NOW FEATURING A NEW AFTERWORD, "PANDEMIC ETHICS" From two eminent scholars comes a provocative examination of bioethics and our culture’s obsession with having it all without paying the price. Shockingly, the United States has among the lowest life expectancies and highest infant mortality rates of any high-income nation, yet, as Amy Gutmann and Jonathan D. Moreno show, we spend twice as much per capita on medical care without insuring everyone. A “remarkable, highly readable journey” (Judy Woodruff ) sure to become a classic on bioethics, Everybody Wants to Go to Heaven but Nobody Wants to Die explores the troubling contradictions between expanding medical research and neglecting human rights, from testing anthrax vaccines on children to using brain science for marketing campaigns. Providing “a clear and compassionate presentation” ( Library Journal ) of such complex topics as radical changes in doctor-patient relations, legal controversies over in vitro babies, experiments on humans, unaffordable new drugs, and limited access to hospice care, this urgent and incisive history is “required reading for anyone with a heartbeat” (Andrea Mitchell).

Biotechnology (BT) offers exciting and promising prospects for healing the sick and relieving the suffering. But because of their impressive powers to alter the workings of body and mind, the "dual uses" of the same technologies make them attractive also to people who are not sick but who would use them to look younger, perform better, feel happier, or become more "perfect." These applications of BT present us with difficult challenges. This report considers such possible "beyond therapy" uses and explores both their scientific basis and the ethical and social issues they will raise. In enjoying the benefits of BT, we will need to hold fast to an account of the human being, seen not in material or mechanistic or med. terms, but in psychic and moral and spiritual ones.

"With this one compact statement, Jacob Needleman has forced the discussion of both science and religion in our time into a new, more mature and discriminating phase. . . . It is a way station where those who are seriously exploring the transformation of consciousness will have to stop, take thought, and perhaps re-plot their course."--Theodore Roszak "I want to strongly recommend it to every reader seriously interested in our present cultural situation."--Fritjof Capra "Needleman is unique; he is really on to something. . . . A fine book"--Harvey Cox Western science has operated for centuries on the assumption that we can understand the universe without understanding ourselves. We are just now seeking to make the necessary connection between the general laws of nature to those of our own (inner) nature. But the job won't be done with "massive injections of the new consciousness"; we cannot democratize the sacred by cheapening its demands. "My aim in this book therefore" says Needleman, "has not been to speak of the convergence of science and spirituality, but of their separation. As in nature itself, organic unity is a reciprocal relationship between separate but interdependent entities. In human life as well, there can be no real unity except through the awareness of real divisions. One may then hope to experience the magic power of sustained awareness by itself to bring the harmony that we have until now fruitlessly attempted to impose on ourselves and on our endangered civilization." Jacob Needleman is a professor of philosophy at San Francisco State University and the author of many books, including Money and the Meaning of Life , and The American Soul . In addition to his teaching and writing, he serves as a consultant in the fields of psychology, education, medical ethics, philanthropy, and business, and has been featured on Bill Moyers's acclaimed PBS series A World of Ideas .

My 'discovery' of the Polish School of philosophy of medicine stemmed from my studies in the genesis of Ludwik Fleck's epistemology. These studies, and my interest in the scientific roots of Fleck's epistemology were a nearly 'natural' result of my own biography: like Fleck I had been trained, an had worked as an immunologist, and had later switched to studies in the social history of medicine and biology. Moreover, it so happened that Fleck's book, Genesis and Development of a Scientific Fact -the description of a science as it is, not as it should be -was the first epistemological study in which I found echos of my experience in the laboratory. My interest in Fleck was also highlightened by the fact that in his works, and, as I discovered later, in the works of his predecessors of the Polish School of philosophy of medicine, was formulated the problem that had stimulated my interest in the history of medicine and biology, and is still central to my present investigations: the relationships between biological knowledge and clinical practice. The writing of the book was made possible through to the help of many colleagues and friends. The unfailing support for my research, whatever its subject might be, from my colleagues from Unit 158 of INSERM and in particular from its head Patrice Pinell, has made my study of the Polish School possible.