Ectogenesis refers to the artificial gestation of a fetus outside the womb. Despite certain advantages for women's reproductive liberty, feminist groups remain divided regarding this technology. This book argues that reproduction imposes unjust burdens on women, and thus the ideals of equal opportunity demand continued research into ectogenesis.

The whole field of drug research has become a minefield of sensitive issues with the opponents entrenched at opposite extremes taking pot shots at each other. The attacks made on drug research and the pharmaceutical industry in particular have become so venomous that an attempt needed to be made to provide a balanced ethical appraisal of the situation. Neither pro- nor antagonists are fully right, but some common grounds need to be found. The author believes that this commons grounds resides in the religious and philosophical foundations on which western industrial society has been built.

This book addresses the pressing issues involved with the ethical conduct of research in one developing world region - the Arab Region. Clinical research has soared in the developing world -as pharmaceutical companies continue their search for regions with large, treatment naive populations - including the Arab region, and has profound implications for the health and the economies for the area. The ethical issues involved with the conduct of such research, however, have so far not been adequately addressed. This volume presents the issues regarding research ethics and research governance that have relevance for health authorities, regulators, industry, and academia. As a multi-authored volume it includes both international and local experts on ethical issues in research, representing all stakeholders, thus presenting a balanced view on this timely topic.

This collection addresses whether ethicists, like authorities in other fields, can speak as experts in their subject matter. Though ethics consultation is a growing practice in medical contexts, there remain difficult questions about the role of ethicists in professional decision-making. Contributors examine the nature and plausibility of moral expertise, the relationship between character and expertise, the nature and limits of moral authority, how one might become a moral expert, and the trustworthiness of moral testimony. This volume engages with the growing literature in these debates and offers new perspectives from both academics and practitioners. The readings will be of particular interest to bioethicists, clinicians, ethics committees, and students of social epistemology. These new essays promise to advance discussions in the professionalization and accreditation of ethics consultation.

Dr. James Hansen's vision and insight regarding the nature of the health care crisis evolved from positions of medical staff leadership, teaching, participating in the governance process, and developing a free clinic. These positions, together with his 35 years as a consulting physician, presented him with the opportunity to view physician behavior and its impact both on patients and upon health care in general. These observations crystallized his conclusion that the essence of successful health care springs from the physician-patient relationship. Dr. Hansen received his undergraduate degree from Vanderbilt University. He then attended the University of Southern California School of Medicine where he received his MD in 1965. His post graduate training in internal medicine occupied the next four years at the Los Angeles County-USC Medical Center. After a three year stint in the Army he returned to Wadsworth VA-UCLA for a fellowship in gastroenterology. Dr. Hansen is certified by the American Board of Internal Medicine, the American Board of Gastroenterology, a Fellow of the American College of Physicians, and a Clinical Professor of Internal Medicine at the University of California, Davis School of Medicine. He has been in private practice since 1973. He was appointed to the Mercy Healthcare Board of Trust in 1988, serving in that capacity for three years. He served as chief-of-staff for both American River Hospital and Mercy San Juan Hospital from 1990-1993 and was actively engaged in consolidating the medical. staffs of those two hospitals which merged in 1993. He was the chairman of the Physician Leadership Group for the 5-hospital Mercy Healthcare Sacramento system from 1995-1998 during a period of hospital redesign. Dr. Hansen was actively involved in teaching at UC Davis, School of Medicine for nearly 20 years as a voluntary clinical faculty person. In 1994 he helped develop a free clinic in Sacramento and became its medical director until moving to Maui in 2001. Dr. Hansen has been in the private practice of gastroenterology in Maui since 2001. Dr. Hansen's unique perspective as a practicing physician, physician leader, and medical educator provides the perspective and passion for his quest of the root cause and cure of the health care crisis. This book offers a solution for the health care crisis, which focuses on the need for a grass level approach and revolution led by the citizenry.

Walton offers a comprehensive, flexible model for physician-patient decision making, the first such tool designed to be applied at the level of each particular case. Based on Aristotelian practical reasoning, it develops a method of reasonable dialogue, a question- and-answer process of interaction leading to informed consent on the part of the patient, and to a decision--mutually arrived at--reflecting both high medical standards and the patient's felt needs. After setting forth his model, he applies it to three vital ethical issues: acts of omission, the cessation of treatment, and possible side effects of treatments. In the final chapter, Walton shows how his method functions in light of the real-life complexities of the clinical encounter and how it bears on ethical questions concerning health-care policy, attitudes toward treatment and toward the medical profession, reasonableness of expectations, and the setting of realistic goals of treatment.

This volume consists of fourteen chapters selected from papers presented at the conference Ethics, Medicine and Health Care: An Appraisal of the Thought of H. Tristram Engelhardt, Jr.' along with a response to those chapters by Engelhardt and a Foreword by Laurence B. McCullough. The chapters direct primary attention to various aspects of Engelhardt's philosophy of medicine and bioethics as presented in The Foundations of Bioethics and Bioethics and Secular Humanism: The Search for a Common Morality. Among the topics treated are the economics of health care and the medical profession, the libertarian and communitarian aspects of Engelhardt's thought, the moral status of children, abortion, the moral foundations for a health care system, feminism and clinical epistemology, and the relation between secular and religious moralities. In response to the various challenges posed by the authors, Engelhardt considers the implications of the failure of the modern philosophical project, the role of reason in ethics, and the resolution of conflict among communities that do not share the same moral vision. The book will be of interest to professionals in medicine, philosophy, theology, health policy, and law, and to graduate students in those disciplines.

"Personalist Bioethics" calls us to reflect on the intimate meaning of human existence and the social environment, going beyond any specific religious perspective and invoking human reason. It advances a metaphysics that is rationally grounded in philosophical anthropology and has a broad range of ethical applications for professors of bioethics, members of ethics committees, bioethics students, and those interested in the field in general, whether in medicine, law, or philosophy. Readers will find a presentation and discussion of the basic contours of personalist bioethics, comparisons of personalism with other philosophical positions, and ethical investigations of particular topics, ranging from genetic engineering to euthanasia. Translated by John A. Di Camillo and Michael J. Miller.

New developments in science and technology have resulted in shifting ethical challenges in many areas including in genomics research. This book enables those who are involved in genomics research, whether as researcher, participant or policy maker, to understand the ethical issues currently developing in this field and to participate actively in these important debates. A clear account is given of how science and technology are outstripping the capacity of previous ethical regulations to cope with current issues, together with practical illustrations of possible ways forward. Key ethical ideas are presented, drawing on the history of research regulation and on an account of the particular challenges arising in the field of genomics. The book uses a grounded, practical approach to explaining ethical concepts and issues which is geared to enhancing interdisciplinary dialogue. Its broad approach to ethical issues includes relevant considerations from social psychology and there is a particular emphasis on understanding the problems of ethical regulations and practice in the institutional and social context of research. A glossary and numerous text boxes explaining relevant terms and key ideas help to make the work an invaluable resource for both beginners and experts in the field.

This is a collection of Ruth Macklin's previously published articles that appeared in scholarly journals or as chapters in books. Dr. Macklin's pioneering work in ethics and global health spans more than two decades. The articles in this volume range from a chapter in a book published in 1989 to a journal article currently in press. The essays fall into two broad categories: policy and practice, and multinational research. Topics in the first category include cultural beliefs and attitudes regarding family planning, long-acting contraception, abortion, and more broadly, policies and practices affecting women's health. Two essays dealing with justice focus on HIV/AIDS: how developing country governments might distribute medications fairly to all who are in need; and what obligations do industrialized countries and world leaders have to provide affordable medications to developing countries. A theme that runs throughout the essays is a defense of the universality of ethical principles, despite cultural differences that exist around the globe. The section on multinational research includes articles on international ethics guidance documents, such as the Declaration of Helsinki; discussion of the obligations of researchers and sponsors when they conduct research in developing countries; what constitutes exploitation when research is conducted in resource-poor countries; and, as in the first section of the book, the application of universal ethical principles to the global research enterprise. The author criticizes the view that double standards in research are acceptable: one standard for rich countries, and a lower standard for developing countries. Several essays deal with sensitive and controversial ethical aspects of research on reproductive health and HIV/AIDS.

With increasing urgency, decisions about the digitalized future of healthcare and implementations of new assistive technologies are becoming focal points of societal and scientific debates and addresses large audiences. Decisions require a careful weighing of risks and benefits and contextualizing in-depth ethical analysis with robust empirical data. However, up to now, research on social assistive technologies is mostly dispersed over different academic fields and disciplines. A comprehensive overview on discussions regarding values at stake and ethical assessment of recent developments especially in healthcare is largely missing. This publication initiates an interdisciplinary discourse on ethical, legal and social implications of socially assistive technologies in healthcare. Contributions include perspectives from nursing science, social sciences, philosophy, medical ethics, economics and law to present an - to our knowledge - first and comprehensive overview on different aspects of the use and implementation of socially assistive technologies from an ethical perspective. It combines practically relevant insights and examples from current research and development with ethical analysis to uncover exemplary moral tipping points between promotion of participation or well-being and risks and damages to these values. Healthcare professionals involved in implementation of smart technologies as well as scholars from the field of humanities, nursing and medicine, interested in the discussions on ethics and technology in healthcare, will benefit from this new contribution. The publication is part of the international DigitAs conference "Aging between Participation and Simulation - Ethical Dimensions of Socially Assistive Technologies" held at the Institute of Medical Ethics and History of Medicine (Ruhr University Bochum) from 4 February to 8 February 2019. Within this framework, twelve young scholars were invited to discuss their contributions with renowned experts in the field. The Institute of Medical Ethics and History of Medicine is one of the leading institutes in empirically informed ethical analysis in healthcare and medicine and is a member of the European Association of Centres of Medical Ethics (EACME).

Empirical studies of life science research and biotechnologies in Asia show how assemblages of life articulate bioethics governance with global moralities and reveal why the global harmonization of bioethical standards is contrived.

Lisa Bellantoni argues that contemporary bioethics divides into two logically incommensurable positions: a cult of rights, which identifies the worth of human life with our autonomy, and a cult of life, which identifies human worth with the possession of a soul, and thereby, of human dignity.

This open access book about the Zadeh Project demonstrates and explores a core question in clinical ethics: how can ethics consultants be accountable in the face of a robust plurality of ethical standpoints, especially those that underwrite practices and methods for doing ethics consultation as well as those viewpoints and values encountered in daily clinical ethics practice? Underscoring this question is the recognition that the field of clinical ethics consultation has arrived at a crucial point in its maturation. Many efforts are underway to more formally "professionalize" the field, with most aimed toward stabilizing a specific set of institutional considerations. Stretched between these institutional and practical initiatives resides a crucial set of of ethical considerations, chief among them the meaning and scope of responsibility for clinical ethics consultants. Developed around a long-form case scenario, the Zadeh Project provides a multi-layered series of "peer-reviews": critique of the actions of the case scenario's ethics consultant; reflection on clinical ethics method; examination of the many ways that commitments to method and practice can, and do, intersect, overlap, and alter one another. The design and format of this book thus models a key element for clinical ethics practice: the need and ability to provide careful and thoughtful explanation of core moral considerations that emerge among diverse standpoints. Specifically designed for those studying to become and those who are ethics consultants, this book, with its innovative and multi-layered approach, allows readers to share a peer-review-like experience that shows accountability to be what it is, an ethical, not merely procedural or administrative, undertaking.

The human microbiome is the bacteria, viruses, and fungi that cover our skin, line our intestines, and flourish in our body cavities. Work on the human microbiome is new, but it is quickly becoming a leading area of biomedical research. What scientists are learning about humans and our microbiomes could change medical practice by introducing new treatment modalities. This new knowledge redefines us as superorganisms comprised of the human body and the collection of microbes that inhabit it and reveals how much we are a part of our environment. The understanding that microbes are not only beneficial but sometimes necessary for survival recasts our interaction with microbes from adversarial to neighborly. This volume explores some of the science that makes human microbiome research possible. It then considers ethical, legal, and social concerns raised by microbiome research. Chapters explore issues related to personal identity, property rights, and privacy. The authors reflect on how human microbiome research challenges reigning views on public health and research ethics. They also address the need for thoughtful policies and procedures to guide the use of the biobanked human samples required for advancing this new domain of research. In the course of these explorations, they introduce examples from the history of biomedical science and recent legal cases that shed light on the issues and inform the policy recommendations they offer at the end of each topic's discussion. This volume is the product of an NIH Human Microbiome Project grant. It represents three years of conversations focused on consensus formation by the twenty-seven members of the interdisciplinary Microbiome Working Group. "The microbiome is a relatively new area of medical attention. Ethical issues related to the microbiome have barely been identified, much less carefully analyzed. This volume is an excellent start toward that ethical analysis. Many of the arguments are persuasive and provocative. In particular, some contributors challenge the ethical need for anonymizing microbiome specimens as well as the need for individual informed consent for specific uses of these specimens. I highly recommend this volume for all those interested in the microbiome and in new frontiers in medical ethics." -Leonard M. Fleck, Michigan State University

Patricia Rosier died at her home in Fort Myers, Florida, in January of 1986, having sought the help of her prominent physician husband, Peter, to end her cancer-ravaged life with some measure of dignity. By November 1987, Peter had been indicted for first degree murder and faced death in Florida's electric chair. How could it happen? How does a loving husband and father get charged with first degree murder? This compelling true story shows just how easy it is in America's legal system. "Euthanasia" remains a crime in Florida and in most other states, yet the majority of such "criminals" are never prosecuted. But Dr. Rosier was singled out because he "confessed", both in a television interview and in writing, to believing in euthanasia and to assisting his wife's suicide. In Murder of Mercy every heart-pounding moment of Dr. Rosier's legal ordeal is vividly captured by famed trial attorney Stanley M. Rosenblatt, who, together with his wife and law partner, Susan, represented the accused. Describing an intriguing array of legal twists and turns, this riveting book is more than just gripping courtroom drama. Find out why Patricia's father and brothers sought immunity before they would testify. Feel the rush, the exhilaration, of planning defense strategy: How could anyone explain away Dr. Rosier's confessions? Could the Fort Myers judge be persuaded to change the location of the trial? Should Peter Rosier testify in his own defense? The powerful arguments of the State and the defense are laced with ridicule, sarcasm, and scorn: each side accusing the other of treacherous character assassination. Rosenblatt's penetrating assessment of judges, the use of expert witnesses, the exclusion ofrelevant evidence, attorney-client privilege, and the granting of immunity serve as the foundation for a searing critique of America's criminal justice system and the society it is designed to protect.

This volume addresses some of the most prominent questions in contemporary bioethics and philosophy of medicine: 'liberal' eugenics, enhancement, the normal and the pathological, the classification of mental illness, the relation between genetics, disease and the political sphere, the experience of illness and disability, and the sense of the subject of bioethical inquiry itself. All of these issues are addressed from a "continental" perspective, drawing on a rich tradition of inquiry into these questions in the fields of phenomenology, philosophical hermeneutics, French epistemology, critical theory and post-structuralism. At the same time, the contributions engage with the Anglo-American debate, resulting in a fruitful and constructive conversation that not only shows the depth and breadth of continental perspectives in bioethics and medicine, but also opens new avenues of discussion and exploration. For decades European philosophers have offered important insights into the relation between the practices of medicine, the concept of illness, and society more broadly understood. These interventions have generally striven to be both historically nuanced and accessible to non-experts. From Georges Canguilhem's seminal The Normal and the Pathological, Michel Foucault's lectures on madness, sexuality, and biopolitics, Hans Jonas's deeply thoughtful essays on the right to die, life extension, and ethics in a technological age, Hans-Georg Gadamer's lectures on The Enigma of Health, and more recently Jurgen Habermas's carefully nuanced interventions on the question of liberal eugenics, these thinkers have sought to engage the wider public as much as their fellow philosophers on questions of paramount importance to current bioethical and social-political debate. The essays contained here continue this tradition of engagement and accessibility. In the best practices of European philosophy, the contributions in this volume aim to engage with and stimulate a broad spectrum of readers, not just experts. In doing so the volume offers a showcase of the richness and rigor of continental perspectives on medicine and society.

This book provides an assessment of some ethical implications of increasing life spans. Taking as a starting point the idea that to increase longevity is a form of medical enhancement, it examines the value of living longer; the means for extending life spans; the consequences of greater longevity for the fair distribution of resources and healthcare in particular.

Biobank research and genomic information are changing the way we look at health and medicine. Genomics challenges our values and has always been controversial and difficult to regulate. In the future lies the promise of tailored medical treatments and pharmacogenomics but the borders between medical research and clinical practice are becoming blurred. We see sequencing platforms for research that can have diagnostic value for patients. Clinical applications and research have been kept separate, but the blurring lines challenges existing regulations and ethical frameworks. Then how do we regulate it? This book contains an overview of the existing regulatory landscape for biobank research in the Western world and some critical chapters to show how regulations and ethical frameworks are developed and work. How should international sharing work? How design an ethical informed consent? An underlying critique: the regulatory systems are becoming increasingly complex and opaque. The international community is building systems that should respond to that. According to the authors in fact, it is time to turn the ship around. Biobank researchers have a moral responsibility to look at and assess their work in relation to the bigger picture: the shared norms and values of current society. Research ethics shouldn't only be a matter of bioethicists writing guidelines that professionals have to follow. Ethics should be practiced through discourse and regulatory frameworks need to be part of that public discourse. Ethics review should be then not merely application of bureaucracy and a burden for researchers but an arena where researchers discuss their projects, receive advice and practice their ethics skills.

This book examines the position of children who provide tissue to potentially save the life of another. It questions whether child donors of all ages have been treated appropriately and whether they are sufficiently protected in acting as tissue donors, and ultimately considers whether a new regulatory response is needed to benefit donor children. The book couples a legal exposition of the donor child's position with the medico-ethical reality of clinical practice. In recent years, a growing body of literature concerning the clinical experiences and outcomes for child donors has emerged. This book adds to this by examining another dimension - the regulatory frameworks at play. It examines the ethical arguments for and against children acting as tissue donors and provides an original analysis of the legal and non-legal regulatory frameworks governing children's participation in the United Kingdom, United States and Australia. It combines these doctrinal and theoretical approaches with insights into clinical practice gained from the results of qualitative research conducted with health professionals. The analysis inevitably explores the more general issues of children's right to make medical decisions, the role of parents in decision-making, the value of the best interests test and alternative (legal and ethical) standards, rights of participation of children before the courts, and the role of law and other forms of regulation in a clinical context.

Shocked by the fact that, in the Netherlands, psychiatric patients are considered potentially appropriate candidates for physician-assisted suicide, Olevitch examines the research and data and finds that, even in the United States, the situation is threatening. She describes how the rhetoric of the assisted-suicide movement can confuse potential suicide victims and their helpers, and how surrogate medical decisions are a growing threat in the lives of incompetent patients. Olevitch argues the assisted-suicide movement is based not on the level-headed realism its advocates claim, but on a lack of information about up-to-date ways of bringing about psychological wellness, on a misguided panic about finances, a phobic view of medical procedures, a lack of understanding of the support needed by average medical patients, and a misguided belief in superficial safeguards.

Olevitch describes how Rational Emotive Behavior Therapy and Cognitive Behavior Therapy can be used to help terminally ill or disabled people overcome their profound depression. Another cognitive focus is added as she presents material answering questions including what patients are really thinking when they request assisted suicide or when they decline medical procedures. Well-known psychologist Albert Ellis says of the volume, Carefully read this unusual book and see how it can be useful to you, whether you are a physician, a mental health professional, or an unfortunate patient

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.

This volume brings together a set of critical essays on the thought of Professor Doctor H. Tristram Engelhardt Junior, Co-Founding Editor of the Philosophy and Medicine book series. Amongst the founders of bioethics, Professor Engelhardt, Jr. looms large. Many of his books and articles have appeared in multiple languages, including Italian, Romanian, Portuguese, Spanish, and Chinese. The essays in this book focus critically on a wide swath of his work, in the process elucidating, critiquing, and/or commending the rigor and reach of his thought. This volume compasses analyses of many different aspects of Engelhardt's work, including social and political philosophy, biopolitics, the philosophy of medicine, and bioethics. It brings together internationally known scholars to assess key elements of Engelhardt's work.

This book discusses and provides insight on the legal and ethical dilemmas of managing those with Fetal Alcohol Spectrum Disorder (FASD). This book provides a clear perspective for those clinicians and legal professionals who are working with those with this disorder, and correspondingly increases their understanding when arranging effective supports for this population. Historically, the primary focus on FASD has been on children. However, this is a lifelong disorder and the implications of this disorder become even more prominent and complex in adulthood. Those with this condition can struggle with impulsiveness, and a host of cognitive difficulties. This correspondingly impacts their independence and employability, and produces an elevated risk for homelessness and other residential issues, involvement in substance use, being exploited, development of behavioural issues, and subsequent legal difficulties. Their cognitive difficulties result in challenges for legal systems around the world to understand their issues, and to design appropriate remedial strategies, recommendations for treatments and supports, and even for understanding the failure of many of these individuals to be able to change their behaviours effectively. This produces various legal and ethical dilemmas, which are discussed in detail in this volume by 28 authors from Europe, New Zealand and North America. These include discussions regarding the rights of the unborn child, the alcohol industry's duty to warn, whether small amounts of alcohol during pregnancy can be condoned, and even the current use of involuntary hospitalization for addicted mothers. Other chapters discuss the need for training on FASD for front line officers, use of lies during interrogation of those with FASD, medical and legal interventions for offenders with FASD, access to diagnostic services and follow-up supports, and whether FASD can be considered a mitigating factor for sentencing. Furthermore, caregivers also provide their stories regarding the daily dilemmas that are faced in raising those with FASD.