These CQ Sources were compiled by Bette Anton and Judith Schaeffer Young.

The question of whether or not either elderly people or those whose life expectancy is short have commensurately reduced claims on their fellows, have, in short, fewer or less powerful rights than others, is of vital importance but is one that has seldom been adequately examined. Despite ringing proclamations of justice and equality for all, the fact is that most societies discriminate between citizens on the basis both of age and life expectancy.

I would have preferred that the Special Section on Children as Organ Donors had focused on the donation of a specific organ because morally relevant differences are obscured when the subject is discussed in general terms. The donation of a lobe of liver and peripheral blood or bone marrow stem cells does not result in the permanent loss of vital tissue because these organs regenerate; however, a kidney does not regenerate and its donor loses a vital organ permanently. Liver tissue and peripheral blood or bone marrow stem cells are typically required to save a life, but, because most patients with end-stage renal disease can be kept alive on dialysis, the donation of a kidney is rarely life saving. Also, donor risk is organ specific; for example, it is more dangerous to donate a lobe of liver than it is to donate peripheral blood or bone marrow stem cells.

Health care services are constantly assessed by their ability to accommodate values popular in contemporary societies. Autonomy, justice, and human dignity have for some time been among such values in the affluent West. Relative newcomers in the field are the notions of “precaution” and “solidarity,” which seem to attract, in particular, Continental European ethicists.This article was produced as a part of the projects Ethical, Legal and Social Aspects of Human Genetic Databases: A European Comparison (ELSAGEN), financed between 2002 and 2004 by the European Community (QLG6-CT-2001-00062); Public Policies, Law and Bioethics: A Framework for Producing Public Health Policy Across the European Union by Examining Concepts of European and Universal Ethical Standards (EuroPHEN), financed between 2003 and 2006 by the European Community (QLRT-2001-02320); and Ethical and Social Aspects of Bioinformatics (ESABI), financed between 2004 and 2007 by the Academy of Finland (SA 105139). My thanks are due to these institutions for their support, and to Peter Herissone-Kelly for checking my English.

Given that, globally, health professionals' involvement in crises—especially complex crises where human action plays a contributing role—has risen to new proportions, emergency preparedness is an increasingly integral capacity of health systems. As the United States has come to see itself as vulnerable to violence, its leaders have begun to reorganize the country's health system around protection from terrorism and other health emergencies, upholding this as an essential element or “indispensable pillar” in their strategy for securing the homeland. Biodefense and emergency preparedness have thus come to capture the energies and expertise of nearly all health professionals and, increasingly, to define the specific ends that organize their work.The author thanks Lisa S. Parker and members of the Duke University–University of North Carolina at Chapel Hill Bioethics Forum for their helpful comments on earlier versions of this essay.

David and I were at a conference on Amelia Island in Florida back in 1995. The meeting, sponsored by the University of Florida, was entitled, “Physician-Assisted Death: Implications for Patients, Care Providers, and Society,” a title that seems quaint given the controversy over the right to die engendered by the Schiavo case. But that's a different talk for a different time.

“That's my dad on the floor.”

And there he was unconscious in a pool of blood in the bathroom. A paramedic who had accompanied him to the john was holding him off the ground, the USMC tattoo on his forearm cradling his head. My sister shrieked, and I went down on my knees to see about his airway. “We need a doctor here. Cardiac Team!” Could this really be happening to him? To us? Jesus Christ.

“Dissecting Bioethics,” edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.

The section is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people's actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are therefore particularly appreciated.

The themes covered in the section so far include dignity, naturalness, public interest, community, disability, autonomy, parity of reasoning, symbolic appeals, and toleration.

All submitted papers are peer reviewed. To submit a paper or to discuss a suitable topic, contact Tuija Takala at [email protected].

In “Ethics and the Underpinnings of Policy in Biodefense and Emergency Preparedness,” Lisa Eckenwiler advances discussion about emergency preparedness by exploring ethical commitments that shape healthcare and defense policy in an age of terrorism. Eckenwiler rightly discerns that policymakers' assumptions about controlling and containing hostile malefactors and (lack of) the need for public consent regarding security measures are part of an epistemic framework that orders the current response to terrorism. Again rightly, she suggests that (1) citizens ought to have a say in shaping and interpreting such fundamental assumptions, (2) a reductive medical model that focuses on mitigation and the management of casualties is insufficient for understanding and responding to the complex social, political, and economic factors that precipitate terrorist attacks, and (3) there is in emergency preparedness an ethically problematic disproportion between the demands society places on public health/medical professionals and the resources society provides for them to meet these demands. She is also probably correct in claiming that, properly understood, the ethical underpinnings of public health policy are teleological in nature (though her conception of the telos is suspect).

From the first days of conscription, physicians have declared their opposition to unjust wars by using their good offices to aid draft evaders.

Transplantation is now the best therapy for eligible patients with end-stage organ disease. For patients with failed kidneys, successful renal transplantation improves the quality and increases the quantity of their lives. For people with other types of organ failure, transplantation offers the only hope for long-term survival.This study was supported by a grant from the Upstate New York chapter of the National Kidney Foundation.

Elizabeth H. Blackburn, Ph.D., is a leader in the area of telomere and telomerase research—in fact, in 1984 she codiscovered the ribonucleoprotein enzyme telomerase, opening up new potentials in cancer research and therapy. This and subsequent work has earned her numerous honors, not the least of which are the National Academy of Science Award in Molecular Biology, an Honorary Doctorate of Science from Yale University, the American Cancer Society Medal of Honor, and many more awards. Dr. Blackburn is a Fellow of the American Academy of Arts and Sciences, the Royal Society of London, the American Academy of Microbiology, and the American Association for the Advancement of Science. She was elected to the National Academy of Sciences, and is a Member of the Institute of Medicine.

“Dissecting Bioethics,” edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.

The section is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people's actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are therefore particularly appreciated.

The themes covered in the section so far include dignity, naturalness, public interest, community, disability, autonomy, parity of reasoning, symbolic appeals, and toleration.

All submitted papers are peer reviewed. To submit a paper or to discuss a suitable topic, contact Tuija Takala at [email protected].

“Human rights” is a global topic. As soon as one agrees that a right is a human right, one cannot restrict it to certain groups. People have human rights by virtue of their humanity, not by virtue of their nationality, their status, their gender, their ethnicity, and so forth. This is why the topic is one of the most exciting, but also one of the most contentious discussed in the humanities and the social sciences. It is a topic that suggests numerous questions in three main areas: concept, content, and enforcement.

Every day in the United States 17 people die waiting for an organ transplant. The waiting list for organs, which now contains the names of 82,000 people, has more than tripled in the last 10 years. The U.S. policy on who can donate an organ is based both on previous consent of the potential donor and on the consent of the donor's family. This foundation greatly limits the number of potential donors. Spain is the world's leader in providing organs to its population, and the underlying principle of their policy on donors in presumed consent. That is, those people who have not expressly opposed donating their organs are considered eligible for donation. This policy, along with a plan of public education and a strong infrastructure for organ procurement, is what has enhanced their donor rates. Spain is not alone: other countries have seen the benefits of presumed consent and the limits of opt-in systems. The United States must put to use the experiences of these countries to stem the tide of organ shortage and give new life to those desperately awaiting organs.I would like to thank Dr. Philip Lee, Geoffrey Heller, and Dr. Linda Hogle for their invaluable advice on this article.

“Dissecting Bioethics,” edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.The section is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people's actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are therefore particularly appreciated.The themes covered in the section so far include dignity, naturalness, public interest, community, disability, autonomy, parity of reasoning, symbolic appeals, and toleration.All submitted papers are peer reviewed. To submit a paper or to discuss a suitable topic, contact Tuija Takala at [email protected].

Those of us trained in clinical ethics often find that we lack sufficient background in organizational and business ethics to help our healthcare administrators solve broad institutional issues. Organizational Ethics in Health Care: Principles, Cases, and Practical Solutions, written by five individuals from the Park Ridge Center for the Study of Health, Faith, and Ethics, is a valuable resource for ethics professionals who want to broaden their organizational ethics competency and enhance their service to the institution. The book combines theoretical ethical analysis with case studies and practical advice. The authors argue that “an organization is a moral being with moral responsibilities that must be met in carrying out its mission” (p. 250). The focus and goal of organizational ethics is “the study of personal and organizational moral norms and choices as they contribute to the activities and goals of an organization and to the integral human fulfillment of persons and communities” (p. 15). Throughout the book the authors use a virtue ethics approach. They offer plausible examples of how institutions can embody virtues such as honesty, integrity, and commitment to justice. Meanwhile they refrain from oversimplifying the process or denying the arduous and often thankless task of implementing an organizational ethics program.

Global bioethics is a bold project. In its moderate form, it aims to find solutions to the dilemmas posed by modern medicine and the biological sciences through intercultural understanding of human obligations and opportunities. In its more ambitious form, it endeavors to cover all possible ethical problems arising with regard to life and living things on earth. Given the ambitiousness of even the moderate aim, it is unsurprising that disputes are frequent and agreements are scarce. One of the most contentious issues is whether human rights should play an important role in global bioethics or not.A longer version of this discussion paper will appear as “The Future of Human Rights—Human Rights and Bioethics.” In: van den Anker, C Smith R, eds. Essential Guide to Human Rights. London: Hodder Arnold; forthcoming in 2005.

Whether one loves, hates, or is indifferent to statistics, it is impossible to avoid the fact that scientific medicine is founded on statistical thinking. Statistics does much more than help us determine if a drug or treatment procedure is efficacious. It provides a rational framework for studying a stunningly broad array of medical questions. Will an annual mammogram measurably decrease a 40-year-old woman's risk of early death? What is the best public health response to minimize morbidity and mortality from an intentional release of Bacillus anthracis? How can we rationally allocate limited medical and financial resources to deal with public health risks into the future? All of these questions, and most associated with public health and even curative health care, ultimately require quantitative evaluation. Dig down to the epistemological heart of medicine, and there you will find statistics and mathematics smiling, some might say glaring, back at you.

Developments in the last several years have sparked renewed interest in the ethics of research involving humans. Issues relating to the global extent of research and its guiding principles are of particular importance to researchers, health officials, and individual ethics committees who want a deeper and more encompassing inquiry regarding the foundation and evolution of human research. This department of CQ launches a long overdue effort to explore these wider issues. Readers are invited to submit papers to Charles MacKay, 5011 Worthington Drive, Bethesda, MD, 20816, USA. E-mail: [email protected].Funding was provided by a research fund of the faculty of medicine, University of Geneva. I thank Prof. T.W. Harding and Prof. C.-N. Robert for their support.