Chapter 2 of the sixth edition of Beauchamp's and Childress's Principles of Biomedical Ethics is titled "Moral Character."  This section is largely a discussion of virtue ethics, which I personally espouse.  Virtue ethics, however, is not a principle component of libertarian bioethics so my comments will be focused on portions of the chapter that address the use or non-use of aggression in medicine, which is the primary concentration of libertarian bioethics.

The authors relate a story regarding a physician in Cracow Poland under Nazi occupation choosing whether or not to "inject cyanide into four immobile patients or abandon them to the SS, who were at that moment emptying the ghetto and had already demonstrated that they would brutally torture and kill captives and patients."  The doctor ultimately decides to euthanize the patients without their consent.  The authors imply that they do not believe the physician murdered his four patients and, in fact, label him a "moral hero."  The libertarian bioethicist, on the contrary, immediately recognizes the doctor committed 4 murders , for murder is defined as aggression against another human that intentionally leads to the death of that human.  The libertarian bioethicist makes no judgment regarding the heroic status of the physician because this type of judgment is outside the purview of libertarian bioethics.  Yet, the context of the doctor's decision would be taken into account if a libertarian justice system became involved in this scenario, for the aggrieved parties (family, next-of-kin, or friends or others designated by the deceased) could easily, and rightly in the estimation of the LIBERTARIAN BIOETHICS BLOGger, seek no punishment for the 4 murders and laud the physician as a "moral hero" for killing their loved ones in a humane way rather than abandoning them to be killed in an inhumane way by the Nazis. 

The authors also comment on conscientious objections by health care professionals.  They specifically cite "a physician's refusal to honor a patient's valid advance directive to withdraw artificial nutrition and hydration under certain circumstances, a nurse's refusal to participate in an abortion or sterilization procedure, and a pharmacist's refusal to fill a woman's prescription for an emergency contraception."  They mention the ethical duty of these health care professionals to inform potential future employers of their relevant objections and "public policy" implications but do not discuss the more common scenario of health care professionals refusing to perform certain work duties after employed.  The libertarian answer is the recognition that these health care professionals are probably violating their contracts (and thus private-property rights of their employers) by declining to perform contract-designated duties and, thus, are subject to disciplinary procedures by their employers, including termination of employment.

The authors also discuss organ and tissue donations from living donors.  They assert that transplant teams can "decline some heroic offers of organs for moral reasons - even when the donors are competent, their decisions informed and voluntary, and their moral excellence beyond question."  I agree with the authors for the key libertarian point in this scenario is that physicians are not slaves and thus, as long as they are not violating the terms of their employment contracts, do not have to provide any medical services to anyone for any reason. 

The next chapter in this textbook analyzes the concept of moral status. 

This is the final blog post concerning Ronald White's 2007 article in The Independent Review titled "Institutional Review Board Mission Creep: The Common Rule, Social Science, and the Nanny State."  The concluding topic is the Conclusion: The Rise of the Nanny State section of the paper.  The LIBERTARIAN BIOETHICS BLOGger plans to meld these multiple posts into an op-ed and an academic essay.

White's penultimate paragraphs, like the Alternatives to IRBs section, are disappointing.  He accurately details the scientific research problems caused by the rise of IRB culture (the "Nanny State") but does not provide a solution or solutions.  The root solution, of course, is abolition of government-funded IRBs via abolition of the State.  

Anecdotally, my experiences with hospital IRBs have been negative.  The IRBs I have interacted with have been populated by overworked professionals with minimal knowledge concerning the proposed scientific research or the scientific method.  The bulk of the work by these hospital IRBs was performed by administrative secretaries (bureaucrats), whose primary mission, reminiscent of Mussolini, appeared to be starting and stopping the meetings on time.  Due to the quantity of protocols requiring IRB approval my IRB meeting appearances typically lasted for 5 minutes and consisted of me briefly answering a solitary arbitrary question.  My research protocols were approved by the IRB if application forms were completed appropriately; revisions were requested if forms were not completed appropriately.  All involved, except the administrative secretaries, viewed the IRB process as a colossal joke and understood that the primary reason for the existence of the hospital IRBs was  to fulfill absurd State hospital regulations, not to protect research subjects from physical harm.  Thus, my experiences anecdotally confirm White's negative IRB critique.

Hans-Hermann Hoppe's 1993 essay titled "A Four-Step Health-Care Solution" solves the U.S. healthcare crisis in 15 paragraphs.  This article was originally published in The Free Market.  The LIBERTARIAN BIOETHICS BLOGger is surprised to discover he has never commented on Hoppe's plan in this blog.

Hoppe's solution is simple.  To paraphrase, abolish licensing requirements for health care personnel and facilities, abolish restrictions on the production and sale of medical products and devices, abolish regulation of the health insurance industry, and abolish subsidies to the sick and/or unhealthy.  Abolition is cool again!!!

A bonus for review of Hoppe's article is the excellent explication of insurable vs. uninsurable events in the deregulation of the health insurance industry section.  I cannot recommend this essay more highly.  Frankly, one cannot be a 21st century libertarian if one has not read Hoppe's healthcare plan.

The Preface to the original edition of Singer's The Expanding Circle is included in the 2011 edition of the same work.  The original Preface is the chapter after the 2011 Preface.  Besides noting the truism that "religion no longer provides a satisfactory answer to the puzzle about the nature of morality", the original Preface adds zilch to the enlightenment gained by reviewing the 2011 Preface.