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Books > Medicine > General issues > Medical ethics
Healthcare delivery in the 21st century has become increasingly complex and demanding . Clinical consultations frequently raise scientific, ethical and legal challenges. While scientific issues may be resolved using an evidence-based medicine (EBM) approach, ethical theory is needed to justify decision making in the face of ethical conflict. Medical ethics, law and human rights: a South African perspective provides the conceptual background and analytic skills necessary to assist with the resolution of ethical dilemmas encountered in the South African healthcare environment. Medical ethics, law and human rights: a South African perspective uses case studies to help the healthcare team to identify and analyse ethical, moral and value concepts, and to apply these to scenarios that they may encounter on a daily basis. Part 1 explores theories and principles of ethics (including African philosophy), introduces medical law, discusses health and human rights, and also makes the transition from theory to practice. Part 2 looks at specific topics in healthcare that raise challenges from an ethics perspective - HIV/AIDS, use of social media, euthanasia, human reproduction, genetics and genomics. In view of the increasing emphasis on ethical considerations in healthcare from the Health Professions Council of South Africa (HPCSA), coupled with the rising incidence of litigation in healthcare, Medical ethics, law and human rights: a South African perspective is essential reading for health science, law and philosophy students as well as practising healthcare professionals.
Nurses are faced with questions related to professional practice and what they may or may not do on a daily basis. Nurses also need to deal with the many conflicting demands made by patients, colleagues and hospital management. The ‘new approach’ adopted in this book offers insight into the dilemmas faced by the 21st century nurse. The professional practice issues are addressed in the form of case studies, using real-life examples that put the problems into context. This approach also offers a broad view of the nursing profession, taking into account macro-environmental influences, as well as the new technologies impacting on the profession. A New Approach to Professional Practice explains the legal, professional and ethical framework within which the nurse must practise. The text also touches on the professional heritage and explains the rights of the patient and the rights and responsibilities of the nurse. Subjects such as modern-day challenges, legal and ethical questions, accountability, duty to care, responsibility, and maintenance of standards are also addressed. Key Features:
Clinical Ethics at the Crossroads of Genetic and Reproductive Technologies offers thorough discussions on preconception carrier screening, genetic engineering and the use of CRISPR gene editing, mitochondrial gene replacement therapy, sex selection, predictive testing, secondary findings, embryo reduction and the moral status of the embryo, genetic enhancement, and the sharing of genetic data. Chapter contributions from leading bioethicists and clinicians encourage a global, holistic perspective on applied challenges and the moral questions relating the implementation of genetic reproductive technology. The book is an ideal resource for practitioners, regulators, lawmakers, clinical researchers, genetic counselors and graduate and medical students. As the Human Genome Project has triggered a technological revolution that has influenced nearly every field of medicine, including reproductive medicine, obstetrics, gynecology, andrology, prenatal genetic testing, and gene therapy, this book presents a timely resource.
Hospice care is one of the fastest-growing segments of the U. S. healthcare system, a trend that is expected to accelerate as the median age of the population continues to rise over the next three decades. Despite over forty percent of the population now dying while on hospice care, very little has been published on the ethical opportunities and challenges experienced in the everyday lives of those giving and receiving hospice care. This book is the first comprehensive collection devoted to analyzing distinctive ethical issues arising in the delivery of hospice care and designed to promote best ethical practices for hospice care professionals and organizations. Thirteen newly commissioned chapters by seventeen hospice experts populate three thematic sections of the book, each devoted to an aspect of the intersection between ethics and hospice care. Contributors have unique qualifications and abilities to articulate and respond to ethically significant phenomena that - while not always unique to hospice care - arise in especially poignant and complex ways when caring for patients enrolled in hospice. As the shift or return to home-based care at the end of life continues, hospice professionals and programs will be faced with a broader array of terminal illnesses, cultural beliefs and traditions, and patient and family values than ever before. Hospice will no longer be tailored solely to the final stage of cancer, but will need to accommodate patients whose illnesses are variable in their progression and whose treatment plans include many medical options. The ethical orientations and frameworks that have served hospice for the past 50 years will need to be supplemented and refined if hospice is to fulfill this changing social mission. Hospice Ethics explores a new paradigm for hospice ethics from a multi-disciplinary and provides an important educational resource for professional training in end of life care.
The philosopher Henry Richardson's short book is a defense of a position on a neglected topic in medical research ethics. Clinical research ethics has been a longstanding area of study, dating back to the aftermath of the Nazi death-camp doctors and the Tuskegee syphilis study. Most ethical regulations and institutions (such as Institutional Review Boards) have developed in response to those past abuses, including the stress on obtaining informed consent from the subject. Richardson points out that that these ethical regulations do not address one of the key dilemmas faced by medical researchers - whether or not they have obligations towards subjects who need care not directly related to the purpose of the study, termed 'ancillary care obligations'. Does a researcher testing an HIV vaccine in Africa have an obligation to provide anti-retrovirals to those who become HIV positive during the trial? Should a researcher studying a volunteer's brain scan, who sees a possible tumor, do more than simply refer him or her to a specialist? While most would agree that some special obligation does exist in these cases, what is the basis of this obligation, and what are its limits? Richardson's analysis of those key questions and the development of his own position are at the heart of this book, which will appeal to bioethicists studying research ethics, to policy makers, and to political and moral philosophers interested in the obligations of beneficence, one of the key issues in moral theory.
According to popular belief, technical skill is far more important for surgeons than thoughtful deliberation. Nothing could be further from the truth. Although surgeons must sometimes make decisions rapidly on the basis of incomplete evidence and must respond to unexpected catastrophes in the operating room rapidly, those events are intermittent - most of the time surgeons deliberate on diagnostic problems and thoughtfully manage postoperative care, which is often intellectually challenging. The relationship of surgeons with their patients is, in a real sense, far more intimate and trusting than that of any other professional, a claim that is supported by the fact that patients surrender their bodies to their surgeons in a state of total helplessness and vulnerability when they undergo anesthesia. Because of that responsibility, no other professional group has a greater sense of dedication to the welfare of their patients than surgeons. Surgical culture is deeply steeped in ethics, and surgeons confront and resolve ethical dilemmas as much or more than most other professionals, although they often may not recognize the situations they resolve are problems in ethics - they are just part of the daily routine. This book is a compendium of articles from the recent surgical literature that address ethical issues chosen by surgeons because they are controversial and pertinent to the practice of surgery. The reader will not find a great deal of sophisticated dissection of fine philosophical distinctions in these discussions of ethical conflicts and controversies in surgery. Instead, they will discover differing viewpoints from thoughtful essayists, mostly surgeons, whose feet are firmly in contact with the ground and who have extensive experience in the real world of surgery, medicine, and law.
Decisions about life-sustaining treatment are often ethically challenging for patients, surrogate decision-makers, and health care professionals. Providing safe, effective, and compassionate care near the end of life is a priority for health care organizations. In times of uncertainty, crisis, or reflection, and in efforts to improve health care for seriously ill patients, guidelines can help. This is the first updated, expanded edition of The Hastings Center's 1987 Guidelines on the Termination of Life-Sustaining Treatment and Care of the Dying, which shaped the ethical and legal framework for decision-making on treatment and end-of-life care in the United States. The new edition, the product of an authoritative consensus process, incorporates 25 years of research, innovation, and developments in law and policy. It summarizes the current framework for making good decisions about treatment and care and identifies educational and organizational goals for health care systems. It covers care planning, decision-making for adults and for children, care transitions, the determination of death, and the policies and processes that support good care at the bedside. It also addresses the psychological and social dimensions of care near the end of life, with attention to effective communication with patients and loved ones and among team members. This book is written for physicians, nurses, and other clinicians in hospitals, nursing homes, home care, and hospice. It is structured for ease of reference during difficult clinical situations and includes extensive practical recommendations supported by print and online resources. This book is also essential reading for clinical ethicists, ethics committee members, health lawyers, and medical and nursing directors. As the U.S. confronts the challenges of health care reform, an aging population, increasing technological capacity to extend life, and serious cost implications, The Hastings Center Guidelines are invaluable to educators, scholars, and policymakers.
On August 5, 2010, a cave-in left thirty-three Chilean miners trapped underground. The Chilean government embarked on a massive rescue effort that is estimated to have cost between ten and twenty million dollars. There is a puzzle here. Many mine safety measures that would have been more cost effective had not been taken in Chile earlier, either by the mining companies, the Chilean government or by international donors. The Chilean story illustrates a persistent puzzle: the identified lives effect. Human beings show a greater inclination to assist persons and groups identified as those at high risk of great harm than to assist persons and groups who will suffer - or already suffer - similar harm but are not identified as yet. The problem touches almost every aspect of human life and politics: health, the environment, the law. What can social and cognitive sciences teach us about the origin and triggers of the effect? Philosophically and ethically, is the effect a "bias" to be eliminated or is it morally justified? What implications does the effect have for health care, law, the environment and other practice domains? This volume is the first book to tackle the effect from all necessary perspectives: psychology, public health, law, ethics, and public policy.
In Death, Dying, and Organ Transplantation: Reconstructing Medical
Ethics at the End of Life, Miller and Truog challenge fundamental
doctrines of established medical ethics. They argue that the
routine practice of stopping life support technology in hospitals
causes the death of patients and that donors of vital organs
(hearts, lungs, liver, and both kidneys) are not really dead at the
time that their organs are removed for life-saving transplantation.
These practices are ethically legitimate but are not compatible
with traditional rules of medical ethics that doctors must not
intentionally cause the death of their patients and that vital
organs can be obtained for transplantation only from dead donors.
Health research has made spectacular strides over the past few decades. The value of health research is obvious and irrefutable. What is not so apparent is that people who participate in research may be harmed during the process. Africa prides itself in having some of the most respected universities globally. It is a continent of immense research potential. At the same time, Africa suffers from many of the health burdens of low-income regions. While it affords many research opportunities, this creates the potential for the misuse of power on vulnerable individuals and populations. This book explores why participants in health research require protection. It also explains how ethical principles and the law can assist inter alia research ethics committees, researchers, funders and institutions at which research is conducted, to safeguard the rights and dignity of individuals contributing to the research enterprise. It engages with this imbalance and examines how well-intentioned aims of ethical health research can be achieved while simultaneously maximising the protection of research participants. It draws on local and international documents and expertise to inform the resolution of many ethical dilemmas and complexities that inevitably arise in health research. Health Research Ethics: Safeguarding the Interests of Research Participants provides a solid understanding of the normative values for protecting research participants against exploitation, harm and wrong. Since research ethics is multidisciplinary, this book will be of value to a range of professionals and academics inter alia those from the health sciences, social sciences, and legal disciplines.
Contemporary bioethics, now roughly 40 years old as a discipline,
originated in the United States with a primarily Anglo-American
cultural ethos. It continues to be professionalized and
institutionalized as a maturing discipline at the intersections of
philosophy, medicine, law, social sciences, and humanities.
Increasingly bioethics - along with its foundational values,
concepts and principals - has been exported to other countries, not
only in the developed West, but also in developing and/or Eastern
countries. Bioethics thus continues to undergo intriguing
transformations as it is globalized and adapted to local cultures.
These processes have occurred rapidly in the last two decades, with
relatively little reflection and examination. "At last-an unabashedly sociological and anthropological look at
the globalization of bioethics, a really fresh approach to a
maturing discipline. The chapters speak from the perspective of
sophisticated Western-developed exporters of the bioethical
paradigm and equally sophisticated] Eastern-developing and
third-world and interdisciplinary critics suspicious of the
canonical view. Trained in the dominant school of American,
mainstream philosophy, Myser draws on her long-standing commitment
to a social and cultural approach to bioethics to take a fresh look
at bioethics globally. She grasps the globalization of bioethics
and the skepticism about analytical philosophy's Americanized
consensus. The book sets the stage for a new era in bioethics
theory and practice {debating] whether a universal common morality
underlies the rich variation in national and cultural bioethics
traditions."
As a critical examination of the pervasive tension existing between defensive medicine and good, ethical patient care, this book investigates the impact of legalities on medical treatment. Physicians today are apprehensive about the threat of malpractice suits. Kapp explores the extent to which this fear is justified. He examines where physicians get their ideas about what the law forbids and requires, how physicians' perceptions of the law and medicine affect medical care, and whether these behavioral manifestations benefit or hurt a physician's ability to practice ethically. Kapp then suggests ways medical professionals can resolve tension caused by conflicting demands and encourage more ethical care.
From preeminent LGBTQ scholar, social critic, and journalist Steven W. Thrasher comes a powerful and crucial exploration of one of the most pressing issues of our times: how viruses expose the fault lines of society. Having spent a ground-breaking career studying the racialization, policing, and criminalization of HIV, Dr. Thrasher has come to understand a deeper truth at the heart of our society: that there are vast inequalities in who is able to survive viruses and that the ways in which viruses spread, kill, and take their toll are much more dependent on social structures than they are on biology alone. Told through the heart-rending stories of friends, activists, and teachers navigating the novel coronavirus, HIV, and other viruses, Dr. Thrasher brings the reader with him as he delves into the viral underclass and lays bare its inner workings. In the tradition of Isabel Wilkerson’s Caste and Michelle Alexander’s The New Jim Crow, The Viral Underclass helps us understand the world more deeply by showing the fraught relationship between privilege and survival.
Medicine and Money: A Study of the Role of Beneficence in Health Care Cost Containment is a frank discussion of the moral problems associated with the need to control health care costs. The book provides a base for physicians to address these concerns and examines the events leading to America's current health care crisis, diminishing beneficence. After a brief definition of the problem, Frank H. Marsh and Mark Yarborough continue by describing the threat of cost containment and justifying beneficence-based health care system. Special importance is given to Medicine and Money by the lengthy suggestions on implementing beneficence in the health care system. Marsh and Yarborough address the problem of eroding morality and rising cost concerns of our present health care system. They argue that if the central role of beneficence is abandoned, the medical profession will be unable to properly meet the challenge it faces. Medicine and Money divides its argument into two sections. In the first section, the current crisis in health care is examined and a justification for beneficence is given. The second section describes how beneficence can be implemented in the health care system as a means to control health care costs. Medicine and Money is written for every member of the medical and philosophical communities.
Oral health care professionals are becoming increasingly aware that almost every clinical consultation raises scientific, ethical and legal challenges. While scientific challenges may be resolved using an evidence-based medicine (EBM) approach, moral complexity must be resolved using ethical theory to justify decision making in the face of ethical conflict. Ethics and the dental team, the first title of its kind in South Africa, provides the theoretical background necessary for the resolution of ethical dilemmas. Ethics and the dental team uses case studies to demonstrate how to identify, analyse and apply ethical, moral and value concepts to scenarios that are encountered on a daily basis.
Currently, there is a critical need to integrate diversity and inclusion into health professions curricula and to diversify educators' approaches to teaching. The COVID-19 pandemic has most recently highlighted the systemic barriers that exist for our most vulnerable patients. To address these inequities, it is important to promote diversity and inclusion in thought, practice, and curricular content. Social and cultural experiences uniquely influence the learning experience, so a plurality of perspectives should be represented in educational material and seen in the classroom. Cases on Diversity, Equity, and Inclusion for the Health Professions Educator serves as a tool to enhance the structure and competencies of learners in health professions. This case book engages both learners and educators in health professions in robust discussions that serve to enhance awareness and knowledge around these issues with the expectation that knowledge will translate into practices that eventually reduce health inequities. Covering topics such as ableism, barriers to healthcare access, and mental health stigma, this case book is an indispensable resource for health professionals, educators and students in the health professions, hospital administrators, medical librarians, sociologists, government officials, researchers, and academicians.
Improving quality of life is one of the main advantages of integrating new innovations into medicine. New technologies are revolutionizing medicine and opening new opportunities for patients, doctors, clinics, and companies. The patient's well-being is monitored autonomously by smartphones, digital medical records simplify everyday clinical work, virtual reality is used for treatment, and robots help in the operating room. The new technological possibilities in healthcare not only change patients' lives, but also the work of doctors, clinics, and companies. In the fields of healthcare and medicine, new technologies can be used for patient communication, health monitoring, or for the treatment of patients, and modern research is devoted to advancing and understanding these technologies. Ethical Implications of Reshaping Healthcare With Emerging Technologies includes the most up-to-date research in the fields of healthcare and medicine worldwide, provides answers to the forms of treatment that are already possible in medicine, and illuminates the future possibilities that are already being researched. In addition, today's knowledge is translated and shown in how new technologies such as autonomous VR-system can be used for pain reduction as part of a treatment. Finally, this book examines the ethical guidelines in healthcare and medicine that are associated with the rapid development of these technologies. This book will be useful for the healthcare industry, hospital administration, the health insurance industry, doctors, healthcare workers, business professionals, IT specialists, medical software designers, scientists, practitioners, researchers, academicians, and students looking for the latest information on the use of emerging technologies in healthcare settings.
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