Books, Journals, New Media Section Editor: Harriet
S. Meyer, MD, Contributing Editor, JAMA; David H. Morse, MS, University
of Southern California, Norris Medical Library, Journal Review Editor.
Baruch Brody identifies Taking Issue: Pluralism and
Casuistry in Bioethics as a collection of previously published dissenting
essays. He defines his voice as one that disagrees with much of the standard
literature in medical ethics. He argues, among other things, for the permissibility
of placebo-controlled trials of surgical procedures and for a fundamental
moral distinction between killing and letting die.
The stands Brody takes are not new; those of us who swim in the often-turbulent
waters of bioethics have encountered these streams before. Most major religious
traditions distinguish between "passive" and "active" euthanasia (see, for
example, A Different Death1 and Introduction to Jewish and Catholic Bioethics2).
While the issue of sham surgery in clinical research remains controversial,3 some ethicists would go beyond the question, "Is
such a procedure permissible and if so, under what conditions?" to ask, "Can
it be ethical not to use sham surgery to rigorously
evaluate a surgical procedure before it is introduced into practice?"4 A comprehensive look at medical ethics literature
would also find many who agree with the other stands Brody argues in Taking Issue, including the need to develop judgments about
rates of compensation for research subjects, the need to reconceptualize our
understanding of brain death, the permissibility of waiving the informed consent
requirement for research in some cases, and the permissibility of more widespread
use of animals as research subjects.
Kilburn BB. Bioethics. JAMA. 2004;291(17):2131-2132. doi:10.1001/jama.291.17.2131