Issues concerning patients' rights are at the center of bioethics, but the political basis for these rights has rarely been examined. In "Bioethics in a Liberal Society: The Political Framework of Bioethics Decision Making," Thomas May offers a compelling analysis of how the political context of liberal constitutional democracy shapes the rights and obligations of both patients and health care professionals. May focuses on how a key feature of liberal society--namely, an individual's right to make independent decisions--has an impact on the most important relational facets of health care, such as patients' autonomy and professionals' rights of conscience.

Although a liberal political framework protects individual judgments, May asserts that this right is based on the assumption of an individual's competency to make sound decisions. May uses case studies to examine society's approach to medical decision making when, for reasons ranging from age to severe mental disorder, a person lacks sufficient competency to make independent and fully informed choices. To protect the autonomy of these vulnerable patients, May emphasizes the need for health care ethics committees and ethics consultants to help guide the decision-making process in clinical settings. "Bioethics in a Liberal Society" is essential reading for all those interested in understanding how bioethics is practiced within our society.

Rated as one of the top 15 breakthroughs in medicine over the last 150 years, evidence-based medicine (EBM) has become highly influential in medicine. Put simply, EBM promotes a seemingly irrefutable, principle: that decision-making in medical practice should be based, as much as possible, on the most up-to-date research findings. EBM has been particularly popular within psychiatry, a field that is haunted by a legacy of controversial interventions. For advocates, anchoring psychiatric practice in research data makes psychiatry more scientific valid and ethically legitimate. Few, however, have questioned whether EBM, a concept pioneered by those working in other areas of medicine, can be applied to psychiatric disorders. In this groundbreaking book, the Canadian psychiatrist and ethicist Mona Gupta analyzes the basic assumptions of EBM, and critically examines their applicability to psychiatry. By highlighting the basic ethical tensions between psychiatry and EBM, the author addresses the fundamental and controversial question - should psychiatrists practice evidence-based medicine at all?

Unfit for the Future argues that the future of our species depends on our urgently finding ways to bring about radical enhancement of the moral aspects of our own human nature. We have rewritten our own moral agenda by the drastic changes we have made to the conditions of life on earth. Advances in technology enable us to exercise an influence that extends all over the world and far into the future. But our moral psychology lags behind and leaves us ill equipped to deal with the challenges we now face. We need to change human moral motivation so that we pay more heed not merely to the global community, but to the interests of future generations. It is unlikely that traditional methods such as moral education or social reform alone can bring this about swiftly enough to avert looming disaster, which would undermine the conditions for worthwhile life on earth forever. Persson and Savulescu maintain that it is likely that we need to explore the use of new technologies of biomedicine to change the bases of human moral motivation. They argue that there are in principle no philosophical or moral objections to such moral bioenhancement. Unfit for the Future challenges us to rethink our attitudes to our own human nature, before it is too late.

Profoundly important ethical and political controversies turn on the question of whether biological life is an essential aspect of a human person, or only an extrinsic instrument. Lee and George argue that human beings are physical, animal organisms - albeit essentially rational and free - and examine the implications of this understanding of human beings for some of the most controversial issues in contemporary ethics and politics. The authors argue that human beings are animal organisms and that their personal identity across time consists in the persistence of the animal organisms they are; they also argue that human beings are essentially rational and free and that there is a radical difference between human beings and other animals; criticize hedonism and hedonistic drug-taking; present detailed defenses of the prolife positions on abortion and euthanasia; and defend the traditional moral position on marriage and sexual acts.

In a world where incredible medical technologies are possible ... does "can do" mean "should do"? Why the Church Needs Bioethics helps you understand and constructively engage bioethical challenges with the resources of Christian wisdom and ministry. Three rich and true-to-life case studies illustrate the urgency of such bioethical issues as reproductive and genetic technologies, abortion, forgoing treatment, assisted suicide, stem cell research, and human enhancement technologies. Leading Christian voices bring biblical and theological perspective to bear on the incredible medical technologies available today; mobilize useful insights from health care, law, and business; and demonstrate the powerful ways the church can make a difference through counseling, pastoral care, intercultural ministry, preaching, and education. This book equips students, church and lay leaders, and people in health-related fields with the knowledge to make faithful bioethical decisions and to help foster a world where human beings are shown respect as people created in the image of God. Contributors to Why the Church Needs Bioethics include leading Bible and theology scholars, such as D. A. Carson and Kevin Vanhoozer; leaders in the areas of preaching (Greg Scharf) and ethics (Scott Rae); and 15 other experts in the fields of biblical-theological studies, ministry, communication, business, law, healthcare, and bioethics.

Patient autonomy is a much discussed and debated subject in medical ethics, as well as in healthcare practice, medical law, and healthcare policy. This book provides a detailed and nuanced analysis of both the concept of autonomy and the principle of respect for autonomy, in an accessible style. The unique feature of this book is that it combines empirical research into hospital practice with thorough philosophical analyses. As such, it is an example of a new movement in applied ethics, that of 'empirical ethics'.

The key themes are informed consent and medical decision making, personal well-being, competence, paternalism and decision making for incompetent patients. Much attention is also devoted to autonomy in non-decision making situations - patient control over small everyday aspects of care, authenticity and existential aspects of illness, autonomy and the 'ethics of care', and the relationship between autonomy and trust in the physician-patient relationship.

This book will be of interest to those working or studying in the field of medical ethics and applied ethics but also to healthcare professionals and health policy makers.

The Edge of Life: Human Dignity and Contemporary Bioethics treats a number of distinct moral questions and ?nds their answer in the dignity of the person, both as an agent and as a patient (in the sense of the recipient of action). Characteristically one's view of the human being ultimately shapes one's outlook on these matters. This book addresses questions that divide a culture of life from a culture of death as well as a number of questions debated within the Catholic tradition itself. The Edge of Life offers a critique of the new bio-ethic, represented by such notable authors as Peter Singer; it also attempts to shore up some of the dif?culties leveled by critics against the traditional ethic as well as to answer some questions disputed by those within the tradition. This book does not treat the basic principles of morality but rather many of their applications and suppositions. (For an account of contemporary debates within the Catholic tradition on these matters, see Kaczor 2002). Rather, The Edge of Life seeks to address a number of disputed contemporary questions touching upon human dignity at what has been called "the margins of life. " The ?rst section of the book treats the dignity of the human person as recipient of action and as agent. Chapter two examines various accounts of when a human being becomes a person.

Culture, Health, and Social Change is the first of three volumes on Aging conceived for the International Library of Ethics, Law, and the New Medicine. Leading scholars from a range of disciplines contest some of the predominant paradigms on aging, and critically assess modern trends in social health policy. How we approach and understand "aging" will have indelible effects on existing and future elder citizens. Acknowledging the cultural variances that exist in the human experience of aging is therefore of vital importance in order to respond to individual needs in a manner that is not paternalistic, discriminatory, or exclusionary.

Like its predecessor, New Dimensions in Bioethics, this volume developed out of a series of lectures at Yale University's Institution for Social and Policy Studies. Each speaker in the Bioethics & Public Policy Seminar Series was invited because of her or his expertise in a given area of bioethics. Each of the more successful participants was invited to contribute a manuscript for publication. The essays are bound together by the application of an ethical analysis to scientific questions, and by consideration of policy implications. At its inception, bioethics was virtually synonymous with medical ethics. As the field grew and attracted new practitioners, it became clear that other applications of this new subject required extension of its scope. For example, environmental ethics, propelled by such authors as Aldo Leopold and Rachel Carson, quickly developed a vigorous literature of its own. More recently, developments in the analysis of the human genome, the enticing medical possibilities offered by the therapeutic use of stem cells, the complexities surrounding the cloning of animals and possibly humans and the development of transgenic agricultural crops have given new impetus to the expansion of traditional bioethical horizons. Bioethics must now adjust to these new realities, for it is clear that public interest in the field is growing as these new challenges appear.

The contributions to this volume grew out of papers presented at an international conference Individual, Community & Society: Bioethics in the Third Millennium, held in Hong Kong, Special Administrative Region of the People's Republic of China, between 25-28 May 1999. The conference was organized by the Centre for Comparative Public Management and Social Policy, and Ethics in Contemporary China Research Group, in the Faculty of Humanities and Social Sciences at the City University of Hong Kong. The conference brought together scholars from east and west to investigate the challenges to caring and to traditional moral authorities that would confront bioethics in the third millennium. They explored the implications of moral loss and moral diversity in post-traditional and post-modern societies, and how these would shape the character of medical care and bioethics discourse in the new era. A proceedings volume under the same title of Individual, Community & Society: Bioethics in the Third Millennium, was published in May 1999 for the conference meeting.

This volume explores Confucian views regarding the human body, health, virtue, suffering, suicide, euthanasia, human drugs, ' human experimentation, and justice in health care distribution. These views are rooted in Confucian metaphysical, cosmological, and moral convictions, which stand in contrast to modern Western liberal perspectives in a number of important ways. In the contemporary world, a wide variety of different moral traditions flourish; there is real moral diversity. Given this circumstance, difficult and even painful ethical conflicts often occur between the East and the West with regard to the issues of life, birth, reproduction, and death. The essays in this volume analyze the ways in which Confucian bioethics can clarify important moral concepts, provide arguments, and offer ethical guidance. The volume should be of interest to both general readers coming afresh to the study of bioethics, ethics, and Confucianism, as well as for philosophers, ethicists, and other scholars already familiar with the subject.

Once confined to the research laboratory, the genetic engineering of plants is now a big business that is changing the face of modern agriculture. Giant corporations are creating designer crops with strange powers, from cholesterol-reducing soybeans to plants that act as miniature drug factories, churning out everything from vaccines to insulin. They promise great benefits: better health for consumers, more productive agriculture - even an end to world hunger. But the vision has a dark side, one of profit-driven tampering with life and the possible destruction of entire ecosystems. In this text Daniel Charles takes us deep inside research labs, farm sheds and corporate boardrooms to reveal the hidden story behind this agricultural revolution. He tells how a handful of scientists at Monsanto drove biotechnology from the lab into the field, and how the company's opponents are fighting back with every tool available to them, including the cynical manipulation of public fears. A dramatic account of boundless ambition, political intrigue and the quest for knowledge, this is ultimately a story of idealism and of conflicting dreams about the shape of a better world.

NAMED ONE OF THE BEST BOOKS OF THE YEAR by The New Yorker and Science News What happens when you try to recreate a woolly mammoth-fascinating science, or conservation catastrophe? Jurassic Park meets The Sixth Extinction in Rise of the Necrofauna, a provocative look at de-extinction from acclaimed documentarist and science writer Britt Wray, PhD. In Rise of the Necrofauna, Wray takes us deep into the minds and labs of some of the world's most progressive thinkers to find out. She introduces us to renowned futurists like Stewart Brand and scientists like George Church, who are harnessing the powers of CRISPR gene editing in the hopes of "reviving" extinct passenger pigeons, woolly mammoths, and heath hens. She speaks with Nikita Zimov, who together with his eclectic father Sergey, is creating Siberia's Pleistocene Park-a daring attempt to rebuild the mammoth's ancient ecosystem in order to save earth from climate disaster. Through interviews with these and other thought leaders, Wray reveals the many incredible opportunities for research and conservation made possible by this emerging new field. But we also hear from more cautionary voices, like those of researcher and award-winning author Beth Shapiro (How to Clone a Woolly Mammoth) and environmental philosopher Thomas van Dooren. Writing with passion and perspective, Wray delves into the larger questions that come with this incredible new science, reminding us that de-extinction could bring just as many dangers as it does possibilities. What happens, for example, when we bring an "unextinct" creature back into the wild? How can we care for these strange animals and ensure their comfort and safety-not to mention our own? And what does de-extinction mean for those species that are currently endangered? Is it really ethical to bring back an extinct passenger pigeon, for example, when countless other birds today will face the same fate? By unpacking the many biological, technological, ethical, environmental, and legal questions raised by this fascinating new field, Wray offers a captivating look at the best and worst of resurrection science. Published in Partnership with the David Suzuki Institute.

This textbook untangles the complicated ethical dilemmas that arise during the day-to-day work of healthcare chaplaincy, and offers a sturdy but flexible framework which chaplains can use to reflect on their own practice. Tackling essential issues such as consent, life support, abortion, beginning and end of life and human dignity, it enables chaplains to tease out the ethical implications of situations they encounter, to educate themselves on relevant legal matters and to engage with different ethical viewpoints. The book combines case studies of familiar scenarios with thorough information on legal matters, while providing ample opportunity for workplace reflection and offering guidance as to how chaplains can best support patients and their families while preserving their own integrity and well-being. Clear, sensitive and user-friendly, this will be an indispensable resource for healthcare chaplains and all healthcare professionals interested in spiritual care.

There is the world of ideas and the world of practice; the French are often for sup pressing the one and the English the other; but neither is to be suppressed. -Matthew Arnold The Function of Criticism at the Present Time From its inception, bioethics has confronted the need to reconcile theory and practice. At first the confrontation was purely intellectual, as writers on ethical theory (within phi losophy, theology, or other humanistic disciplines) turned their attention to topics from the world of medical practice. Recently the confrontation has grown more intense. The ap pointment of clinical ethicists in hospitals and other health care settings is an accelerating trend in North America. Concomitantly, those institutions involved in training peo ple in clinical ethics have added organized exposure to the world of practice, in the form of placement requirements, to the normal academic course load. In common with other dis ciplines, bioethics has begun to see clinical training as a con dition of didactic theory and apprenticeship."

What rational justification is there for conceiving of all living things as possessing inherent worth? In "Respect for Nature," Paul Taylor draws on biology, moral philosophy, and environmental science to defend a biocentric environmental ethic in which all life has value. Without making claims for the moral rights of plants and animals, he offers a reasoned alternative to the prevailing anthropocentric view--that the natural environment and its wildlife are valued only as objects for human use or enjoyment. "Respect for Nature" provides both a full account of the biological conditions for life--human or otherwise--and a comprehensive view of the complex relationship between human beings and the whole of nature.

This classic book remains a valuable resource for philosophers, biologists, and environmentalists alike--along with all those who care about the future of life on Earth. A new foreword by Dale Jamieson looks at how the original 1986 edition of "Respect for Nature" has shaped the study of environmental ethics, and shows why the work remains relevant to debates today.

The past two decades have seen unparalleled developments in our knowledge of the brain and mind. However, these advances have forced us to confront head-on some significant ethical issues regarding our application of this information in the real world- whether using brain images to establish guilt within a court of law, or developing drugs to enhance cognition. Historically, any consideration of the ethical, legal, and social implications of emerging technologies in science and medicine has lagged behind the discovery of the technology itself. These delays have caused problems in the acceptability and potential applications of biomedical advances and posed significant problems for the scientific community and the public alike - for example in the case of genetic screening and human cloning. The field of Neuroethics aims to proactively anticipate ethical, legal and social issues at the intersection of neuroscience and ethics, raising questions about what the brain tells us about ourselves, whether the information is what people want or ought to know, and how best to communicate it. A landmark in the academic literature, the Oxford Handbook of Neuroethics presents a pioneering review of a topic central to the sciences and humanities. It presents a range of chapters considering key issues, discussion, and debate at the intersection of brain and ethics. The handbook contains more than 50 chapters by leaders from around the world and a broad range of sectors of academia and clinical practice spanning the neurosciences, medical sciences and humanities and law. The book focuses on and provides a platform for dialogue of what neuroscience can do, what we might expect neuroscience will do, and what neuroscience ought to do. The major themes include: consciousness and intention; responsibility and determinism; mind and body; neurotechnology; ageing and dementia; law and public policy; and science, society and international perspectives. Tackling some of the most significant ethical issues that face us now and will continue to do so over the coming decades, The Oxford Handbook of Neuroethics will be an essential resource for the field of neuroethics for graduate students and postdoctoral fellows, basic scientists in the neurosciences and psychology, scholars in humanities and law, as well as physicians practising in the areas of primary care in neurological medicine.

Situated at the intersection of natural science and philosophy, Our Genes explores historical practices, investigates current trends, and imagines future work in genetic research to answer persistent, political questions about human diversity. Readers are guided through fascinating thought experiments, complex measures and metrics, fundamental evolutionary patterns, and in-depth treatment of exciting case studies. The work culminates in a philosophical rationale, based on scientific evidence, for a moderate position about the explanatory power of genes that is often left unarticulated. Simply put, human evolutionary genomics - our genes - can tell us much about who we are as individuals and as collectives. However, while they convey scientific certainty in the popular imagination, genes cannot answer some of our most important questions. Alternating between an up-close and a zoomed-out focus on genes and genomes, individuals and collectives, species and populations, Our Genes argues that the answers we seek point to rich, necessary work ahead.

This book is a collection of essays by scientists, historians, philosophers of science, and students. The essays meld biotechnology into science fiction stories and thereby open a conversation about the morality of what we may be one day, and what it may mean to be human as our biotechnological endeavors continue to evolve. The biotechnology "revolution," launched on a global scale many decades ago, has taken a direct course toward re-creating life. Yet there are still many choices to be made in shaping the future that it may one day make possible. The book motivates readers toward deep reflection and continual discourse, which are essential if biotechnology is to evolve in ethical, meaningful, and sustainable ways.

This compact and innovative book tackles one of the central issues in drug policy: the lack of a coherent conceptual structure for thinking about drugs. Drugs generally fall into one of seven categories: prescription, over the counter, alternative medicine, common-use drugs like alcohol, tobacco and caffeine; religious-use, sports enhancement; and of course illegal street drugs like cocaine and marijuana. Our thinking and policies varies wildly from one to the other, with inconsistencies that derive more from cultural and social values than from medical or scientific facts. Penalties exist for steroid use, while herbal remedies or cold medication are legal. Native Americans may legally use peyote, but others may not. Penalties may vary for using different forms of the same drug, such as crack vs. powder cocaine. Herbal remedies are unregulated by the FDA; but medical marijuana is illegal in most states. Battin and her contributors lay a foundation for a wiser drug policy by promoting consistency and coherency in the discussion of drug issues and by encouraging a unique dialogue across disciplines. The contributors are an interdisciplinary group of scholars mostly based at the University of Utah, and include a pharmacologist, a psychiatrist, a toxicologist, a trial court judge, a law professor, an attorney, a diatary specialist, a physician, a health expert on substance abuse, and Battin herself who is a philosopher. They consider questions like the historical development of current policy and the rationales for it; scientific views on how drugs actually cause harm; how to define the key notions of harm and addiction; and ways in which drug policy can be made more consistent. They conclude with an examination of the implications of a consistent policy for various disciplines and society generally. The book is written accessibly with little need for expert knowledge, and will appeal to a diverse audience of philosophers, bioethicists, clinicians, policy makers, law enforcement, legal scholars and practitioners, social workers, and general readers, as well as to students in areas like pharmacy, medicine, law, nursing, sociology, social work, psychology, and bioethics.

von K. D. Bock Gestatten Sie, daB ich einleitend Sinn und Zweck dieses Kolloquiums kurz umreiBe. Risikofaktoren sind, vorbehaltlich einer genaueren, vielleicht auch etwas abweichenden Definition, die Herr Epstein in seinem einfuhrenden Referat geben wird, Haupt-oder Teilursachen von Krankheiten oder Krankheitskomplikationen. Sie zeichnen sich durch einige Besonderheiten aus, die es rechtfertigen, sie von der ku- rativen Medizin abzugrenzen und sie auch als Spezialfall der Praven- tivmedizin zu betrachten. Man kann zwei Arten von Risikofaktoren unterscheiden. Zum einen sind Risikofaktoren angeborene oder erworbene biologische Norm- abweichungen oder exogene Einwirkungen, die bei (noch) gesunden Individuen auftreten. Die Eigenschaft, noch nicht krank zu sein, hat der Risikofaktorentrager gemeinsam mit Personen, die z. B. einer Schutzimpfung unterzogen werden. Jedoch unterscheidet er sich von daB ihn das Risiko erstens permanent und zweitens diesen dadurch, immer auch personlich bedroht, wahrend z. B. bei einer Massen- schutzimpfung der einzelne vielleicht uberhaupt nicht oder nur zeit- weise dem Risiko einer Infektion ausgesetzt ist. Zum anderen wird aber auch eine bereits manifeste Krankheit als Risiko/aktor bezeich- net, wenn sie bestimmte Komplikationen allein-oder mitverursacht, z. B. die arterielle Hypertonie die Hirnblutung. Der Risikofaktorentrager erkrankt trotzdem nicht in jedem Faile und auch dann meist nach unterschiedlich langer Dauer der Einwirkung des Risikos. Insofern enthalt das Risikofaktorenkonzept ein progno- stisches Element, das nur in statistischer Form (mehr oder weniger genau) erfaBbar ist, jiir den konkreten Einze/fall aber keine Aussage zu- laj1t. Diese wichtige Tatsache wird in der praktischen Anwendung oft nicht berucksichtigt.

In Rescuing Humanity, Willem H. Vanderburg reminds us that we have relied on discipline-based approaches for human knowing, doing, and organizing for less than a century. During this brief period, these approaches have become responsible for both our spectacular successes and most of our social and environmental crises. At their roots is a cultural mutation that includes secular religious attitudes that veil the limits of these approaches, leading to their overvaluation. Because their use, especially in science and technology, is primarily built up with mathematics, living entities and systems can be dealt with only as if their "architecture" or "design" is based on the principle of non-contradiction, which is true only for non-living entities. This distortion explains our many crises. Vanderburg begins to explore the limits of discipline-based approaches, which guides the way toward developing complementary ones capable of transcending these limits. It is no different from a carpenter going beyond the limits of his hammer by reaching for other tools. As we grapple with everything from the impacts of social media, the ongoing climate crisis, and divisive political ideologies, Rescuing Humanity reveals that our civilization must learn to do the equivalent if humans and other living things are to continue making earth a home.

Why do American Black people generally have worse health than American White people? To answer this question, Black Health dispels any notion that Black people have inferior bodies that are inherently susceptible to disease. This is simply false racial science used to justify White supremacy and Black inferiority. A genuine investigation into the status of Black people's health requires us to acknowledge that race has always been a powerful social category that gives access to the resources we need for health and wellbeing to some people, while withholding them from other people. Systemic racism, oppression, and White supremacy in American institutions have largely been the perpetrators of differing social power and access to resources for Black people. It is these systemic inequities that create the social conditions needed for poor health outcomes for Black people to persist. An examination of social inequities reveals that is no accident that Black people have poorer health than White people. Black Health provides a succinct discussion of Black people's health, including the social, political, and at times cultural determinants of their health. Using real stories from Black people, Ray examines the ways in which Black people's multiple identities—social, cultural, and political—intersect with American institutions—such as housing, education, environmentalism, and health care—to facilitate their poor outcomes in pregnancy and birth, pain management, sleep, and cardiovascular disease.