Organ shortage is an ongoing problem in many countries. The needless death and suffering which have resulted necessitate an investigation into potential solutions. This examination of contemporary ethical means, both practical and policy-oriented, of reducing the shortfall in organs draws on the experiences of a range of countries. The authors focus on the resolution and negotiation of ethical conflict, examine systems approaches such as the 'Spanish model' and the US Breakthrough Collaboratives, evaluate policy proposals relating to incentives, presumed consent, and modifications regarding end-of-life care, and evaluate the greatly increased use of (non-heart-beating) donors suffering circulatory death, as well as living donors. The proposed strategies and solutions are not only capable of resolving the UK's own organ-shortage crisis, but also of being implemented in other countries grappling with how to address the growing gap between supply and demand for organs.

Is the advancement of scientific knowledge and the development of biomedical technologies - known as the 'New Medicine' - desirable? George P. Smith asks this fundamental question while also confronting the distribution of these scarce medical resources. Law, economics, medical science, philosophy and ethics all coalesce in this discussion of how to structure normative standards of conduct that will improve the quality of human life. The author begins by examining various economic constructs as aids for achieving a fair and equitable delivery of health care services. He then assesses their level of practical application and evaluates the costs and benefits to society of pursuing the development and use of the 'New Medicine'. The book ends with a case study of organ and tissue transplantation that illustrates the implementation of distributive justice. The author concludes that as long as clinical medicine maintains its focus on healing and alleviating suffering among patients, a point of equilibrium will be reached that advances the common good. This timely and compelling exploration will be a must-read for scholars, researchers, policymakers and all those interested in advances in medical technology and the issues surrounding access to health care.

Each year, tens of thousands of children are conceived with donated gametes (sperm or eggs). By some estimates, there are over one million donor-conceived people in the United States and, of course, many more the world over. Some know they are donor-conceived. Some do not. Some know the identity of their donors. Others never will. Questions about what donor-conceived people should know about their genetic progenitors are hugely significant for literally millions of people, including donor-conceived people, their parents, and donors. But the practice of gamete donation also provides a vivid occasion for thinking about questions that matter to everyone. What is the value of knowing who your genetic progenitors are? How are our identities bound up with knowing where we come from? What obligations do parents have to their children? And what makes someone a parent in the first place? In Conceiving People: Identity, Genetics and Gamete Donation, Daniel Groll argues that people who plan to create a child with donated gametes should choose a donor whose identity will be made available to the resulting child. This is not, Groll argues, because having genetic knowledge is fundamentally important. Rather, it is because donor-conceived people are likely to develop a significant interest in having genetic knowledge and parents must help satisfy their children's significant interests. In other words, because a donor-conceived person is likely to care about having genetic knowledge, their parents should care too.

This book assists health care providers to understand the specific interplay of the roles and relationships currently forming the debates in pediatric clinical ethics. It builds on the fact that, unlike adult medical ethics, pediatric ethics begins within an acutely and powerfully experienced dynamic of patient-family-state-physician relationship. The book provides a unique perspective as it interacts with established approaches as well as recent developments in pediatric ethics theory, and then explores these developments further through cases. The book first focuses on setting the stage by introducing a theoretical framework and elaborating how pediatric ethics differ from non-pediatric ethics. It approaches different theoretical frameworks in a critical manner drawing on their strengths and weaknesses. It helps the reader in developing an ability to engage in ethical reasoning and moral deliberation in order to focus on the wellbeing of the child as the main participant in the ethical deliberation, as well as to be able to identify the child's moral claims. The second section of the book focuses on the practical application of these theoretical frameworks and discusses specific areas pertaining to decision-making. These are: the critically ill child, new and enduring ethical controversies, and social justice at large, the latter of which includes looking at the child's place in society, access to healthcare, social determinants of health, and vaccinations. With the dynamic changes and challenges pediatric care faces across the globe, as well as the changing face of new technologies, no professional working in the field of pediatrics can afford not to take due note of this resource.

Psychotherapists have an ethical requirement to inform clients about their treatment methods, alternative treatment options, and alternative conceptions of their problem. While accepting the basis for this "informed consent" requirement, therapists have traditionally resisted giving too much information, arguing that exposure to alternative therapies could cause confusion and distress. The raging debates over false/recovered memory syndrome and the larger move towards medical disclosure have pushed the question to the fore: how much information therapists should provide to their clients?

In Negotiating Consent in Psychotherapy, Patrick O'Neill provides an in-depth study of the ways in which therapists and clients negotiate consent. Based on interviews with 100 therapists and clients in the areas of eating disorders and sexual abuse, the book explores the tangle of issues that make informed consent so difficult for therapists, including what therapists believe should be part of consent and why; how they decide when consent should be renegotiated; and how clients experience this process of negotiation and renegotiation.

1. MEDICINE Illness, disease and disability plague man in every culture. But the form they take is not the same everywhere. Neither is man's reaction. Coping strategies, and the experience and knowledge backing them, depend very much on cultural setting. So medicine, the fabric of strategy and know ledge, can only be understood in the context of culture. In western society today, severe judgements are passed on medicine. Its store of knowledge and experience, and its repertory of strategies, have grown immensely during the last few decades. But it hardly alleviates dominant ailments, especially chronic diseases, diseases of old age and disturbances of social and mental functioning. We know that these ailments have come to the fore as the incidence of more "primitive" diseases declined in industrial societies. Infant deaths, and malnutrition and infections striking at young age, have dwindled to marginal significance in Western Europe and life expectancy at birth is twice that of some 150 years ago. Thus our new troubles are connected with past successes."

This volume is a contribution to the continuing interaction between law and medicine. Problems arising from this interaction have been addressed, in part, by previous volumes in this series. In fact, one such problem constitutes the central focus of Volume 5, Mental Illness: Law and Public Policy 1]. The present volume joins other volumes in this series in offering an exploration and critical analysis of concepts and values underlying health care. In this volume, however, we look as well at some of the general questions occasioned by the law's relation with medicine. We do so out of a conviction that medi cine and the law must be understood as the human creations they are, reflect ing important, wide-ranging, but often unaddressed aspects of the nature of the human condition. It is only by such philosophical analysis of the nature of the conceptual foundations of the health care professions and of the legal profession that we will be able to judge whether these professions do indeed serve our best interests. Such philosophical explorations are required for the public policy decisions that will be pressed upon us through the increasing complexity of health care and of the law's response to new and changing circumstances. As a consequence, this volume attends as much to issues in public policy as in the law. The law is, after all, the creature of human deci sions concerning prudent public policy and basic human rights and goods."

Issues in reproductive ethics, such as the capacity of parents to 'choose children', present challenges to philosophical ideas of freedom, responsibility and harm.This book responds to these challenges by proposing a new framework for thinking about the ethics of reproduction that emphasizes the ways that social norms affect decisions about who is born. The book provides clear and thorough discussions of some of the dominant problems in reproductive ethics - human enhancement and the notion of the normal, reproductive liberty and procreative beneficence, the principle of harm and discrimination against disability - while also proposing new ways of addressing these. The author draws upon the work of Michel Foucault, especially his discussions of biopolitics and norms, and later work on ethics, alongside feminist theorists of embodiment to argue for a new bioethics that is responsive to social norms, human vulnerability and the relational context of freedom and responsibility. This is done through compelling discussions of new technologies and practices, including the debate on liberal eugenics and human enhancement, the deliberate selection of disabilities, PGD and obstetric ultrasound."

There is a diversity of 'ethical practices' within medicine as an institutionalised profession as well as a need for ethical specialists both in practice as well as in institutionalised roles. This Brief offers a social perspective on medical ethics education. It discusses a range of concepts relevant to educational theory and thus provides a basic illumination of the subject. Recent research in the sociology of medical education and the social theory of Pierre Bourdieu are covered. In the end, the themes of Bourdieuan Social Theory, socio-cultural apprenticeships and the 'characterological turn' in medical education are draw together the context of medical ethics education.

Thousands of people from more than eighty countries have traveled to China since 2001 to undergo fetal cell transplantation. Galvanized by the potential of stem and fetal cells to regenerate damaged neurons and restore lost bodily functions, people grappling with paralysis and neurodegenerative disorders have ignored the warnings of doctors and scientists back home in order to stake their futures on a Chinese experiment. Biomedical Odysseys looks at why and how these individuals have entrusted their lives to Chinese neurosurgeons operating on the forefront of experimental medicine, in a world where technologies and risks move faster than laws can keep pace. Priscilla Song shows how cutting-edge medicine is not just about the latest advances in biomedical science but also encompasses transformations in online patient activism, surgical intervention, and borderline experiments in health care bureaucracy. Bringing together a decade of ethnographic research in hospital wards, laboratories, and online patient discussion forums, Song opens up important theoretical and methodological horizons in the anthropology of science, technology, and medicine. She illuminates how poignant journeys in search of fetal cell cures become tangled in complex webs of digital mediation, the entrepreneurial logics of postsocialist medicine, and fraught debates about the ethics of clinical experimentation. Using innovative methods to track the border-crossing quests of Chinese clinicians and their patients from around the world, Biomedical Odysseys is the first book to map the transnational life of fetal cell therapies.

Bioethics and the Fetus: Medical, Moral, and Legal Issues is the ninth volume in the Biomedical Ethics Reviews series of texts designed to review and update the literature on issues of central importance in bioethics today. All of the essays in this volume examine moral and/or legal problems involving human fetal life; summaries of these essays may be found in the text's Introduction. Bioethics is, by its nature, interdisciplinary in character. Recog- nizing this fact, the authors represented in the present volume have made every effort to minimize the use of technical jargon. At the same time, we believe the purpose of providing a review of the recent literature, as well as of advancing bioethical discussion, is well served by the pieces collected herein. We look forward to the next volume in our series, and very much hope the reader will also. James M. Humber Robert F. Almeder vii Contributors Andrea L. Bonnicksen * Department of Political Science, Northern lllinois University, DeKalb, lllinois David W. Drebushenko * Department of Philosophy, Central Michigan University, Mount Pleasant, Michigan Roger B. Dworkin * School of Law, Indiana University, Bloomington, Indiana Mary B. Mahowald * Pritzker School of Medicine, The University of Chicago, Chicago, lllinois Christine Overall * Department of Philosophy, Queens University, Kingston, Ontario, Canada WadeL. Robison* College of Liberal Arts, Rochester Institute of Technology, Rochester, New York Barbara Katz Rothman * Department of Sociology, Baruch College, CUNY, New York, New York Thomas A.

Die dynamische Entwicklung der Lebenswissenschaften unterwirft die menschliche Natur in zunehmendem Mass der Moeglichkeit technischer Intervention. Dieser Prozess erreicht mit der Option verbessernder Eingriffe in die genetische Ausstattung des Menschen eine neue Dimension, die ethische, politische und zunehmend auch rechtliche Debatten ausgeloest hat, in denen tiefgreifende normative Dissense sichtbar werden. Die Autorin eroertert zunachst die Zulassigkeit von Massnahmen des genetischen Enhancements anhand des geltenden deutschen Rechts und analysiert kunftige gesetzliche Regelungsoptionen. Sodann wirft sie die Frage auf, ob die Begrundung einer Unverfugbarkeit der Naturlichkeit des menschlichen Genoms mit Argumenten, die sich im Rahmen einer sakularen, religioes neutralen Rechtsordnung als rechtliche formulieren lassen, moeglich ist oder ob die Vorstellung eines schlechthin unverfugbaren naturlichen Substrats des Menschen nur von einem Staat um- und durchgesetzt werden kann, der, wider dem von der Theorie des politischen Liberalismus (John Rawls) postulierten Erfordernis der public justification, nicht auf jede religioes-transzendente Verankerung des Rechts verzichtet.

While neuroscience has provided insights into the structure and function of nervous systems, hard questions remain about the nature of consciousness, mind, and self. Perhaps the most difficult questions involve the meaning of neuroscientific information, and how to pursue and utilize neuroscientific knowledge in ways that are consistent with some construal of social 'good'. Written for researchers and graduate students in neuroscience and bioethics, Scientific and Philosophical Perspectives in Neuroethics explores important developments in neuroscience and neurotechnology, and addresses the philosophical, ethical, and social issues and problems that such advancements generate. It examines three core questions. First, what is the scope and direction of neuroscientific inquiry? Second, how has progress to date affected scientific and philosophical ideas, and finally, what ethical issues and problems does this progress and knowledge incur, both now and in the future?

Cultivating Moral Character and Virtue in Professional Practice is a pioneering collection of essays focused on the place of character and virtue in professional practice. Professional practices usually have codes of conduct designed to ensure good conduct; but while such codes may be necessary and useful, they appear far from sufficient, since many recent public scandals in professional life seem to have been attributable to failures of personal moral character. This book argues that there is a pressing need to devote more attention in professional education to the cultivation or development of such moral qualities as integrity, courage, self-control, service and selflessness. Featuring contributions from distinguished leaders in the application of virtue ethics to professional practice, such as Sarah Banks, Ann Gallagher, Geoffrey Moore, Justin Oakley and Nancy Sherman, the volume looks beyond traditional professions to explore the ethical dimensions of a broad range of important professional practices. Inspired by a successful international and interdisciplinary conference on the topic, the book examines various ways of promoting moral character and virtue in professional life from the general ethical perspective of contemporary neo-Aristotelian virtue theory. The professional concerns of this work are of global significance and the book will be valuable reading for all working in contemporary professional practices. It will be of particular interest to academics, practitioners and postgraduate students in the fields of education, medicine, nursing, social work, business and commerce and military service.

Should we make people healthier, smarter, and longer-lived if genetic and medical advances enable us to do so? Matti Hayry asks this question in the context of genetic testing and selection, cloning and stem cell research, gene therapies and enhancements. The ethical questions explored include parental responsibility, the use of people as means, the role of hope and fear in risk assessment, and the dignity and meaning of life. Taking as a starting point the arguments presented by Jonathan Glover, John Harris, Ronald M. Green, Jurgen Habermas, Michael J. Sandel, and Leon R. Kass, who defend a particular normative view as the only rational or moral answer, Matti Hayry argues that many coherent rationalities and moralities exist in the field, and that to claim otherwise is mistaken.

This is the second volume of Biomedical Ethics Reviews, a series of texts designed to review and update the literature on issues of central importance in bioethics today. Five topics are dis cussed in the present volume. Section I, Public Policy andRe search with Human Subjects, reviews the history of the moral issues involved in the history of research with human subjects, and confronts most of the major legal and moral problems involving research on human subjects. Questions addressed in this section range from those concerning informed and proxy consent to those dealing with the adequacy of monitoring hu man research via institutional review boards (IRBs). Section II deals with a second broad topic in bioethics, The Right to Health Care in a Democratic Society. Here the concern not merely that of determining whether there is a right to is health care, but also, if there is such a right, how it ought best be understood and implemented. To answer questions such as these, we learn that one must distinguish legal from moral rights, assess the merits of various theories of rights, clarify the relationship between rights and duties, and attempt to deter mine a just method for the distribution of health care. Advances in medical technology often pose new legal and moral problems for legislators and health care practitioners."

The field of global health is expanding rapidly. An increasing number of trainees are studying and working with marginalized populations, often within low and middle-income countries. Such endeavours are beset by ethical dilemmas: mitigating power differentials, addressing cultural differences in how health and illness are viewed, and obtaining individual and community consent in research. This introductory textbook supports students to understand and work through key areas of concern, assisting them in moving towards a more critical view of global health practise.

Divided into two sections covering the theory and practice of global health ethics, the text begins by looking at definitions of global health and the field s historical context. It draws on anti-colonial perspectives concepts, developing social justice and solidarity as key principles to guide students. The second part focuses on ethical challenges students may face in clinical experiences or research. Topics such as working with indigenous communities, the politics of global health governance, and the ethical challenges of advocacy are explored using a case study approach. "

An Introduction to Global Health Ethics" includes recommended resources and further readings, and is ideal for students from a range of disciplines including public health, medicine, nursing, law and development studies who are undertaking undergraduate and graduate courses in ethics or placements overseas.

In the past decade the body of literature in the area of biomedical ethics has expanded at an astounding rate. Indeed, on every major topic, the literature in this area has mUltiplied, and continues to do so, so rapidly that one can easily fall behind important advances in our thinking about and understanding of the problems of contemporary bioethics. Awareness of this need to keep apace of developments in the area prompted a recent reviewer of our earlier collection Biomedical Ethics and the Law (Plenum, 2nd edition, 1979) to suggest that somebody ought to offer the service of providing a biennial review or update of the literature on the various central topics in bioethics. Thomas Lanigan, of The Humana Press, agreed with this last sug gestion and so asked us to edit a series of texts consisting of previously unpublished essays on selected topics, a series that would seek to re view and update recent literature on the central topics, while also striv ing to advance distinctive solutions to the problems on the topics under discussion. Accordingly, this first collection of previously unpublished essays focuses on the selected topics, and the authors commissioned were charged with addressing the basic problems assigned while also bringing the reader either directly or indirectly up to date on the rele vant literature."

Public attention on embryo research has never been greater. Modern reproductive medicine technology and the use of embryos to generate stem cells ensure that this will continue to be a topic of debate and research across many disciplines. This multidisciplinary book explores the concept of a 'healthy' embryo, its implications on the health of children and adults, and how perceptions of what constitutes child and adult health influence the concept of embryo 'health'. The concept of human embryo health is considered from preconception to pre-implantation genetic diagnosis to recent foetal surgical approaches. Burgeoning capacities in both genetic and reproductive science and their clinical implications have catalysed the necessity to explore the concept of a 'healthy' embryo. The authors are from five countries and 13 disciplines in the social sciences, humanities, biological sciences and medicine, ensuring that the book has a broad coverage and approach.

Biomedical Ethics Reviews: 1985 is the third volume in a series of texts designed to review and update the literature on issues of central impor tance in bioethics today. Four topics are discussed in the present volume: ( 1) Should citizens of the United States be permitted to buy, sell, and broker human organs? (2) Should sex preselection be legally proscribed? (3) What decision-making procedure should medical per sonnel employ in those cases where there is a high degree of uncer tainty? (4) What do we mean when we use the terms "health" and "disease"? Each topic constitutes a separate section in our text; intro ductory essays briefly summarize the contents of each section. Bioethics is, by its nature, interdisciplinary in character. Recognizing this fact, the authors represented in the present volume have made every effort to minimize the use of technical jargon. At the same time, we believe the purpose of providing a review of the recent literature, as well as of advancing bioethical discussion, is admirably served by the pieces collected herein. We look forward to the next volume in our series, and very much hope the reader will also."

Biomedical Ethics Reviews * 1987 is the fifth volume in a series of texts designed to review and update the literature on issues of central importance in bioethics today. Three topics are discussed in the present volume: (1) Prescribing Drugs for the Aged and Dying; (2) Animals as a Source of Human Transplant Organs, and (3) The Nurse's Role: Rights and Responsibilities. Each topic constitutes a separate sec tion in our text; introductory essays briefly summarize the contents of each section. Bioethics is, by its nature, interdisciplinary in character. Recognizing this fact, the authors represented in the present volume have made every effort to minimize the use of techni cal jargon. At the same time, we believe the purpose of pro viding a review of the recent literature, as well as of advancing bioethical discussion, is admirably served by the pieces col lected herein. We look forward to the next volume in our series, and very much hope the reader will also.

"Ethics in Speech and Language Therapy" is a key text for students, practitioners and managers alike. The demands of practice, legislation, registration and the recognition of competencies all point to the need for speech and language therapists to be explicitly educated about ethics. This book provides an overview of this key topic, grounds ethical practice in the broader context of morals and values; discusses frameworks for ethical decision making; discusses common ethical issues in speech and language therapy practice and service management; and considers factors which complicate ethical decision making.

Every one of us will die, and the processes we go through will be our own unique to our own experiences and life stories. It is reasonable to reflect on what kinds of dying processes may be better or worse for us as we move toward our end. Such consideration, however, can raise troubling ethical concerns for patients, families, and healthcare providers. Even after forty years of concerted focus on biomedical ethics, these moral concerns persist in the care of lethally impaired, terminally ill, and inured patients. End-of-Life Care and Pragmatic Decision Making provides a pragmatic philosophical framework based on a radically empirical attitude toward life and death. D. Micah Hester takes seriously the complexities of experiences and argues that when making end-of-life decisions healthcare providers ought to pay close attention to the narratives of patients and the communities they inhabit so that their dying processes embody their life stories. He discusses three types of end-of-life patient populations adults with decision-making capacity, adult without capacity, and children (with a strong focus on infants) to show the implications of pragmatic empiricism and the scope of decision making at the end of life for different types of patients.

This volume offers a theoretical and practical overview of the ethics of pediatric medicine. It serves as a fundamental handbook and resource for pediatricians, nurses, residents in training, graduate students, and practitioners of ethics and healthcare policy. Written by a team of leading experts, Pediatric Bioethics addresses those difficult ethical questions concerning the clinical and academic practice of pediatrics, including an approach to recognizing boundaries when confronted with issues such as end of life care, life-sustaining treatment, extreme prematurity, pharmacotherapy, and research. Thorny topics such as what constitutes best interests, personhood, or distributive justice and public health concerns such as immunization and newborn genetic screening are also addressed.