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Philosophical debates over the fundamental principles that should guide life-and-death medical decisions usually occur at a considerable remove from the tough, real-world choices made in hospital rooms, courthouses, and legislatures. David Orentlicher seeks to change that, drawing on his extensive experience in both medicine and law to address the translation of moral principle into practice--a move that itself generates important moral concerns. Orentlicher uses controversial life-and-death issues as case studies for evaluating three models for translating principle into practice. Physician-assisted suicide illustrates the application of ''generally valid rules,'' a model that provides predictability and simplicity and, more importantly, avoids the personal biases that influence case-by-case judgments. The author then takes up the debate over forcing pregnant women to accept treatments to save their fetuses. He uses this issue to weigh the ''avoidance of perverse incentives,'' an approach to translation that follows principles hesitantly for fear of generating unintended results. And third, Orentlicher considers the denial of life-sustaining treatment on grounds of medical futility in his evaluation of the ''tragic choices'' model, which hides difficult life-and-death choices in order to prevent paralyzing social conflict. Matters of Life and Death is a rich and stimulating contribution to bioethics and law. It is the first book to examine closely the broad problems of translating principle into practice. And by analyzing specific controversies along the way, it develops original insights likely to provoke both moral philosophers and those working on thorny issues of life and death.

Medical laws and legislation. --- Medical ethics. --- Medical ethics --- Medical care --- Law and legislation --- United States --- Bok, Sissela: on deceit of the public. --- Brett, Allan: on camouflaging rationing. --- Brody, Howard: on medical futility. --- Calabresi, Guido: on tragic choices. --- Dworkin, Ronald: on a right to assisted suicide. --- Epstein, Richard: on legal prohibitions of consensual killing. --- Frader, Joel: on camouflaging rationing. --- Gilgunn, Catherine: and medical futility law. --- HIV testing: mandatory testing and reporting. --- New Jersey law: on brain death. --- Rawls, John: on rules. --- Schauer, Frederick: on rules. --- amniocentesis: for Down’s syndrome. --- aresponsible agencies: for making tragic choices. --- bodily integrity: as a core right. --- courts: and a right to assisted suicide. --- curable patient: example of. --- death: natural versus unnatural. --- duty to warn: for psychiatrists. --- folic acid: supplementation during pregnancy. --- general rights: versus specific rights. --- generally valid rules. --- indeterminacy: of legal principles. --- killing: versus letting die. --- lesser rights: versus greater rights. --- moral intuition: and right-to-die law. --- perverse incentives concern. --- pragmatism. --- rules: and avoiding bias. --- specific rights: versus general rights. --- theories in medical ethics. --- translating theory into practice. --- virtue ethics: as a leading bioethical theory.