Imagine that you are an environmentalist who passionately believes that it is wrong to drill for oil in the Arctic National Wildlife Refuge. How do you convince someone that a decision to drill is wrong? Debates about the environment and how humans ought to treat it have gone on for decades, yet arguments in favor of preserving biodiversity often lack empirical substance or are philosophically naive, making them far less effective than they could be. This book critically examines arguments that are commonly offered in support of biodiversity conservation. The authors adopt a skeptical viewpoint to thoroughly test the strength of each argument and, by demonstrating how scientific evidence can be integrated with philosophical reasoning, they help environmentalists to better engage with public debate and judiciously inform public policy. This interdisciplinary and accessible book is essential reading for anyone who engages in discussions about the value of biodiversity conservation.

Recent rapid advances in the biosciences have led to considerable debate about the social, ethical, and legal implications of research and its applications. The mapping of the human genome, advances in cloning techniques, the harvesting of embryonic stem cells for research, increasing use of genetic testing in healthcare, and the development of large-scale genetic databases have not only generated high expectations about new diagnostics and treatments but also considerable widespread fear about their consequences. This book offers a critical appraisal of bioethics and its implications as it pertains to the fields of health and medicine and public health, with a particular emphasis on recent technological innovations as they provide a noteworthy exemplar of the power of bioethics in shaping policies, practices and notions of societal benefits. Whereas other books have tended to examine ethical dilemmas and challenges of applying ethical principles, often in relation to a limited array of issues, this book investigates the socio-political implications of bioethics discourse and practices in relation to a range of controversial (or potentially controversial) developments. Providing a benchmark for future debate and scholarly work, this volume will be of interest to policymakers, clinicians, scholars, and others who are looking for new ways of making sense and evaluating recent developments in the field of bioethics.

Modern epigenetics unites scientists from life sciences, organic chemistry as well as computer and engineering sciences to find an answer to the question of how environmental influences can have a lasting effect on gene expression, maybe even into the next generations. This volume examines from an interdisciplinary perspective the ethical, legal and social aspects of epigenetics.

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.

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.

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.

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.

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.

The privacy concerns discussed in the 1990s in relation to the New Genetics failed to anticipate the relevant issues for individuals, families, geneticists and society. Consumers, for example, can now buy their personal genetic information and share it online. The challenges facing genetic privacy have evolved as new biotechnologies have developed, and personal privacy is increasingly challenged by the irrepressible flow of electronic data between the personal and public spheres and by surveillance for terrorism and security risks. This book considers the right to know and the right not to know about your own and others' genomes. It discusses new privacy concerns and developments in ethical thinking, with the greater emphasis on solidarity and equity. The multidisciplinary approach covers current topics such as biobanks and forensic databases, DIY testing, group rights and accountability, the food we eat and the role of the press and the new digital media.

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.

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.

This book offers a new theory of property and distributive justice derived from Talmudic law, illustrated by a case study involving the sale of organs for transplant. Although organ donation did not exist in late antiquity, this book posits a new way, drawn from the Talmud, to conceive of this modern means of giving to others. Our common understanding of organ transfers as either a gift or sale is trapped in a dichotomy that is conceptually and philosophically limiting. Drawing on Maussian gift theory, this book suggests a different legal and cultural meaning for this property transfer. It introduces the concept of the 'divine lien', an obligation to others in need built into the definition of all property ownership. Rather than a gift or sale, organ transfer is shown to exemplify an owner's voluntary recognition and fulfilment of this latent property obligation.

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.