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 work brings together a wide range of perspectives on ethics and morality from formal research studies of practitioners' dilemmas to theoretical and philosophical explanations of the ethics of psychotherapy. Numerous practical and thought-provoking insights from 25 years of professional experience in these fields aim to make this a useful text for any student, client, trainer, supervisor or practitioner. There are also useful examples of thinking structures for the analysis, learning and understanding of ethics as well as a selection of ethical dilemmas for practice and training, supervision, research and other professional purposes. Based on current research in psychotherapy outcome, this volume also places under the spotlight issues such as the relative importance of theoretical approaches to psychotherapy, and the relevance of values and ideology and the interests of professionalisation as well as the interests of patients. The books focus is the uses and abuses of the therapeutic relationship - the heart of the matter - across all disciplines and across all approaches. Its Copernican contribution is to conceptualise ethics not as a kind of "add on" to therapy, but as the sun around which the work of psychotherapy and psychoanalysis revolves. Sole or jointly authored chapters include research on ethical dilemmas, issues of values and responsibility, supervision, training and research and collegial relationships, examples of documents to give to clients or supervisees, writing for publication (and its pitfalls), as well as dilemmas involving the ethics and complaints procedures of professional bodies such as UKCP organizations.

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.
Less attention has been given to careful analysis and refinement of some key concepts and values that guide and motivate these studies of health inequalities. The essays in this book demonstrate the need to identify and debate alternative positions on the choice of measures of health inequality; the definitions of 'inequality' and 'inequity' in health, and their interrelationship; the ethical basis for attaching priority to narrowing gaps in longevity and health among individuals, groups, and societies; and the possible solutions to a series of puzzles involving uncertainty and variable population size.
The authors of these essays are philosophers, economists, epidemiologists, and physicians contributing to our understanding of ethical issues in population health. Their contributions will be of interest to anyone interested in inequalities in health, including specialists in health policy, public health, epidemiology, moral philosophy, demography, and health economics.

Biomedical research on humans is an important part of medical progress. But, when health and lives are at risk, safety and ethical practices need to be the top priority. The need for the committees that regulate and oversee such research -- institutional review boards, or IRBs -- is growing. Evaluating the Science and Ethics of Research on Humans is a guide for new and veteran members of IRBs that will help them better understand the issues involved and the tasks they will be required to perform.

The most important purpose of an IRB is to protect the human participants in research. For three major research areas -- drugs, medical devices, and genetic information -- Dennis J. Mazur shares the methods he has found useful in protecting human participants through the systematic review of scientific protocols and informed consent forms and through adherence to the federal regulations that apply. New members will gain understanding of how proposed research projects are to be reviewed from both scientific and ethical dimensions, how and when to ask key questions of principal investigators, how to work with principal investigators and research teams to ensure the best protection of human participants, and why to schedule regularly spaced reviews of a project that may have adverse outcomes.

Containing helpful summaries and checklists throughout and based on Mazur's thirty years of research experience, this accessible and informative guide will give all IRB members the tools they need to protect human lives and facilitate the research process.

Deficiencies and shortfalls in the supply of human organs for transplantation and human tissue for research generate policy dilemmas across the world and have often given rise to major and deleterious controversies, such as those relating to organ and tissue retention practices following post-mortem examination. They also create an environment in which illegitimate commercial activities flourish. At the same time, patients are denied the therapy they desperately require and researchers are impeded from carrying out vital work into the causes of, and efficacious treatments for, major illnesses and diseases. David Price sets out a clear and integrated legal and policy framework which emanates from the tissue source but protects the interests of donors and relevant professionals through tailored property entitlements, but without presupposing rights to trade in 'original' materials.

Ethical dilemmas are not new in the area of health care and policy making, but in recent years, their frequency and diversity have grown considerably. All health professionals now have to consider the ethical implications of an increasing array of treatments, interventions and health promotion activities on an almost daily basis. This goes hand in hand with increasing medical knowledge, and the growth of new and innovative medical technologies and pharmaceuticals. In addition, the same technology and knowledge is increasing professional and public awareness of new potential public health threats (e.g. pandemic influenza). At the level of public policy, concerns over the rising costs of health care have led to a more explicit focus on 'health promotion', and the surveillance of both 'patients' and the so-called 'worried well'. Health professionals and policy makers also have to consider the implications of managing these risks, for example restricting individual liberty through enforced quarantine (in the wake of SARS and more recently swine flu) and the more general distribution of harms and benefits. Balancing the rights and responsibilities of individuals and wider populations is becoming more complex and problematic. This book will play a key role in opening out a discussion of public health ethics. It examines the principles and values that support an ethical approach to public health practice and provides examples of some of the complex areas which those practising, analysing and planning the health of populations have to navigate. It will therefore be essential reading for current practitioners, those involved in public health research and a valuable aid for anyone interested in examining the tensions within and the development of public health.

This is a valuable, up-to-date, and newly revised collection of articles by noted experts to address all aspects of the stem cell controversy.

All human behaviour is, ultimately, a moral undertaking, in which each situation must be considered on its own merits. As a result ethical conduct is complex. Despite the proliferation of Codes of Conduct and other forms of professional guidance, there are no easy answers to most human problems. Mental Health Ethics encourages readers to heighten their awareness of the key ethical dilemmas found in mainstream contemporary mental health practice. This text provides an overview of traditional and contemporary ethical perspectives and critically examines a range of ethical and moral challenges present in contemporary 'psychiatric-mental' health services. Offering a comprehensive and interdisciplinary perspective, it includes six parts, each with their own introduction, summary and set of ethical challenges, covering: fundamental ethical principles; legal issues; specific challenges for different professional groups; working with different service user groups; models of care and treatment; recovery and human rights perspectives. Providing detailed consideration of issues and dilemmas, Mental Health Ethics helps all mental health professionals keep people at the centre of the services they offer.

This is a lucid, readable discussion of ethical questions in health care as they arise on the business or organizationl level: an effort to spell out an ethical perspective for healthcare organizations. It will be of use to students in health services management programmes, health care professionals, healthcare administrators, and members of healthcare ethics committees.

For courses in medical law or ethics in programs for nurses, medical assistants, and other allied health care professionals. A plain-language guide to the law and ethics of healthcare Medical Law and Ethics examines the essentials of pertinent laws and the ethical demands of healthcare professions. Clear and readable, the text helps students identify the ethical norms they will adhere to in their chosen field. Real legal cases and stimulating exercises challenge learners to envision their responses to legal and ethical dilemmas in healthcare today. The 6th edition covers issues of increasing concern in hospitals and medical offices, including the opioid crisis in the US, electronic recordkeeping, and the needs of elderly and handicapped populations. New! Also available with MyLab Health Professions By combining trusted author content with digital tools and a flexible platform, MyLab personalizes the learning experience and improves results for each student. Developed for allied health students and instructors, MyLab Health Professions supports students' mastery and application of the skills they'll need for a successful career in health care. Note: You are purchasing a standalone product; MyLab Health Professions does not come packaged with this content. Students, if interested in purchasing this title with MyLab Health Professions, ask your instructor to confirm the correct package ISBN and Course ID. Instructors, contact your Pearson representative for more information.

Bioethics was "born in the USA" and the values American bioethics embrace are based on American law, including liberty and justice. This book crosses the borders between bioethics and law, but moves beyond the domestic law/bioethics struggles for dominance by exploring attempts to articulate universal principles based on international human rights. The isolationism of bioethics in the US is not tenable in the wake of scientific triumphs like decoding the human genome, and civilizational tragedies like international terrorism. Annas argues that by crossing boundaries which have artificially separated bioethics and health law from the international human rights movement, American bioethics can be reborn as a global force for good, instead of serving mainly the purposes of U.S. academics. This thesis is explored in a variety of international contexts such as terrorism and genetic engineering, and in U.S. domestic disputes such as patient rights and market medicine. The citizens of the world have created two universal codes: science has sequenced the human genome and the United Nations has produced the Universal Declaration of Human Rights. The challenge for American bioethics is to combine these two great codes in imaginative and constructive ways to make the world a better, and healthier, place to live.

A book for nurses, doctors and all who provide end of life care, this essential volume guides readers through the ethical complexities of such care, including current policy initiatives, and encourages debate and discussion on their controversial aspects. Divided into two parts, it introduces and explains clinical decision-making processes about which there is broad consensus, in line with guidance documents issued by WHO, BMA, GMC, and similar bodies. The changing political and social context where 'patient choice' has become a central idea, and the broadened scope of patients' best interests, have added to the complexity of decision-making in end of life care. The authors discuss issues widely encountered by GPs, nurses, and hospital clinicians. These include patient choice, consent, life prolonging treatment, and symptom relief including sedation. Part two explores the more controversial current end of life care initiatives, such as advance care planning, preferred place of care and death, euthanasia and assisted suicide, extended ideas of 'best interests', and the view that there are therapeutic duties to the relatives of patients. Throughout their discussion the authors draw attention to loose ends and contradictions in some of the proposals. Examining the current policy of consumerist choice, they reject its place in the health service, proposing a realistic, fair, humane, and widely adoptable system of end of life care.
As knowledge of ethical theories is required in training courses, and the vocabulary of ethical theory is widespread in current discussions, a substantial appendix on ethical theories and terms is available online.
Written by the same authors as The Philosophy of Palliative Care: Critique and Reconstruction, which won the Medical Journalists' Association Specialist Book Award 2007, this new book for non-specialists is essential reading for all health care professionals involved in providing end of life care.

This second edition addresses a variety of ethical issues that arise in the care of oncology patients. Many volumes have been written on medical ethics in the past 30 years. However, few have focused on ethical issues specific to the care of cancer patients. This book brings together such a focused examination. The contributors include clinicians, (doctors, nurses, and social workers), ethicists, medical humanists, medical educators, and a cancer survivor. The issues raised have direct relevance to the care of oncology patients in treatment as well as research settings. The chapters address issues that are central to contemporary medical practice and medical ethics inquiry.

Ethical Issues in Cancer Patient Care, Second Edition will have direct importance for practicing physicians, nurses and others caring for cancer patients. In addition, medical students, medical educators and ethicists will find this book of interest.

Eating disorders (EDs) have become a social epidemic in the developed world. This book addresses the close links between EDs and exercise, helping us to understand why people with EDs often exercise to excessive and potentially harmful levels. This is also the first book to examine this issue from an ethical and legal perspective, identifying the rights and responsibilities of people with EDs, their families and the fitness professionals and clinicians that work with them.

The book offers an accessible account of EDs and closely examines the concept of addiction. Drawing on a wide range of medical, psychological, physiological, sociological and philosophical sources, the book examines the benefits and risks of exercise for the ED population, explores the links between EDs and other abuses of the body in the sports environment and addresses the issue of athletes with disordered eating behaviour. Importantly, the book also surveys current legislation and professional codes of conduct that guide the work of fitness professionals and clinicians in this area and presents a clear and thorough set of case histories and action points to help professionals better understand, and care for, their clients with EDs.

Exercise and Eating Disorders is important reading for students of applied ethics, medical ethics and the ethics of sport, as well as for fitness professionals, psychiatrists, clinical psychologists, sports coaches and sport and exercise scientists looking to improve their understanding of this important issue.

In the warped world of prescription drug pricing, generic drugs can cost more than branded ones, old drugs can be relaunched at astronomical prices, and low-cost options are shut out of the market. In Drugs, Money and Secret Handshakes, Robin Feldman shines a light into the dark corners of the pharmaceutical industry to expose a web of shadowy deals in which higher-priced drugs receive favorable treatment and patients are channeled toward the most expensive medicines. At the center of this web are the highly secretive middle players who establish coverage levels for patients and negotiate with drug companies. By offering lucrative payments to these middle players (as well as to doctors and hospitals), drug companies ensure that inexpensive drugs never gain traction. This system of perverse incentives has delivered the kind of exorbitant drug prices - and profits - that everyone loves except for those who pay the bills.

Was konnen die psychologischen und gesellschaftlichen Ursachen von diversen Suchten und Zwangen und Krankheiten sein? Besteht ein Zusammenhang zwischen dem eigenen Menschenbild und unserem Verstandnis von Krankheit und Gesundheit? Was hat Krankheit mit unerfullten Sehnsuchten zu tun? Was bedeutet die Sehnsucht nach dem eigenen Selbst?

Dieses Werk nimmt den Leser mit auf eine Reise zum tieferen Verstandnis von seelischen Ursachen von Suchten, Zwangen und chronischen Erkrankungen. Dabei verbindet der Autor Dr. Otto Teischel eine existenz- und psychoanalytisch verstehende therapeutische mit einer philosophischen Perspektive.

Er verdeutlicht, welche Auswirkungen ungestillte Sehnsuchte, z.B. die Sehnsucht nach Freiheit und Autonomie, auf das korperliche Wohlbefinden haben konnen. Erhellende Erklarungen zu Filmbeispielen mit Szenenfotos, beispielhafte Analysen und Patienten-Falldarstellungen dienen zur Veranschaulichung der Inhalte.

Abgerundet wird das Werk durch das Aufzeigen von Praventions- und Heilungswegen, die verdeutlichen, wie Menschen gesund werden bzw. gesund bleiben konnen.

Zielgruppen sind alle, die mit mehr oder weniger leidenden Menschen arbeiten und sich fur die Zusammenhange von Korper, Seele und Geist interessieren."

Following recent high profile cases of surgical error in the Uk and USA, patient safety has become a key issue in healthcare, now placed at the heart of junior doctor's training. Errors made by doctors are very similar to those made in other high risk organizations, such as aviation, nuclear and petrochemical industries. Practical Patient Safety aims to demonstrate how core principles of safety from these industries can be applied in surgical and medical practice, in particular through training for health care professionals and healthcare managers.
While theoretical aspects of risk management form the backdrop, the book focuses on key techniques and principles of patient safety in a practical way, giving the reader practical advice on how to avoid personal errors, and more importantly, how to start patient safety training within his or her department or hospital.

This book presents a critical analysis of the debate in Muslim countries at the religious, legal and political level, sparked by the introduction of new biomedical technologies such as cloning, genetics, organ transplants and in vitro fertilisation. The book draws on law, sociology, anthropology, politics and the history of science. For this reason it will be of interest to scholars and operators in a wide variety of disciplines and fields.

Alasdair Maclean analyses the ethical basis for consent to medical treatment, providing both an extensive reconsideration of the ethical issues and a detailed examination of English law. Importantly, the analysis is given a context by situating consent at the centre of the healthcare professional-patient relationship. This allows the development of a relational model that balances the agency of the two parties with their obligations that arise from that relationship. That relational model is then used to critique the current legal regulation of consent. To conclude, Alasdair Maclean considers the future development of the law and contrasts the model of relational consent with Neil Manson and Onora O'Neill's recent proposal for a model of genuine consent.

Obwohl der Gewissenbegriff im Bewusstsein der meisten Medizinethiker durch den Strukturwandel im Gesundheitswesen in den letzten Jahrzehnten erheblich an Bedeutung verloren hat, bahnt sich im Zuge der fortschreitenden Pluralisierung des Wertempfindens in modernen Gesellschaften (nicht zuletzt durch das Wiedererstarken religioes-weltanschaulicher Positionen) eine erneute Diskussion um den Gewissensvorbehalt bei der Erbringung medizinischer Leistungen an. Der vorliegende Band nahert sich der Gewissenthematik bewusst aus interdisziplinarer Perspektive, um die verschiedenen Dimensionen einer Gewissenentscheidung auszuleuchten und die Folgen der fortschreitenden Verrechtlichung und OEkonomisierung fur die Gewissensfreiheit der verschiedenen im Gesundheitswesen tatigen Berufsgruppen kritisch zu reflektieren.

The field of medical education and training has undergone dramatic changes within the past few years, and continues to evolve. Modernising Medical Careers, changes in the statutory role of the Postgraduate Medical Education and Training Board, and the Good Doctors, Safer Patients report from Liam Donaldson, Chief Medical Officer, are just some of the factors affecting the way doctors are now learning. In this book, Yvonne Carter and Neil Jackson, experienced medical educators of both undergraduates and postgraduates who have demonstrated a long standing commitment to multi-professional education and training, bring together a prestigious team of contributors with a wide variety of experience across diverse academic, service and lay backgrounds, to provide a comprehensive, up to date review of medical education and training.
With the demands on young doctors increasing, along with higher patient expectations, the need for ongoing education and training within the medical profession has never been higher. This book offers theoretical and practical guidance for those planning, delivering, and receiving education and training in ever-changing healthcare environments. Themes covered include assessment, professionalism and medical regulation, educational standards, patients' expectations, Continuing Professional Development, leadership and management, the European Working Time Directive, Fitness to Practice, interprofessional learning, the development of the NHS workforce, equality and diversity, and ethical and legal issues. Medical education needs to be a lifelong process, and this book integrates both undergraduate and postgraduate issues throughout, to encourage continued learning.
This book will help ensure that future generations of doctors are trained to meet the changing needs of our population.

Can trust be restored by making people and institutions more accountable? Or do complex systems of accountability and control damage trust? Onora O'Neill challenges current approaches, investigates sources of deception in our society and re-examines questions of press freedom. This year's Reith Lectures present a philosopher's view of trust and deception and ask whether and how trust can be restored in modern democracy.