Tom Koch - Thieves of Virtue

Thieves of Virtue

Basic Bioethics

Arthur Caplan, editor

Books Acquired under the Editorship of Glenn McGee and Arthur Caplan

Peter A. Ubel,

Pricing Life: Why Its Time for Health Care Rationing

Mark G. Kuczewski and Ronald Polansky, eds.,

Bioethics: Ancient Themes in Contemporary Issues

Suzanne Holland, Karen Lebacqz, and Laurie Zoloth, eds.,

The Human Embryonic Stem Cell Debate: Science, Ethics, and Public Policy

Gita Sen, Asha George, and Piroska stlin, eds.,

Engendering International Health: The Challenge of Equity

Carolyn McLeod,

Self-Trust and Reproductive Autonomy

Lenny Moss,

What Genes Cant Do

Jonathan D. Moreno, ed.,

In the Wake of Terror: Medicine and Morality in a Time of Crisis

Glenn McGee, ed.,

Pragmatic Bioethics, 2nd edition

Timothy F. Murphy,

Case Studies in Biomedical Research Ethics

Mark A. Rothstein, ed.,

Genetics and Life Insurance: Medical Underwriting and Social Policy

Kenneth A. Richman,

Ethics and the Metaphysics of Medicine: Reflections on Health and Beneficence

David Lazer, ed.,

DNA and the Criminal Justice System: The Technology of Justice

Harold W. Baillie and Timothy K. Casey, eds.,

Is Human Nature Obsolete? Genetics, Bioengineering, and the Future of the Human Condition

Robert H. Blank and Janna C. Merrick, eds.,

End-of-Life Decision Making: A Cross-National Study

Norman L. Cantor,

Making Medical Decisions for the Profoundly Mentally Disabled

Margrit Shildrick and Roxanne Mykitiuk, eds.,

Ethics of the Body: Post- Conventional Challenges

Alfred I. Tauber,

Patient Autonomy and the Ethics of Responsibility

David H. Brendel,

Healing Psychiatry: Bridging the Science/Humanism Divide

Jonathan Baron,

Against Bioethics

Michael L. Gross,

Bioethics and Armed Conflict: Moral Dilemmas of Medicine and War

Karen F. Greif and Jon F. Merz,

Current Controversies in the Biological Sciences: Case Studies of Policy Challenges from New Technologies

Deborah Blizzard,

Looking Within: A Sociocultural Examination of Fetoscopy

Ronald Cole-Turner, ed.,

Design and Destiny: Jewish and Christian Perspectives on Human Germline Modification

Holly Fernandez Lynch,

Conflicts of Conscience in Health Care: An Institutional Compromise

Mark A. Bedau and Emily C. Parke, eds.,

The Ethics of Protocells: Moral and Social Implications of Creating Life in the Laboratory

Jonathan D. Moreno and Sam Berger, eds.,

Progress in Bioethics: Science, Policy, and Politics

Eric Racine,

Pragmatic Neuroethics: Improving Understanding and Treatment of the MindBrain

Martha J. Farah, ed.,

Neuroethics: An Introduction with Readings

Books Acquired under the Editorship of Arthur Caplan

Sheila Jasanoff, ed.,

Reframing Rights: Bioconstitutionalism in the Genetic Age

Christine Overall,

Why Have Children? The Ethical Debate

Yechiel Michael Barilan,

Human Dignity, Human Rights, and Responsibility: The New Language of Global Bioethics and Bio-Law

Tom Koch,

Thieves of Virtue: When Bioethics Stole Medicine

Thieves of Virtue

When Bioethics Stole Medicine

Tom Koch

The MIT Press
Cambridge, Massachusetts
London, England

2012 Tim Koch

All rights reserved. No part of this book may be reproduced in any form by any electronic or mechanical means (including photocopying, recording, or information storage and retrieval) without permission in writing from the publisher.

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Library of Congress Cataloging-in-Publication Data

Koch, Tom, 1949

Thieves of virtue : when bioethics stole medicine / Tom Koch.

p. cm.

Includes bibliographical references and index.

ISBN 978-0-262-01798-5 (hardcover : alk. paper)

ISBN 978-0-262-30460-3 (retail e-book)

1. BioethicsHistory. 2. BioethicsPolitical aspects. 3. BioethicsPhilosophy. 4. Medical ethicsPolitical aspects. 5. Medical ethicsPhilosophy. I. Title.

QH332.K63 2012

174.2dc23

2012004932

10 9 8 7 6 5 4 3 2 1

Series Foreword

Glenn McGee and I developed the Basic Bioethics series and collaborated as series coeditors from 1998 to 2008. In fall 2008 and spring 2009 the series was reconstituted, with a new editorial board, under my sole editorship. I am pleased to present the thirty-third book in the series.

The Basic Bioethics series makes innovative works in bioethics available to a broad audience and introduces seminal scholarly manuscripts, state-of-the-art reference works, and textbooks. Topics engaged include the philosophy of medicine, advancing genetics and biotechnology, end-of-life care, health and social policy, and the empirical study of biomedical life. Interdisciplinary work is encouraged.

Arthur Caplan

Basic Bioethics Series Editorial Board

Joseph J. Fins

Rosamond Rhodes

Nadia N. Sawicki

Jan Helge Solbakk

Acknowledgments

Like philosophy, writing is popularized as a solitary endeavor, the work of the individual to be completed in solitude. But like the ethics that philosophy promotes writingat least writing for publicationis a decidedly communal enterprise. From conception through publication, it is the result of the labors of many and not the authors alone.

I have been informed, for example, by presenters at the American Society of Bioethics and the Humanities (ASBH) and other meetings, not the least by those with whom I have most strongly disagreed. My library is filed with the writings of those authors, noted and underlined, a paper communion with their thinking. Those authors, and others, have served as peer reviewers whose critical comments have improved the journal articles that I in turn have written and that served as building blocks for this book.

I have learned much, and more, perhaps, from the students who like the fellow in the Bob Marley tee shirt, have challenged my understanding over the years. In medicine, Ive been privileged to work with a group of medical students at the University of British Columbia who meet most weeks to discuss medical ethics and ethical practice at the home of Drs. Margaret and Robin Cottle.

It was through my conversations with students at an ASBH meeting that I first met MIT acquisitions editor Clay Morgan. He found my dialogue with students interesting and encouraged me to submit a proposal based on those student discussions. Series editor Art Caplan approved it and this book was begun as a result. The original, draft manuscript benefited greatly from the critical comments of peer reviewers, the unsung heroes of publishing. Their observations were most important where they were least complimentary and I am grateful to them all.

At the MIT Press I was fortunate to have the assistance of Kathleen A. Caruso, the production editor who brought Julia Collins on board as text editor. Together they identified problems and helped assure the result would be if not error-free (what book ever is?) then as error-free as possible. It was through Kathleens good offices that I was able to employ Tobiah Waldron as an indexer. I believe in indexes but am talentless in their construction. Tobiah served ably where my own efforts would have failed.

In clinic and hospital I have been privileged to learn from and work with a series of nurses and physicians. These include, in a partial list, the late William McArthur of Vancouver, a friend and teacher; Dr. Harvey Pasternak of Toronto and Dr. Margaret Cottle of Vancouver, BC. Earlier in my career I had the opportunity to work at The Hospital for Sick Children with caring and talented physicians like Dr. Arlette LeFebvre and Dr. Jonathan Hellmann.