In his latest book, renowned ethicist James F. Childress highlights the role of imagination in practical reasoning through various metaphors and analogies. On the one hand, his discussion of ethical problems contributes to a better understanding of the scope and strength of different moral principles, such as justice, beneficence, and respect for autonomy. In particular, he defends a plausible interpretation of the meaning and weight of the principle of respect for autonomy over against many of its defenders as well as its critics. On the other hand, Childress demonstrates the major role of metaphorical, analogical, and symbolic reasoning in biomedical ethics, largely in conjunction with, rather than in opposition to, principled reasoning. Although Childress states his methodological argument in general terms, he mainly shows how principles, metaphors, analogies, and the like, illuminate moral problems and issues in science, medicine, and health care. The essays that comprise this volume cover several major problem areas in contemporary biomedical ethics. These areas include: the relationships between physicians and patients, screening and testing for HIV infection, informed consent to and refusal of life-sustaining treatment, withdrawing artificial nutrition and hydration, allocating scarce health care resources, providing access to and controlling the costs of health care, and obtaining organs and tissues for transplantation. Most of the essays in this volume have been thoroughly revised and updated for this publication. Together they comprise an important statement from one of our foremost ethicists.
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