This volume deals with the topic of health inequalities and health disparities. The volume is divided into five sections. The first section includes an introductory look at the issue of health care inequalities and disparities and also an introduction to the volume. One of the backdrops to this topic in the United States was The National Healthcare Disparities Report and its focus on the ability of Americans to access health care and variation in the quality of care. Disparities related to socioeconomic status were included, as were disparities linked to race and ethnicity and the report also tried to explore the relationship between race/ethnicity and socioeconomic position, as explained in more detail in the first article in the book. The second article discusses a newer overall approach to issues related to health inequalities and health disparities.
The remaining four sections of the book address more specific topics relating to inequalities and disparities. The second section examines racial and ethnic inequalities and disparities. The third section includes articles that address the issue from the perspective of research about health care providers and health care facilities. The last two sections of the book focus on consumers and topics of health care disparities, with Section 4 focused on issues related to substance abuse, mental health and related concerns. Section 5 includes articles looking at issues of vulnerable women, women with breast cancer and people with colorectal cancer.
Inequalities and Disparities in Health Care and Health is important reading for medical sociologists and people working in other social science disciplines studying health-related issues.The volume also provides vital information for health services researchers, policy analysts and public health researchers.
* A great resource for health services researchers, policy analysts and public health researchers
* An in-depth look at bioethics, focussing on health inequalities and disparities

The main question explored by the book is: How can cross-border access to human genetic resources, such as blood or DNA samples, be governed in such a way as to achieve equity for vulnerable populations in developing countries? The book situates the field of genomic and genetic research within global health and research frameworks, describing the concerns that have been raised about the potential unfairness in exchanges during recent decades. Access to and sharing in the benefits of human biological resources are aspects not regulated by any international legal framework such as the Convention on Biological Diversity, which applies only to the exchange of plants, animals and microorganisms, as well as to associated traditional knowledge. Examples of genetic research perceived as exploitative are provided in order to illustrate the legal vacuum concerning the global governance of human genetic resources. The main conclusions drawn from the legal and ethical analysis are: • Benefit sharing is crucial in order to avoid the exploitation of developing countries in human genetic research. • With functioning research ethics committees, undue inducement is less of a concern in genetic research than in other areas of medical research (e.g. clinical trials). • Concerns remain over research involving indigenous populations; accordingly, recommendations are provided. In drawing these conclusions, the book addresses in detail a highly pressing topic in global bioethics and international law. In this regard, it combines bioethical arguments with jurisprudence, in particular with reference to the law of equity and the legal concepts of duress (coercion), unconscionable dealing, and undue inducement.

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.

In 2009 the University Medicine Greifswald launched the “Greifswald Approach to Individualized Medicine� (GANI_MED) to implement biomarker-based individualized diagnostic and therapeutic strategies in clinical settings. Individualized Medicine (IM) has led not only to controversies about its potentials, but also about its societal, ethical and health economic implications. This anthology focusses on these areas and includes – next to clinical examples illustrating how the integrated analysis of biomarkers leads to significant improvement of therapeutic outcomes for a subgroup of patients – chapters about the definition, history and epistemology of IM. Additionally there is a focus on conceptual philosophical questions as well as challenges for applied research ethics (informed consent process, the IT-based consent management and the handling of incidental findings). Finally it pays attention to health economic aspects. The possibilities of IM to initiate a paradigm shift in the German health care provision are investigated. Furthermore, it is asked whether the G-DRG system is ready for the implementation of such approaches into clinical routine.

How can we accept that we ought to stop smoking, follow a diet, exercise, or take medications? The goal of this book is to describe the mechanisms of patients’ adherence to long-term therapies, whose improvement, according to the World Health Organization (WHO), would be more beneficial than any biomedical progress. For example, approximately half of the patients do not regularly follow medical prescriptions, resulting in deleterious effects on people’s health and a strong impact on health expenditure. This book describes how our beliefs, desires, and emotions intervene in our choices concerning our health, by referring to concepts developed within the framework of the philosophy of mind. In particular, it tries to explain how we can choose between an immediate pleasure and a remote reward—preserving our health and our life. We postulate that such an “intertemporal� choice can be directed by a “principle of foresight� which leads us to give priority to the future. Just like patients’ non-adherence to prescribed medications, doctors often don’t always do what they should: They are non-adherent to good practice guidelines. We propose that what was recently de-scribed as “clinical inertia� could also represent a case of myopia: From time to time doctors fail to consider the long-term interests of their patient. Both patients’ non-adherence and doctors’ clinical inertia represent major barriers to the efficiency of care. However, it is also necessary to respect patients’ autonomy. The analysis of relationship between mind and care which is provided in this book sheds new light on the nature of the therapeutic alliance between doctor and patient, solving the dilemma between the ethical principles of beneficence and autonomy.

Focusing on the period between the 1970s and the present, Life as Surplus is a pointed and important study of the relationship between politics, economics, science, and cultural values in the United States today. Melinda Cooper demonstrates that the history of biotechnology cannot be understood without taking into account the simultaneous rise of neoliberalism as a political force and an economic policy. From the development of recombinant DNA technology in the 1970s to the second Bush administration's policies on stem cell research, Cooper connects the utopian polemic of free-market capitalism with growing internal contradictions of the commercialized life sciences. The biotech revolution relocated economic production at the genetic, microbial, and cellular level. Taking as her point of departure the assumption that life has been drawn into the circuits of value creation, Cooper underscores the relations between scientific, economic, political, and social practices. In penetrating analyses of Reagan-era science policy, the militarization of the life sciences, HIV politics, pharmaceutical imperialism, tissue engineering, stem cell science, and the pro-life movement, the author examines the speculative impulses that have animated the growth of the bioeconomy. At the very core of the new post-industrial economy is the transformation of biological life into surplus value. Life as Surplus offers a clear assessment of both the transformative, therapeutic dimensions of the contemporary life sciences and the violence, obligation, and debt servitude crystallizing around the emerging bioeconomy.

This book provides the reader with a theoretical and practical understanding of two health care delivery models: the patient/child centred care and family-centred care. Both are fundamental to caring for children in healthcare organizations. The authors address their application in a variety of paediatric healthcare contexts, as well as an understanding of legal and ethical issues they raise. Each model is increasingly pursued as a vehicle for guiding the delivery of health care in the best interests of children. Such models of health care delivery shape health care policies, programs, facility design, resource allocation decisions and day-to-day interactions among patients, families, physicians and other health care professionals. To maximize the health and ethical benefits these models offer, there must be shared understanding of what the models entail, as well as the ethical and legal synergies and tensions they can create. This book is a valuable resource for paediatricians, nurses, trainees, graduate students, practitioners of ethics and health policy.

Biobank research and genomic information are changing the way we look at health and medicine. Genomics challenges our values and has always been controversial and difficult to regulate. In the future lies the promise of tailored medical treatments and pharmacogenomics but the borders between medical research and clinical practice are becoming blurred. We see sequencing platforms for research that can have diagnostic value for patients. Clinical applications and research have been kept separate, but the blurring lines challenges existing regulations and ethical frameworks. Then how do we regulate it? This book contains an overview of the existing regulatory landscape for biobank research in the Western world and some critical chapters to show how regulations and ethical frameworks are developed and work. How should international sharing work? How design an ethical informed consent? An underlying critique: the regulatory systems are becoming increasingly complex and opaque. The international community is building systems that should respond to that. According to the authors in fact, it is time to turn the ship around. Biobank researchers have a moral responsibility to look at and assess their work in relation to the bigger picture: the shared norms and values of current society. Research ethics shouldn’t only be a matter of bioethicists writing guidelines that professionals have to follow. Ethics should be practiced through discourse and regulatory frameworks need to be part of that public discourse. Ethics review should be then not merely application of bureaucracy and a burden for researchers but an arena where researchers discuss their projects, receive advice and practice their ethics skills.

This book puts the ethics, policy and politics of stem cells into context in a way that helps readers understand why past and current issues have developed the way they have and what the implications are for their work going forward. It also addresses emerging issues as the field progresses towards clinical and industrial uses. While there is a superabundance of material on the ethics of embryo use and questions of embryonic "personhood," there is little that covers what practicing scientists and managers need to know in order to plan and execute responsible research. Furthermore, researchers funded by the NIH are required to have ethics training as a condition of the grant. As such, this book is an essential resource to all of these pre-professional students whether they plan to move into industry, government or academia.

This anthology of essays presents a sample of studies from recent philosophy of medicine addressing issues which attempt to answer very general (interdependent) questions: (a) what is a disease and what is health? (b) How do we (causally) explain diseases? (c) And how do we distinguish diseases, i.e. define classes of diseases and recognize that an instance X of disease belongs to a given class B? (d) How do we assess and choose cure/ therapy? The book is divided into three sections: classification, disease and evidence. In general, attention is focused on statistics in medicine and epidemiology, issues in psychiatry and connecting medicine with evolutionary biology and genetics. Many authors position the theories that they address within their historical contexts. The nature of health and disease will be addressed in several essays that also touch upon very general questions about the definition of medicine and its status. Several chapters scrutinize classification because of its centrality within philosophical problems raised by medicine and its core position in the philosophical questioning of psychiatry. Specificities of medical explanation have recently come under a new light, particularly because of the rise of statistical methods and several chapters investigate these methods in specific contexts such as epidemiology or meta-analysis of random testing. Taken together this collection addresses the question of how we gather, use and assess evidence for various medical theories. The rich assortment of disciplines featured also includes epidemiology, parasitology and public health, while technical aspects such as the application of game theory to medical research and the misuse of the DSM in forensic psychiatry are also given an airing. The book addresses more than the construction of medical knowledge, however, adding cogent appraisal of the processes of decision making in medicine and the protocols used to justify therapeutic choices.

This workbook is a companion to Clinical Ethics Consultation: A Practical Guide to Changing Culture, Building Capacity and Solving Problems Case by Case. The Toolkit lays out the process for clinical ethics consultation in a series of steps within five phases: Pre-Consult, Interviews, Mid-Consult, Consult meeting(s), and Post-Consult. For each step, the Toolkit provides directions for how to complete it, tips for success, and worksheets for capturing data and analysis. The Clinical Ethics Consultation Toolkit is the playbook from which clinical ethics consultants can draw methods and strategies for effectively delivering ethics consultation.

This book provides a careful and comprehensive, step-by-step method for providing clinical ethics consultation. This Guide can be applied in almost any healthcare setting and takes the reader from establishing an intake process and developing strategies for interviewing those involved in the situation, to undertaking a consultation meeting and following up on a clinical consult. The book is an invaluable resource to any clinical ethicist, or committee or consult team member who is seeking to provide their service with rigour and quality. Written in simple language, the book explores ideas and concepts that will help the reader to understand, think through, and ultimately offer useful ethical consultation when facing ethically challenging issues.

This book offers the policy-maker or decision-maker key insights and practical information regarding the features of ethics frameworks best suited to the ethical assessment of human cognitive enhancement (HCE) applications, such as pharmaceutical cognitive enhancers and noninvasive brain stimulation techniques. This book takes as its departure point the entrenched philosophical debate between opponents and proponents of HCE and the increased feasibility of some applications of HCE. Recent calls for policy-making in the area of human enhancement reflect the need to find a balance between addressing current ethical issues and issues that are more speculative in nature or are underpinned by abstract philosophical concepts. Practical ethical approaches for policy or decision-making should enable the development of an evidence base for the risks and benefits of HCE applications. Moreover, such practical approaches should also incorporate a broader range of value bases that would facilitate convergence regarding certain decisions and judgements. This book identifies and evaluate tools that help us to go beyond polarised philosophical debates in order to assist practical decision makers in concrete ethical deliberation and decision-making. The focus is on systematic methods with which to identify relevant ethical values and assess the impacts of an HCE application on those values in order to facilitate decision-making regarding the ethical acceptability or desirability of the application.

Genetics and its related technologies are revolutionising the world in which we live: The media is regularly dominated by the latest genetically modified (GM) food, human gene therapy or cancer chip technology; maverick scientists are in the process of cloning humans and the human genome sequence is available on the Internet. Fifty years ago we did not know what a gene was - today the awesome power of genetics is being released on an unsuspecting public, and with it a whole series of ethical dilemmas undreamth of even ten years ago. Does the question now become not 'can we?' but 'should we?'
By demystifying genetic engineering and exploring the basic biology underlying the living world, A Terrible Beauty is Born explains how clones and cloning technology are in many ways extensions of processes occurring constantly in nature. Used wisely these processes have the potential to bring enormous benefits; abused, they carry with them potential dangers which we ignore at our peril.

Behavioral neuroscience encompasses the disciplines of neurobiology and psychology to study mechanisms of behavior. This volume provides a contemporary overview of the current state of how ethics informs behavioral neuroscience research. There is dual emphasis on ethical challenges in experimental animal approaches and in clinical and nonclinical research involving human participants.

This book moves away from the frameworks that have traditionally guided ethical decision-making in the Western clinical setting, towards an inclusive, non-coercive and, reflective dialogic approach to moral decision-making. Inspired in part by Jurgen Habermas's discourse theory of morality and principles of communicative action, the book offers a proportionist approach as a way of balancing out the wisdom in traditional frameworks, set in the actual reality of the clinical situation at hand. Putting this approach into practice requires having a conversation, a dialogue or a discourse, with collaboration amongst all the stakeholders. The aim of the dialogue is to reach consensus in the decision, via mutual understanding of the values held by the patient and others whom they see as significant. This book aims to underscore the moral philosophical foundations for having a meaningful conversation. Life and Death Decision in the Clinical Setting is especially relevant in our contemporary era, characterised medically by an ever-increasing armamentarium of life-sustaining technology, but also by increasing multiculturalism, a multiplicity of faiths, and increasing value pluralism.

This volume explores the ethics of making or expanding families through adoption or technologically assisted reproduction. For many people, these methods are separate and distinct: they can choose either adoption or assisted reproduction. But for others, these options blend together. For example, in some jurisdictions, the path of assisted reproduction for same-sex couples is complicated by the need for the partner who is not genetically related to the resulting child to adopt this child if she wants to become the child's legal parent. The essays in this volume critically examine moral choices to pursue adoption, assisted reproduction, or both, and highlight the social norms that can distort decision-making. Among these norms are those that favour people having biologically related children ('bionormativity') or that privilege a traditional understanding of family as a heterosexual unit with one or more children where both parents are the genetic, biological, legal, and social parents of these children. As a whole, the book looks at how adoption and assisted reproduction are morally distinct from one another, but also emphasizes how the two are morally similar. Choosing one, the other, or both of these approaches to family-making can be complex in some respects, but ought to be simple in others, provided that one's main goal is to become a parent.

In this volume Allen Buchanan collects ten of his most influential essays on justice and healthcare and connects the concerns of bioethicists with those of political philosophers, focusing not just on the question of which principles of justice in healthcare ought to be implemented, but also on the question of the legitimacy of institutions through which they are implemented. With an emphasis on the institutional implementation of justice in healthcare, Buchanan pays special attention to the relationship between moral commitments and incentives.
The volume begins with an exploration of the difficulties of specifying the content of the right to healthcare and of identifying those agents and institutions that are obligated to help ensure that the right thus specified is realized, and then progresses to an examination of the problems that arise in attempts to implement the right through appropriate institutions. In the last two essays Buchanan pursues the central issues of justice in healthcare at the global level, exploring the idea of healthcare as a human right and the problem of assigning responsibilities for ameliorating global health disparities.
Taken together, the essays provide a unique and consistent position on a wide range of issues, including conflicts of interest in clinical practice and the claims of medical professionalism, the nature and justification for the right to health care, the relationship between responsibility for healthcare and the nature of the healthcare system, and the problem of global health disparities. The result is an approach to justice in healthcare that will facilitate more productive interaction between the normative analysis of philosophers and the policy work of economists, lawyers, and political scientists.

Science is built on trust. The assumption is that scientists will conduct their work with integrity, honesty, and a strict adherence to scientific protocols. Written by geoscientists for geoscientists, Scientific Integrity and Ethics in the Geosciences acquaints readers with the fundamental principles of scientific ethics and shows how they apply to everyday work in the classroom, laboratory, and field. Resources are provided throughout to help discuss and implement principles of scientific integrity and ethics. Volume highlights include: Examples of international and national codes and policies Exploration of the role of professional societies in scientific integrity and ethics References to scientific integrity and ethics in publications and research data Discussion of science integrity, ethics, and geoethics in education Extensive coverage of data applications Scientific Integrity and Ethics in the Geosciences is a valuable resource for students, faculty, instructors, and scientists in the geosciences and beyond. It is also useful for geoscientists working in industry, government, and policymaking. Read an interview with the editors to find out more: https: //eos.org/editors-vox/ethics-crucial-for-the-future-of-the-geosciences

Bioethics is the study of ethical issues arising out of advances in the life sciences and medicine. Historically, bioethics has been associated with issues in research ethics and clinical ethics as a result of research scandals such as the Tuskegee Syphilis Study and public debates about the definition of death, medical paternalism, health care rationing, and abortion. As biomedical technologies have advanced, challenging new questions have arisen for bioethics and new sub-disciplines such as neuroethics and public health ethics have entered the scene. This volume features ten original essays on five cutting-edge controversies in bioethics written by leading philosophers. I. Research Ethics: How Should We Justify Ancillary Care Duties? II. Clinical Ethics: Are Psychopaths Morally Accountable? III. Reproductive Ethics: Is There A Solution to the Non-Identity Problem? IV. Neuroethics: What is Addiction and Does It Excuse? V. Public Health Ethics: Is Luck Egalitarianism Implausibly Harsh? S. Matthew Liao and Collin O'Neil's concise introduction to the essays in the volume, the annotated bibliographies and study questions for each controversy, and the supplemental guide to additional current controversies in bioethics give the reader a broad grasp of the different kinds of challenges in bioethics.

The social practice of forming, shaping, expressing, contesting, and maintaining personal identities makes human interaction, and therefore society, possible. Our identities give us our sense of how we are supposed to act and how we may or must treat others, so how we hold each other in our identities is of crucial moral importance. To hold someone in her identity is to treat her according to the stories one uses to make sense of who she is. Done well, holding allows individuals to flourish personally and in their interactions with others; done poorly, it diminishes their self-respect and restricts their participation in social life. If the identity is to represent accurately the person who bears it, the tissue of stories that constitute it must continue to change as the person grows and changes. Here, good holding is a matter of retaining the stories that still depict the person but letting go of the ones that no longer do. The book begins with a puzzling instance of personhood, where the work of holding someone in her identity is tragically one-sided. It then traces this work of holding and letting go over the human life span, paying special attention to its implications for bioethics. A pregnant woman starts to call her fetus into personhood. Children develop their moral agency as they learn to hold themselves and others in their identities. Ordinary adults hold and let go, sometimes well and sometimes badly. People bearing damaged or liminal identities leave others uncertain how to hold and what to let go. Identities are called into question at the end of life, and persist after the person has died. In all, the book offers a glimpse into a fascinating moral terrain that is ripe for philosophical exploration.

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.

This book addresses the debate usually tagged as being about 'markets in human body parts' which is antagonistically divided into pro-market and anti-market positions. The author provides a set of propositions about how to approach this and shows a way out of the concrete impasse of it. Assumptions about markets and bodies that characterize this debate are analyzed and described while the author argues that these assumptions are in fact constitutive for exchanges of human bodily material - but in unacknowledged ways. It is concluded that what we need is a different analytical approach to better understand the mechanisms at play when organizations exchange organs, tissues and cells for use in transplantation and fertility medicine.

Neuroscientists are mining nucleic acids, blood, saliva, and brain images in hopes of uncovering biomarkers that could help estimate risk of brain disorders like psychosis and dementia; though the science of bioprediction is young, its prospects are unearthing controversy about how bioprediction should enter hospitals, courtrooms, or state houses. While medicine, law, and policy have established protocols for how presence of disorders should change what we owe each other or who we blame, they have no stock answers for the probabilities that bioprediction offers. The Neuroethics of Biomarkers observes, however, that for many disorders, what we really care about is not their presence per se, but certain risks that they carry. The current reliance of moral and legal structures on a categorical concept of disorder (sick verses well), therefore, obscures difficult questions about what types and magnitudes of probabilities matter. Baum argues that progress in the neuroethics of biomarkers requires the rejection of the binary concept of disorder in favor of a probabilistic one based on biological variation with risk of harm, which Baum names a "Probability Dysfunction. " This risk-reorientation clarifies practical ethical issues surrounding the definition of mental disorder in the DSM-5 and the nosology of conditions defined by risk of psychosis and dementia. Baum also challenges the principle that the acceptability of bioprediction should depend primarily on whether it is medically useful by arguing that biomarkers can also be morally useful through enabling moral agency, better assessment of legal responsibility, and fairer distributive justice. The Neuroethics of Biomarkers should be of interest to those within neuroethics, medical ethics, and the philosophy of psychiatry.

This book is a comprehensive, empirically-grounded exploration of the relationship between bioethics, culture, and the perspective of being affected. It provides a new outlook on how complex "bioethical" issues become questions of everyday life. The authors focus on two contexts, genetic testing and end-of-life care, to locate and demonstrate emerging themes of responsibility, such as self-responsibility, responsibility for kin, and the responsibility of society. Within these themes, the duty to know versus the right not to know one's genetic fate (in the context of genetic testing), or the sanctity of life versus self-determination (in the context of end of life care) are identified as culturally embedded dilemmas that are very much relevant for lay persons. Furthermore, cultural factors such as religion, history, utopian and dystopian views of biomedical technologies, outlooks on the body and on health/illness, and citizenship are examined. Health issues are increasingly becoming a question of assessing risk and responsibility: How can we better prepare ourselves for the future? We all make such assessments in a way that combines personal inclinations, professional recommendations, and cultural framings. There is still much to be learned about the interplay between these three dimensions.