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Books > Medicine > General issues > Medical ethics
New Harvest includes contributions from specialists in medical, philosophical, psychological, religious, and legal fields. These essays are not simply a collection, but were developed from a single conception of the four ethical concerns of trans plan tation described in the first chapter. The indi vid ual chapters are all parts of a structure unified by the search for ethical foundations basic to the four concerns. Transplantation is surrounded by a great deal of under standable emotional sensitivi ty. The authors trust that words like "procurement," "harvest," and possibly other expressions found in this book will not offend. We use the current lan but do so with objectivity and respect for those who guage, are personally involved in transplantation. We have made room for, and indeed have invited, different and sometimes conflicting points of view on the complicated ethical ques tions raised by transplant operations. We can not assume that there is one right answer to these questions, at least at our present level of scientific knowledge and ethical wisdom. We do not presume to have identified and analyzed all the ethical questions raised with equal thoroughness. There are four ways in which the scope of the book is limited. Identifying these limitations also helps designate what it is in its own right. First, some questions have been given more attention than others.
"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.
This book is about trust and its implications for a medical theological ethics. Beginning with its earliest work, there has been attention to trust running through the bioethics literature in the United States, and much of this discussion has examined its theological elements. Clearly, trust is indispensable when describing the patient-physician relationship, so why is there a need for yet another study? There is no doubt that people generally trust physicians. Traditionally the physician is the patient's fiduciary agent, whose sole obligation is to act only in the patient's best interest. In recent times, however, there is a perception on the part of people within and without health care that physicians have other obligations that compete with their obligation to the patient. If we acknowledge that one price for the successes of technological biomedicine is high in terms of financial cost, another price of Sllccess seems to be distrust, cynicism, and suspicion directed by the public toward the medical profes sion. If this uneasiness is the price society pays for medical success, what is the price of success for the doctor? Because of their role within the social order, physicians have claimed and been granted autonomy, authority, and special status. In return, the profes sion has pledged to serve the well-being and interests of humankind. This fiduciary commitment becomes a taken-for-granted aspect of the physician's identity, both for the physician for whom this dedication is definitional and for the public which expects trustworthy service from this person."
Informed consent is a central topic in contemporary biomedical ethics. Yet attempts to set defensible and feasible standards for consenting have led to persistent difficulties. In Rethinking Informed Consent in Bioethics, first published in 2007, Neil Manson and Onora O'Neill set debates about informed consent in medicine and research in a fresh light. They show why informed consent cannot be fully specific or fully explicit, and why more specific consent is not always ethically better. They argue that consent needs distinctive communicative transactions, by which other obligations, prohibitions, and rights can be waived or set aside in controlled and specific ways. Their book offers a coherent, wide-ranging and practical account of the role of consent in biomedicine which will be valuable to readers working in a range of areas in bioethics, medicine and law.
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.
One of the most challenging tasks facing clinicians today is the assessment of patients' capacities to consent to treatment. The protection of a patient's right to decide, as well as the protection of incompetent patients from the potential harm of the decisions they might make, rests largely on clinicians' abilities to judge patients' capacities to decide what treatment they will receive. Confusing laws and complex ethical questions surrounding competence to consent to treatment have made the process of competence assessment intimidating for many clinicians. Health professionals - physicians, medical students nad residents, nurses, and mental health practitioners - have long needed a consice guidebook that translates the issue for practice. This is what this book accomplishes. The aurthors describe the place of competence in the doctrine of informed consent and show how assessments of competence to consent to treatment can be structured by using a specific set of general medical and psychiatric treatment settings, explain how the assessment should be conducted, and offer a structured interview method to assist the task. They also explore the often difficult process of making the judgement about competence and desire what to do when patients' capacities are limited.
In der Debatte uber den moralischen Status menschlicher Embryonen ist nicht immer klar, uber welche Argumente genau eigentlich gestritten wird. Dieses Studienbuch bietet Studierenden und Forschenden, aber auch dem an der aktuellen Debatte interessierten Laien die Moeglichkeit, sich uber den gegenwartigen Diskussionsstand gezielt zu informieren und die wichtigsten Argumente in klarer und knapper Form kennenzulernen. Sie besagen folgendes: Da Embryonen als Mitglieder der Spezies homo sapiens sapiens Menschen sind, besitzen sie Wurde (Spezies-Argument); Embryonen entwickeln sich kontinuierlich, d.h. ohne moralrelevante Einschnitte, zu erwachsenen Menschen, die Wurde besitzen (Kontinuumsargument); Embryonen sind in moralrelevanter Hinsicht identisch mit erwachsenen Menschen, die Wurde besitzen (Identitatsargument); Embryonen haben das Potential, Menschen zu werden, und dieses Potential ist uneingeschrankt schutzenswert (Potentialitatsargument). Diese Argumente werden jeweils durch eine Pro-Position und eine Contra-Position dargestellt und verteidigt oder kritisiert. In einem begleitenden Beitrag der Herausgeber werden die vier Argumente im Zusammenhang rekonstruiert, bewertet und durch neue Argumente unterstutzt. Der Band wird erganzt durch eine knappe Darstellung der embryonalen Fruhphase, ein naturwissenschaftlich- medizinisches Glossar, eine ausfuhrliche Bibliographie zur Embryonendebatte sowie durch ein Personen- und Sachregister.
We have provided the reader with a resource for applied ethical decision-making for use in clinical, educational, and research settings. The Rehabilitation Psychologist using this book will have a choice of utilizing a Quick Reference guide including pro-con positions regarding possible resolutions and a tabular summary of the varied case examples presented, or making use of more detailed discussion of the ethical concepts pertinent to each case. The most important aspect of this book is inclusion of psycho-social context information for each case example. This critical factor allows the reader to understand the flow of events and other factors influencing the actions of the key stakeholders, thereby facilitating the ethical decision-making process. The mix of case examples is intentionally broad-based, including ample clinical practice situations, along with challenges found in educational and research settings. There is also variety among the case examples, with two detailed scenarios in each chapter, along with two briefer learning exercises with focused summaries. The reader is challenged to analyze each case and compare the results with the preferred resolution proposed by the authors. Finally, at the end of the book, the reader has access to a list of ethics-relevant reading resources. These resources are divided into categorical domains that will assist with literature searches and further research into applied ethics. The authors trust that this book will serve as a preparatory experience for those psychologists studying for the Rehabilitation Psychology specialty board exam, as well as trainees and clinicians at all levels who desire an applied approach to utilizing the APA Ethics Code as an invaluable guide to everyday professional practice.
Michael Ryan (d. 1840) remains one of the most mysterious figures in the history of medical ethics, despite the fact that he was the only British physician during the middle years of the 19th century to write about ethics in a systematic way. Michael Ryan s Writings on Medical Ethics offers both an annotated reprint of his key ethical writings, and an extensive introductory essay that fills in many previously unknown details of Ryan s life, analyzes the significance of his ethical works, and places him within the historical trajectory of the field of medical ethics."
Clearly argued and written in nontechnical language, this book provides a definitive account of informed consent. It begins by presenting the analytic framework for reasoning about informed consent found in moral philosophy and law. The authors then review and interpret the history of informed consent in clinical medicine, research, and the courts. They argue that respect for autonomy has had a central role in the justification and function of informed consent requirements. Then they present a theory of the nature of informed consent that is based on an appreciation of its historical roots. An important contribution to a topic of current legal and ethical debate, this study is accessible to everyone with a serious interest in biomedical ethics, including physicians, philosophers, policy makers, religious ethicists, lawyers, and psychologists. This timely analysis makes a significant contribution to the debate about the rights of patients and subjects.
Tentative estimates suggest that one in ten patients suffers from an adverse event in hospital. In Germany, approx. 1.8 million out of approx. 18 million inpatients suffer from adverse events; 50 percent of these cases are estimated to be avoidable. In the US, nearly 100,000 people die from the consequences of mistreatment. The intensive care units record 1.7 medical errors per patient and day. The most affected disciplines are the operative disciplines, particularly general surgery. Medical errors mainly occur when the indication for surgery is being made, during surgery and post-surgery. Suspicious oncological diagnostic results and post-operative complications are also often ignored. This book deals with complications and typical medical errors in surgery. It shows solutions and ways of dealing effectively with these errors and how to establish an efficient security management system.
Inthis Brief, Daniel Sokol interprets'doing medical ethics' broadly to capture the application of ethical knowledge to a concrete situation, rather than just resolving a moral dilemma contained within a case.It instructs clinicians on how toidentify and analyse a clinical ethics case, andguides the reader inpublishing in general medical, specialist medical, and medical ethics journals, andthrough presenting on ethical issues at conferences. In addition to this, advice on how to teach medical ethics, and apply for research ethics approval, is included. ..".an admirably short and clear guide to doing medical ethics... I welcome this book and urge medical students and doctors of all grades to read it in paper, on-line or on your portable screen reader." Sir Richard Thompson, President of the Royal College of Physicians, UK "Dr. Sokol has provided the field with a much needed, easy and comprehensive tool on 'doing' clinical ethics that all should have in their back pockets." Dr. Nneka Mokwunye, Director of Bioethics, Washington Hospital Center, Washington DC, USA "This is a magnificent guide to clinical ethics and reflects the author's very well known and widely respected academic gravitas and real life experience in clinical ethics. It is a "must read" for anyone involved in the field." Mr. Vassilios Papalois, Consultant Surgeon and Chairman, Imperial College Healthcare NHS Trust Clinical Ethics Committee, UK "
Since Dolly the sheep was born, controversy has swirled around the technology of cloning. We recoil at the prospect of human copies, manufactured men and women, nefarious impersonators and resurrections of the dead. Such reactions have serious legal consequences: lawmakers have banned stem cell research along with the cloning of babies. But what if our minds have been playing tricks on us? What if everything we thought we knew about human cloning is rooted in intuition rather than fact? Human Cloning: Four Fallacies and their Legal Consequences is a rollicking ride through science, psychology and the law. Drawing on sources ranging from science fiction films to the Congressional Record, this book unmasks the role that psychological essentialism has played in bringing about cloning bans. It explains how hidden intuitions have caused conservatives and liberals to act contrary to their own most cherished ideals and values.
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.
"This book encourages readers to reflect on the nature and values of health care practice through its challenging but accessible style. It will be a stimulating and thought-provoking read for anyone involved in day-to-day health care." - Professor Jane Wills, London South Bank University "[This book] offers frameworks and guidance that all health care workers will find stimulating and challenging and that all of them will benefit by considering." - Professor Linda Jones, Open University Why is thinking about values and ethics a crucial component of health care training and practice? How can we go about engaging in such thinking? Values, Ethics and Health Care responds to these essential questions. It examines key ethical frameworks and debates within the field of healthcare, locating them firmly in their social and occupational contexts. Guiding students through a range of dilemmas and difficulties encountered in health care practice with case studies and real-life examples, this lively text illustrates how to apply knowledge to professional practice and decision-making. Key features of the book: - Offers a critical and reflective understanding of health care ethics and values - Presents an interprofessional approach - Relates theory to 'everyday' ethics - Includes student-friendly features such as real-life examples, 'thinking about' points and links to further reading. The book will be essential reading for undergraduates taking modules in Values, Ethics and Professional Practice as part of health studies degree programmes. It will also be useful for postgraduates as well as practitioners in the field.
Ethical Problems and Genetics Practice provides a rich, case-based account of the ethical issues arising in the genetics clinic and laboratory. By analysing a wide range of evocative and often arresting cases from practice, Michael Parker provides a compelling insight into the complex moral world of the contemporary genetics professional and the challenges they face in the care of patients and their families. This book is essential reading for anyone interested in the ethical issues arising in everyday genetics practice. Ethical Problems and Genetics Practice is also a sustained engagement with the relationships between bioethics and social science. In proposing and exemplifying a new approach to bioethics, it makes a significant contribution to debates on methods and interdisciplinarity and will therefore also appeal to all those concerned with theoretical and methodological approaches to bioethics and social science.
This practical book is written specifically for junior doctors by a team of highly experienced authors, as an introductory guide to clinical research. It covers all areas that a junior doctor needs to consider, including funding, study design, ethics, data analysis, disseminating findings, and furthering one's research career. It presents a balance view of clinical research and is written by authors actively involved in clinical research both at the 'coal-face' and at a more supervisory level. Research can be a difficult process and it is essential to make sure that the project is set up in the correct way in order to get verifiable results. This easy-to-read guide is available to help junior doctors develop a good study design and present evidence of a sound academic practice, which will make obtaining funding more likely and be time-efficient. Getting started early in research and developing a solid, gradual understanding of clinical research through using this approachable book will be of huge benefit to junior doctors and their discipline.
When bioethicists debate the use of technologies like surgery and pharmacology to shape our selves, they are, ultimately, debating what it means for human beings to flourish. They are debating what makes animals like us truly happy, and whether the technologies at issue will bring us closer to or farther from such happiness. The positions that participants adopt in debates regarding such ancient and fundamental questions are often polarized, and cannot help but be deeply personal. It is no wonder that the debates are sometimes acrimonious. How, then, should critics of and enthusiasts about technological self-transformation move forward? Based on his experience at the oldest free-standing bioethics research institute in the world, Erik Parens proposes a habit of thinking, which he calls "binocular." As our brains integrate slightly different information from our two eyes to achieve depth of visual perception, we need to try to integrate greatly different insights on the two sides of the debates about technologically shaping our selves-if depth of intellectual understanding is what we are after. Binocular thinking lets us benefit from the insights that are visible from the stance of the enthusiast, who emphasizes that using technology to creatively transform our selves will make us happier, and to benefit from the insights that are visible from the stance of the critic, who emphasizes that learning to let our selves be will make us happier. Parens observes that in debates as personal as these, we all-critics and enthusiasts alike-give reasons that we are partial to. In the throes of our passion to make our case, we exaggerate our insights and all-too-often fall into the conceptual traps that language sets for us. Foolishly, we make conceptual choices that no one who truly wanted understanding would accept: Are technologies value-free or value-laden? Are human beings by nature creators or creatures? Is disability a medical or a social phenomenon? Indeed, are we free or determined? Parens explains how participating in these debates for two decades helped him articulate the binocular habit of thinking that is better at benefiting from the insights in both poles of those binaries than was the habit of thinking he originally brought to the debates. Finally, Parens celebrates that bioethics doesn't aspire only to deeper thinking, but also to better acting. He embraces not only the intellectual aspiration to think deeply about meaning questions that don't admit of final answers, but also the ethical demand to give clear answers to practical questions. To show how to respect both that aspiration and that demand, the book culminates in the description of a process of truly informed consent, in the context of one specific form of using technology to shape our selves: families making decisions about appearance normalizing surgeries for children with atypical bodies.
"Carefully reasoned, clearly articulated, and pulls no
punches...Boldly tackles the most contentious issues in bioethics
and public policy....Worst Case Bioethics is certain to provoke
strong responses across disciplines and ideologies on issues of
great importance."- Mark Rothstein, Journal of Legal Medicine
Life Before Birth provides a coherent framework for addressing
bioethical issues in which the moral status of embryos and fetuses
is relevant. It is based on the "interest view" which ascribes
moral standing to beings with interests, and connects the
possession of interests with the capacity for conscious awareness
or sentience. The theoretical framework is applied to ethical and
legal topics, including abortion, prenatal torts, wrongful life,
the crime of feticide, substance abuse by pregnant women,
compulsory cesareans, assisted reproduction, and stem cell
research. Along the way, difficult philosophical problems, such as
identity and the non-identity problem are thoroughly explored. The
book will be of interest not only to philosophers, but also
physicians, lawyers, policy makers, and anyone perplexed by the
many difficulties surrounding the unborn.
Clinical trials receive a lot of media attention; we hear or read about them almost daily in reports heralding new and promising treatments or reports raising questions about the safety or efficacy of an established treatment. The randomized trial is the foundation of evidence-based medicine and the cornerstone for comparative effectiveness research. This book is designed for budding students of clinical trials, novice researchers, and for the serious lay reader wanting to know more about the inner workings of trials, how they are reported, who and what gets studied, what to make of results, and how to shop for trials as a patient. Written with wit and charm, this guide will interest readers in way that formal, didactic texts cannot. Features: * Provides invaluable information on clinical trials, presented in a clear, approachable way for novice researchers * The book explains how trials are built, how they are run, and how the data is interpreted afterward * Features a glossary of abbreviations used by trialists
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.
This analysis of the law's approach to healthcare decision-making critiques its liberal foundations in respect of three categories of people: adults with capacity, adults without capacity and adults who are subject to mental health legislation. Focusing primarily on the law in England and Wales, the analysis also draws on the law in the United States, legal positions in Australia, Canada, Ireland, New Zealand and Scotland and on the human rights protections provided by the ECHR and the Convention on the Rights of Persons with Disabilities. Having identified the limitations of a legal view of autonomy as primarily a principle of non-interference, Mary Donnelly questions the effectiveness of capacity as a gatekeeper for the right of autonomy and advocates both an increased role for human rights in developing the conceptual basis for the law and the grounding of future legal developments in a close empirical interrogation of the law in practice.
How state welfare politics-not just concerns with "race improvement"-led to eugenic sterilization practices. Honorable Mention, 2018 Outstanding Book Award, The Disability History AssociationShortlist, 2019 Wallace K. Ferguson Prize, Canadian Historical Association Between 1907 and 1937, thirty-two states legalized the sterilization of more than 63,000 Americans. In Fixing the Poor, Molly Ladd-Taylor tells the story of these state-run eugenic sterilization programs. She focuses on one such program in Minnesota, where surgical sterilization was legally voluntary and administered within a progressive child welfare system. Tracing Minnesota's eugenics program from its conceptual origins in the 1880s to its official end in the 1970s, Ladd-Taylor argues that state sterilization policies reflected a wider variety of worldviews and political agendas than previously understood. She describes how, after 1920, people endorsed sterilization and its alternative, institutionalization, as the best way to aid dependent children without helping the "undeserving" poor. She also sheds new light on how the policy gained acceptance and why coerced sterilizations persisted long after eugenics lost its prestige. In Ladd-Taylor's provocative study, eugenic sterilization appears less like a deliberate effort to improve the gene pool than a complicated but sadly familiar tale of troubled families, fiscal and administrative politics, and deep-felt cultural attitudes about disability, dependency, sexuality, and gender. Drawing on institutional and medical records, court cases, newspapers, and professional journals, Ladd-Taylor reconstructs the tragic stories of the welfare-dependent, sexually delinquent, and disabled people who were labeled "feebleminded" and targeted for sterilization. She chronicles the routine operation of Minnesota's three-step policy of eugenic commitment, institutionalization, and sterilization in the 1920s and 1930s and shows how surgery became the "price of freedom" from a state institution. Combining innovative political analysis with a compelling social history of those caught up in Minnesota's welfare system, Fixing the Poor is a powerful reinterpretation of eugenic sterilization.
Of every thousand children born in Iceland, two will die before
their first birthday, but in Mozambique the death rate is sixty
times higher. Even within countries - including some of the
wealthiest - inequalities in longevity and health can be
substantial. In recent years, epidemiologists have documented the
extent of these inequalities both between and within countries,
stimulating in turn research both on their sources and on possible
means for their alleviation. These extensive and influential
efforts in research and in policy development have raised health
inequalities to a prominent position among the central concerns of
both national and global health. |
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