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Books > Science & Mathematics > Biology, life sciences > Life sciences: general issues > Bio-ethics
When Joseph Murray performed the first successful living kidney donor transplant in 1954, he thought this would be a temporary stopgap. Today, we are no closer to the goal of adequate organ supply without living donors-if anything, the supply-demand ratio is worse. While most research on the ethics of organ transplantation focuses on how to allocate organs as a scarce medical resource, the ethical treatment of organ donors themselves has been relatively neglected. In The Living Organ Donor as Patient: Theory and Practice, Lainie Friedman Ross and J. Richard Thistlethwaite, Jr. argue that living donor organ transplantation can be ethical provided that we treat living solid organ donors as patients in their own right. Ross and Thistlethwaite develop a five-principle framework to examine some of the attempts to increase living donation. It uses the three principles of the Belmont Report: respect for persons, beneficence, and justice modified to organ transplantation, as well as the principles of vulnerability and special relationships creating special obligations. Their approach requires that the transplant community fully embrace current and prospective living organ donors as patients to whom we have special obligations. Only when living organ donors are regarded as patients in their own right and have a living donor advocate team dedicated to their well-being can the moral limits of living solid organ donation be realized and living donors be given the full respect and care they deserve.
In recent years concerns over the use of results of scientific
advances, expectations about how medical decisions are made, and
demographic changes have raised ethical questions about how
resources are allocated, and how the principles of beneficence, and
respect for patient autonomy are applied. The effect that bioethics
can have on policy decisions and health care delivery demand an
enhanced approach to our understanding of such complex issues. This
volume opens a window to how empirical social research can be used
to illuminate and answer such quandaries and offers a practical
resource for those wishing to engage in this type of research.
Through a thorough look at both quantitative and qualitative
methods utilized in key research investigations in bioethics, the
book examines the impact of such investigations on clinical and
policy decision-making, scholarship and on the advancement of
theory. The varied sociological and anthropological research
examples that are presented allow readers to better understand the
richness and breadth of such work as well as relevant practical and
theoretical approaches.
Solving intractable biotechnological questions of evolution, medicine, and genetics is now easier due to methods permitting the rapid analysis of molecular sequence data. These advances have exposed ethical and policy concerns. How would genomic information be used and by whom? Should individuals be able to make decisions regarding their own genomic data? How accurate are these genetic tests and how should they be regulated? These and other ethical conundrums are the subject of this book. Bioethicists, biomedical policy experts and lawyers, physicians, nursing and allied health students as well as science educators will find this book helpful and engaging in exploring the complexities of modern evolutionary, genetic and biomedical data.
Solving intractable biotechnological questions of evolution, medicine, and genetics is now easier due to methods permitting the rapid analysis of molecular sequence data. These advances have exposed ethical and policy concerns. How would genomic information be used and by whom? Should individuals be able to make decisions regarding their own genomic data? How accurate are these genetic tests and how should they be regulated? These and other ethical conundrums are the subject of this book. Bioethicists, biomedical policy experts and lawyers, physicians, nursing and allied health students as well as science educators will find this book helpful and engaging in exploring the complexities of modern evolutionary, genetic and biomedical data.
As the demand for organs continues to outstrip availability and waiting lists surge, the pressure to make morally questionable, unethical decisions becomes more likely and trust in transplant medicine starts to erode. Medical ethics expert and former health professional, Trevor Stammers, analyses the complex ethical web that constitutes the worldwide exchange of organs and tissues. Key philosophical questions concerning existence, consciousness, the nature of death and the right to life connect organ donation and transplantation to real-life case studies exploring difficulties with the 'dead donor rule' for deceased donation, organ donation euthanasia, xenotransplantation and the creation of organoids and 'organs-on-chips', alongside examples of human trafficking and systematic state murder to provide organs. Controversial cases from Japan, Germany, USA and Singapore are examined alongside the Spanish, Welsh, and Chilean experience of deceased donation opt-out schemes to highlight the variety of threats and challenges to public trust in transplant medicine. Charting these examples provides valuable material for debates and discussions in the philosophy of medicine and medical ethics more generally. Stammers suggests viable alternatives to current ethical failings by focusing on the moral arguments that define public trust, moving the debate on transplant ethics in vital new directions.
Having children is probably as old as the first successful organism. It is often done thoughtlessly. This book is an argument for giving procreating some serious thought, and a theory of how, when, and why procreation may be permissible. procreative ethics, procreation itself is often done Rivka Weinberg begins with an analysis of the kind of act procreativity is and why we might be justifiably motivated to engage in it. She then proceeds to argue that, by virtue of our ownership and control of the hazardous material that is our gametes, we are parentally responsible for the risks we take with our gametes and for the persons that develop when we engage in activity that allows our gametes to unite with others and develop into persons. Further argument establishes that when done respectfully, and in cases where the child's chances of leading a life of human flourishing are high, procreation may be permissible. procreating some serious thought, and a theory of how, when, Along the way, Weinberg argues that the non-identity problem is a curiously common mistake. Arguments intending to show that procreation is impermissible because life is bad for people and imposed on them without their consent are shown to have serious flaws. Yet because they leave us with lingering concerns, Weinberg argues that although procreation is permissible under certain conditions, it is not only a welfare risk but also a moral risk. Still, it is a risk that is often permissible for us to take and impose, given our high level of legitimate interest in procreativity. In order to ascertain when the procreative risk is permissible to impose, contractualist principles are proposed to fairly attend to the interests prospective parents have in procreating and the interests future people have in a life of human flourishing. The principles are assessed on their own merits and in comparison with rival principles. They are then applied to a wide variety of procreative cases.
Countless public health agencies are trying to solve our most intractable public health problems - among them, the obesity and opioid epidemics - by partnering with corporations responsible for creating or exacerbating those problems. We are told industry must be part of the solution. But is it time to challenge the partnership paradigm and the popular narratives that sustain it? In The Perils of Partnership, Jonathan H. Marks argues that public-private partnerships and multi-stakeholder initiatives create "webs of influence" that undermine the integrity of public health agencies; distort public health research and policy; and reinforce the framing of public health problems and their solutions in ways that are least threatening to the commercial interests of corporate "partners". We should expect multinational corporations to develop strategies of influence - but public bodies can and should develop counter-strategies to insulate themselves from corporate influence in all its forms. Marks reviews the norms that regulate public-public interactions (separation of powers) and private-private interactions (antitrust and competition law), and argues for an analogous set of norms to govern public-private interactions. He also offers a novel framework to help public bodies identify the systemic ethical implications of their current or proposed relationships with industry actors. Marks makes a compelling case that the default public-private interaction should be at arm's length: separation, not collaboration. He calls for a new paradigm that avoids the perils of corporate influence and more effectively protects and promotes public health. The Perils of Partnership is essential reading for public health officials and policymakers - but anyone interested in public health will recognize the urgency of this book.
This is an open access title available under the terms of a CC BY-NC-ND 4.0 International licence. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations. Personal autonomy is often lauded as a key value in contemporary Western bioethics. Though the claim that there is an important relationship between autonomy and rationality is often treated as uncontroversial in this sphere, there is also considerable disagreement about how we should cash out the relationship. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient's right to refuse medical treatment, regardless of whether the reasons underpinning the choice are known and rational, or indeed whether they even exist. Jonathan Pugh brings recent philosophical work on the nature of rationality to bear on the question of how we should understand personal autonomy in contemporary bioethics. In doing so, he develops a new framework for thinking about the concept of autonomy, one that is grounded in an understanding of the different roles that rational beliefs and rational desires have to play in it. Pugh's account allows for a deeper understanding of d the relationship between our freedom to act and our capacity to decide autonomously. His rationalist perspective is contrasted with other prominent accounts of autonomy in bioethics, and the revisionary implications it has for practical questions in biomedicine are also outlined.
This book serves as an introduction to the concepts of medical biotechnology, with great details about fundamentals and early disciplines of study as well as emerging fields and the latest research. The book follows a chronological order from the earliest discoveries and breakthroughs of medical biotechnology to the latest areas of study. The book contains up-to-date citations for each chapter and section, which makes it easy for the reader to understand the concept and also to follow the latest developments in the particular area. It is an ideal book for undergraduate and graduate students who aspire to derive basic knowledge and are also keen on learning about the latest advancements in the field of medical biotechnology.
Human Embryos and Preimplantation Genetic Technologies: Ethical, Social, and Public Policy Aspects presents the first holistic analysis of PGD and PGS as it is practiced and regulated worldwide. In addition to scientific and technical aspects, the book provides perspectives on the ethical, legal, religious, policy and social implications of global assisted reproduction technologies, including in Africa, Asia, Europe, North and South America, and Australia. Chapters cover history, ethics, feminism, family dynamics, psychological and interpersonal factors, the current state of PGD and PGS in 20 different sovereign nations and religious communities, and provide an analysis of public policy concerns and future directions.
Research on human beings saves countless lives, but has at times harmed the participants. To what degree then should government regulate science, and how? The horrors of Nazi concentration camp experiments and the egregious Tuskegee syphilis study led the US government, in 1974, to establish Research Ethics Committees, known as Institutional Review Boards (IRBs) to oversee research on humans. The US now has over 4,000 IRBs, which examine yearly tens of billions of dollars of research - all studies on people involving diseases, from cancer to autism, and behavior. Yet ethical violations persist. At the same time, critics have increasingly attacked these committees for delaying or blocking important studies. Partly, science is changing, and the current system has not kept up. Since the regulations were first conceived 40 years ago, research has burgeoned 30-fold. Studies often now include not a single university, but multiple institutions, and 40 separate IRBs thus need to approve a single project. One committee might approve a study quickly, while others require major changes, altering the scientific design, and making the comparison of data between sites difficult. Crucial dilemmas thus emerge of whether the current system should be changed, and if so, how. Yet we must first understand the status quo to know how to improve it. Unfortunately, these committees operate behind closed doors, and have received relatively little in-depth investigation. Robert Klitzman thus interviewed 45 IRB leaders and members about how they make decisions. What he heard consistently surprised him. This book reveals what Klitzman learned, providing rare glimpses into the conflicts and complexities these individuals face, defining science, assessing possible future risks and benefits of studies, and deciding how much to trust researchers - illuminating, more broadly, how we view and interpret ethics in our lives today, and perceive and use power. These committees reflect many of the most vital tensions of our time - concerning science and human values, individual freedom, government control, and industry greed. Ultimately, as patients, scientists, or subjects, the decisions of these men and women affect us all.
Environmental issues are an ever-increasing focus of public discourse and have proved concerning to religious groups as well as society more widely. Among biblical scholars, criticism of the Judeo-Christian tradition for its part in the worsening crisis has led to a small but growing field of study on ecology and the Bible. This volume in the Oxford Handbook series makes a significant contribution to this burgeoning interest in ecological hermeneutics, incorporating the best of international scholarship on ecology and the Bible. The Handbook comprises 30 individual essays on a wide range of relevant topics by established and emerging scholars. Arranged in four sections, the volume begins with a historical overview before tackling some key methodological issues. The second, substantial, section comprises thirteen essays offering detailed exegesis from an ecological perspective of selected biblical books. This is followed by a section exploring broader thematic topics such as the Imago Dei and stewardship. Finally, the volume concludes with a number of essays on contemporary perspectives and applications, including political and ethical considerations. The editors Hilary Marlow and Mark Harris have drawn on their experience in Hebrew Bible and New Testament respectively to bring together a diverse and engaging collection of essays on a subject of immense relevance. Its accessible style, comprehensive scope, and range of material means that the volume is a valuable resource, not only to students and scholars of the Bible but also to religious leaders and practitioners.
The foundations of research ethics are riven with fault lines emanating from a fear that if research is too closely connected to weighty social purposes an imperative to advance the common good through research will justify abrogating the rights and welfare of study participants. The result is an impoverished conception of the nature of research, an incomplete focus on actors who bear important moral responsibilities, and a system of ethics and oversight highly attuned to the dangers of research but largely silent about threats of ineffective, inefficient, and inequitable medical practices and health systems. In For the Common Good: Philosophical Foundations of Research Ethics, Alex John London defends a conception of the common good that grounds a moral imperative with two requirements. The first is to promote research that generates the information necessary to enable key social institutions to effectively, efficiently, and equitably safeguard the basic interests of individuals. The second is to ensure that research is organized as a voluntary scheme of social cooperation that respects its various contributors' moral claims to be treated as free and equal. Connecting research to the goals of a just social order grounds a framework for assessing and managing research risk that reconciles these requirements and justifies key oversight practices in non-paternalistic terms. Reconceiving research ethics as resolving coordination problems and providing credible assurance that these requirements are being met expands the issues and actors that fall within the purview of the field and provides the foundation for a more unified and coherent approach to domestic and international research. This is an open access title available under the terms of a CC BY-NC-ND 4.0 license. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations.
Emerging medical technologies are changing our views on human nature and what it means to be alive, healthy, and leading a good life. Reproductive technologies, genetic diagnosis, organ transplantation, and psychopharmacological drugs all raise existential questions that need to be tackled by way of philosophical analysis. Yet questions regarding the meaning of life have been strangely absent from medical ethics so far. This book brings phenomenology, the main player in the continental tradition of philosophy, to bioethics, and it does so in a comprehensive and clear manner. Starting out by analysing illness as an embodied, contextualized, and narrated experience, the book addresses the role of empathy, dialogue, and interpretation in the encounter between health-care professional and patient. Medical science and emerging technologies are then brought to scrutiny as endeavours that bring enormous possibilities in relieving human suffering but also great risks in transforming our fundamental life views. How are we to understand and deal with attempts to change the predicaments of coming to life and the possibilities of becoming better than well or even, eventually, surviving death? This is the first book to bring the phenomenological tradition, including philosophers such as Martin Heidegger, Edith Stein, Maurice Merleau-Ponty, Jean-Paul Sartre, Hans-Georg Gadamer, Paul Ricoeur, Hans Jonas, and Charles Taylor, to answer such burning questions.
The Universal Declaration on Bioethics and Human Rights, 2005, marked a significant step towards the recognition of universal standards in the field of science and medicine. This book provides an overview of the ethical and legal developments which have occurred in the field of bioethics and human rights since then. The work critically analyzes the Declaration from an ethical and legal perspective, commenting on its implementation, and discussing the role of non-binding norms in international bioethics. The authors examine whether the Declaration has contributed to the understanding of universal or global bioethics, and to what degree states have implemented the principles in their domestic legislation. The volume explores the currency of the Declaration vis-a-vis the more recent developments in technology and medicine and looks ahead to envisage the major bioethical challenges of the next twenty years. In this context, the book offers a comprehensive ethical and legal study of the Declaration with an in-depth analysis of the meaning of the provisions, in order to clarify the extension of human rights in the field of medicine and the obligations incumbent upon UNESCO member States, with reference to their implementation practice.
There are more connections between spirituality and science than you might think... In 2004, biologist Dee Denver heard the Dalai Lama speak in Bloomington, Indiana. The famous Tibetan monk's speech that day exposed him to the centrality of impermanence in Buddhist thinking, a topic that directly connected to his mutation research in evolutionary biology. He left the event shocked and startled by the unexpected parallels between Buddhism and biology. This experience is not wholly unique to Denver. Spirituality and science are two inherently humane ways to approach our world. Why shouldn't more people look at them in tandem? In this book, Denver shares Buddhist ideas and the tradition's colonial and more recent interactions with biology. He then applies the scientific method to Buddhist principles and draws connections between Buddhist ideas and current research in biology. In doing this, he proposes a new approach to science, Bodhi science, that integrates Buddhist teachings and ethical frameworks. Denver's research supports a connected synergy between biological and Buddhist thinking. This scientific approach to Buddhism offers strong evidence supporting the validity of fundamentally Buddhist principles and logic. The book builds on historical evidence from Sri Lanka, Japan, and Tibetan Buddhism to illustrate these connections.
Most people believe that parents have moral rights and responsibilities regarding their children. These rights and responsibilities undergird the nuclear family and are essential to the flourishing of its members. However, their basis and contents are hotly contested. Do a child's genetic parents have a right to parent her? The importance of genetic ties is affirmed by many people's gut responses, everyday talk, and many court decisions, but the moral justification for tying parenthood rights to genetics is unclear. Parents are routinely permitted to make far-reaching decisions about their children's medical care, education, religious practice, and even how to punish them. When can parental rights be limited by the interests of the child or society? Matters are no more settled when it comes to parental responsibilities. It is commonly thought that if a man conceives a child through voluntary sexual intercourse he acquires parental responsibilities, even if he took every precaution against conception. On the other hand, sperm donors are widelythough not universallythought to have no responsibilities towards their progeny. What is the basis for these disparate judgments? Parents are expected to do a lot for their children as they raise them. But there are surely limits. Sometimes parents have to balance the needs of multiple family members or just want to have time for themselves. What is the extent of their parental responsibilities? In The Moral Foundations of Parenthood, Joseph Millum provides a philosophical account of moral parenthood. He explains how parental rights and responsibilities are acquired, what those rights and responsibilities consist in, and how parents should go about making decisions on behalf of their children. In doing so, he provides a set of frameworks to help solve pressing ethical dilemmas relating to parents and children.
Since the therapeutic value of umbilical cord blood (UCB) stem cells was first recognised in the late 1980s, there has been a proliferation of both public and private UCB banks worldwide. However, the ability to utilise such a potentially valuable resource has provoked a number of controversies. In a distinctly accessible style, this book unpacks the socio-legal implications of the UCB collection process and constructs a detailed analysis of the law and ethics that surrounds UCB banking in the UK, including ownership of the cells. Its enquiry is located within the theoretical framework of altruism versus self-interest and explores the notions of risk and choice associated with this distinctive blend of public/private healthcare provision. The book evaluates the impact of the Human Tissue Act 2004 and the European Union Tissues and Cells Directive (2004/23/EC) on the UCB industry and provides a unique insight into the effect that the law may have on the NHS whose maternity staff and premises are used to collect UCB. This book would be of interest primarily to a UK readership in addition to expectant families, health professionals, students, academics, practitioners and the UCB industry elsewhere in the world.
Human Dignity in Bioethics brings together a collection of essays that rigorously examine the concept of human dignity from its metaphysical foundations to its polemical deployment in bioethical controversies. The volume falls into three parts, beginning with meta-level perspectives and moving to concrete applications. Part 1 analyzes human dignity through a worldview lens, exploring the source and meaning of human dignity from naturalist, postmodernist, Protestant, and Catholic vantages, respectively, letting each side explain and defend its own conception. Part 2 moves from metaphysical moorings to key areas of macro-level influence: international politics, American law, and biological science. These chapters examine the legitimacy of the concept of dignity in documents by international political bodies, the role of dignity in American jurisprudence, and the implications-and challenges-for dignity posed by Darwinism. Part 3 shifts from macro-level topics to concrete applications by examining the rhetoric of human dignity in specific controversies: embryonic stem cell research, abortion, human-animal chimeras, euthanasia and palliative care, psychotropic drugs, and assisted reproductive technologies. Each chapter analyzes the rhetorical use of 'human dignity' by opposing camps, assessing the utility of the concept and whether a different concept or approach can be a more productive means of framing or guiding the debate.
Transplantation is a medically successful and cost-effective way to treat people whose organs have failed-but not enough organs are available to meet demand. Ethics and the Acquisition of Organs is concerned with the major ethical problems raised by policies for acquiring organs. The main topics are the rights of the dead, the role of the family, opt in and opt out systems, the conscription of organs, living organ donation from adults and children, directed donation and priority for donors, and the sale of organs. In this ground-breaking work, T. M. Wilkinson uses concepts from moral and political theory such as autonomy, rights, posthumous interests, justice, and well-being, in a context informed by the clinical, legal, and policy aspects of transplantation. The result is a rigorous philosophical exploration of real problems and options. He argues that the ethics of acquiring organs for transplantation is not only of great intellectual interest, but also of practical importance. As such, this book will be of profit not only to students and academics who work in applied ethics and bioethics, but also to the lawyers, policy-makers, clinicians, and lobby groups interested in transplantation.
Much recent thought on the ethics of new biomedical technologies, and work in ethics and political philosophy more generally, is committed to hidden and contestable views about the nature of biological reality. This selection of essays by Tim Lewens, a leading expert in the field, teases out these biological foundations of bioethical writing and subjects them to scrutiny. The topics covered include human enhancement, the risks of technical progress, the alleged moral threat of synthetic biology, the reality of human nature, the relevance of evolutionary psychology to social policy, the nature of the distinction between health and disease, and justice in healthcare decision-making.
Introduction to Bioethics provides a comprehensive and yet concise coverage of the broad field of bioethics, dealing with the scientific, medical, social, religious and, where appropriate, political and international concerns. The book introduces the various modes of ethical thinking and then helps the reader to apply that thinking to issues relating to the environment, to plants and animals and to humans. Written in an accessible manner, Introduction to Bioethics focuses on key issues directly relevant to those studying courses ranging from medicine through to biology and agriculture. Ethical analysis is threaded throughout each chapter and supplementary examples are included to stimulate further thought. In addition there are numerous mini-case studies to aid understanding, together with key references and further reading.
This book provides insights into dynamic and complex interrelationships between professionalism and medical practice. It does so by looking into the most relevant and recent theoretical and practical frameworks and by systematizing and integrating extensive and growing literature on medical professionalism. Through honest and prudent contributions from very diverse backgrounds and contexts, this book provides an understanding of medical professionalism derived from a broader historical and cultural context in order to contribute to everyday professional life and practice - the very place of its existence. The book presents the conflicting and sometimes irreconcilable demands and challenges physicians face in everyday practice. A better understanding of these fundamental issues is the only way for medicine to maintain and preserve its unique morality, the same one that enabled its existence in the first place. The book is relevant for everyone immersed and interested in the subject of medical professionalism as a resource, which may ease or guide them through the complexities of issues at hand. It will also contribute to the ongoing debate on medical professionalism, medical ethics, bioethics, and professionalism and ethics in general.
Prenatal diagnosis, especially noninvasive prenatal testing (NIPT), has changed the experience of pregnancy, prenatal care and responsibilities in Israel and Germany in different ways. These differences reflect the countries' historical legacies, medico-legal policies, normative and cultural identities. Building on this observation, the contributors of this book present conversations between leading scholars from Israel and Germany based on an empirical bioethical perspective, analyses about the reshaping of 'life' by biomedicine, and philosophical reflections on socio-cultural claims and epistemic horizons of responsibilities. Practices and discussions of reproductive medicine transform the concepts of responsibility and irresponsibility. |
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