Daniel Callahan--whose cofounding of The Hastings Center in 1969 was one of the most important milestones in the history of bioethics-has written on an uncommonly wide range of issues over a long career. They have moved back and forth between clinical care of individual patients and the ethical problems of health care research and delivery. Through his many writings, four core problems have recurred in all of his work, and influence each of the others. What is health and how has its understanding been shaped by medical progress and the culture of medicine and society? What is progress, a deep value in modern health care and how should we judge it? What kinds of technological innovations that come out of the drive for progress are really good for us-and what do we do when there is a clash between individual good and social good in the use of expensive technologies, a problem now evident in the unsustainable high costs of health care? How should our understanding of the place of an inevitable death in all our lives, and its place in medicine, help us to better think of the goals of medicine and the goals of our life in seeking a good death?
Those four questions have been with bioethics from its beginning and will remain with it for the indefinite future. They are the roots of bioethics.
Senior Research Scholar, President Emeritus and co-founder, Hastings Center of Bioethics. Co-director of the Yale-Hastings Program in Ethics and Health Policy. Authof of 41 books including most recently Taming the Beloved Beast: Why Medical Technology Costs are Destroying Our Health Care System (Princeton University Press, August 2009); Medicine and the Market: Equity vs. Choice (Johns Hopkins University Press, 2006).
Introduction ; 1. The Hastings Center and the Early Years of Bioethics ; 2. A Memoir of An Interdisciplinary Career ; 3. Minimalist Ethics ; 4. Individual Good and Common Good ; 5. The WHO Definition of Health ; 6. End-of-Life Care: A Management or Philosophical Problem? ; 7. Death, Mourning and Medical Progress ; 8. Terminating Life-Sustaining Treatment For The Demented ; 9. Killing and Allowing to Die: Why It Is A Mistake To Derive and "Is" from an "Ought" ; 10. Rationing: Theory, Passion, and Politics ; 11. Consumer-Directed Health Care: Promise Or Puffery? ; 12. Social Allocation of Resources For Patients with ESDR ; 13. Shaping Biomedical Research: The Case of NIH ; 14. Time For a Change: Planning Our Medical Future ; 15. Too Much of A Good Thing: How Splendid Technologies Can Go Wrong ; 16. Demythologizing The Stem Cell Juggernaut ; 17. Health Technology Assessment Implementation: The Politics of Ethics ; 18. Bioethics and Fatherhood