The Ends of Human Life: Medical Ethics in a Liberal Polity

The years since the late 1950s have spawned public debate on medical ethical issues ranging from abortion, terminating life-sustaining care, and euthanasia to informed consent, the just allocation of medical resources, and surrogate motherhood. Yet for all the increased attention focused on these issues, there has been no consensus on their resolution. Ezekiel Emanuel, who is trained as both a physician and a political theorist, rejects the claim that most of these medical ethical dilemmas are created by the recent advances in medical technology; he maintains instead that the seemingly endless debates are the inevitable consequence of liberal political values. He proposes an alternative ideology, a liberal communitarianism which imagines a federation of political communities dedicated to democratic deliberations to guide the formulation of laws and policies. Emanuel outlines six conceptions of the "good life" that involve different views of medical ethics, pointing out that choosing among them violates the liberal tenet of neutrality. A further problem lies in the fact that although almost no one believes the current U.S health system is just or excellent, we cannot agreee on a national health care program. He describes his own solution, showing that the communitarian vision is compatible with many characteristics of the American medical system and can provide an ethical framework for resolving these pressing medical ethical issues. It is aimed at physicians, medical ethicists, political philosophers, and students of public policy. It should also interest general readers concerned with the major medical and ethical problems confronting society.