In 1841 the American sailing ship "William Brown" struck an iceberg. About half of the passengers and all of the crew were saved in two small, open boats. The next night, half of the passengers in the larger long-boat were thrown overboard because the boat was overfull. This was the first case of lifeboat ethics, of hard choices in the face of scarcity. Since then the question has been who should die so that others, equally needy, might live? Both the case of the "William Brown" and the ethics it spawned have been used in recent years to describe the problem of health care rationing...

In 1841 the American sailing ship "William Brown" struck an iceberg. About half of the passengers and all of the crew were saved in two small, open boats. The next night, half of the passengers in the larger long-boat were thrown overboard because the boat was overfull. This was the first case of lifeboat ethics, of hard choices in the face of scarcity. Since then the question has been who should die so that others, equally needy, might live? Both the case of the "William Brown" and the ethics it spawned have been used in recent years to describe the problem of health care rationing...

As a society, we are faced with a series of dilemmas--abortion, euthanasia, genetic engineering, organ transplant allocation, support or non-support of the elderly and fragile--that seem to offer no resolution. How do we choose between the needy and the ailing? Choices must be made in both the world of law and the realm of medical ethics. What we need is what we do not have--a perspective in the larger sense of the word--a view that makes apparent the sweep of the issues at hand. The failure of perspective in bioethics and medical decision making is absolute. It results from the limits of...

In the seventeenth century, a map of the plague suggested a radical idea--that the disease was carried and spread by humans. In the nineteenth century, maps of cholera cases were used to prove its waterborne nature. More recently, maps charting the swine flu pandemic caused worldwide panic and sent shockwaves through the medical community. In Disease Maps, Tom Koch contends that to understand epidemics and their history we need to think about maps of varying scale, from the individual body to shared symptoms evidenced across cities, nations, and the world.

Disease Maps...

Bioethics emerged in the 1960s from a conviction that physicians and researchers needed the guidance of philosophers in handling the issues raised by technological advances in medicine. It blossomed as a response to the perceived doctor-knows-best paternalism of the traditional medical ethic and today plays a critical role in health policies and treatment decisions. Bioethics claimed to offer a set of generally applicable, universally accepted guidelines that would simplify complex situations. In Thieves of Virtue, Tom Koch contends that bioethics has failed to deliver on its...