Why is death bad for us, even on the assumption that it involves the absence of experience? Is it worse for us than prenatal nonexistence? Kamm begins by considering these questions, critically examining some answers other philosophers have given. She explores in detail suggestions based on our greater concern over the loss of future versus past goods and those based on the insult to persons which death involves. In the second part, Kamm deals with the question, "Whom should we save from death if we cannot save everyone?" She considers whether and when the numbers of lives we can save matter in our choice, and whether the extra good we achieve if we save some lives rather than others should play a role in deciding whom to save. Issues such as fairness, solidarity, the role of random decision procedures, and the relation between subjective and objective points of view are discussed, with an eye to properly incorporating these into a nonconsequentialist ethical theory. In conclusion, the book examines specifically what differences between persons are relevant to the distribution of any scarce resource, discussing for example, the distribution (and acquisition) of bodily organs for transplantation. Kamm provides criticism of some current procedures for distribution and acquisition of a scarce resource and makes suggestions for alternatives.

In Better than Human?, noted bioethicist Allen Buchanan grapples with the ethical dilemmas of the medical revolution now upon us. Biomedical enhancements, he writes, can make us smarter, have better memories, be stronger, quicker, have more stamina, live much longer, be more resistant to disease and to the frailties of aging, and enjoy richer emotional lives. They can even improve our character, or at least strengthen our powers of self-control. In spite of the benefits that biomedical enhancements may bring, many people instinctively reject them. Some worry that we will lose something important-our appreciation for what we have or what makes human beings distinctively valuable. To think clearly about enhancement, Buchanan argues, we have to acknowledge that nature is a mixed bag and that our species has many "design flaws". We should be open to the possibility of becoming better than human, while never underestimating the risk that our attempts to improve may backfire.

Legal and ethical competence is a cornerstone of professional midwifery practice and an essential part of midwifery training. Law and Ethics for Midwifery is a unique and practical resource for student midwives. Written by an experienced midwifery lecturer, this text draws on a wide variety of real life case studies and focuses particularly on the core areas of accountability, autonomy and advocacy. Opening with two chapters providing overviews respectively of ethical theories and legislation, the book is then arranged thematically. These chapters have a common structure which includes case studies, relevant legislation, reflective activities and a summary, and they run across areas of concern from negligence through safeguarding to record-keeping. Grounded in midwifery practice, the text enables student midwives to consider and prepare for ethical and legal dilemmas they may face as midwives in clinical practice.

Research using genetic data raises various concerns relating to privacy protection. Many of these concerns can also apply to research that uses other personal data, but not with the same implications for failure. The norms of exclusivity associated with a private life go beyond the current legal concept of personal data to include genetic data that relates to multiple identifiable individuals simultaneously and anonymous data that could be associated with any number of individuals in different, but reasonably foreseeable, contexts. It is the possibilities and implications of association that are significant, and these possibilities can only be assessed if one considers the interpretive potential of data. They are missed if one fixates upon its interpretive pedigree or misunderstands the meaning and significance of identification. This book demonstrates how the public interest in research using genetic data might be reconciled with the public interest in proper privacy protection.

Those involved in end-of-life decision making must take into account both legal and ethical issues. This book starts with a critical reflection of ethical principles including ideas such as moral status, the value of life, acts and omissions, harm, autonomy, dignity and paternalism. It then explores the practical difficulties of regulating end-of-life decisions, focusing on patients, healthcare professionals, the wider community and issues surrounding 'slippery slope' arguments. By evaluating the available empirical evidence, the author identifies preferred ways to regulate decisions and minimise abuses at the end of life, and outlines an ethical theory which can provide practical guidance for those engaged in end-of-life decisions.

Biotech Juggernaut: Hope, Hype, and Hidden Agendas of Entrepreneurial BioScience relates the intensifying effort of bioentrepreneurs to apply genetic engineering technologies to the human species and to extend the commercial reach of synthetic biology or "extreme genetic engineering." In 1980, legal developments concerning patenting laws transformed scientific researchers into bioentrepreneurs. Often motivated to create profit-driven biotech start-up companies or to serve on their advisory boards, university researchers now commonly operate under serious conflicts of interest. These conflicts stand in the way of giving full consideration to the social and ethical consequences of the technologies they seek to develop. Too often, bioentrepreneurs have worked to obscure how these technologies could alter human evolution and to hide the social costs of keeping on this path. Tracing the rise and cultural politics of biotechnology from a critical perspective, Biotech Juggernaut aims to correct the informational imbalance between producers of biotechnologies on the one hand, and the intended consumers of these technologies and general society, on the other. It explains how the converging vectors of economic, political, social, and cultural elements driving biotechnology's swift advance constitutes a juggernaut. It concludes with a reflection on whether it is possible for an informed public to halt what appears to be a runaway force.

John Coggon argues that the important question for analysts in the fields of public health law and ethics is 'what makes health public?' He offers a conceptual and analytic scrutiny of the salient issues raised by this question, outlines the concepts entailed in, or denoted by, the term 'public health' and argues why and how normative analyses in public health are inquiries in political theory. The arguments expose and explain the political claims inherent in key works in public health ethics. Coggon then develops and defends a particular understanding of political liberalism, describing its implications for critical study of public health policies and practices. Covering important works from legal, moral, and political theory, public health, public health law and ethics, and bioethics, this is a foundational text for scholars, practitioners and policy bodies interested in freedoms, rights and responsibilities relating to health.

Human information and communication technology (ICT) implants have developed for many years in a medical context. Such applications have become increasingly advanced, in some cases modifying fundamental brain function. Today, comparatively low-tech implants are being increasingly employed in non-therapeutic contexts, with applications ranging from the use of ICT implants for VIP entry into nightclubs, automated payments for goods, access to secure facilities and for those with a high risk of being kidnapped. Commercialisation and growing potential of human ICT implants have generated debate over the ethical, legal and social aspects of the technology, its products and application. Despite stakeholders calling for greater policy and legal certainty within this area, gaps have already begun to emerge between the commercial reality of human ICT implants and the current legal frameworks designed to regulate these products. This book focuses on the latest technological developments and on the legal, social and ethical implications of the use and further application of these technologies.

The sixth edition of the Manual for Research Ethics Committees was first published in 2003, and is a unique compilation of legal and ethical guidance which will prove useful for members of research ethics committees, researchers involved in research with humans, members of the pharmaceutical industry and students of law, medicine, ethics and philosophy. Presented in a clear and authoritative form, it incorporates the key legal and ethical guidelines and specially written chapters on major topics in bioethics by leading academic authors and practitioners, pharmaceutical industry associations and professional bodies.

Historically associated with military service, conscientious objection has become a significant phenomenon in health care. Mark Wicclair offers a comprehensive ethical analysis of conscientious objection in three representative health care professions: medicine, nursing and pharmacy. He critically examines two extreme positions: the 'incompatibility thesis', that it is contrary to the professional obligations of practitioners to refuse provision of any service within the scope of their professional competence; and 'conscience absolutism', that they should be exempted from performing any action contrary to their conscience. He argues for a compromise approach that accommodates conscience-based refusals within the limits of specified ethical constraints. He also explores conscientious objection by students in each of the three professions, discusses conscience protection legislation and conscience-based refusals by pharmacies and hospitals, and analyzes several cases. His book is a valuable resource for scholars, professionals, trainees, students, and anyone interested in this increasingly important aspect of health care.

This interdisciplinary collection of essays demonstrates how the ethical and political problems we are confronted with today have come to focus largely on life. The contributors to this volume define and assess the specific meaning of life itself. It is only by doing so that we can understand why life has become an all-encompassing problem, why all questions, especially ethical and political, have become vital questions. We have reached a moment in history where every distinction and opposition is no longer in relation to life, but within it, and where life is at once a theoretical and practical problem. This book throws light on this nexus of problems at the heart of contemporary debates in bioethics and biopolitics. It helps us understand why and how life is understood, valued, cared for and framed today. Taking a genuinely transdisciplinary approach, these essays demonstrate how life is a multifaceted problem and how diverse the origins, foundations and also consequences of bioethics and biopolitics therefore are.

This collection contains twenty-one thought-provoking essays on the controversies surrounding the moral and legal distinctions between euthanasia and "letting die." Since public awareness of this issue has increased this second edition includes nine entirely new essays which bring the treatment of the subject up-to-date. The urgency of this issue can be gauged in recent developments such as the legalization of physician-assisted suicide in the Netherlands, "how-to" manuals topping the bestseller charts in the United States, and the many headlines devoted to Dr. Jack Kevorkian, who has assisted dozens of patients to die. The essays address the range of questions involved in this issue pertaining especially to the fields of medical ethics, public policymaking, and social philosophy. The discussions consider the decisions facing medical and public policymakers, how those decisions will affect the elderly and terminally ill, and the medical and legal ramifications for patients in a permanently vegetative state, as well as issues of parent/infant rights. The book is divided into two sections. The first, "Euthanasia and the Termination of Life-Prolonging Treatment" includes an examination of the 1976 Karen Quinlan Supreme Court decision and selections from the 1990 Supreme Court decision in the case of Nancy Cruzan. Featured are articles by law professor George Fletcher and philosophers Michael Tooley, James Rachels, and Bonnie Steinbock, with new articles by Rachels, and Thomas Sullivan. The second section, "Philosophical Considerations," probes more deeply into the theoretical issues raised by the killing/letting die controversy, illustrating exceptionally well the dispute between two rivaltheories of ethics, consequentialism and deontology. It also includes a corpus of the standard thought on the debate by Jonathan Bennet, Daniel Dinello, Jeffrie Murphy, John Harris, Philipa Foot, Richard Trammell, and N. Ann Davis, and adds articles new to this edition by Bennett, Foot, Warren Quinn, Jeff McMahan, and Judith Lichtenberg.

T. A. Cavanaugh's Hippocrates' Oath and Asclepius' Snake: The Birth of the Medical Profession articulates the Oath as establishing the medical profession's unique internal medical ethic - in its most basic and least controvertible form, this ethic mandates that physicians help and not harm the sick. Relying on Greek myth, drama, and medical experience (e.g., homeopathy), the book shows how this medical ethic arose from reflection on the most vexing medical-ethical problem - injury caused by a physician - and argues that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession. The book argues that medicine as a profession necessarily involves stating before others what one stands for: the good one seeks and the bad one seeks to avoid on behalf of the sick, and rejects the view that medicine is purely a technique lacking its own unique internal ethic. It concludes noting that medical promising (as found in the White Coat Ceremony through which U. S. medical students matriculate) implicates medical autonomy which in turn merits respect, including honoring professional conscientious objections.

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.