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SOCIETY'S CHOICES -- Copyright -- Preface -- Acknowledgments -- Contents -- Executive Summary -- SOURCES OF ETHICAL ISSUES IN BIOMEDICINE -- THE SOCIETAL CONTEXT OF BIOETHICAL PROBLEM SOLVING -- SYSTEMATIC APPROACHES TO BIOETHICS -- THE SPECTRUM OF SOCIETAL RESPONSES -- Political and Legal Mechanisms -- Professional and Institutional Mechanisms -- Individual and Community Responses -- CRITERIA FOR SUCCESS -- Intellectual Integrity: Logic, Scholarship, and Sound Judgment -- Logic -- Scholarship -- Sound Judgment -- Sensitivity to Democratic Values: Respect, Representation, and Openness -- Respect for Affected Parties -- Representation of Diverse Views -- Open versus Closed Meetings -- Effectiveness: Communication, Authority -- Communication -- Authority -- Different Goals, Different Yardsticks of Success: Achieving Consensus, Achieving Results -- Can Bioethics Be Disadvantageous? -- CONCLUSIONS AND RECOMMENDATIONS -- A Multilevel Approach to Bioethics Deliberation -- Nongovernmental Organizations and Individuals -- States -- Advisory Bodies in Federal Agencies -- A Supra-agency Commission -- PART I -- 1 Introduction -- DEFINING "ETHICAL" ISSUES -- SOURCES OF ETHICAL ISSUES IN BIOMEDICINE -- Biomedical Research Involving Human Subjects -- Changes in Health Care -- Making Decisions About Health Care -- The Health Care System: Financing and Structure -- New Diagnostic and Therapeutic Capabilities in Medicine -- Academic-Industry Relationships in Biotechnology -- REFERENCES -- 2 The Social Context of Bioethical -- THE AMERICAN CHARACTER -- Ambivalence About Government -- The Political Process -- The Religious Sphere -- ACTORS SHAPING THE SOCIAL CONTEXT FOR BIOETHICS -- Minorities: A History of Distrust -- Women: A Struggle for Control -- Gays and Lesbians: A New Activism -- HEALTH CARE AND SCIENCE: SHAPING THE SOCIAL CONTEXT FOR BIOETHICS.