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

Stem cells and the emerging field of regenerative medicine are at the frontiers of modern medicine. These areas of scientific inquiry suggest that in the future, damaged tissue and organs might be repaired through personalized cell therapy as easily as the body repairs itself, revolutionizing the treatment of numerous diseases. Yet the use of stem cells is fraught with ethical and public policy dilemmas that challenge scientists, clinicians, the public health community, and people of good will everywhere. How shall we deal with these amazing biomedical advances, and how can we talk about potential breakthroughs with both moral and scientific intelligence? This book provides an innovative look at these vexing issues through a series of innovative Socratic dialogues that elucidate key scientific and ethical points in an approachable manner. Addressing the cultural and value issues underlying stem cell research while also educating readers about stem cells' biological function and medical applications, Stem Cell Dialogues features fictional characters engaging in compelling inquiry and debate. Participants investigate the scientific, political, and socioethical dimensions of stem cell science using actual language, analysis, and arguments taken from scientific, philosophical, and popular literature. Each dialogue centers on a specific, recognizable topic, such as the policies implemented by the George W. Bush administration restricting the use of embryonic stem cells; the potential role of stem cells in personalized medicine; the ethics of cloning; and the sale of eggs and embryos. Additionally, speakers debate the use of stem cells to treat paralysis, diabetes, stroke effects, macular degeneration, and cancer. Educational, entertaining, and rigorously researched (with 300 references to scientific literature), Stem Cell Dialogues should be included in any effort to help the public understand the science, ethics, and policy concerns of this promising field.

This book is available as open access through the Bloomsbury Open Access programme and is available on www.bloomsburycollections.com. The field of biotechnology has provided us with radical revisions and reappraisals of the nature and possibilities of our biological existence. Yet beyond its immediate utility, does a life that is healthier, longer, or freer from disease make us 'better' or more moral people? Bioscience and the Good Life explores the complex relationship between modern biosciences and human flourishing, their sympathies and schisms, and the instances of their reconciliation. Here cognitive enhancement, longevity, and the spectacle of excellence in sports, are examined within the context of what constitutes a life well lived. Framing biotechnological innovation in the discourse of duty and ethics, Brassington advances an insightful and involved response to the existing debates between bioscientific optimists and pessimists, one which mediates their differences, and expands the traditional scope of their arguments.

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

Healthcare providers are constantly confronted with illness and injury, and the challenges of healing. Yet this very work, the relief of suffering, inflicts on healthcare providers suffering of their own that is often crippling. The most common terms for the pain caregivers and healers suffer from are burnout and moral distress. These common terms are, however, often used judgmentally—as if those trying to heal others have failed themselves, their colleagues, and their patients. The net result is that much discussion of burnout and moral distress, and the interventions they underwrite, have served only to worsen the crisis. Into the Field of Suffering: Finding the Other Side of Burnout provides a much-needed reframing of burnout and moral distress. These depleting experiences are approached as trials virtually inevitable in the course of the healer's vocation. The challenge medical professionals and caregivers face is not avoiding them, but meeting them directly with insight into the role of moral distress and burnout in the development of their vocation. Into the Field of Suffering presents a set of analytical frameworks and awareness skills, which have the potential to transform the work of healers and caregivers. There is a growing body of academic literature on these topics, and many memoirs recounting distressing situations and wounding traumas. Into the Field of Suffering takes its place alongside these works, while offering a distinctly different approach that treats as essential the spiritual dimension of the healing vocation. Practices, teachings and dialogues to assist in the cultivation of compassion and gratitude are key components in this presentation. Schenck and Neely address their readers in a direct voice, speaking to the sense of failure and discouragement so many healthcare professionals and caregivers experience on a daily basis. This is a book that carries a mentor's voice and presence, born out of experience with burnout and moral distress, and grounded in hundreds of conversations, de-briefings and interviews with healthcare workers and caregivers, patients and families.

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.

The Neonatal Intensive Care Unit is a site where hi-tech medicine and vulnerable human beings come into close contact. Focusing on a number of medical and ethical challenges encountered by staff and parents, this book provides a new perspective on the complexity of these treatments and the inventiveness of those involved.

Mainstream discussions of ethics often search for a problem-solving theory or explore ontological status. This book argues instead that the proper starting point should be the words and deeds of ordinary people in ordinary disagreements - the ethical concepts in play can only derive full meaning within the context of ordinary human lives.

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 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.

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.

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.

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.

This book discusses the ethical and legal challenges related to innovations, with reference to both scientific research and emerging technologies. It analyzes scientific research with specific reference to experimentation, with a focus on vulnerable people (minors, women, people in developing countries), compassionate care, biobanks and ethical committees. In the context of emerging technologies, it examines the ethical and legal aspects of neuroscience, genomics, ICT, big data, biometrics, converging technologies, enhancement and robotics. The book provides conceptual tools and categories to help readers understand and acquire a critical awareness of the current debates in the field.

Never before have the scope and limits of scientific freedom been more important or more under attack. New science, from artificial intelligence to gene editing, creates unique opportunities for making the world a better place. It also presents unprecedented dangers. This book is about the opportunities and challenges - moral, regulatory and existential - that face both science and society. How are scientific developments impacting on human life and on the structure of societies? How is science regulated and how should it be regulated? Are there ethical boundaries to scientific developments in sensitive areas? Such are the questions that the book seeks to answer. Both the survival of humankind and the continued existence of our planet are at stake. -- .

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.

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.

Our technological culture has an extremely dynamic character: old ways of reproducing ourselves, managing nature and keeping animals are continually replaced by new ones; norms and values with respect to our bodies, food production, health care and environmental protection are regularly being put up for discussion. This constantly confronts us with new moral problems and dilemmas. In discussion with other approaches this book argues that pragmatism, with its strong emphasis on the interaction between technology and values, gives us both procedural help and stresses the importance of living and cooperating together in tackling these problems and dilemmas. The issues in this book include the interaction of technology and ethics, the status of pragmatism, the concept of practice, and discourse ethics and deliberative democracy. It has an interactive design, with original contributions alternating with critical comments. The book is of interest for students, scholars and policymakers in the fields of bioethics, animal ethics, environmental ethics, pragmatist philosophy and science and technology studies.

This book addresses the question of animal rights in the context of literary criticism. Working from a committed position, it asks the question, 'What would literary studies look like if we took animal rights seriously?' It offers critical surveys of the main themes in the history of animal rights and some of the more important contemporary positions together with readings of a wide range of literary texts from classical antiquity to the present day.