1 Historical Introduction INTRODUCTION This chapter is mainly about the history of medicine and its ethics. As usually c- ceived, history is retrograde: It is what happened yesterday, and, much as we may try, it is what happened yesterday seen with a set of today's eyes. Trying to understand yesterday's culture may help us put on a pair of corrective glasses, but it fails in - tirely correcting our vision. Contemporary cultural anthropology may likewise help us understand the way today's events and cultural habits shape what we call history tomorrow. Past events and the kaleidoscopic pattern of today's cultures may help guide us into a future that in at least some respects is ours to forge. Learning about ethics yesterday and thinking about ethics as it expresses itself in various cultures today can help us shape the ethics of tomorrow: This is true whether we are speaking of that part of social ethics called "medical" or of any other part of social ethics. The social aspects of medical practice-how the institution called medicine fits into and works within the greater society called culture-shape the way its ethics ultimately must play itself out.

This book begins the discourse on post-trial access to drugs in developing countries. Underlying ethical issues in global health inequalities and global health research serve as the context of the debate. Due to rampant allegations of violations of rights of research participants, especially in developing countries, it discusses the regulatory infrastructure and ethical oversight of international clinical research, thus emphasizing the priority of safeguarding the rights of research participants and host populations as desiderata in conducting clinical trials in developing countries. This is the first book that analyzes the major obstacles of affordable access to drugs in developing countries - patent and non-patent factors and how they can be overcome through a middle ground approach and a new paradigm to establish global health justice which includes national and global health responsibilities. The book also deals extensively with all complex aspects of the discourse on affordable access to drugs in developing countries, including intellectual property law, international regulations, political and cultural systems, international trade agreements. Furthermore it contains a robust ethical debate and in-depth analysis. The book crafts a paradigm of global health justice involving a sliding scale of national and global responsibilities for the realization of the right to health in general and access to drugs in particular.

George Annas, America's leading proponent of patient rights, spells them out for you in this revised, up-to-date edition of his groundbreaking classic. Thorough, comprehensive, and easy to follow-using a question-and-answer format in much of the text-The Rights of Patients explores all aspects of becoming an informed patient: * hospital organization * hospital rules * emergency treatment * admission and discharge * the patient rights movement * informed consent * surgery * obstetrical care * human experimentation and research * privacy and confidentiality * care of the dying * death, autopsy, and organ donation * medical malpractice.

With the advance of biomedicine, certain individuals and groups are vulnerable because of their incapacities to defend themselves. The International Bioethics Committee as a UNESCO working group has for the last several years dedicated to deepen this principle of human vulnerability and personal integrity. This book serves to supplement this effort with a religious perspective given a great number of the world's population is affiliated with some religious traditions. While there is diversity within each of these traditions, all of them carry in them the mission to protect the weak, the underprivileged, and the poor. Thus, here presented is a collection of papers written by bioethics experts from six major world religions-Buddhism, Christianity, Confucianism, Hinduism, Islam and Judaism-who were gathered to discuss the meaning and implications of the principle of vulnerability in their respective traditions.

The roles of both the consumer and the health advocate professional have become increasingly significant in to day's climate of "rationed" health care. It seems clear that the timely exchange of ideas among seasoned health care advocates is necessary if we are to deal with the complex problems of a technologically advanced so ciety seeking to ration its heath care in a truly humane way. Toward such a timely exchange, the first Confer ence on Advocacy in Health Care was organized by the Health Advocacy Program of Sarah Lawrence College and recently held. Advocacy in Health Care: The Power of a Silent Constituency is the proceedings of the conference and will, we believe, greatly extend our efforts to share both the problems and solutions that effective patient advocacy entails. Never before has the issue of advocating for special population groups by combining the resources of consumers and professionals been the exclusive focus of one volume. This book discusses the power of such an alignment and describes specific organizational techniques that have been effective in bringing about changes in the delivery system. The final section of the book, "Questions, Com ments and Answers," presents a selection of topics of special interest that surfaced during the open disc- vii viii Preface sion at the last conference session. The comments were forthright in their criticism of public policy, and the vigor of the argument underscored the vitality of the co alition between professionals and consumers."

Nanobiotechnology is the convergence of existing and new biotechnology with the 1 ability to manipulate matter at or near the molecular level. This ability to manipulate matter on a scale of 100 nanometers (nm) or less is what constitutes the nanotechnology revolution occurring today, the potentially vast economic and social implications of which are yet to be fully understood (Royal Society, 2004). The most immediate way to understand the implications of nanobiotechnology for ethics is to consider the real life concerns of communities that are mobilizing within civil society. The conflicts and ethical debates surrounding nanotechnology will, almost by definition, emerge on the fault lines between different civil society actors, researchers and financial interests associated with nanobiotechnology, as well as (potentially) government regulators. These fault lines are all reflected within the concerns (as expressed d- cursively) of the communities mobilizing. This chapter will explore converging d- courses regarding converging technologies. Converging Technologies (CT) are already a familiar theme in the next gene- tion of biotechnology, nanotechnology, pharmacogenomics and proteomics research 2 and development. Nanobiotechnology means that previously separate disciplines (IT, physics, chemistry, and biology) are merging and converging to create new applications and even new life forms through converged technological platforms. Schummer (2004), and Glimell and Fogelberg (2003, p. 43), note the predominance of interdisciplinarity as a core theme of nano-discourse.

In this book, scholars with different disciplinary and national backgrounds argue for possible answers and analyse case studies on current issues of governance in biomedical research. These issues comprise among others the research-care distinction, risk evaluation in early human trials, handling of incidental findings, nocebo effects, cluster randomized trials, publication bias, or consent in biobank research. This book demonstrates how new technologies and research possibilities multiply or intensify already known governance challenges, leaving room for ethical analysis and complex moral choices. Clinical researchers, research ethics committee members and research ethicists have all to deal with such challenges on a daily basis. While general reflection on core concepts of research ethics is seldom pointless, those confronted with hard moral choices do need more practical and contextualized reflection on the said issues. This book particularly provides such contextualized reflections and aims to inform all those who study, conduct, regulate, fund, or participate in biomedical research.

This book provides an elaboration and evaluation of the dominant conceptions of genetic counseling as they are accounted for in three different models: the teaching model; the psychotherapeutic model; and the responsibility model. The elaboration of these models involves an identification of the larger traditions, visions and theories of communication that underwrite them; the evaluation entails an assessment of each model's theses and ultimately a comparison of their adequacy in response to two important concerns in genetic counseling: the contested values of non-directiveness and the recognition of differences across perspectives, with special focus on how religious and spiritual beliefs of patients are coordinated with the networks of meaning in genetics. Several insights are made explicit in this project through the work of Robert Brandom. Brandom's deontic scorekeeping model demonstrates how dialogue is at the root of grasping a conceptual content. Against this backdrop, professional communications such as genetic counseling can be seen as late developments in linguistic practices that have structural challenges. Brandom's model reminds us that the professional needs the client's understanding to grasp conceptual content in a particular context.

As the field of bioethics has matured, increasing attention is being paid to how bioethical issues are treated in different moral and religious traditions and in different parts of the world. It is often difficult, however, to get accurate information about these matters. The Bioethics Yearbook Series provides interested parties with analyses of how such issues as new reproductive techniques, abortion, maternal-fetal conflicts, care of seriously ill newborns, consent, confidentiality, equitable access, cost-containment, withdrawing treatment, active euthanasia, the definition of death, and organ transplantation are being discussed in these different traditions and different parts of the world. The first volume, and every second succeeding volume, will discuss developments in the Anglican, Baptist, Buddhist, Catholic, Eastern Orthodox, Hindu, Jewish, LDS, Lutheran, Methodist, Muslim, and Presbyterian Traditions. The second volume, and every second volume succeeding it, will discuss official governmental and medical society policies on these topics throughout the world.

This book is a critical examination of certain basic issues and themes crucial to understanding how ethics currently interfaces with health care and biomedical research. Beginning with an overview of the field, it proceeds through a delineation of such key notions as trust and uncertainty, dialogue involving talk and listening, the vulnerability of the patient against the asymmetric power of the health professional, along with professional and individual responsibility. It emphasizes several themes fundamental to ethics and health care: (1) the work of ethics requires strict focus on the specific situational understanding of each involved person. (2) Moral issues, at least those intrinsic to each clinical encounter, are presented solely within the contexts of their actual occurrence; therefore, ethics must not only be practical but empirical in its approach. (3) Each particular situation is in its own way imprecise and uncertain and the different types and dimensions of imprecision and uncertainty are critical for everyone involved. (4) Finally, medicine and health care more broadly are governed by the effort to make sense of the healer's experiences with the patient, whose own experiences and interpretations are ingredient to what the healer seeks to understand and eventually treat. In addition to providing a way to develop ethical considerations in clinical life and research projects, the book proposes that narratives provide the finest way to state and grapple with these themes and issues, whether in classrooms or real-life situations. It concludes with a prospective analysis of newly emerging issues presented by and within the new genetics, which, together within a focus on the phenomenon of birth, leads to an clearer understanding of human life.

Living and Dying Well takes an informed, interdisciplinary approach to the problems, data, theory, and procedures that a just society must consider when establishing policies regarding human life and death. Leading psychologist Lewis Petrinovich expands on the controversial arguments developed in his earlier work, Human Evolution, Reproduction, and Morality, and considers such contemporary issues as: the morality of human genetic screening and of the Human Genome Project; organ transplants; the allowance of suicide and euthanasia; and physicians assisting in the dying process.

This book offers a unique description of how phenomenology can help professionals from medical, environmental and social fields to explore notions such as interaffectivity, empathy, epoche, reduction, and intersubjective encounter. Written by a group of top scholars, it uniquely covers the relationship between phenomenology and bioethics, and focuses not only on medical cases, but also on the environment and emerging technologies. This variety of themes, whilst including techno-ethics, environmental ethics, animal ethics, and medical ethics, is conducive to appreciating broadly how phenomenology can improve our quality of our life. Despite its difficult themes, the book appeals to an audience of both academics and professionals who are willing to understand how to increase the quality of care in their professional field. Chapter 8 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.

The intense fervor of a Mississippi Methodist preacher, the meticulous reasoning of an Oxford logician, the dogged persistence of a head longshoreman, the unflagging humor of a Rabelaisian satirist. To have met Paul Ramsey at a lecture in a medical university; a heady conference at Hastings-on Hudson; a congressional hearing; deliberations at a church assembly; or a bull session in some coffee shop was to be confronted with a gentleman of unforgettable energy, insight, and delight. In many roles--as a young instructor in religious studies at Princeton University, a concerned moral theologian commenting on the ethics of the "sit-ins" and nuclear issues, an observer and dialogue partner with physicians at Georgetown and other medical centers, a faithful editor and analyst of Jonathan Edwards' ethical writings, a trustee of the Hastings center, a voluminous correspondent with others who would join to disciplined pursuit of values--Paul Ramsey in all roles was indefatigable in zeal, rigorous in demand and gracious in coadventuring (to use one of his wonderful metaphors). This volume captures a unique exchange between Paul Ramsey and his most prominent colleagues. In one sense it remains a Festschrift in his honor, characterized, at times, by a markedly informal tone."

Hardbound. Volume 5 covers many ethical problems in bioethics from the relevance of the law in making medical decisions, to genetics, and to assisted reproduction. Authors apply ethical theory, meta-ethical theory and valuational perspectives to a variety of ethical issues.

This book discusses the common principles of morality and ethics derived from divinely endowed intuitive reason through the creation of al-fitr' a (nature) and human intellect (al-'aql). Biomedical topics are presented and ethical issues related to topics such as genetic testing, assisted reproduction and organ transplantation are discussed. Whereas these natural sources are God's special gifts to human beings, God's revelation as given to the prophets is the supernatural source of divine guidance through which human communities have been guided at all times through history. The second part of the book concentrates on the objectives of Islamic religious practice - the maqa' sid - which include: Preservation of Faith, Preservation of Life, Preservation of Mind (intellect and reason), Preservation of Progeny (al-nasl) and Preservation of Property. Lastly, the third part of the book discusses selected topical issues, including abortion, assisted reproduction devices, genetics, organ transplantation, brain death and end-of-life aspects. For each topic, the current medical evidence is followed by a detailed discussion of the ethical issues involved.

Many debates about the moral status of things-for example, debates about the natural rights of human fetuses or nonhuman animals-eventually migrate towards a discussion of the capacities of the things in question-for example, their capacities to feel pain, think, or love. Yet the move towards capacities is often controversial: if a human's capacities are the basis of its moral status, how could a human having lesser capacities than you and I have the same "serious" moral status as you and I? This book answers this question by arguing that if something is human, it has a set of typical human capacities; that if something has a set of typical human capacities, it has serious moral status; and thus all human beings have the same sort of serious moral status as you and I. Beginning from what our common intuitions tell us about situations involving "temporary incapacitation"-where a human organism has, then loses, then regains a certain capacity-this book argues for substantive conclusions regarding human fetuses and embryos, humans in a permanent vegetative state, humans suffering from brain diseases, and humans born with genetic disorders. Since these conclusions must have some impact on our ongoing moral and political debates about the proper treatment of such humans, this book will be useful to professionals and students in philosophy, bioethics, law, medicine, and public policy.

This casebook provides a set of cases that reveal the current complexity of medical decision-making, ethical reasoning, and communication at the end of life for hospitalized patients and those who care for and about them. End-of-life issues are a controversial part of medical practice and of everyday life. Working through these cases illuminates both the practical and philosophical challenges presented by the moral problems that surface in contemporary end-of-life care. Each case involved real people, with varying goals and constraints,who tried to make the best decisions possible under demanding conditions. Though there were no easy solutions, nor ones that satisfied all stakeholders, there are important lessons to be learned about the ways end-of-life care can continue to improve. This advanced casebook is a must-read for medical and nursing students, students in the allied health professions, health communication scholars, bioethicists, those studying hospital and public administration, as well as for practicing physicians and educators.

This book brings into sharp relief the extent to which the medical profession has enabled or participated in actions that are at moral crossroads. Physical and psychological abuse and violations of medical codes have already been brought to light by concerned bioethicists responding to ethical lapses of the "war on terror." This book goes to the next level by looking at three areas that also merit our attention and call us to speak out against abuses. These are (1) dehumanization (such as forced nudity, hooding, sensory deprivation, exploitation of phobias, waterboarding, and environmental manipulation), (2) non-consensual forced-feeding, and (3) solitary confinement. Each area raises important questions for the medical profession. Author Wanda Teays calls upon doctors and nurses to reflect on the role they play in the unethical treatment of prisoners and detainees by crossing moral boundaries around each of these areas. In the process, we are reminded that bioethics is global, not local - and the concerns of the discipline encompass issues with a wider scope.

In the last three decades, bioethics has matured into a field of study with several areas of concentration, including medical ethics, environmental ethics and more recently, genetic ethics. For reasons related to both the developmental history of the subject and to the poignancy of the problems presented, most textbooks and collections of essays have dealt with only a single area, medical ethics. In fact, to many not in the field, the word bioethics has become synonymous with medical ethics. The aim of this collection of essays, entitled New Dimensions in Bioethics: Science, Ethics and the Formation of Public Policy, is to enlarge this restrictive vision of the field as it is usually studied at universities. By combining essays relevant to medical ethics with companion essays on environmental ethics and genetic ethics, the book emphasizes similarities in the methods of analysis used in diverse bioethical problems, whether dealing with genes, with people or the environment. In this way, New Dimensions in Bioethics: Science, Ethics and the Formation of Public Policy, hopes to contribute to the intellectual unity of the subject and to suggest changes in the way bioethics can be taught and studied at both the graduate and undergraduate level.

George P. Smith, II is a leading figure in the world of medical law and ethics. During his long career he has addressed some of the most important issues in bioethics and has contributed much original thought to debates in the field. This book celebrates his contribution to scholarship in this area and brings together his key writings in bioethics. The chapters include previously published material which has been substantially updated to reflect recent developments in medicine and law. The book covers topics such as: human rights and medical law; the allocation of resources and distributive justice; ethical relativism; science and religion; and public health emergencies. Taken as a whole, this book examines the extent to which law, medicine, economics, and bioethics interact as synergistic vectors of force in shaping and setting both personal and public responses to the complexities of biotechnology, or what has been referred to as "The New Biology." All too often, past considerations of this topic have neglected to recognise the synergistic influences of law as a catalyst for codifying contemporary values into normative standards. Professor Smith reaches the conclusion that if traditional bioethical principles are to be seen as pertinent constructs for policy making, they must be broadened through the law of public health and Human rights. Law and Bioethics: Intersections along the Mortal Coil casts law as the pivotal force in bringing stability to the ongoing debates on how to maintain bioethical relevance in decision making and in so doing, it offers an excellent overview of the current bioethical issues in medical law considered in light of recent and ongoing technological developments in medicine. This book will be of particular interest to academics and students of Law, Political Science, Philosophy and Economics.

Arguing About Bioethics is a fresh and exciting collection of essential readings in bioethics, offering a comprehensive introduction to and overview of the field. Influential contributions from established philosophers and bioethicists, such as Peter Singer, Thomas Nagel, Judith Jarvis Thomson and Michael Sandel, are combined with the best recent work in the subject.

Organised into clear sections, readings have been chosen that engage with one another, and often take opposing views on the same question, helping students get to grips with the key areas of debate. All the core issues in bioethics are covered, alongside new controversies that are emerging in the field, including:

• embryo research
• selecting children and enhancing humans
• human cloning
• using animals for medical purposes
• organ donation
• consent and autonomy
• public health ethics
• resource allocation
• developing world bioethics
• assisted suicide.

Each extract selected is clear, stimulating and free from unnecessary jargon. The editor 's accessible and engaging section introductions make Arguing About Bioethics ideal for those studying bioethics for the first time, while more advanced readers will be challenged by the rigorous and thought-provoking arguments presented in the readings.

Biotechnology is a recognized research area that has increasingly advanced into new technologies and modern practices raising several legal, ethical and regulatory issues. The revolutionary speed of biotech innovations has had a significant impact on the protection of the rights of the individual. Fundamental rights provide a framework within which the justification of "limitations and restrictions"" "to biotechnology innovations and research results have to be assessed. The legal regulation of scientific research and scientific investigations impact more and more directly on the freedom of research and therapies as well as on the broad diffusion of knowledge. Closely related is also the debated question of the technological manipulation of life and the boundary of scientific knowledge with regard to the topical question of genetic invention patents and their side effects on access to scientific information and health care opportunities.

Drawing on expertise from different disciplines, the volume comprises invited papers and plenary presentations given at the conference entitled "Biotech Innovations & Fundamental Rights" that took place on Januray 20-21 2011 at the Department of Juridical Sciences of the University of Ferrara. Each contribution covers a different aspect of the legal and scientific issues involved in regulation of biotechnology. In particular the focus of attention has been given to genetic research, genetic data, freedom of scientific research in genetics and biotech patents.

This book discusses three possible human enhancement paradigms and explores how each involves different values, uses of technology, and different degrees and kinds of ethical concerns. A new framework is advanced that promotes technological innovation that serves the improvement of the human condition in a respectful and sustainable way.

CHRISTOPH REHMANN-SUTTER, MARCUS DUWELL, DIETMAR MIETH When we placed "finitude," "limits of human existence" as a motto over a round of discussion on biomedicine and bioethics (which led to this collection of essays) we did not know how far this would lead us into methodological quandaries. However, we felt intuitively that an interdisciplinary approach including social and cultural sciences would have an advantage over a solely disciplinary (philosophical or theological) analysis. Bioethics, if it is to have adequate discriminatory power, should include sensitivity to the cultural contexts of biomedicine, and also to the cultural contexts of bioethics itself. Context awareness, of course, is not foreign to philosophical or theological bioethics, for the simple reason that the issues tackled in the debates (as in other fields of ethics) could not be adequately understood outside their contexts. Moral issues are always accompanied by contexts. When we try to unpack them - which is necessary to make them accessible to ethical discussion - we are regularly confronted with the fact that in removing too much of the context we do not clarify an issue, but make it less comprehensible. The context - at least some essential parts of it - is intrinsic to the issue. Unpacking in ethics is therefore a different procedure. It does not mean peeling the context off, but rather identifying which contextual elements are essential for an understanding of the key moral aspects of the issue, and explaining how they establish its particular character."

Should transhuman and posthuman persons ever be brought into existence? And if so, could they be generated in a good and loving way? This study explores how society may respond to the actual generation of new kinds of persons from ethical, philosophical, and theological perspectives. Contributors to this volume address a number of essential questions, including the ethical ramifications of generating new life, the relationships that generators may have with their creations, and how these creations may consider their generation. This collection's interdisciplinary approach traverses the philosophical writings of Aristotle, Aquinas, Kant, Nietzsche, and Heidegger, alongside theological considerations from Jewish, Christian, and Islamic traditions. It invites academics, faith leaders, policy makers, and stakeholders to think through the ethical gamut of generating posthuman and transhuman persons.