The Impact of International Bioethics on the 'Sanctity of Life Ethics', and the Ability of OB Gyn's to Practice According to Conscience. pg.5

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V. Endnotes:

** This paper was presented at the international conference, "The Future of Obstetrics and Gynaecology: The Fundamental Human Right to Practice and Be Trained According to Conscience"; sponsored by the International Federation of Catholic Medical Associations (FIAMC), and MaterCare International, Rome, Italy, June 18, 2001. Edited August 28, 2001.

1 For extensive philosophical the theological references pertaining to the correct formation of conscience and its relation to the medical moral decision making process, see my recent article on the use of abortifacients: "The Woman and the Physician Facing Abortion: The Role of Correct Science in the Formation of Conscience and the Moral Decision Making Process", presented at "The Scientific Congress, The Guadalupan Appeal: The Dignity and Status of the Human Embryo", Mexico City, October 28–29, 1999; published in Un Appello Per La Vita: The Guadalupan Appeal: Dignita E Statuto Dell'embryione Umano (Libreria Editrice Vaticana (2000), pp. 203–223; also in, Linacre Quarterly Nov./Dec. 2000. [Back]

2  See, e.g.: Keith Moore and T. V. N. Persaud, The Developing Human: Clinically Oriented Embryology (6th ed. only) (Philadelphia: W. B. Saunders Company, 1998): "Human development is a continuous process that begins when an oocyte (ovum) from a female is fertilized by a sperm (or spermatozoon) from a male. (p. 2); ibid.: ... but the embryo begins to develop as soon as the oocyte is fertilized. (p. 2); ibid.: Zygote: this cell results from the union of an oocyte and a sperm. A zygote is the beginning of a new human being (i.e., an embryo). (p. 2); ibid.: Human development begins at fertilization, the process during which a male gamete or sperm ... unites with a female gamete or oocyte ... to form a single cell called a zygote. This highly specialized, totipotent cell marks the beginning of each of us as a unique individual." (p. 18).
William Larsen, Human Embryology (New York: Churchill Livingstone, 1997): "In this text, we begin our description of the developing human with the formation and differentiation of the male and female sex cells or gametes, which will unite at fertilization to initiate the embryonic development of a new individual. ... Fertilization takes place in the oviduct ... resulting in the formation of a zygote containing a single diploid nucleus. Embryonic development is considered to begin at this point. (p. 1); ibid.: This moment of zygote formation may be taken as the beginning or zero time point of embryonic development." (p. 17).
Ronan O'Rahilly and Fabiola Muller, Human Embryology & Teratology (New York: Wiley–Liss, 1994): "Fertilization is an important landmark because, under ordinary circumstances, a new, genetically distinct human organism is thereby formed. (p. 5); ibid.: Fertilization is the procession of events that begins when a spermatozoon makes contact with a secondary oocyte or its investments ... (p. 19); ibid.: The zygote ... is a unicellular embryo." (p. 19); ibid.: "The ill–defined and inaccurate term pre–embryo, which includes the embryonic disc, is said either to end with the appearance of the primitive streak or ... to include neurulation. The term is not used in this book." (p. 55).
Bruce Carlson, Human Embryology and Developmental Biology (St. Louis, MO: Mosby, 1994): "Human pregnancy begins with the fusion of an egg and a sperm." (p. 3); " ... finally, the fertilized egg, now properly called an embryo, must make its way into the uterus ...." (p. 3).
Carlson (1994), p. 407: "After the eighth week of pregnancy the period of organogenesis (embryonic period) is largely completed and the fetal period begins." O'Rahilly and Muller (1994), p. 55: "The embryonic period proper ... occupies the first 8 postovulatory weeks ... The fetal period extends from 8 weeks to birth ... ."; Moore and Persaud (1998), p. 6: "The embryonic period extends to the end of the eighth week ... After the embryonic period, the developing human is called a fetus. During the fetal period (ninth week to birth) ... ." [Back]

3  See especially, e.g., Albert Jonsen, The Birth of Bioethics (New York: Oxford University Press, 1998); David J. Rothman, Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making (New York: BasicBooks⁄Perseus Books, L.L.C., 1991). Dr. Irving holds a doctoral degree level concentration in "secular bioethics" from the Kennedy Institute of Ethics, Georgetown University; her 400–page doctoral dissertation on bioethics and human embryo research was, Philosophical and Scientific Analysis of the Nature of the Human Embryo (Washington, D. C.: Georgetown University, 1991). For extensive historical, governmental, and scientific references on the "birth" of bioethics, and an analysis of its principles, see Dianne N. Irving, "What is 'bioethics'? (Quid Est 'Bioethics'?"), in Joseph Koterski (ed.), Life and Learning X: University Faculty for Life: Proceedings of the Conference 2000 (in press). For earlier discussions about "bioethics", see also, D. N. Irving, "The Bioethics Mess", Crisis Magazine, Vol. 19, No. 5, May 2001; "The Stem Cell Decision in the Labs: Beware of Flawed Ethics and False Science", Newsday.com, July 15, 2001, B5; "Quality Assurance Auditors: Between a Rock and a Hard Place", Quality Assurance: Good Practice, Regulation, and Law March 1994, 3(1):33–52; ",Which Ethics for Science and Public Policy?",, Accountability in Research 1993, 3(2–3):77–99; ",Science, Philosophy and Expertise: An Evaluation of the Arguments on 'Personhood'",, Linacre Quarterly Feb. 1993, 60(1):18–46. See also, Wesley J. Smith, Culture of Death: The Assault on Medical Ethics in America (San Francisco, CA: Encounter Books, 2000); ",Is Bioethics Ethical?", Weekly Standard (April 3, 2000), pp. 26–30; ",The Deadly Ethics of Futile Care Theory,", Weekly Standard (November 30⁄December 7, 1998), pp. 32–35. See also, Ruth Shalit, ",When We Were Philosopher Kings",, The New Republic (April 28, 1997); Eugene Russo, ",'Bioethicists' Proliferate Despite Undefined Career Track",, The Scientist (Apr. 12, 1999), 13:8:16 http://www.the-scientist.com/yr1999/apr/prof_990412.html; Neil Boyce, "And Now, Ethics For Sale?", U.S. News, July 30, 2001 [http://www.usnews.com/usnews/issue/010730/usnews/bioethics.htm]; Sheryl Gay Stolberg, "Bioethicists Fall Under Familiar Scrutiny", New York Times, Aug. 1, 2001 http://www.nytimes.com/2001/08/02/health/genetics/02BIOE.html?ex=997764716&ei=1&en=6bde73650ad5c911; William Saletan, " The Ethicist's New Clothes", Slate Magazine http://slate.msn.com/framegame/entries/01-08-16_113959.asp]. [Back]

4  These bioethics positions have been addressed at great length by bioethicists for over 30 years now, using predominantly the bioethics principles as so defined in The Belmont Report, since the formal beginning of the field — especially in such typical secular bioethics journals as The Hastings Center Report; The Journal of Medicine and Philosophy; The Journal of Clinical Ethics; Bioethics News; The Journal of Law and Medicine; Law, Medicine and Health Care; American Journal of Law and Medicine; The Kennedy Institute of Ethics Journal; Bioethics; Medical Humanities Review; Cambridge Quarterly of Healthcare Ethics; Christian Bioethics; Journal of Religious Ethics; Philosophy and Public Affairs; etc. (See also, Jonsen, p. 414). There now exists an entire library containing, almost exclusively, bioethics articles, books and archives — i.e., The Kennedy Institute of Ethics (the National Reference Center for Bioethics Literature) at Georgetown University which is also contained in the software Bioethics Line (which is plugged into the NIH National Library of Medicine and to bioethics centers around the world). The arguments from these secular bioethics journals, books, etc., also have been continuously applied for over 30 years to "ethics" issues in other fields, e.g., medical research, law, business, engineering, religion, politics, education, military ethics, etc. — and then extended to international issues and governing bodies. (See note 31, infra). [Back]

5  See, e.g., National Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services (Washington, D.C.: United States Catholic Conference, Inc., 1995); these directives are supposed to be made known by Catholic health care institutions and followed by "the sponsors, trustees, administrators, chaplains, physicians, health care personnel, and patients or residents of these institutions and services.", p. 2. See also, The Pontifical Council for Pastoral Assistance, Charter For Health Care Workers (Boston: St. Paul Books and Media, 1995); Humanae Vitae (1968); Declaration on Procured Abortion (1974); Declaration on Euthanasia (1980); Donum Vitae (1987); Veritatis Splendor (1993); Evangelium Vitae (1995). [Back]

6  See, Humanae Vitae (Boston: Pauline Books & Media, 1968): "It is, in fact, indisputable, as our predecessors have many times declared, that Jesus Christ, when communicating to Peter and to the apostles His divine authority and sending them to teach all nations His commandments, constituted them as guardians and authentic interpreters of all the moral law, not only, that is, of the law of the Gospel, but also of the natural law, which is also an expression of the will of God, the faithful fulfillment of which is equally necessary for salvation." (p. 2; emphases added); the National Conference of Catholic Bishop's, Ethical and Religious Directives for Catholic Health Care Services: "The moral teachings that we profess here flow principally from the natural law, understood in the light of the revelation Christ has entrusted to his Church." (p. 2; emphases added). See generally, Thomas Aquinas, Summa Theologica, Ia IIae, q. 94, Fathers of the English Dominican Province (trans.) (Westminster, MD: Christian Classics, 1981); Austin Fagothey, Right and Reason (3rd ed. only)(St. Louis, MO: The C.V. Mosby Company, 1963); Vernon Bourke, Ethics (New York: The Macmillan Company, 1953); Ralph McInerny, Ethica Thomistica (Washington, D.C.: The Catholic University of America Press, 1982). [Back]

7  The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research; U.S. Department of Health, Education and Welfare (Washington, D.C.: Government Printing Office, 1978). [Back]

8  See, e.g., Tom Beauchamp and James Childress, Principles of Biomedical Ethics (New York: Oxford University Press, 1979), pp. 7–9; also, Tom Beauchamp and LeRoy Walters (eds.), Contemporary Issues in Bioethics (Belmont, CA: Wadsworth Publishing Company, Inc., 1982), pp. 1-3. [Back]

9  Jonsen (1998), pp. 20 - 26. [Back]

10  The National Research Act, Public Law 93-348, 93rd Congress, 2nd session (July 12, 1974); 88 STAT 342. [Back]

11  Jonsen (1998), pp. 94–98, 333. [Back]

12  Ibid., Jonsen (1998), p. 98. [Back]

13  The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, established by Title II of The National Research Act (Public Law 93–348). [Back]

14  The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research; U.S. Department of Health, Education and Welfare (Washington, D.C.: Government Printing Office, 1978). [Back]

15  Title 45; Code of Federal Regulations; Part 46 [45 CFR 46]; Office for the Protection from Research Risks [OPRR]; U.S. Department of Health and Human Services, 1981 [revised 1983, 1991, 1993, and incorporated into the Federal Policy (or, Common Rule), 1991.] [Back]

16  John Rawls, A Theory of Justice (Cambridge: Belknap Press of Harvard University Press, 1971); Rawls, "Justice as Fairness", in Tom Beauchamp and LeRoy Walters (eds.), Contemporary Issues in Bioethics (2nd ed.) (Belmont, CA: Wadsworth Publishing Company, Inc., 1982), pp. 44–46, and pp. 23-24. [Back]

17  E.g., Tom Beauchamp and James Childress, Principles of Biomedical Ethics (1st ed.) (New York: Oxford University Press, 1979), pp. 45-47; Tom Beauchamp and LeRoy Walters (eds.), Contemporary Issues in Bioethics (2nd ed.) (Belmont, CA: Wadsworth Publishing Company, Inc., 1982), p.26; Tom Beauchamp, Philosophical Ethics (New York: McGraw–Hill Book Company, 1982, pp. 124–128, 141, 188–190; Tom Beauchamp; and Laurence B. McCullough, Medical Ethics: The Moral Responsibilities of Physicians (New Jersey: Prentice–Hall, Inc., 1984), pp. 13–16, 21–22, 39–40, 46, 48, 133–35, 162–64. The Belmont Report, pp. 6–7. [Back]

18  In Jonsen (1998), p. 328. [Back]

19  The Belmont Report, pp. 6-7: "Persons are treated in an ethical manner not only by respecting their decisions and protecting them from harm, but also by making efforts to secure their well-being. Such treatment falls under the principle of beneficence. The term "beneficence" is often understood to cover acts of kindness or charity that go beyond strict obligation. In this document beneficence is understood in a stronger sense, as an obligation. Two general rules have been formulated as complementary expressions of beneficent actions in this sense: (1) do not harm and (2) maximize possible benefits and minimize possible harms. The Hippocratic maxim "do not harm" has long been a fundamental principle of medical ethics. Claude Bernard extended it to the realm of research, saying that one should not injure one person regardless of the benefits that might come to others. However, even avoiding harm requires learning what is harmful; and, in the process of obtaining this information, persons may be exposed to risk of harm. ... In the case of scientific research in general, members of the larger society are obliged to recognize the longer term benefits and risks that may result from the improvement of knowledge and from the development of novel medical, psychotherapeutic, and social procedures," (emphases added). See also, Tom Beauchamp and James Childress, Principles of Biomedical Ethics (1st ed.) (New York: Oxford University Press, 1979), pp. 135–167; Tom Beauchamp and LeRoy Walters, Contemporary Issues in Bioethics (eds.) (2nd ed.) (Belmont, California: Wadsworth Publishing Company, 1982), pp. 28–43. [Back]

20  "Concern for the interests of the subject must always prevail over the interests of science and society [Basic principles]... The physician can combine medical research with professional care, the objective being the acquisition of new medical knowledge, only to the extent that medical research is justified by its potential diagnostic or therapeutic value for the patient [Medical research combined with clinical care – clinical research]... In research on man, the interests of science and society should never take precedence over considerations related to the wellbeing of the subject [non–therapeutic biomedical research involving human subjects – non–clinical biomedical research], Declaration of Helsinki 1993 (revised 1964, 1975, 1983, 1989), as published in United States Department of Health and Human Services (1993), Office for the Protection from Research Risks: Protecting Human Research Subjects: Institutional Review Board Guidebook (1993), pp. A6–4 to A6–6 (emphases added). See also: The Nuremberg Code, ibid., pp. A6–1 to A6–2; United Nations (1947) Universal Declaration of Human Rights; United Nations (1991) Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care; and International Covenant on Civil and Political Rights (ratified, Sen. Comm. on Foreign Affairs 1992). [Back]

21  Norman Daniels, Just Health Care (New York: Cambridge University Press, 1985); Jonsen (1998), p. 222. [Back]

22  See, e.g.: Superintendent of Belchertown State School v. Saikewicz, Mass Supreme Court, 1977. 373 Mass. 728, 736 (p. 7); Jonsen (1998), p. 267. The legal concept of "substituted judgment" has been specifically rejected by many writers and courts, e.g.: Mathy Mezey et al., "Life–Sustaining Treatment Decisions by Spouses of Patients with Alzheimer's Disease," Journal of the American Geriatrics Society (Feb. 1996), pp. 144–150; David C. Thomasma, "A Communal Model for Presumed Consent for Research on the Neurologically Vulnerable," Accountability in Research (1996), 4:227–239; Ralph Baergen, "Revisiting the Substituted Judgment Standard," Journal of Clinical Ethics (Spring 1995), pp. 30–38; Rosalind E. Ladd and Edwin N. Forman, "Adolescent Decision–Making: Giving Weight to Age–Specific Values," Theoretical Medicine (Dec. 1995), pp. 333–345; Jeremiah Suhl et al., "Myth of Substituted Judgment: Surrogate Decision–Making Regarding Life Support is Unreliable," Archives of Internal Medicine (1994), 154:90–96; John Hardwig, "The Problem of Proxies With Interests of Their Own: Toward a Better Theory of Proxy Decisions," Journal of Clinical Ethics (Spring 1993), pp. 20–27; James Coyne King, "The Search for Objectivity in Applying the Substituted Judgment Rule in Medical Care Cases," Boston Bar Journal (1993), 37:10–12, 14; Robert A. Perlman et al., "Contributions of Empirical Research to Medical Ethics," Theoretical Medicine (Sept. 1993), pp. 197–210; Lynne E. Lebit, "Compelled Medical Procedures Involving Minors and Incompetents and Misapplication of the Substituted Judgment Doctrine," Journal of Law and Health (1992–1993), pp. 107–130; Alexander M. Capron, "Substituting Our Judgment," Hastings Center Report (March–April 1992), pp. 58–59; Ezekiel J. Emanuel and Linda L. E. Emanuel, "Proxy Decision–Making for Incompetent Patients: An Ethical and Empirical Analysis," Journal of the American Medical Association (1992), 267:2067–2071; Jan Hare et al, "Agreement Between Patients and Their Self–Selected Surrogates on Difficult Medical Decisions," Archives of Internal Medicine (1992), 152:1049–1054; Thomas G. Gulkeil and Paul S. Appelbaum, "Substituted Judgment: Best Interests in Disguise," Hastings Center Report (June 1983), pp. 8–11; George J. Annas, "Precatory and Mindless Mimicry: The Case of Mary O'Connor," Hastings Center Report (Dec. 1988), pp. 31–33. For recent court decisions, see Illinois. Appellate Court, First District, Fourth Division. In re C.A. North Eastern Reporter, 2nd series. 1992 Oct 15 (date of decision). 603:1171–1194; Illinois. Supreme Court. Curran v. Bosze. North Eastern Reporter, 2nd series. 1990 Dec. 20 (date of decision). 566:1319–1345; Florida. District Court of Appeal, Second District. In re Guardianship of Browning. Southern Reporter, 2nd series. 1989 Apr. 10 (date of decision). 543:258–276; Missouri. Supreme Court, en banc. Cruzan by Cruzan v. Harmon. South Western Reporter, 2nd Series. 1988 Nov 16 (date of decision). 760:408–445. [Back]

23  Arthur Dyck, "Assessing the Population Debate," The Monist 61 (Jan. 1977); Jonsen (1998), p. 302. [Back]

24  Daniel Callahan, "Bioethics: Private Choice and Common Good", Hastings Center Report (May–June 1994), 24:3:31. [Back]

25  Gilbert C. Meilaender, Body Soul, and Bioethics (Notre Dame, IN: University of Notre Dame Press, 1995), p. x. [Back]

26  Jonsen, in Edwin DuBose, Ronald Hamel and Laurence O'Connell (eds.), A Matter of Principles?: Ferment in U.S. Bioethics (Valley Forge, PA: Trinity Press International, 1994), p.1. [Back]

27 Renee C. Fox and Judith P. Swazey, "Leaving the Field", Hastings Center Report (September–October 1992), 22:5:9-15. [Back]

28  Raanan Gillon (ed.), Principles of Health Care Ethics (New York: John Wiley & Sons, 1994). [Back]

29  See D. N. Irving, "Science, philosophy and expertise: An evaluation of the arguments on 'personhood'", Linacre Quarterly Feb. 1993, 60(1):18–46. Also, note 3, supra. [Back]

30  E.g., see Jonsen (1998), p. 345. [Back]

31  For extensive discussions and references for the following, see D. Irving, "What Is 'Bioethics'? "Quid Est Bioethics?", in Joseph Koterski (ed.), Life and Learning X: University Faculty For Life: Proceedings of the Conference (in press). See, e.g.: The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, The Belmont Report (Washington, D. C: U.S. Department of Health, Education, and Welfare, 1978) is the explicit (sometimes implicit) "ethical" basis for all of the following documents (a very small sample): United States Code of Federal Regulations: Protection of Human Subjects [OPRR] 45 CFR 46 (revised Jan. 12, 1981, Mar. 8, 1983; reprinted July 1989, revised 1991 –– now in the Common Rule for all departments of the federal government which volunteer to comply), (Washington, D.C.: DHHS); The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, 10 individual Reports including Summing Up (Washington, D.C., U.S. Government Printing Office, 1983); National Institutes of Health: Report of the Human Fetal Tissue Transplant Research Panel (Washington, D.C.: NIH, December 1988); NIH Guide for Grants and Contracts (Washington, D.C.: NIH, 1990); Office for the Protection from Research Risks (OPRR –– now the OHRP), Protecting Human Research Subjects: Institutional Review Board Guidebook (Washington, D.C. NIH, 1993); National Institutes of Health: Report of the Human Embryo Research Panel (Washington, D.C.: NIH, Sept. 27, 1994); NIH Guidelines on the Inclusion of Women and Minorities as Subjects in Clinical Research, Federal Reg. 59 FR 14508 (Washington, D.C.: NIH, March 28, 1994); NIH Outreach Notebook On the Inclusion of Women and Minorities in Biomedical and Behavioral Research (Washington, D.C.: NIH, 1994); the CIOMS/WHO International Ethical Guidelines for Biomedical Research Involving Human Subjects (Geneva: CIOMS/WHO, 1993); the proposed legislation in the State of Maryland for the use of incompetent mentally ill patients in experimental research; the current NIH Human Pluripotent Stem Cell Research Guidelines, (Washington, D.C.: NIH, 2000). See also Jonsen (1998), esp. Chapter 12. [Back]

32 See Jonsen (1998), p. 342: "'Federal ethics' became a significant source of opinion in bioethics as public moral discourse took place not only on federal premises but also in state agencies, professional societies, institutional committees, and public forums." [Back]

33  See Jonsen (1998), pp. 362–365. [Back]

34  See, e.g., Tom Beauchamp and Terry Pinkard, Ethics and Public Policy (New Jersey: Prentice–Hall, Inc., 1983). [Back]

35  Charles Harris, Michael Pritchard, and Michael Rabins, (eds.), Engineering Ethics: Concepts and Cases (Belmont, CA: Wadsworth Publishing Company, 1995), esp. pp. 97–102; p. 186 note 4; p. 224 notes 2 and 3. [Back]

36  See, e.g., Tom Beauchamp, Case Studies in Business, Society and Ethics (New Jersey: Prentice–Hall, Inc., 1983). [Back]

37  See Jonsen (1998), pp. 342–344, 371–372. [Back]

38  See, "High School Bioethics Project", Kennedy Institute of Ethics, Georgetown University: http://www.georgetown.edu/research/kie/ [Back]

39  See, Jonsen (1998), p. 377. [Back]

40  Ibid., Jonsen (1998), pp. 109–110. [Back]

41  Ibid., Jonsen (1998), pp. 109–110. [Back]

42  The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research; Report and Recommendations; Research on the Fetus; U.S. Department of Health, Education and Welfare, 1975, p. 5. [Back]

43  Title 45; Code of Federal Regulations; Part 46 [45 CFR 46]; Office for the Protection from Research Risks [OPRR]; U.S. Department of Health and Human Services, 1983, p. 12. [Back]

44  Wilhelm His (the "Father of Human Embryology"), Anatomie menschlicher Embryonen (Leipzig: Vogel, 1880–1885). For an extensive discussion of the erroneous science used in bioethics on these issues, see D. N. Irving, "When does a human being begin? 'Scientific' myths and scientific facts", International Journal of Sociology and Social Policy, 1999, 19:3/4:22–47. Also, for detailed scientific references, see note 2, supra. [Back]

45  For a long and detailed philosophical and scientific analysis of the "delayed personhood" arguments of 28 current bioethicists see my 400-page Doctoral Dissertation, A Philosophical and Scientific Analysis of the Nature of the Early Human Embryo (Department of Philosophy, Georgetown University, Washington, D. C: University Microfilms, 1991). A very short summary of the dissertation can be found in Dianne N. Irving, "Science, Philosophy and Expertise: An Evaluation of the Arguments on 'Personhood'", Linacre Quarterly (Feb. 1993), 60(1):18–46. [Back]

46  A short list of bioethicists who argue for "personhood" at "brain birth" (or beyond) includes: Jonathan Glover, What Sort of People Should There Be? (New York: Pelican Books, 1984); Glover, Causing Death and Saving Lives (New York: Pelican Books, 1977); Clifford Grobstein, "The Early Development of Human Embryos", Journal of Medicine and Philosophy (1985),10:213-236; Grobstein, Science and the Unborn (New York: Basic Books, 1988), p. 61; Joseph Fletcher, Humanhood: Essays in Biomedical Ethics (New York: Prometheus Books, 1979), and in Jonsen (1998), pp. 46–47; Tris Engelhardt, The Foundations of Bioethics (New York: Oxford University Press, 1985), p. 111; John Robertson, "Extracorporeal Embryos and the Abortion Debate", Journal of Contemporary Health Law and Policy (1986), 2;53;53–70; Robertson, "Symbolic Issues in Embryo Research", The Hastings Center Report (1995, Jan./Feb.), 37–38; Robertson, "The Case of the Switched Embryos", The Hastings Center Report (1995), 25:6:13-24; Michael Tooley, "Abortion and Infanticide", in The Rights and Wrongs of Abortion, M. Cohen et al (eds.) (New Jersey: Princeton University Press, 1974), pp. 59 and 64; Peter Singer and Helga Kuhse, "The Ethics of Embryo Research", Law, Medicine and Health Care (1987), 14:13–14; Kuhse and Singer, "For Sometimes Letting — and Helping — Die", Law, Medicine and Health Care (1986), 3:40:149-153; Kuhse and Singer, Should The Baby Live? The Problem of Handicapped Infants (Oxford University Press, 1985), p. 138; Singer, "Taking Life: Abortion", in Practical Ethics (London: Cambridge University Press, 1981), pp. 122–123; Singer and Kuhse, Stephen Buckle, Karen Dawson, Pascal Kasimba (eds.), Embryo Experimentation (New York: Cambridge University Press, 1990); R. M. Hare, "When Does Potentiality Count? A Comment on Lockwood," Bioethics (1988), 2:3:214; Michael Lockwood, "When Does Life Begin?", in Michael Lockwood (ed.), Moral Dilemmas in Modern Medicine (New York: Oxford University Press, 1985), p.10; Hans–Martin Sass, "Brain Life and Brain Death: A Proposal for Normative Agreement," Journal of Medicine and Philosophy (1989), 14:45-59; Michael Lockwood, "Warnock versus Powell (and Harradine): When Does Potentiality Count?" Bioethics (1988), 2:3:187–213; see Robert Edwards, Donald MacKay, Bernard B. Haring, D. Wells, in D. Gareth Jones, "Brain Birth and Personal Identity", Journal of Medical Ethics (1989), 15:4; Goldenring, "Development of the Fetal Brain," New England Journal of Medicine (1982), 307:564; Thomasine Kushner, "Having a Life Versus Being Alive," Journal of Medical Ethics (1984), 10:5–8; M. C. Shea, "Embryonic Life and Human Life," Journal of Medical Ethics (1985), 11:205–209; Richard G. Frey, The Ethics of the Search for Benefits: Animal Experimentation in Medicine", in Raanan Gillon (ed.), Principles of Health Care Ethics (New York: John Wiley & Sons, 1994), pp. 1067–1075. [Back]

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