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By Raymond J. Devettere

This variation contains chapters on controlled care and clinical genetics, in addition to an extended bankruptcy on advantage and choice making. It updates debts of controversies, together with late-term abortion, cloning, germ-line genetic examine, the human genome undertaking, mind dying, non-heart beating organ donors, and physician-assisted suicide. Case experiences, drawn from landmark public situations, illustrate such concerns as scientific futility, genetic screening, AIDS study, managed-care mix-ups, and the ignoring of sufferers' needs by means of medical professionals.

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The second level of ethical reasoning is judgmental. Here I also find myself considering a particular situation and want to know what will achieve the good in the circumstances, but I am not actually going to do, or be significantly affected by, what I decide. I am not the moral agent. Making ethical judgments on this level is far less personal than practicing prudence because someone else is confronted with the ethical question. In the examples given above, I might be a friend of the person wrestling with the decision about cardiopulmonary resuscitation, or I might be a colleague helping the physician decide whether or not he should give the patient with acquired immune deficiency syndrome (AIDS) access to medications that will probably be used for suicide.

Speculative reason is chiefly concerned with necessary things which cannot be otherwise than they are, and so truth is found without diminution in the particular conclusions just as in the general principles. But practical reason is concerned with things which can be otherwise than they are, and this includes human behavior, and thus, even if there is some force in the general principles, the more you descend to the particular conclusions, the greater is their failure. Thomas Aquinas, Summa Theologiae, I II, q.

Judgments about our actions in an ethics of the good are very much concerned with what happens to us. Actions are good when they help us live well, bad when they undermine our living well. In an ethics of the good, the virtues and the prudential reasoning needed to establish them in each situation are basic, not the principles. Action-guiding principles enter the picture only when they are helpful, as they often are, in reinforcing the virtues. Evaluating moral features as good or bad implies, of course, some standard of evaluation.

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