the University of Pennsylvania, Jonathan Baron became concerned that bioethicists were neglecting decision analysis. He writes, "In practice, bioethical advice tends to be based on tradition and intuitive judgments. Often its advice is reasonable and leads to good outcomes." But in other cases, judgments `override considerations of consequences'. So he asks, "If the consequences of a decision are expected to be worse - as in the case of testing a therapy on healthy adults instead of babies who had nothing to lose - where do bioethicists get the authority to cause harm?"

He advocates that decision-makers adopt the utilitarian approach to problems, judging decisions in terms of their consequences. Decision analysis is, he contends, very close to applied utilitarianism: both hold that the best option is the one that does the most expected good.

In this book, he presents an outline of what applied bioethics might look like if it took utilitarian decision analysis more seriously. In subsequent chapters he applies this approach to matters of end-of-life, the value of life, coercion and consent, conflicts of interest, drug research and allocation of health resources.

Baron opposes relying on the intuitive appeal to bioethical principles. "These include naturalism, bias towards harms of omission as opposed to those of action, confusion of coercion with predictability of choice, elevation of rules of thumb to absolutes (such as the necessity of consent or equality in allocation), and confusions about quantitative issues in allocation."

For example, some assert that `going against Nature' is wrong, as an argument to dismiss cloning, genetically modified foods and genetic modification of people. But such dogmas are far too sweeping: they would dismiss every invention. Similarly, the European Union's `precautionary principle', whereby new technologies are not adopted unless they are proven to be risk-free, stifles innovation. He urges us to weigh expected risks against expected benefits.

In all, Baron makes a persuasive case for making utilitarian decision analysis the basis for our judgments about health matters.