An incisive examination of bioethics and American healthcare, and their profound effects on American culture over the last 60 years, from two eminent scholars.

Gutmann and Moreno--"incisive, influential, and pragmatic thinkers" (Arthur Caplan)--demonstrate that the stakes have never been higher for prolonging and improving life. From health care reform and death-with-dignity to child vaccinations and gene editing, they explain how bioethics came to dominate the national spotlight, leading and responding to a revolution in doctor-patient relations, a burgeoning world of organ transplants, and new reproductive technologies that benefit millions but create a host of legal and ethical challenges.

With striking examples, the authors show how breakthroughs in cancer research, infectious disease, and drug development provide Americans with exciting new alternatives, yet often painful choices. They address head-on the most fundamental challenges in American health care: Why do we pay so much for health care while still lacking universal coverage? How can medical studies adequately protect individuals who volunteer for them? What's fair when it comes to allocating organs for transplants in truly life-and-death situations?

A lucid and provocative blend of history and public policy, this urgent work exposes the American paradox of wanting to have it all without paying the price.