This series is directed to health care professionals who are leading the tra- formation of health care by using information and knowledge. Launched in 1988 as Computers in Health Care, the series offers a broad range of titles: some addressed to specific professions such as nursing, medicine, and health administration; others to special areas of practice such as trauma and radi- ogy. Still other books in the series focus on interdisciplinary issues, such as the computer-based patient record, electronic health records, and networked health care systems. Renamed Health Informatics in 1998 to reflect the rapid evolution in the discipline now known as health informatics, the series will continue to add titles that contribute to the evolution of the field. In the series, eminent - perts, serving as editors or authors, offer their accounts of innovations in health informatics. Increasingly, these accounts go beyond hardware and so- ware to address the role of information in influencing the transformation of healthcare delivery systems around the world. The series also increasingly focuses on "peopleware" and the organizational, behavioral, and societal changes that accompany the diffusion of information technology in health services environments.

This book traces the growth of managed care as a mechanism for curbing excessive growth in health costs, and the controversies that have risen around for-profit health care. Also examined are decentralization in US health care, and the absence of comprehensive health care planning, access rules, and minimum health care benefit standards. Finally, the author proposes a framework for improving access to quality, affordable health care in a competitive market environment.

This volume is dedicated to the philosophy of medicine advanced by Edmund D. Pellegrino, a renowned physician educator and philosopher. Pellegrino's thinking about the philosophy of medicine centers on the importance of illness in the life of the patient, and the professional relationship established by promising to alleviate suffering. From this relationship norms are established that contribute to the staying power of medicine as a moral enterprise. Chapters are included from established thinkers and newcomers to the field, all of whom have been influenced by Pellegrino. Some chapters expand upon his thinking for primary care, managed care, and other delivery systems. Other chapters explain in more detail certain key concepts in Pellegrino's thought, like beneficence, doing no harm, and clinical phronesis or prudential decision making. Still others explore areas of difficulty like the reliance on role modeling and virtue ethics, the problem of pluralism and a loss of professional normative ethics, and the search for the foundations of the philosophy of medicine. Constructing a viable philosophy of medicine for the next century is an essential task for grounding the morality of medicine during enormous social and economic change. Pellegrino's thinking and the ideas of those he has influenced will contribute immensely to this challenge.

Reframing Disease Contextually will be of particular interest to philosophers of medicine, bioethicists, and philosophers. It may also be of value to medical professionals, historians of western medicine, and health policy makers who take interest in the conceptual foundations of medicine.

This book:
- provides an overview of key debates in the history of modern western medicine on the nature, knowledge, and value of disease;
- illustrates how these debates relate;
- provides a "contextual" or "localized" way of understanding disease;
- includes case studies of e.g. AIDS, genetic disease, and gendered disease;
- conveys the importance of the intersection and interrelation between and among factors that make up disease;
- illustrates how bioethical discussions about disease naming, classification, diagnosis, prognosis, and treatment are part of a much greater discussion in philosophy of medicine.

Physician-Assisted Death is the eleventh volume of Biomedical Ethics Reviews. We, the editors, are pleased with the response to the series over the years and, as a result, are happy to continue into a second decade with the same general purpose and zeal. As in the past, contributors to projected volumes have been asked to summarize the nature of the literature, the prevailing attitudes and arguments, and then to advance the discussion in some way by staking out and arguing forcefully for some basic position on the topic targeted for discussion. For the present volume on Physician-Assisted Death, we felt it wise to enlist the services of a guest editor, Dr. Gregg A. Kasting, a practicing physician with extensive clinical knowledge of the various problems and issues encountered in discussing physician assisted death. Dr. Kasting is also our student and just completing a graduate degree in philosophy with a specialty in biomedical ethics here at Georgia State University. Apart from a keen interest in the topic, Dr. Kasting has published good work in the area and has, in our opinion, done an excellent job in taking on the lion's share of editing this well-balanced and probing set of essays. We hope you will agree that this volume significantly advances the level of discussion on physician-assisted euthanasia. Incidentally, we wish to note that the essays in this volume were all finished and committed to press by January 1993."

Renowned philosophers and medical ethicists debate and discuss the profoundly important concepts of disease and health. Christopher Boorse begins with an extensive reexamination of his seminal definition of disease as a value-free scientific concept. In responding to all those who criticized this view, which came to be called "naturalism" or "neutralism," Boorse clarifies and updates his landmark ideas on this crucial question. Other distinguished thinkers analyze, develop, and oftentimes defend competing, nonnaturalistic theories of disease. Their combined thoughts review and update an issue of central importance in bioethics today.

Leading bioethicists and philosophers examine and debate the question of how the health care system should deal with using complimentary and alternative medicines. The distinguished authorities writing here both defend and criticize alternative medicine, with some arguing that the medical system should change substantially in order to accommodate alternative medicine, and others claiming that virtually all alternative treatments are worthless. In the heat of the debate many fundamental issues are raised concerning our health care system, among them the questions of therapeutic effectiveness, media truthfulness, the patient's freedom to choose among treatment options, health insurance coverage, the ability of the current healthcare delivery system to meet patients' needs, and government approval of alternative medicines.

Western societies generally recognize both a legal and a moral right to privacy. However, at the present time there is no settled opin ion in the United States regarding how these rights should relate to medical information. On the one hand, virtually everyone agrees that one' s medical records should not be open to just any interested person' s inspection. On the other hand, most also agree that some sacrifices in medical privacy are necessary for scientific advancement, public health protection, and other social goals. However, what limits should be set upon those sacrifices, and how those limits should be determined, have long been issues of debate. In recent years this debate has intensified. There are a variety ofreasons for this; to mention only three: (1) Over the years the US health care delivery system has become increasingly complex, and with this complexity there has come a need for more and more people to have access to patients' medical records. With each transference of information, breaches in confidentiality become more likely. (2) Medical costs have risen at an alarming rate. This makes health insurance a virtual necessity for adequate medical care, and people worry that they will be denied employment and/or medical cov erage if certain sorts of medical information are not kept strictly confi dential. (3) Finally, many medical records are now kept in computer files, and the impossibility of guaranteeing confidentiality for files of this sort is a constant worry."

Is the involuntary commitment of the mentally ill morally proper? How can we determine proper psychiatric care in a managed health care system? And can a mental health professional violate patient's confidentiality when they believe a patient is a threat to someone? In six non-ideological essays, leading bioethicists, including one with practical experience in medical administration, search for clear moral and legal guidelines for dealing with the complex issues presented when treating mentally ill patients. Objective and readily understandable, Mental Illness and Public Health Care illuminates for the educated reader some of the key ethical issues facing mental health care professionals and provides convincing practical conclusions with real moral import.

A collection of objective essays reviewing the principal arguments for and against stem cell research. Among the issues considered are whether stem cell research treats embryos as "commodities," violates the rights of human embryos, or alienates women from their reproductive labor, and whether human embryos are entitled to full membership in the moral community.

The primary objective of The Health Care Ethics Con sultant is to focus attention on an immediate practical problem: the role and responsibilities, the education and training, and the certification and accreditation of health care ethics consultants. The principal questions addressed in this book include: Who should be considered health care ethics consultants? Whom should they advise? What should be their responsi bilities and what kind of training should they have? Should there be some kind of accreditation or certification program to ensure that those who call themselves ethics consultants are in fact qualified to advise, consult, research, and write in health care ethics? The distinguished authors ofthese articles are persons with diverse backgrounds, interests, presumptions, and val ues. Not surprisingly, therefore, diverse responses have emerged to the questions posed. Though the book's chapters are individually authored, they are informed by the group discussions that went on during active workshop sessions, and by knowledge of the contributions of others. All of the chapters meaningfully represent their consensus. This is not to say that there were no disagreements regarding specific details, but rather that there were no fundamental objections on the book's basic content among a panel of authors who share basic premises regarding the role, responsibilities, education, and certifica tion of health care ethics consultants."

In the modern practice of medicine, new challenges complicate the ethical care of patients. Today's times require a contemporary take on the concept of medical ethics. The idea for this textbook was born out of a need for a teaching resource that merges medical ethics theory with the practical needs of modern clinical medicine. In Evidence-Based Medical Ethics: Cases for Practice-Based Learning, the authors address what has been missing in existing text books and ethics courses to date - clear-cut ethical and legal guidelines that provide a method for the reader to learn how to systematically manage dilemmas seen in the everyday practice of medicine. The reader is guided through several "typical" patient scenarios and prompted by various questions that should be entertained by the treating health care provider. Then, relevant evidence-based medicine, legal precedent, and the ethical theory that applies to the situation are revealed. Often, finding the "best" ethical solution for each problem is automatic, as the solution often becomes self-evident during information-gathering. This general method is reinforced throughout the text with multiple different cases, using a practice-based approach by building on the reader's developing skills. Additionally, we have sought to emphasize a culturally competent manner in resolving these dilemmas, respectfully addressing issues of age, gender, and culture whenever possible. The main goal of Evidence-Based Medical Ethics: Cases for Practice-Bases Learning is to assist the reader in adapting a patient-centered and evidence-based approach to dilemmas faced in their future practice of medicine.

This important work takes as its subject one of medicine 's most pressing arenas of ethical debate. There has been a consistent interest in ethical issues arising in the context of HIV research. Ongoing international and multi-site studies and the continuing search for an HIV vaccine continue to prompt examination of how this research is conducted. Also examined are how participants are engaged in the studies and the obligations of the researchers to individual participants and their communities during the course of and following the conclusion of the research. Each chapter of this book is authored primarily by one of the editors (secondarily by the other) and is accompanied by one to two case studies.

This book offers a reflection on the central role that the ethics of informed consent plays in Rapid Tissue Donation (RTD). RTD is an advanced oncology procedure that involves the procurement, for research purposes, of "fresh" tissues within two to six hours of a cancer patient's death. Since RTD involves the retrieval of tissues after death, and since the collected tissues are of great importance for medical research, the need for any form of informed consent to regulate this procedure has been questioned. This book argues for the necessity of informed consent to govern RTD, and it provides the reader with a bespoke informed consent process applicable to cancer patients. The analysis unfolds at the intersection between applied ethics, public health ethics, and clinical ethics, and it is informed by philosophical theories of informed consent and by the social implications of individual choices. By viewing medical issues relating to informed consent in oncology from an ethical perspective, the book combines philosophical analysis with discussion of concrete cancer-related issues. As a result, the book is suitable for readers interested in ethical reasoning as well as for those with a medical background. It contributes to contemporary research by offering an original analysis that relies on a rigorous philosophical approach to address innovative issues at the cutting edge of medical research and policy making.

Social Work and Animals represents a pioneering contribution to the literature of social work ethics and moral philosophy. It advances cogent and detailed arguments for the inclusion of animals within social work's moral framework, arguments that have profound theoretical and practical implications for the discipline and its practitioners.

In this book, Dr. Richard Allen Williams has assembled the very best scholars on healthcare disparities to raise the public consciousness of this issue. Arranged into discrete categories, this volume contains comprehensive coverage, both historical and current, of the healthcare disparity crisis currently plaguing our country in hopes of leading us all to a brighter future.

To what extent should we use technology to try to make better human beings? Because of the remarkable advances in biomedical science, we must now find an answer to this question.
Human enhancement aims to increase human capacities above normal levels. Many forms of human enhancement are already in use. Many students and academics take cognition enhancing drugs to get a competitive edge. Some top athletes boost their performance with legal and illegal substances. Many an office worker begins each day with a dose of caffeine. This is only the beginning. As science and technology advance further, it will become increasingly possible to enhance basic human capacities to increase or modulate cognition, mood, personality, and physical performance, and to control the biological processes underlying normal aging. Some have suggested that such advances would take us beyond the bounds of human nature.
These trends, and these dramatic prospects, raise profound ethical questions. They have generated intense public debate and have become a central topic of discussion within practical ethics. Should we side with bioconservatives, and forgo the use of any biomedical interventions aimed at enhancing human capacities? Should we side with transhumanists and embrace the new opportunities? Or should we perhaps plot some middle course?
Human Enhancement presents the latest moves in this crucial debate: original contributions from many of the world's leading ethicists and moral thinkers, representing a wide range of perspectives, advocates and sceptics, enthusiasts and moderates. These are the arguments that will determine how humanity develops in the near future.

Medical ethics in Imperial Germany were entangled with professional, legal and social issues. This book shows how doctors' ethical decision-making was led by their notions of male honour, professional politics and a paternalistic doctor-patient relationship rather than concern for patients' interests or the right of the sick to self-determination.

Taking a unique approach that emphasizes careful reasoning, this cutting-edge reader is structured around twenty-seven landmark arguments that have provoked heated debates on current ethical issues. Contemporary Moral Arguments: Readings in Ethical Issues, Second Edition, opens with an extensive two-chapter introduction to moral reasoning and moral theories that provides students with the background necessary to analyze the arguments in the following chapters. Chapters 3-12 present seventy-six readings that are organized-in the conventional way-into ten topical areas: abortion; drugs and autonomy (new to this edition); euthanasia and assisted suicide; genetic engineering and cloning; the death penalty; war, terrorism, and torture; pornography; economic justice and health care; animal rights and environmental duties; and global obligations to the poor. Offering a special feature not found in other anthologies, the selections are also organized in an unconventional way, by argument, so that students can more easily see how philosophers have debated each other on these critical issues. Each argument opens with an introduction that outlines the argument's key points, provides context for it, and reviews some of the main responses to it. Each introduction is followed by two to four essays that present the argument's classic statement, critiques and defenses of it, and related debates. Contemporary Moral Arguments incorporates more pedagogical features than any other reader, including: * Essay questions-ideal for writing assignments-after each of the twenty-seven argument sections * Four types of boxes throughout: Facts and Figures, Public Opinion, Legalities, and Time Lines * A list of key terms at the end of each chapter, all defined in the glossary, and suggestions for further reading * An Instructor's Manual and Testbank on CD featuring chapter and reading summaries, lecture outlines in PowerPoint format, and essay and objective questions with an answer key * A Companion Website at www.oup.com/us/vaughn containing the same material as the Instructor's Manual along with such student resources as self-quizzes and flash cards NEW TO THIS EDITION: * An expanded introductory chapter on moral reasoning that dissects a sample essay step by step and includes exercises on arguments * A new chapter (4) on drugs and autonomy, including four classic articles * A new section on ethical egoism (in Chapter 2) and three additional readings in other chapters * Numerous updated text boxes that reflect the latest information on abortion, euthanasia and assisted suicide, genetic engineering, capital punishment, war and terrorism, and economic and global justice

Global Public Health: A New Era is a comprehensive account of the international state of public health, including an agenda for improving the practice of the discipline across the world. It addresses three major issues, presented in distinct sections: the changing global context for public health; the state of public health theory and practice in both developed and developing countries, and strategies for strengthening the practice of public health in the twenty-first century.
Part One surveys the complex old and new challenges facing public health practitioners, and then summarizes the state of health globally using new data based on measures of the Global Burden of Disease developed by the World Health Organization, and other groups, to better describe population health states and trends.
Part Two presents the first detailed review of the global state of public health. It analyzes the public health situation in all regions of the world. Six chapters cover Europe, North and Latin America, and Australia and New Zealand, including a new chapter focusing on the UK. Three chapters cover China, India, and Sub-Saharan Africa. The lessons from these chapters are surprisingly similar: the challenges are gerat; the public health workforce and infrastructure have long been neglected, and much needs to be done to reinvigorate the practice of public health.
The third section covers several cross-cutting themes, including the developing field of international public health ethics and the central and neglected role of the public in strengthening the practice of public health. The final chapter summarizes the major themes of the book, and explores the opportunities for building the capacity of the public health workforce to respond to the major global health needs. Despite the enormity of the challenges facing public health practitioners, especially in low and middle income countries, the tone adpoted in the final section of the book is relatively optimistic. The editors are convinced that a reinvigorated public health practice will contribute substantially to improving the public health situation, especially for the most disadvantaged populations, whether in poor or wealthy countries.

Public health is an important and fast-developing area of ethical discussion. In this volume a range of issues in public health ethics are explored using the resources of moral theory, political philosophy, philosophy of science, applied ethics, law, and economics.
The twelve original papers presented consider numerous ethical issues arise within public health ethics. To what extent can the public good or the public interest justify state interventions that impose limits upon the freedom of individuals? What role should the law play in regulating risks? Should governments actively aim to change our preferences about such things as food, smoking or physical exercise? What are public goods, and what role (if any) do they play in public health? To what extent do individuals have moral obligations to contribute to protecting the community or the public good? Where is it appropriate to concentrate upon prevention rather than cure? Given the fact that we cannot be protected from all harm, what sorts of harm provide a justification for public health action? What limits do we wish to place upon public health activities? How do we ensure that the interests of individuals are not set aside or forgotten in the pursuit of population benefits? An excellent line-up of authors from North America, Europe, and the UK tackle these questions.

To what extent should we use technology to try to make better human beings? Because of the remarkable advances in biomedical science, we must now find an answer to this question.
Human enhancement aims to increase human capacities above normal levels. Many forms of human enhancement are already in use. Many students and academics take cognition enhancing drugs to get a competitive edge. Some top athletes boost their performance with legal and illegal substances. Many an office worker begins each day with a dose of caffeine. This is only the beginning. As science and technology advance further, it will become increasingly possible to enhance basic human capacities to increase or modulate cognition, mood, personality, and physical performance, and to control the biological processes underlying normal aging. Some have suggested that such advances would take us beyond the bounds of human nature.
These trends, and these dramatic prospects, raise profound ethical questions. They have generated intense public debate and have become a central topic of discussion within practical ethics. Should we side with bioconservatives, and forgo the use of any biomedical interventions aimed at enhancing human capacities? Should we side with transhumanists and embrace the new opportunities? Or should we perhaps plot some middle course?
Human Enhancement presents the latest moves in this crucial debate: original contributions from many of the world's leading ethicists and moral thinkers, representing a wide range of perspectives, advocates and sceptics, enthusiasts and moderates. These are the arguments that will determine how humanity develops in the near future.

Since its first publication in 1996, Ethics and Epidemiology has been an invaluable resource for practicing public health professionals and MPH students around the world. This third edition presents an international perspective of prominent epidemiologists, ethicists, and legal scholars to address important ethical developments in epidemiology and related public health fields from the last decade, including the rise of public health ethics and the complex inter-relations between professional ethics in epidemiology, public health ethics, and research ethics. Ethics and Epidemiology, Third Edition is organized topically and divided into four parts covering "Foundations," "Key Values and Principles," "Methods," and "Issues." New or updated chapters include ethical issues in public health practice, ethical issues in genetic epidemiology, and ethical issues in international health research and epidemiology. Now updated with timely global examples, Ethics and Epidemiology, Third Edition provides an in-depth account to the theoretical and practical moral problems confronting public health students and professionals and offers guidance for how justified moral conclusions can be reached.

Progress in genetic and reproductive technology now offers us the possibility of choosing what kinds of children we do and don't have. Should we welcome this power, or should we fear its implications? There is no ethical question more urgent than this: we may be at a turning-point in the history of humanity. The renowned moral philosopher and best-selling author Jonathan Glover shows us how we might try to answer this question, and other provoking and disturbing questions to which it leads.
Surely parents owe it to their children to give them the best life they can? Increasingly we are able to reduce the number of babies born with disabilities and disorders. But there is a powerful new challenge to conventional thinking about the desirability of doing so: this comes from the voices of those who have these conditions. They call into question the very definition of disability. How do we justify trying to avoid bringing people like them into being?
In 2002 a deaf couple used sperm donated by a friend with hereditary deafness to have a deaf baby: they took the view that deafness is not a disability, but a difference. Starting with the issues raised by this case, Jonathan Glover examines the emotive idea of "eugenics," and the ethics of attempting to enhance people, for non-medical reasons, by means of genetic choices. Should parents be free, not only to have children free from disabilities, but to choose, for instance, the colour of their eyes or hair? This is no longer a distant prospect, but an existing power which we cannot wish away. What impact will such interventions have, both on the individuals concerned and on society as a whole?
Should we try to make generalimprovements to the genetic make-up of human beings? Is there a central core of human nature with which we must not interfere?
This beautifully clear book is written for anyone who cares about the rights and wrongs of parents' choices for their children, anyone who is concerned about our human future. Glover handles these uncomfortable questions in a controversial but always humane and sympathetic manner.

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.