This is an original contribution to the much debated area of the value that we should place on human life. With the euthanasia issue highlighted in the public arena this book argues for a non-absolutist highest value on life ethic and how that fits with society's current emphasis on individual autonomy. By the use of everyday examples the impact of placing a high value on life is explored. It will be useful for students of ethics, nursing and medicine and those engaged in the public debate on euthanasia.

in the culture of medicine, and they saw their mission as a generation of profit for stockholders, not necessarily medical care for clients. Cost-effective medicine was the goal in the context of a profit-making enterprise. Although preventive health care programs were promised, very few were realized and they were not nearly comprehensive. The definition of unnecessary testing slowly expanded to mean virtually any high-cost test requiring the service of a medical specialist, and low priced generalist physicians with limited diagnostic and therapeutic skills were made available to patients with the instruction they should limit their access to high-cost specialists. Managed care organizations tended to re ward primary care physicians who avoided specialty referrals, and severed contracts with those who persisted in sending their patients to outside consultants. Most notoriously, managed care organizations maintained veto authority over the provision of complex and expensive care, and that veto was often wielded in defiance of a physician's recommendation by managed care employees without medical training or experience. Managed care did indeed slow the rate in increase of medical costs, but not without limitations on the care provided to patients and the professional integrity of physicians. Managed care organizations were so successful that they could provide extremely high salaries to their executives even in the context of limiting cost and care. It is these developments that the papers of this symposium addressed. The most fundamental ethical issue is posed in the first paper by Dr."

Debate regarding organ sales is largely innocent of the history of thought on the matter. This volume seeks to remedy this shortcoming. Positions for or against a market in human organs are nested within moral intuitions, ontological or political theoretical premises, or understandings of special moral concerns, such as permissible uses of the body, which have a long history of analysis. The essays compass the views of Plato, Aristotle, Aquinas, Locke, Kant, Hegel, Mill and Christianity, as well as particular methodological approaches, such as the phenomenology of the body, natural law theory, legal theory and libertarian critique of legal theory. These discussions cluster a number of conceptually independent philosophical concerns: (1) What is the appropriate understanding of the relationship between persons and their bodies? (2) What does it mean to own' an organ? (3) Do governments have moral authority to regulate how persons use their own body parts? (4) What are the costs and benefits of a market in human organs? Such questions are related by an urgent public health challenge: the considerable disparity between the number of patients who could significantly benefit from organ transplantation and the number of human organs available for transplantation. This volume explores the theoretical, normative, and historical foundations for alternative policies for procurement and transplantation of human organs.

The potential of modern medicine in a pluralistic world leads to the potential for moral conflict. The most prevalent bioethical theories often either overestimate or underestimate the amount of shared moral belief that can be used to address those conflicts. This work presents a means for taking seriously the pluralism in the modern world while recognizing the likelihood of moral "acquaintance" between persons with differing views. It criticizes moral theories that overstate the extent of the problem of pluralism as well as those that imply too much agreement between reasonable moral persons, yet it locates a means for the resolution of many moral conflicts in moral acquaintanceship. Drawing from the work of H. Tristram Engelhardt, Jr., casuists and principle-based theorists, and Erich Loewy and Kevin W. Wildes's initial development of the concept of moral acquaintanceship, Moral Acquaintances and Moral Decisions is philosophically indepth work with direct applications for decisionmaking in real medical settings. A work in moral theory as well as a source of real world guidance, clinically oriented bioethics professionals as well as students of bioethical theory should find the theory of moral acquaintanceship provided here important to their work.

Religion is a dominant force in the lives of many Americans. It animates, challenges, directs and shapes, as well, the legal, political, and scientific agendas of the new Age of Biotechnology. In a very real way, religion, biomedical technology and law are - epistemologically - different. Yet, they are equal vectors of force in defining reality and approaching an understanding of it. Indeed, all three share a synergetic relationship, for they seek to understand and improve the human condition.

This book strikes a rich balance between thorough analysis (in the body), anchored in sound references to religion, law and medical scientific analysis, and a strong scholarly direction in the end notes. It presents new insights into the decision-making processes of the new Age of Biotechnology and shows how religion, law and medical science interact in shaping, directing and informing the political processes.

This volume will be of interest to both scholars and practitioners in the fields of religion and theology, philosophy, ethics, (family) law, science, medicine, political science and public policy, and gender studies. It will serve as a reference source and can be used in graduate and undergraduate courses in law, medicine and religion.

Within contemporary society, globalization has emerged as a key concern at the centre of ethical, legal and policy debates relating to health care. Conflicts between public interests and individual rights, the challenge of regulating health professionals and access to health services, and the effects of a global market all feature prominently in these discussions. As a result of globalization, these issues can no longer be understood solely within the political boundaries that define traditional notions of individuals and communities. Rather, solutions demand a global conception of rights and obligations, which in turn requires new approaches to health policy formulation and a reevaluation of existing ethical and legal frameworks. In essence, the impact of globalization on human health is testing the robustness of modern regulatory systems, legal doctrines and ethical paradigms. PUBLIC HEALTH: DEVELOPING GLOBAL CONCERNS The interconnectedness of the global economy presents new challenges in public health. While globalization has facilitated improvements in health care, it has also created new hazards and avenues for the exploitation of vulnerable persons. It is becoming increasingly apparent that both national and international responses are required. Indeed, as the chapters in this section convey, public health is rightly a global concern. Globalization has led to a sharing of both risks and responsibilities in public health. Belinda Bennett reminds us of the ease with which infectious diseases can spread within the global community, given the speed of modern travel and trade.

Pope John Paul II surprised much of the medical world in 2004 with his strongly worded statement insisting that patients in a persistent vegetative state should be provided with nutrition and hydration. This collection of essays featuring some of the most prominent Catholic bioethicists addresses the Pope s statements, the moral issues surrounding artificial feeding and hydration, the refusal of treatment, and the ethics of care for those at the end of life."

A theory of Clinical Bioethics based on the integration of the moral logic of health care practice ("internal morality") and the larger social concerns and processes ("external morality")

Clinical Bioethics. A Search for the Foundations compares major theoretical models in the foundation of clinical bioethics and explains medicine as a normative practice. The goals of medicine are discussed with particular reference to the subjectivisation of health and the rationalisation of health care institutions. This volume provides a consistent reconstruction of bioethical judgment both at the level of epistemological statute and institutional context, i.e. clinical ethics committees and clinical ethics consultation.

Among the vast literature on contemporary reproductive technologies, Prosthetic Bodies stands out in its effective combination of insights, methods, and theories from the history of medicine, constructivist science and technology studies, and feminist theory. The double focus on IVF and related techniques, and fetal treatment and surgery, enables the identification of debatable tendencies within today's reproductive medicine: the translation of ever more medical problems basically unrelated to women's own reproductive health - and, in the case of fetal diagnosis and treatment, sometimes formerly even unrelated to reproduction as such - into medical indications for invasive, often highly experimental interventions in women's bodies. The analyses show how, through the operations and workings of reproductive technologies themselves, as well as a variety of discursive mechanisms within scientific language, today's recasting of men's fertility problems and children's congenital anomalies as women's reproductive problems comes to appear inevitable. The book challenges the ability of traditional forms of medical ethics and law to adequately identify this incremental process. The careful analyses and arguments in Prosthetic Bodies will be relevant to students of science and technology, gender studies, philosophy, medical ethics, and law, and others interested in the cultural, ethical, and political ramifications of contemporary reproductive technologies.

With implications that go to the core of what it means to be human, the issues raised by genetic manipulation–especially cloning–have sparked a passionate debate among governmental, religious, and scientific quarters, as well as the media and the general public. Keeping to the actual science rather than speculation is of the utmost importance for an enlightened approach to this weighty discussion.

In clear, lively prose, The Science and Ethics of Engineering the Human Germ Line: Mendel’s Maze provides an authoritative treatment of the principles of science and bioethics that bear upon such technologies as germ-line insertion and cloning. It offers a realistic assessment of possible applications, limitations, and new developments likely to arise in these areas.

Written by a top physician-investigator, this book progresses from the basics of building a living organism from inanimate parts through to recombinant DNA technology, assisted reproductive technologies, and gene transfer and germ-line engineering. Ethical considerations are woven into this material throughout, while a special section covers the intellectual role played by various social biases.

As genetic and reproductive technologies spread from the laboratory to the clinic–and society takes further notice–students and practitioners of biology and medicine, as well as the interested general reader, will find The Science and Ethics of Engineering the Human Germ Line: Mendel’s Maze to be an essential and accessible guide to these important subjects.

Working Virtue is the first substantial collective study of virtue theory and contemporary moral problems. Leading figures in ethical theory and applied ethics discuss topics in bioethics, professional ethics, ethics of the family, law, interpersonal ethics, and the emotions.
Virtue ethics is centrally concerned with character traits or virtues and vices such as courage (cowardice), kindness (heartlessness), and generosity (stinginess). These character traits must be looked to in any attempt to understand which particular actions are right or wrong and how we ought to live our lives. As a theoretical approach, virtue ethics has made an impressive comeback in relatively recent history, both posing an alternative to, and, in some ways, complementing well-known theoretical stances such as utilitarianism and deontology. Yet there is still very little material available that presents virtue-ethical approaches to practical contemporary moral problems, such as what we owe distant strangers, our parents, or even non-human animals. This book fills the gap by dealing with these and other pressing moral problems in a clear and theoretically nuanced manner.
The contributors offer a variety of perspectives, including pluralistic, eudaimonistic, care-theoretical, Chinese, comparative, and stoic. This variety allows the reader to appreciate not only the wide range of topics for which a virtue-ethical approach may be fitting, but also the distinctive ways in which such an approach may be manifested.

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. Theyconclude 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.

Our ability to map and intervene in the structure of the human brain is proceeding at a very quick rate. Advances in psychiatry, neurology, and neurosurgery have given us fresh insights into the neurobiological basis of human thought and behavior. Technologies like MRI and PET scans can detect early signs of psychiatric disorders before they manifest symptoms. Electrical and magnetic stimulation of the brain can non-invasively relieve symptoms of obsessive-compulsive disorder, depression and other conditions resistant to treatment, while implanting neuro-electrodes can help patients with Parkinsons and other motor control-related diseases. New drugs can help regenerate neuronal connections otherwise disrupted by schizophrenia and similar diseases.
All these procedures and drugs alter the neural correlates of our mind and raise fascinating and important ethical questions about their benefits and harms. They are, in a sense, among the most profound bioethical questions we face, since these techniques can touch on the deepest aspects of the human mind: free will; personal identity; the self; and the soul. This is the first single-author book on what has come to be known as neuroethics. Walter Glannon uses a philosophical framework that is fully informed by cutting edge neuroscience as well as contemporary legal cases such as Terri Schiavo, to offer readers an introduction to this fascinating topic. He starts by describing the state of the art in neuroscientific research and treatment, and gives the reader an up-to-date picture of the brain. Glannon then looks at the ethical implications of various kinds of treatments, such as: whether or not brain imaging will end up changing our viewson free will and moral responsibility; whether patients should always be told that they are at future risk for neurological diseases; if erasing unconscious emotional memories implicated in depression can go too far; if forcing behavior-modifying drugs or surgery on violent offenders can ever be justified; the implications of drugs that enhance cognitive abilities; and how to define brain death and the criteria for the withdrawal of life-support. While not exhaustive, Glannons work addresses a wide range of fascinating issues and his pathbreaking work should appeal to philosophers, psychiatrists, neurologists, neurosurgeons, radiologists, psychologists, and bioethicists.

This book explores and elaborates three theories of public reason, drawn from Rawlsian political liberalism, natural law theory, and Confucianism. Drawing together academics from these separate approaches, the volume explores how the three theories critique each other, as well as how each one brings its theoretical arsenal to bear on the urgent contemporary debate of medical assistance in dying. The volume is structured in two parts: an exploration of the three traditions, followed by an in-depth overview of the conceptual and historical background. In Part I, the three comprehensive opening chapters are supplemented by six dynamic chapters in dialogue with each other, each author responding to the other two traditions, and subsequently reflecting on the possible deficiencies of their own theories. The chapters in Part II cover a broad range of subjects, from an overview of the history of bioethics to the nature of autonomy and its status as a moral and political value. In its entirety, the volume provides a vibrant and exemplary collaborative resource to scholars interested in the role of public reason and its relevance in bioethical debate.

This book assists health care providers to understand the specific interplay of the roles and relationships currently forming the debates in pediatric clinical ethics. It builds on the fact that, unlike adult medical ethics, pediatric ethics begins within an acutely and powerfully experienced dynamic of patient-family-state-physician relationship. The book provides a unique perspective as it interacts with established approaches as well as recent developments in pediatric ethics theory, and then explores these developments further through cases. The book first focuses on setting the stage by introducing a theoretical framework and elaborating how pediatric ethics differ from non-pediatric ethics. It approaches different theoretical frameworks in a critical manner drawing on their strengths and weaknesses. It helps the reader in developing an ability to engage in ethical reasoning and moral deliberation in order to focus on the wellbeing of the child as the main participant in the ethical deliberation, as well as to be able to identify the child's moral claims. The second section of the book focuses on the practical application of these theoretical frameworks and discusses specific areas pertaining to decision-making. These are: the critically ill child, new and enduring ethical controversies, and social justice at large, the latter of which includes looking at the child's place in society, access to healthcare, social determinants of health, and vaccinations. With the dynamic changes and challenges pediatric care faces across the globe, as well as the changing face of new technologies, no professional working in the field of pediatrics can afford not to take due note of this resource.

This title was first published in 2003. Xenotransplantation - the transplantation of animal organs into humans - poses a fascinating moral dilemma. Should this ability to extend the lives of millions of older people be permitted given that it might trigger a new pandemic similar to AIDS? This study examines the moral dilemma from a combination of humanistic, legalistic, bioethical, economical and technological perspectives. The first part of the book demonstrates that xenografts are the only realistic near-term technological answer to the organ shortage problem. The balance of the book is devoted to assessing whether doctrines such as the 'right to health care' trump the moral and ethical conundrums posed by xenotransplantation. The book concludes with a 'geoethical' solution that proposes authorization of xenotransplantation subject to the prior implementation of a new international organization for epidemiology and basic health care. It also suggests that the costs of operating such an organization could be covered by a global tax on xenografts.

This is a book for anyone who has ever paused to wonder whether cloning will ever be legal. Why it is that "savior siblings" and sex selection provoke such strong reactions? Will there ever be such a thing as an artificial womb?
Assisted reproductive technologies are unique in their capacity to challenge our assumptions and elicit passionate responses. Looking at the moral, philosophical, and legal issues surrounding cases of surrogacy, single or same-sex parenthood, retrieval of sperm from dead or dying patients, and the impregnation of post-menopausal women, this book questions whether these rapidly-developing technologies are refashioning the nature of the family.
The US and UK have played unique roles in the development and regulation of reproductive technologies, and has been at the forefront of controversy over "savior siblings," designer babies, reproductive cloning, and embryo research. This book provides a clear and simple account of the techniques involved in assisted reproduction and embryo research, and discusses the legal and ethical implications of some of these technologies, illustrated by compelling descriptions of real-life cases. The book also addresses the ways in which reproductive technologies are regulated, critically examining the role of the Human Fertilization and Embryology Authority and comparing the UK's approach with that of other countries. Finally, it contemplates the possibility that some of our most deeply-held assumptions about human nature may be called into question by further developments in stem cell research and fertility treatments.

This volume considers the place of feminist bioethics within the broader international bioethics community.

Since its emergence two decades ago, the feminist perspective on bioethics has existed at the periphery of the discipline's mainstream. Concerns over reproduction and women's health issues--along with the concept that prevailing bioethical thought was fundamentally gendered--were largely subsumed by such overarching issues as the protection of research subjects and by theoretical and methodological frameworks derived from Kantian philosophy and practice-oriented principalism. Now feminist bioethics belongs to both the mainstream and the margins. The essays collected here explore the relation of feminist bioethics to mainstream bioethical thought and practice.

The first section looks at the current trajectory of feminist bioethics, its contributions to the mainstream, and how different types of feminism can inform and strengthen feminist bioethics. In the second section, contributors address autonomy, universalism, and trust to probe how feminist perspectives have altered bioethical theory. The third section examines such challenging issues as cancer genetics, childbirth, rape, and prenatal selection to demonstrate the effect of feminist bioethics on mainstream methodology. Contributors to the fourth section reflect on the relationship between feminist bioethical thought and the viewpoints of racial, ethnic, and cultural minorities, including people with disabilities.

Philosophically grounded, methodologically sound, and theoretically rigorous, this paradigm-challenging collection ponders the most dynamic areas of feminist inquiry into bioethical thought and practice and sketches future directions for this rapidly growing field.

The genie is out of the bottle. A whole new world of genetics research is underway with its exciting potential for a better understanding of heredity and genetically inherited disease, with opportunities for prevention, management and cure. But the current explosion of human genetic information has the potential for abuse also, for damage to rights, privacy and fair treatment for individuals and vulnerable groups. This book brings us up to date with important contributions from the authoritative "Encyclopaedia of the Human Genome" on the urgent social, legal and ethical aspects of the Human Genome enterprise, accessibly written and introduced for the undergraduate, postgraduate and general reader.

Environmental health encompasses the assessment and control of those environmental factors that can potentially affect human health, such as radiation, toxic chemicals and other hazardous agents. It is often assumed that the assessment part is just a matter of scientific research, and the control part a matter of implementing standards which unambiguously follow from that research. But it is less commonly understood that environmental health also requires addressing questions of an ethical nature. How can we determine the "acceptable" risk level for the general population or for certain groups? How should we deal with uneven distributions of risks and benefits? How do we communicate about risks with the stakeholders? This multidisciplinary collection brings together a number of leading researchers and scholars in order to generate discussion surrounding these key questions, and to bring the ethical implications of science and technology to the forefront of critical thought. Providing a broad overview of the Ethics of Environmental Health, its philosophical foundations and practical applications, this book offers a significant contribution to ongoing discussions in sustainable development and will be of interest to scholars and practitioners of Environmental Health, urban studies and healthcare.

Working Virtue is the first substantial collective study of virtue theory and contemporary moral problems. Leading figures in ethical theory and applied ethics discuss topics in bioethics, professional ethics, ethics of the family, law, interpersonal ethics, and the emotions. Virtue ethics is centrally concerned with character traits or virtues and vices such as courage (cowardice), kindness (heartlessness), and generosity (stinginess). These character traits must be looked to in any attempt to understand which particular actions are right or wrong and how we ought to live our lives. As a theoretical approach, virtue ethics has made an impressive comeback in relatively recent history, both posing an alternative to, and, in some ways, complementing well-known theoretical stances such as utilitarianism and deontology. Yet there is still very little material available that presents virtue-ethical approaches to practical contemporary moral problems, such as what we owe distant strangers, our parents, or even non-human animals. This book fills the gap by dealing with these and other pressing moral problems in a clear and theoretically nuanced manner. The contributors offer a variety of perspectives, including pluralistic, eudaimonistic, care-theoretical, Chinese, comparative, and stoic. This variety allows the reader to appreciate not only the wide range of topics for which a virtue-ethical approach may be fitting, but also the distinctive ways in which such an approach may be manifested.

What role should religion play in a religiously pluralistic liberal society? Public bioethics unavoidably raises this question in a particularly insistent fashion. As the 20 papers in this collection demonstrate, the issues are complex and multifaceted. The authors address specific and highly contested issues as assisted suicide, stem cell research, cloning, reproductive health, and alternative medicine as well as more general questions such as who legitimately speaks for religion in public bioethics, what religion can add to our understanding of justice, and the value of faith-based contributions to healthcare. Christian (Catholic and Protestant), Jewish, Islamic, and Buddhist viewpoints are represented. The first book to focus on the interface of religion and bioethics, this collection fills a significant void in the literature.

Dorothy Wertz and John Fletcher pioneered the first international study of ethical and social issues in genetics in 18 nations. This book reports and discusses their second and more representative study in 36 nations. The survey focused on actual situations that occur in the practice of medical genetics, presented as case vignettes that can also be used in teaching and policy discussion. Among the issues discussed are privacy, prenatal diagnosis, patient autonomy, directiveness in counseling, sex selection, forensic DNA banking, "genetic discrimination," and "eugenics."
This is Dorothy Wertz's final book, as she died in April, 2003. It is a one of a kind cross-cultural study of complex ethical issues in the uses of genetic information. No one else has attempted to look at the international aspects of medical genetics on such a broad scale. The results provide a resource for discussion both within and among nations. Much bioethical and policy discussion now occurs in an information vacuum. The survey showed that what people would do, and their reasons for doing it, differed considerably from what ethicists think they "should" do. Many will be surprised at the results, especially in nations where bioethical discussion is just beginning.
Genetics and Ethics in Global Perspective is of interest to medical geneticists, genetic counselors, social scientists and anthropologists who study cross-cultural issues, bioethicists and bioethics centers and health policy makers.

What will it mean for society if science enables us to choose a future child whose health, athletic ability or intelligence is predetermined? This future is becoming ever more likely with the latest developments in human reproduction -- but concerns are growing about the implications. New procedures making possible heritable genetic modifications such as genome editing open the door to 'sanitized' selective eugenics; but these practices have some unnerving similarities to the discredited eugenic programmes of early twentieth-century regimes. A Christian perspective based on Scripture gives us the resources we urgently need to evaluate both current and future selection practices. Calum MacKellar offers an accessible, inter-disciplinary analysis, blending science, history and Christian theology. This book will enable you to become fully informed about the new scientific developments in human reproduction - developments that will affect us all.

As the state of the natural world declines, environmentally related health problems will increasingly shape the landscape of human health and disease. The confluence of several global trends - rapid population growth combined with an even more dramatic increase in natural resource consumption - drives ecological deterioration, and this in turn poses serious challenges to health. U.S. medicine and bioethics have too long ignored the relevance of these global trends to health care. This groundbreaking work is a call to attention. It brings bioethics and health care squarely into the 21st century.

The book shows how environmental decline relates to human health and to health care practices in the U.S. and other industrialized countries. It outlines the environmental trends that will strongly affect health, and challenges us to see the connections between ways of practicing medicine and the very envrionmental problems that damage ecosystems and make people sick. In addition to philosophical analysis of the converging values of bioethics and environmental ethics, the book offers case studies as well as a number of practical suggestions for moving health care toward sustainability. The exploration of a hypothetical Green Health Center, in particular, offers an intellectual and moral framework for talking about environmental values in health care. Engaging and challenging, this book will appeal not only to health professionals and philosophers, but to anyone concerned about how to preserve and promote both human health and the health of the natural world.