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:

• Explains legal, ethical and professional frameworks within which nurses practise
• Written in clear, accessible language
• Includes rights and responsibilities of nurses
• Offers insight into dilemmas faced by 21st century nurse

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.

Despite the massive scale of global inequalities, until recently few political philosophers or bioethicists addressed their ethical implications. Questions of justice were thought to be primarily internal to the nation state. Over the last decade or so, there has been an explosion of interest in the philosophical issues surrounding global justice. These issues are of direct relevance to bioethics. The links between poverty and health imply that we cannot separate questions of global health from questions about fair distribution of global resources and the institutions governing the world order. Similarly, as increasing numbers of medical trials are conducted in the developing world, researchers and their sponsors have to confront the special problems of doing research in an unjust world, with corresponding obligations to correct injustice and avoid exploitation. This book presents a collection of original essays by leading thinkers in political theory, philosophy, and bioethics. They address the key issues concerning global justice and bioethics from two perspectives. The first is ideal theory, which is concerned with the social institutions that would regulate a just world. What is the relationship between human rights and the provision of health care? How, if at all, should a global order distinguish between obligations to compatriots and others? The second perspective is from non-ideal theory, which governs how people should behave in the unjust world in which we actually find ourselves. What sort of medical care should actual researchers working in impoverished countries offer their subjects? What should NGOs do in the face of cultural practices with which they deem unethical? If coordinated international action will not happen, what ought individual states to do? These questions have more than theoretical interest; their answers are of direct practical import for policymakers, researchers, advocates, NGOs, scholars, and others. This book is the first collection to comprehensively address the intersection of global justice and bioethical dilemmas.

While scholars typically view Plato's engagement with medicine as uniform and largely positive, Susan B. Levin argues that from the Gorgias through the Laws, his handling of medicine unfolds in several key phases. Further, she shows that Plato views medicine as an important rival for authority on phusis (nature) and eudaimonia (flourishing). Levin's arguments rest on careful attention both to Plato and to the Hippocratic Corpus. Levin shows that an evident but unexpressed tension involving medicine's status emerges in the Gorgias and is explored in Plato's critiques of medicine in the Symposium and Republic. In the Laws, however, this rivalry and tension dissolve. Levin addresses the question of why Plato's rivalry with medicine is put to rest while those with rhetoric and poetry continue. On her account, developments in his views of human nature, with their resulting impact on his political thought, drive Plato's striking adjustments involving medicine in the Laws. Levin's investigation of Plato is timely: for the first time in the history of bioethics, the value of ancient philosophy is receiving notable attention. Most discussions focus on Aristotle's concept of phronesis (practical wisdom); here, Levin argues that Plato has much to offer bioethics as it works to address pressing concerns about the doctor-patient tie, medical professionalism, and medicine's relationship to society.

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.

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.

Current Legal Issues, like its sister volume Current Legal Problems, is based upon an annual colloquium held at University College London. Each year, leading scholars from around the world gather to discuss the relationship between law and another discipline of thought. Each colloquium examines how the external discipline is conceived in legal thought and argument, how the law is pictured in that discipline, and analyses points of controversy in the use, and abuse, of extra-legal arguments within legal theory and practice.
Law and Bioethics, the latest volume in the Current Legal Issues series, contains a broad range of essays by scholars interested in the interactions between law and bioethics. It includes studies examining the regulation of stem cell research, human rights and bioethics, the regulation of reproductive technologies, and distributive justice in healthcare and pandemic planning.

Biomedical ethics is a burgeoning academic field with complex and far-reaching consequences. Whereas in Western secular bioethics this subject falls within larger ethical theories and applications (utilitarianism, deontology, teleology, and the like), Islamic biomedical ethics has yet to find its natural academic home in Islamic studies.
In this pioneering work, Abdulaziz Sachedina - a scholar with life-long academic training in Islamic law - relates classic Muslim religious values to the new ethical challenges that arise from medical research and practice. He depends on Muslim legal theory, but then looks deeper than juridical practice to search for the underlying reasons that determine the rightness or wrongness of a particular action. Drawing on the work of diverse Muslim theologians, he outlines a form of moral reasoning that can derive and produce decisions that underscore the spirit of the Shari'a. These decisions, he argues, still leave room to revisit earlier decisions and formulate new ones, which in turn need not be understood as absolute or final. After laying out this methodology, he applies it to a series of ethical questions surrounding the human life-cycle from birth to death, including such issues as abortion, euthanasia, and organ donation.
The implications of Sachedina's work are broad. His writing is unique in that it aims at conversing with Jewish and Christian ethics, moving beyond the Islamic fatwa literature to search for a common language of moral justification and legitimization among the followers of the Abrahamic traditions. He argues that Islamic theological ethics be organically connected with the legal tradition of Islam to enable it to sit in dialogue with secular and scripture-based bioethics in other faith communities. A breakthrough in Islamic bioethical studies, this volume is welcome and long-overdue reading for anyone interested in facing the difficult questions posed by modern medicine not only to the Muslim faithful but to the ethically-minded at large.

In ancient Rome parents would consult the priestess Carmentis shortly after birth to obtain prophecies of the future of their newborn infant. Today, parents and doctors of critically ill children consult a different oracle. Neuroimaging provides a vision of the child's future, particularly of the nature and severity of any disability. Based on the results of brain scans and other tests doctors and parents face heart-breaking decisions about whether or not to continue intensive treatment or to allow the child to die. Paediatrician and ethicist Dominic Wilkinson looks at the profound and contentious ethical issues facing those who work in intensive care caring for critically ill children and infants. When should infants or children be allowed to die? How accurate are predictions of future quality of life? How much say should parents have in these decisions? How should they deal with uncertainty about the future? He combines philosophy, medicine and science to shed light on current and future dilemmas.

The Ethics of Sport explores moral issues that arise in sports, especially competitive athletics, in a manner that is accessible not only to sports fans or participants but also to those critical of sports or simply interested in an introduction to the kind of moral issues raised by the practice of athletics. The issues considered range from the more abstract, such as the importance that should be assigned to winning in sports, to specific controversies such as arguments over the use of performance enhancing drugs, the nature of gender equity, and the evaluation of violence in competition. The book explores different sides of these issues and suggests reasonable resolutions to the kinds of ethical questions prevalent in the practice of sports.

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.
In this book Miller and Truog undertake an ethical examination that aims to honestly face the reality of medical practices at the end of life. They expose the misconception that stopping life support merely allows patients to die from their medical conditions, and they dispute the accuracy of determining death of hospitalized patients on the basis of a diagnosis of "brain death" prior to vital organ donation. After detailing the factual and conceptual errors surrounding current practices of determining death for the purpose of organ donation, the authors develop a novel ethical account of procuring vital organs. In the context of reasonable plans to withdraw life support, still-living patients are not harmed or wronged by organ donation prior to their death, provided that valid consent has been obtained for stopping treatment and for organ donation.
Recognizing practical difficulties in facing the truth regarding organ donation, the authors also develop a pragmatic alternative account based on the concept of transparent legal fictions. In sum, Miller and Truog argue that in order to preserve the legitimacy of end-of-life practices, we need to reconstruct medical ethics.

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.
This volume brings together contributors from a wide variety of disciplines to take a critical, empirical look at bioethics around the globe, examining how it is being transformed - at both local and global levels - in this process of cross-cultural exporting and importing. One concern is to identify sociocultural forces and consequences which may positively or negatively affect ethics and social justice goals. This book thereby offers the first comparative anthropology and sociology of globalizing bioethics in the field, exploring the global dissemination, local adaptations, cultural meanings and social functions of bioethics theories, practices and institutions and comparing developed and developing countries.
The volume considers a full range of countries on every inhabited continent, including: Africa, Asia, Australia, Central and South America, Europe, the Middle East, and North America. Topics include government agendas such as nationalism and nation building; agendas of powerful, associated professions (e.g., medicine, law); theological and political agendas such as 'culture wars'; agendas of entrepreneurial economies of profit; and other cultural and ideological agendas consciously or unconsciously advanced or contested by bioethics work in particular countries based on their unique history, politics and culture. This cross-cultural exploration of globalizing bioethics will be of great interest to a field that is increasingly introspective about its underlying sociocultural assumptions and biases.

"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."
- Robert Veatch, Georgetown University
"This path-breaking volume is the first to explore the global export of Western bioethics to a variety of non-Western settings. Explicitly critical, the book also points to the liberating potential of bioethics to achieve social justice and improve the lives of patients around the world. The book is a must-read for all medical anthropologists interested in bioethics." - Marcia Inhorn, Yale University
"Bioethics Around the Globe should change the way bioethics is conceived and practiced in the U.S. and elsewhere. Its rich and wide-ranging comparative examination opens new possibilities for bioethical reflection. I enthusiastically recommend this wonderful book." - James F. Childress, University of Virginia
"The past 40 years have seen a remarkable spread of bioethics to every part of the world. Dr. Myser's collection is a wonderful and rich exploration of its international impact, revealing important similarities and differences from country to country. It will have an important impact." - Daniel Callahan, The Hastings Center

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.

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.

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