Second Thoughts: Health Care Ethics

by Robert Traer

This book on health care ethics argues that our reasoning should include second thoughts about our initial reaction to an ethical issue. "Second Thoughts" considers AMA and ANA ethical reasoning, US Supreme Court decisions, aid-in-dying laws, feminist ethics, East Asian and Islamic traditions, as well as Catholic teaching. Each chapter includes case studies and questions. One chapter examines decisions by the Trump administration that impact health care policies and implementation of the Affordable Care Act. Ethical reasoning reflects the values of our community, which make our reasoning persuasive. Reasoning may also “trigger new intuitions,” which can alter our community’s moral narrative. Our ethical challenge is to consider carefully both our emotional response and our reasoning. We pursue this quest by distinguishing three patterns of reasoning. First, we address ethical choices by identifying a person’s duty or rights. At all levels of life our social and political institutions make rules to enforce this reasoning. In health care, for example, we assert that a person’s human dignity entails a right to consent to medical treatment. And that this right as a patient means the physician has a duty to inform a patient properly to ensure the patient’s informed consent.Second, we use reason to set goals about how we should act as persons and organizations. In health care, we affirm that caregivers should not only provide health care, but also should be caring as they provide health care. To be caring is not a specific action, but a way of being ethical when we take any action. We use this kind of reasoning to affirm that expressing empathy for each patient is good in itself, apart from any calculation of its measurable consequences. Third, we use reason to predict the likely consequences of taking an action. Caregivers weigh the likely benefits of treatment against the probable risks for the patient, in order to decide what is in the patient's best interests. When we reason by predicting consequences, however, we should have second thoughts about what we think we know and about what may be unknowable.Reasoning by setting goals and predicting consequences are both forward looking, but each way of reasoning has a different process for evaluating what is better or best. When we predict likely consequences to justify an action, we usually consider only the more obvious measurable outcomes. We should also recognize, however, that providing health care while having a caring state of mind will likely affect both patients and caregivers in ways we are unable to measure. Robert Traer teaches for the Dominican University of California. He has a JD in law and a PhD in world religious. His books "Doing environmental Ethics" (second edition), "Doing Ethics in a Diverse World" (with Harlan Stelmach), and "Faith in Human Support in Religious Traditions of a Global Struggle." He and his wife, Nancy, have been married fifty years and have five children, including two adopted from East Asia. They are blessed with ten grandchildren.

216 pages, Paperback

Published April 3, 2018

About the author

Robert Traer served as the executive director of the International Association for Religious Freedom from 1990-2000, and in that capacity represented the work of the IARF on religious freedom at the United Nations. Dr. Traer now teaches courses on ethics at the Dominican University of California in San Rafael. In 2002 he was a Resident Scholar at the Tantur Ecumenical Institute for Theological Studies in Israel. In the spring of 2005 he served with the Ecumenical Accompaniment Program in Israel/Palestine, which is sponsored by the World Council of Churches, and in June 2005 he participated in the Critical Moment Conference in Geneva convened by the World Council of Churches and also drafted the conference report. He is a retired minister in the Presbyterian Church (U.S.A.) and a member of the Bar of the State of Colorado. His writings on human rights are available at http://religionhumanrights.net, and his writings on environmental ethics are at http://doingethics.com. His work on Christian faith, ethics and interfaith dialogue are at http://christian-bible.com. He and his wife, Nancy, have been married forty-one years and have five children, including two adopted daughters from Asia, and six grandchildren.

Education:

Graduate Theological Union, Ph.D. in Comparative Religion (1988)
School of Law of the University of California at Davis, J.D. (1976)
Divinity School of the University of Chicago, D.Min. (1969), M.Th. (1967)
Carleton College, B.A. with Distinction (1965)

Publications Include:

Doing Environmental Ethics (2009)
Doing Ethics in a Diverse World (with H. Stelmach) (2008)
Jerusalem Journal: Finding Hope (2006)
Faith, Belief, and Religion (2001).
Quest for Truth: Critical Reflections on Interfaith Cooperation (1999).
Faith in Human Rights: Support in Religious Traditions for a Global Struggle. (1991).
"U. S. Ratification of the International Covenant on Economic, Social, and Cultural Rights," in Promises to Keep: Prospects for Human Rights, ed. Charles McCoy (2002).

"Ending Religious Violence," Dharma World, Vol. 31 (Jan./Feb. 2004): 9-13.
"Our Interfaith Challenge at the Beginning of the Twenty-first Century," World Faiths Encounter, No. 29 (July 2001): 13-21.
"Beyond 'Religion and...'," Breakthrough News, Global Education Associates, (Sep.-Dec. 2000): 1-3.
"Faith in Human Rights." Church & Society, 88, no. 4 (March/April 1998): 46-58.
"Beyond Tolerance: Call to Repentance," Faith & Freedom, 49, (Spring/Summer 1996): 47-51.
"Thinking Globally, Acting Locally, Faith & Freedom, vol. 48, no. 141 (Autumn/Winter 1995):152-56.
"A Confessional Approach to Interfaith Cooperation." Visions of an Interfaith Future: Proceedings
of Sarva-Dharma-Sammelana, ed. Celia and David Storey (Oxford: International Interfaith Centre, 1994), 318-330.
"Religious Freedom." A Sourcebook for the Community of Religions, ed. Joel Beversluis (Chicago: The Council for a Parliament of the World's Religions, 1993), 114-15.
"Religious Freedom at the End of the 20th Century." Church & Society (Sep./Oct. 1992): 38-50.
"Nonadversarial Conflict Resolution." Dharma World, 19 (Jan./Feb. 1992): 29-31, 35.
"Faith in the Buddhist Tradition." Buddhist-Christian Studies, vol. 2 (1991): 85-120.
"Christian Support for Human Rights in Latin America," International Review of Mission, vol. 80, no. 318 (April 1991):245-49.
"Human Rights in Islam," Islamic Studies, vol. 28, no. 2 (Summer 1409/1989):117-29.
"On Human Rights: The U.S. Lives in a Glass House," Human Rights 16, no. 1 (Spring 1989).
"Christian Support in Asia for Human Rights," Asia Journal of Theology, vol. 3, no. 2 (October 1989):670-83.
"Abolishing the Death Penalty, The California Prisoner, (August 1989):8, 10, 12.
"Chinese Views on Human Rights," China Notes, (Autumn 1988):1-3.
"Religious Communities in the Struggle for Human Rights," The Christian Century (September 1988):835-38.