Taking Issue

Book excerpt: A pioneer in the theory of pluralistic casuistry, the idea that there are almost as many facets to moral choices as there are cases that call for choices, Baruch Brody takes issue with conventional bioethical wisdom and challenges the rigid principalism of contemporary bioethics. His views have been seen as controversial, but they are firmly held, and convincingly argued--all of which have led him to be one of the most widely discussed and highly admired bioethicists of our time. He argues for the fundamental distinction between active and passive euthanasia, for a need to reconceptualize approaches to brain death, and for the right of providers to unilaterally discontinue life support. He shows support for the waiving of the requirement of informed consent for some research, for the widespread use of animals in research, and for the use of placebos in many international clinical trials. When it comes to morality as it is practiced in medicine, Brody makes clear that the ethical issues are never as simple as black and white--that there are myriad factors and fine nuances that can and should challenge decision making as it is commonly practiced in difficult medical cases. In this collection, delving thoughtfully and systematically into methodology, research ethics, clinical ethics, and Jewish medical ethics, he tackles thorny life-and-death questions head-on and fearlessly. He casts a light into all the corners of end-of-life decisions--a field in which he has exemplary credentials--while illuminating a new understanding of morality and ethics. The introduction outlines Brody's approach, defines the terminology used, and contrasts his ethical positions with much of the competing literature. Taking Issue will be invaluable to students and scholars in medical ethics, bioethics, and philosophy of medicine.