This manual will help Institutional Review Boards (IRBs) conduct ethics review that balances the major moral considerations in research with human subjects. Current challenges in the IRB environment are addressed with arguments and insights from dozens of scholars. Useful to the IRB member at any level of experience, Balanced Ethics Review provides the necessary tools needed to create a systemic blueprint for promoting the research and dissemination of scientists and scholars within the standard norms of regulation.

The metaphor of the monster or predator-usually a sexual predator, drug dealer in areas frequented by children, or psychopathic murderer-is a powerful framing device in public discourse about how the criminal justice system should respond to serious violent crimes. The cultural history of the monster reveals significant features of the metaphor that raise questions about the extent to which justice can be achieved in both the punishment of what are regarded as "monstrous crimes" and the treatment of those who commit such crimes. This book is the first to address the connections between the history of the monster metaphor, the 19th century idea of the criminal as monster, and the 20th century conception of the psychopath: the new monster. The book addresses, in particular, the ways in which the metaphor is used to scapegoat certain categories of crimes and criminals for anxieties about our own potential for deviant, and, indeed, dangerous interests. These interests have long been found to be associated with the fascination people have for monsters in most cultures, including the West. The book outlines an alternative public health approach to sex offending, and crime in general, that can incorporate what we know about illness prevention while protecting the rights, and humanity, of offenders. The book concludes with an analysis of the role of forensic psychiatrists and psychologists in representing criminal defendants as psychopaths, or persons with certain personality disorders. As psychiatry and psychology have transformed bad behavior into mad behavior, these institutions have taken on the legal role of helping to sort out the most dangerous among us for preventive "treatment" rather than carceral "punishment."

This book covers the new field of healthcare organization ethics from theory to practical application. It can be used as a text for courses on the subject, as a reference for those interested in the present status of the field, and as a practical guide for healthcare executives, clinicians and committee members who are beginning to develop an organizational ethics program for their institution.

By the time of his death, Herve Guibert had become a singular literary voice on the impact of AIDS in France. He was prolific. His oeuvre contained some twenty novels, including To the Friend Who Did Not Save My Life and The Compassion Protocol. He was thirty-six years old. In Cytomegalovirus, Guibert offers an autobiographical narrative of the everyday moments of his hospitalization because of complications of AIDS. Cytomegalovirus is spare, biting, and anguished. Guibert writes through the minutiae of living and of death-as a quality of invention, of melancholy, of small victories in the face of greater threats-at the moment when his sight (and life) is eclipsed. This new edition includes an Introduction and Afterword contextualizing Guibert's work within the history of the AIDS pandemic, its relevance in the contemporary moment, and the importance of understanding the quotidian aspects of terminal illness.

After the young South African athlete Caster Semenya won the 800m title at the 2009 World Championships she was obliged to undergo gender testing and was temporarily withdrawn from international competition. The way that this controversy unfolded represents a rich and multi-layered example of the construction of gender in wider society and the interrelationships between sport, culture and the media. This is the first book to explore the case in depth, from socio-cultural, ethical and legal perspectives. Analysing what came to be called "the Caster Semenya Case" in a comprehensive and multi-disciplinary fashion, and covering issues from media discourses and the rhetoric and regulations of the sport's governing bodies to the reaction of the athlete herself, the book explores the ethics of how gender norms in sport, and in society more generally, are constructed through appearance, behaviour and sporting performance. This 2009 controversy can be taken as an indicator of the tensions of the time, and served as a link between medical sciences, society and gender. Including discussions of key concepts such as 'intersex', 'body norms', and 'fairness', Gender Testing in Sport is fascinating and important reading for anybody with an interest in sport studies, gender studies or biomedical ethics.

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.

Since the 1970s, we have witnessed astonishing scientific and technical progress in the field of organ transplantation. Patients who suffer organ failure can now often have their lives greatly improved both in terms of quality and quantity of years. The success of transplantation techniques has created an enormous demand for donor organs. Unfortunately, donor organs are in short supply, relative to the number of patients who could greatly benefit from them. Therefore, donor organs are a scarce and valuable resource that must be thoughtfully and fairly allocated among waiting patients. Not surprisingly, this situation raises many pressing ethical questions, each requiring careful consideration. This volume presents a systematic and balanced treatment of some of the most pressing ethical questions including: what is our ethical obligation to become organ donors and who should be allowed to donate?; to what extent can markets facilitate the fair allocation of organs and how should we most fairly determine who should be recipients?; how do we determine death when the donor is not brain dead?; should non-human donor organs be used to save human lives and should we use organs from anencephalic infants and tissue from embryos? ; and what is the role of the news media in covering stories about organ transplantation? Many of the leading authorities in medical ethics come together in this volume to develop extensive analyses and arguments. The reader is provided with a sound understanding of the ethical, as well as many of the broader issues in organ donation and transplantation.

This collection of essays provides educators in medicine and the health sciences an illuminating and challenging introduction to professionalism. The book takes a practical approach toward this topic, looking at what professionalism means, for the individual physician's relationship to his or her patients, to the medical profession as a whole, and to society at large. Written by leading scholars and thinkers in the area of professionalism in medicine, contributors provide a well-rounded analysis of this important topic. Although the intended audience is primarily physicians, medical students and residents, the book is a suitable primer for pre-professional health care students as well.

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.

The ethics of creating - or declining to create - human beings has been addressed in several contexts: debates over abortion and embryo research; literature on "self-creation"; and discussions of procreative rights and responsibilities, genetic engineering, and future generations. Here, for the first time, is a sustained, scholarly analysis of all of these issues - a discussion combining breadth of topics with philosophical depth, imagination with current scientific understanding, argumentative rigor with accessibility. The overarching aim of Creation Ethics is to illuminate a broad array of issues connected with reproduction and genetics, through the lens of moral philosophy. With novel frameworks for understanding prenatal moral status and human identity, and exceptional fairness to those holding different views, David DeGrazia sheds new light on the ethics of abortion and embryo research, genetic enhancement and prenatal genetic interventions, procreation and parenting, and decisions that affect the quality of life of future generations. Along the way, he helpfully introduces personal identity theory and value theory as well as such complex topics as moral status, wrongful life, and the "nonidentity problem." The results include a subjective account of human well-being, a standard for responsible procreation and parenting, and a theoretical bridge between consequentialist and nonconsequentialist ethical theories. The upshot is a synoptic, mostly liberal vision of the ethics of creating human beings.

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.

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."

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.

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.

In Kidney to Share, Martha Gershun tells the story of her decision to donate a kidney to a stranger. She takes readers through the complex process by which such donors are vetted to ensure that they are physically and psychologically fit to take the risk of a major operation. John D. Lantos, a physician and bioethicist, places Gershun's story in the larger context of the history of kidney transplantation and the ethical controversies that surround living donors. Together, they help readers understand the discoveries that made transplantation relatively safe and effective as well as the legal, ethical, and economic policies that make it feasible. Gershun and Lantos explore the steps involved in recovering and allocating organs. They analyze the differences that arise depending on whether the organ comes from a living donor or one who has died. They observe the expertise-and the shortcomings-of doctors, nurses, and other professionals and describe the burdens that we place on people who are willing to donate. In this raw and vivid book, Gershun and Lantos ask us to consider just how far society should go in using one person's healthy body parts in order to save another person. Kidney to Share provides an account of organ donation that is both personal and analytical. The combination of perspectives leads to a profound and compelling exploration of a largely opaque practice. Gershun and Lantos pull back the curtain to offer readers a more transparent view of the fascinating world of organ donation.

To practice medicine and ethics, physicians need wisdom and integrity to integrate scientific knowledge, patient preferences, their own moral commitments, and society's expectations. This work of integration requires a physician to pursue certain goals of care, determine moral priorities, and understand that conscience or integrity require harmony among a person's beliefs, values, reasoning, actions, and identity. But the moral and religious pluralism of contemporary society makes this integration challenging and uncertain. How physicians treat patients will depend on the particular beliefs and values they and other health professionals bring to each instance of shared decision making. This book offers a framework for practical wisdom in medicine that addresses the need for integrity in the life of each health professional. In doing so, it acknowledges the challenge of moral pluralism and the need for moral dialogue and humility as professionals fulfill their obligations to patients, themselves, and society.

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.

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."

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."

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.

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."