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Books > Science & Mathematics > Biology, life sciences > Life sciences: general issues > Bio-ethics
This book observes the idea of race as a false representation for the cause of disease. Race-based medicine, an emerging field in pharmacology, aims to create a specialty market based on racial groups. Within this market, the drug BiDil set a precedent in this area of medicine targeting African Americans as its first racial group. Consequently, selecting African Americans as a "starter group" led to ethical questions regarding the motive behind race-based medicine within the context of the larger treatment of blacks in American medical history. This book therefore links medicine and American eugenics, examines race-based medicine's influence on the perception of the black body, traces the influence of BiDil's approval on the resurgence of race-based medicine, and assesses the black church's response to race-based medicine using black liberation theology as a means to social justice.
The use of the criminal law to punish those who transmit disease is a topical and controversial issue. To date, the law, and the related academic literature, has largely focused on HIV transmission. With contributions from leading practitioners and international scholars from a variety of disciplines, this volume explores the broader question of if and when it is appropriate to criminalise the transmission of contagion. The scope and application of the laws in jurisdictions such as Canada, the United Kingdom and Norway are considered, historical comparisons are examined, and options for the further development of the law are proposed.
This book discusses 'how' to respectfully and responsibly include pregnant women in clinical research. In sharp contrast, the existing literature predominantly focuses on the reasons 'why' the inclusion of pregnant women in clinical research is necessary - viz., to develop effective treatments for women during pregnancy, to promote fetal safety, to reduce harm to women and fetuses from suboptimal care, and to allow access to the benefits of research participation. This book supports the shift to a new default position, whereby pregnant women are included in clinical research unless researchers argue convincingly for their exclusion. This shift raises many as yet unexplored ethical and policy questions about existing barriers to the equitable inclusion of pregnant women in research. This book is original in three key ways. First, it presents an unparalleled depth of analysis of the ethics of research with pregnant women, bringing together many of the key authors in this field as well as experts in research ethics and in vulnerability who have not previously applied their work to pregnant women. Second, it includes innovative theoretical work in ethics and disease specific case studies that highlight the current complexity and future challenges of research involving pregnant women. Third, the book brings together authors who argue both for and against including more pregnant women in formal clinical trials.
In times of global economic and political crises, the notion of solidarity is gaining new currency. This book argues that a solidarity-based perspective can help us to find new ways to address pressing problems. Exemplified by three case studies from the field of biomedicine: databases for health and disease research, personalised healthcare, and organ donation, it explores how solidarity can make a difference in how we frame problems, and in the policy solutions that we can offer.
Bioethics has long been accepted as an interdisciplinary field. The recent 'empirical turn' in bioethics is, however, creating challenges that move beyond those of simple interdisciplinary collaboration, as researchers grapple with the methodological, empirical and meta-ethical challenges of combining the normative and the empirical, as well as navigating the difficulties that can arise from attempts to transcend traditional disciplinary boundaries. Empirical Bioethics: Theoretical and Practical Perspectives brings together contributions from leading experts in the field which speak to these challenges, providing insight into how they can be understood and suggestions for how they might be overcome. Combining discussions of meta-ethical challenges, examples of different methodologies for integrating empirical and normative research, and reflection on the challenges of conducting and publishing such work, this book will both introduce the novice to the field and challenge the expert.
When data from all aspects of our lives can be relevant to our health - from our habits at the grocery store and our Google searches to our FitBit data and our medical records - can we really differentiate between big data and health big data? Will health big data be used for good, such as to improve drug safety, or ill, as in insurance discrimination? Will it disrupt health care (and the health care system) as we know it? Will it be possible to protect our health privacy? What barriers will there be to collecting and utilizing health big data? What role should law play, and what ethical concerns may arise? This timely, groundbreaking volume explores these questions and more from a variety of perspectives, examining how law promotes or discourages the use of big data in the health care sphere, and also what we can learn from other sectors.
Conscience in Reproductive Health Care responds to the growing worldwide trend of health care professionals conscientiously refusing to provide abortions and similar reproductive health services in countries where these services are legal and professionally accepted. Carolyn McLeod argues that conscientious objectors in health care should prioritize the interests of patients in receiving care over their own interest in acting on their conscience. She defends this "prioritizing approach" to conscientious objection over the more popular "compromise approach" without downplaying the importance of health care professionals having a conscience or the moral complexity of their conscientious refusals. McLeod's central argument is that health care professionals who are gatekeepers of services such as abortions are fiduciaries for their patients and for the public they are licensed to serve. As such, they owe a duty of loyalty to these beneficiaries and should give primacy to their beneficiaries' interests in accessing care. This conclusion is informed by what McLeod believes is morally at stake for the main parties to the conflicts generated by conscientious refusals: the objector and the patient. What is at stake, according to McLeod, depends on the relevant socio-political context, but typically includes the objector's integrity and the patient's interest in avoiding harm.
Lochlann Jain's debut non-fiction graphic novel, Things That Art, playfully interrogates the order of things. Toying with the relationship between words and images, Jain's whimsical compositions may seem straightforward. Upon closer inspection, however, the drawings reveal profound and startling paradoxes at the heart of how we make sense of the world. Commentaries by architect and theorist Maria McVarish, poet and naturalist Elizabeth Bradfield, musician and English Professor Drew Daniel, and the author offer further insight into the drawings in this collection. A captivating look at the fundamental absurdities of everyday communication, Things That Art jolts us toward new forms of collation and collaboration.
Imagine that you are an environmentalist who passionately believes that it is wrong to drill for oil in the Arctic National Wildlife Refuge. How do you convince someone that a decision to drill is wrong? Debates about the environment and how humans ought to treat it have gone on for decades, yet arguments in favor of preserving biodiversity often lack empirical substance or are philosophically naive, making them far less effective than they could be. This book critically examines arguments that are commonly offered in support of biodiversity conservation. The authors adopt a skeptical viewpoint to thoroughly test the strength of each argument and, by demonstrating how scientific evidence can be integrated with philosophical reasoning, they help environmentalists to better engage with public debate and judiciously inform public policy. This interdisciplinary and accessible book is essential reading for anyone who engages in discussions about the value of biodiversity conservation.
This volume addresses the proper character of patient informed consent to medical treatment and clinical research. The goal is critically to explore the current individually oriented approach to informed consent which grew out of the dominant bioethics movement that arose in the United States in the 1970s. In contrast to that individually oriented approach, this volume explores the importance of family-oriented approaches to informed consent for medical treatment and clinical research. It draws on both East Asian moral resources as well as a critical response to the ways in which the practice of informed consent has developed in the United States
With a focus on end-of-life discussion in aging and chronically ill populations, this book offers insight into the skill of communicating in complex and emotionally charged discussions. This text is written for all clinicians and professionals in the fields of healthcare and public health who are faced with questions of ethical deliberation when a patient's illness turns from chronic to terminal. This skill is required to manage care well in an age of advanced technology, and numerous autonomous choices. With a palliative care and ethics focus, the manuscript provides case studies illustrating issues which occur in the acuity and chronicity of end of life. Clear tools for clinicians, such as scripting and "the advance care planning video library" are included. The book focuses on the unique concept of outpatient ethics, including readmission prevention and shortened length of stay through good communication for clinicians who will be required to conduct this discussion with patients. The ethical undertone in this text provides a perfect opening for application in healthcare ethics classes, both in fields of public health and healthcare. Medical scholars and physicians, nurse practitioners and physician's assistants, as well as social workers, both in practice and training, will benefit from this text.
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.
Scientific medicine in Miettinen's conception of it is very different from the two ideas about it that come to eminence in the 20th century. To him, medicine is scientific to the extent that it has a rational theoretical framework and a knowledge-base from medical science. He delineates the nature of that theoretical framework and of the research to develop the requisite knowledge for application in such a framework. The knowledge ultimately needed is about diagnostic, etiognostic, and prognostic probabilities, and it necessarily is to be codified in the form of probability functions, embedded in practice-guiding expert systems. In these terms, today's medicine still is mostly pre-scientific, and major innovations are needed within and around medicine for healthcare to get to be in tune with reasonable expectations about it in this Information Age. Thus, while the leading cause of litigation for medical malpractice in the U.S. is failure to expeditiously and correctly diagnose the probability of myocardial infarction in a hospital's emergency room, this book shows that a typical modern textbook of cardiology, just as one of medicine at large, imparts no knowledge about the diagnostic probabilities needed in this, and that the prevailing type of diagnostic research will not produce the requisite knowledge. If the diagnostic pursuits in an ER would be guided by an emergency-room diagnostic expert system, this would guarantee expert diagnoses by all ER doctors. Academic leaders of medicine and medical researchers concerned to advance the knowledge-base of medicine will find a wealth of stimulus for thinking about the deficiencies of the prevailing knowledge culture in and surrounding medicine, and about the directions of the needed progress toward genuinely scientific medicine.
This thought-provoking treatise argues that current human fertility rates are fueling a public health crisis that is at once local and global. Its analysis and data summarize the ecological costs of having children, presenting ethical dilemmas for prospective parents in an era of competition for scarce resources, huge disparities of wealth and poverty, and unsustainable practices putting irreparable stress on the planet. Questions of individual responsibility and integrity as well as personal moral and procreative issues are examined carefully against larger and more long-range concerns. The author's assertion that even modest efforts toward reducing global fertility rates would help curb carbon emissions, slow rising global temperatures, and forestall large-scale climate disaster is well reasoned and more than plausible. Among the topics covered: * The multiplier effect: food, water, energy, and climate. * The role of population in mitigating climate change. * The carbon legacy of procreation. * Obligations to our possible children. * Rights, what is right, and the right to do wrong. * The moral burden to have small families. Toward a Small Family Ethic sounds a clarion call for bioethics students and working bioethicists. This brief, thought-rich volume steers readers toward challenges that need to be met, and consequences that will need to be addressed if they are not.
The social practice of forming, shaping, expressing, contesting, and maintaining personal identities makes human interaction, and therefore society, possible. Our identities give us our sense of how we are supposed to act and how we may or must treat others, so how we hold each other in our identities is of crucial moral importance. To hold someone in her identity is to treat her according to the stories one uses to make sense of who she is. Done well, holding allows individuals to flourish personally and in their interactions with others; done poorly, it diminishes their self-respect and restricts their participation in social life. If the identity is to represent accurately the person who bears it, the tissue of stories that constitute it must continue to change as the person grows and changes. Here, good holding is a matter of retaining the stories that still depict the person but letting go of the ones that no longer do. The book begins with a puzzling instance of personhood, where the work of holding someone in her identity is tragically one-sided. It then traces this work of holding and letting go over the human life span, paying special attention to its implications for bioethics. A pregnant woman starts to call her fetus into personhood. Children develop their moral agency as they learn to hold themselves and others in their identities. Ordinary adults hold and let go, sometimes well and sometimes badly. People bearing damaged or liminal identities leave others uncertain how to hold and what to let go. Identities are called into question at the end of life, and persist after the person has died. In all, the book offers a glimpse into a fascinating moral terrain that is ripe for philosophical exploration.
Remediation in medical education is the act of facilitating a correction for trainees who started out on the journey toward becoming excellent physicians but have moved off course. This book offers an evidence-based and practical approach to the identification and remediation of medical trainees who are unable to perform to standards. As assessment of clinical competence and professionalism has become more sophisticated and ubiquitous, medical educators increasingly face the challenge of implementing effective and respectful means to work with trainees who do not yet meet expectations of the profession and society. Remediation in Medical Education: A Mid-Course Correction describes practical stepwise approaches to remediate struggling learners in fundamental medical competencies; discusses methods used to define competencies and the science underlying the fundamental shift in the delivery and assessment of medical education; explores themes that provide context for remediation, including professional identity formation and moral reasoning, verbal and nonverbal learning disabilities, attention deficit disorders in high-functioning individuals, diversity, and educational and psychiatric topics; and reviews system issues involved in remediation, including policy and leadership challenges and faculty development.
This book examines all aspects of narrative medicine and its value in ensuring that, in an age of evidence-based medicine defined by clinical trials, numbers, and probabilities, clinical science is firmly embedded in the medical humanities in order to foster the understanding of clinical cases and the delivery of excellent patient care. The medical humanities address what happens to us when we are affected by a disease and narrative medicine is an interdisciplinary approach that emphasizes the importance of patient narratives in bridging various divides, including those between health care professionals and patients. The book covers the genesis of the medical humanities and of narrative medicine and explores all aspects of their role in improving healthcare. It describes how narrative medicine is therapeutic for the patient, enhances the patient-doctor relationship, and allows the identification, via patients' stories, of the feelings and experiences that are characteristic for each disease. Furthermore, it explains how to use narrative medicine as a real scientific tool. Narrative Medicine will be of value for all caregivers: physicians, nurses, healthcare managers, psychotherapists, counselors, and social workers. "Maria Giulia Marini takes a unique and innovative approach to narrative medicine. She sees it as offering a bridge - indeed a variety of different bridges - between clinical care and 'humanitas'. With a sensitive use of mythology, literature and metaphor on the one hand, and scientific studies on the other, she shows how the guiding concept of narrative might bring together the fragmented parts of the medical enterprise". John Launer, Honorary Consultant, Tavistock Clinic, London UK
This volume presents a number of controversial cases of enforced medical treatment from around the globe, providing for the first time a common, biopolitcal framework for all of them. Bringing together all these real cases guarantees that a new, more complete understanding of the topic will be within grasp for readers unacquainted with the aspects involved in these cases. On the one hand, readers interested mainly in the legal and medical dimensions of cases like those considered will benefit from the explanation of the biopolitical framework within which each case develops. On the other hand, those focusing on only one of the situations presented here will find the parallels between the cases an interesting expansion of the complexity of the problem. Despite the book's ambitious goal, for those willing to use it as supplemental material or interested in only one of the cases, the chapters can function as self-standing pieces to be read separately. This volume will be a valuable tool for both academics and professionals. Bioethicists in both the analytic and continental traditions, will find the book interesting for not only the specific concepts and issues considered, but also for its constructive bridging of the two schools of thought. In addition to philosophers, the structure of this work will also appeal to lawyers, doctors, human rights activists, and anyone concerned in the most disparate way with real-life cases of enforced medical treatment.
This readable overview offers a public health framework for integrating medical and alternative care to improve health outcomes in patients with chronic illnesses. It details the promise, potential, and challenges of holistic services as patients seek diverse treatment options and health care systems address the demand for more affordable, accessible, and effective care. The book's integrative model describes the process in theory and practice, from cost and reimbursement issues and turf wars between providers to expanding on traditional concepts of illness and wellness. Learning objectives, case studies, discussion questions, and other helpful features make this a vital student text. The book's concentrated coverage: Introduces concepts of integrative health services. Applies integrative health concepts to public health areas, e.g., prevention. Contrasts integrative models of health with the traditional biomedical model. Outlines the scope of integrative health practice. Reviews implications for the public health workforce. Integrative Health Services benefits public health students, pre-med students, and those with an interest in health policy and health trends. Additionally, public health educators, practitioners, and scholars who may not be familiar with integrative health services and conflicts related to their increased use in health care will find it a helpful tool to quickly bring them up to date
Anti-natalism is the provocative view that it is either always or almost always all-things-considered wrong to procreate. Philanthropic anti-natalist arguments say that procreation is always impermissible because of the harm done to individuals who are brought into existence. Misanthropic arguments, on the other hand, hold that procreation is usually impermissible given the harm that individuals will do once brought into existence. The main purpose of this short monograph is to demonstrate that David Benatar's misanthropic argument for anti-natalism ought to be endorsed by any version of African Communitarianism. Not only that, but there are also resources in the African philosophical tradition that offer unique support for the argument. Given the emphasis that indigenous African worldviews place on the importance of procreation and the immediate family unit this result is highly surprising. This book marks the first attempt to bring anti-natalism into conversation with contemporary African ethics.
Neuroscientists are mining nucleic acids, blood, saliva, and brain images in hopes of uncovering biomarkers that could help estimate risk of brain disorders like psychosis and dementia; though the science of bioprediction is young, its prospects are unearthing controversy about how bioprediction should enter hospitals, courtrooms, or state houses. While medicine, law, and policy have established protocols for how presence of disorders should change what we owe each other or who we blame, they have no stock answers for the probabilities that bioprediction offers. The Neuroethics of Biomarkers observes, however, that for many disorders, what we really care about is not their presence per se, but certain risks that they carry. The current reliance of moral and legal structures on a categorical concept of disorder (sick verses well), therefore, obscures difficult questions about what types and magnitudes of probabilities matter. Baum argues that progress in the neuroethics of biomarkers requires the rejection of the binary concept of disorder in favor of a probabilistic one based on biological variation with risk of harm, which Baum names a "Probability Dysfunction. " This risk-reorientation clarifies practical ethical issues surrounding the definition of mental disorder in the DSM-5 and the nosology of conditions defined by risk of psychosis and dementia. Baum also challenges the principle that the acceptability of bioprediction should depend primarily on whether it is medically useful by arguing that biomarkers can also be morally useful through enabling moral agency, better assessment of legal responsibility, and fairer distributive justice. The Neuroethics of Biomarkers should be of interest to those within neuroethics, medical ethics, and the philosophy of psychiatry.
This textbook presents epidemiology in a practical manner, contextualized with discussions of theory and ethics, so that students and professionals from all academic backgrounds may develop a deep appreciation for how to conduct and interpret epidemiological research. Readers will develop skills to: -Search for and appraise literature critically, -Develop important research questions, -Design and implement studies to address those questions, -Perform and interpret fundamental statistical estimations and tests, -Consider the ethical implications of all stages of research, -Report findings in publications, and -Advocate for change in the public health setting. Epidemiology is and will remain a discipline in motion, and this textbook aims at reflecting this dynamism and keeping pace with its momentum. This textbook is not only a classroom tool with high utility but also an essential reference and guide for those engaging in research involving human subjects.
This book looks at health policy through the lens of public versus private: population health versus the somatic, social, or emotional experiences of a patient. Rather than presenting policy/ethics as overly technical, this book takes a novel approach of framing public and private health in terms of political philosophy, ethics, and popular examples. Each chapter ties back to the general ethics or political literature as applicable, which are not customarily parts of the current public health curriculum. The author's work on the Orgcomplexity blog has touched on this subject by systemically exploring public policy issues, and the tone of this book mimics the blog with an extension of the arguments.
In this edited volume, scientists from different disciplines discuss modern biotechnological processes and a knowledge-based bioeconomy. The authors base their arguments on ecological, economic, legal, social and ethical aspects. Moreover, they explore the opportunities, risks, and challenges of bioeconomic concepts and biotechnologies in many subject areas. The chapters consider land use, nature and environment, nutrition, technology and governance, energy, economy, law and regulation, as well as ethics. A special focus should be on new technologies and how they can be used, without compromising the ambitious goal of creating a more sustainable, but also fair world. To do justice to this broad array of topics, the editors frame all topics in overarching introductions and close the volume with final conclusions. Thereby this volume offers data and critical thoughts for any member of a Bioeconomy - be it from academia, the industry or public regulation.
For over thirty years Susan Wolf has been writing about moral and nonmoral values and the relation between them. This volume collects Wolf's most important essays on the topics of morality, love, and meaning, ranging from her classic essay "Moral Saints" to her most recent "The Importance of Love." Wolf's essays warn us against the common tendency to classify values in terms of a dichotomy that contrasts the personal, self-interested, or egoistic with the impersonal, altruistic or moral. On Wolf's view, this tendency ignores or distorts the significance of such values as love, beauty, and truth, and neglects the importance of meaningfulness as a dimension of the good life. These essays show us how a self-conscious recognition of the variety of values leads to new understandings of the point, the content, and the limits of morality and to new ways of thinking about happiness and well-being. |
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