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Society's Choices: Social and Ethical Decision Making in Biomedicine Content     EXECUTIVE SUMMARY   1 PART I     1   INTRODUCTION   27     Defining ''Ethical" Issues,   27     Sources of Ethical Issues in Biomedicine,   30 2   THE SOCIAL CONTEXT OF BIOETHICAL PROBLEM SOLVING   43     The American Character,   43     Actors Shaping the Social Context for Bioethics,   48     Health Care and Science: Shaping the Social Context for Bioethics,   53 3   SYSTEMATIC APPROACHES TO BIOETHICS   67     Academic Bioethics,   67     Scientists and Other Technical Experts,   75     Health Care Professional Education,   80 4   THE SPECTRUM OF SOCIETAL RESPONSES   87     Political and Legal Mechanisms,   89     Professional and Institutional Mechanisms,   115     Individual and Community Responses,   136

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Society's Choices: Social and Ethical Decision Making in Biomedicine 5   CRITERIA FOR SUCCESS   150     Intellectual Integrity   153     Sensitivity To Democratic Values,   155     Effectiveness   159 6   CONCLUSIONS AND RECOMMENDATIONS   168     Interpreting the Committee's Charge,   168     Criteria for Evaluation,   171     A Multilevel Approach to Bioethics Deliberation,   174     Recommendations,   176 PART II COMMISSIONED PAPERS         Moral Epistemology Thomas Nagel   201     Public Moral Discourse Dan W. Brock   215     The Value of Consensus Martin Benjamin   241     Bioethics Commissions: What Can We Learn from Past Successes and Failures? Bradford H. Gray   261     Limiting Life-Prolonging Medical Treatment: A Comparative Analysis of the President's Commission and the New York State Task Force Baruch A. Brody   307     The Formulation of Health Policy by the Three Branches of Government Lawrence Gostin   335     The Role of Religious Participation and Religious Belief in Biomedical Decision Making Charles M. Swezey   358     Trust, Honesty, and the Authority of Science Steven Shapin   388     Institutional Ethics Committees: Local Perspectives on Ethical Issues in Medicine Elizabeth Heitman   409

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Society's Choices: Social and Ethical Decision Making in Biomedicine     The Ethical, Legal, and Social Implications Program of the National Center for Human Genome Research: A Missed Opportunity? Kathi E. Hanna   432     AIDS, Ethics, and Activism: Institutional Encounters in the Epidemic's First Decade Ronald Bayer   458     "La Pénible Valse Hésitation"1: Fetal Tissue Research Review and the Use of Bioethics Commissions in France and the United States R. Alta Charo   477     APPENDIX PAST COMMISSIONS AND ADVISORY BOARDS   503     INDEX   521

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Society's Choices: Social and Ethical Decision Making in Biomedicine SOCIETY'S CHOICES Social and Ethical Decision Making in Biomedicine

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