This book presents ideas, evidence and guidance for those interested in using the most recent advances in knowledge about learning and human development to enhance medical education's ability to form competent, caring and publicly responsible physicians. It does this by establishing the development of a professional identity in medical students and residents as a primary goal of medical education. This new approach is emerging from experience and experiment by medical educators articulating a new way of understanding their mission. It is an optimistic book - the voices are those of the leaders, theorists and experienced practitioners who have found in this new approach a promising way to confront the challenges of a new era in medicine. It summarizes the theoretical basis of identity formation, outlines our current knowledge of how best to assist learners as they acquire a professional identity, and addresses the issue of assessment of progress towards this goal.

This textbook introduces the reader to basic problems in the philosophy of science and ethics, mainly by means of examples from medicine. It is based on the conviction that philosophy, medical science, medical informatics, and medical ethics are overlapping disciplines. It claims that the philosophical lessons to learn from the twentieth century are not that nature is a 'social construction' and that 'anything goes' with respect to methodological and moral rules. Instead, it claims that there is scientific knowledge, but that it is never completely secure; that there are norms, but that they are situation-bound; and that, therefore, it makes good sense to search for scientific truths and try to act in a morally decent way. Using philosophical catchwords, the authors advocate 'fallibilism' and 'particularism'; a combination that might be called 'pragmatic realism'.

Who should have access to assisted reproductive technologies? Which one of many seriously ill patients should be offered the next available transplant organ? When may a surrogate decision maker decide to withdraw life-prolonging measures from an unconscious patient? Questions like these feature prominently in the field of health care ethics and in the education of health care professionals. This book provides a concise introduction to the major concepts, principles and issues in health care ethics, using case studies throughout to illustrate and analyse challenging ethical issues in contemporary health care. Topics range widely, from confidentiality and truthfulness to end-of-life care and research on human subjects. Ethics and Health Care will be a vital resource for students of applied ethics, bioethics, professional ethics, health law and medical sociology, as well as students of medicine, nursing and other health care professions.

This transdisciplinary volume outlines the development of public health paradigms across the ages in a global context and argues that public health has seemingly lost its raison d'etre, that is, a population perspective. The older, philosophical approach in public health involved a holistic, population-based understanding that emphasized historicity and interrelatedness to study health and disease in their larger socio-economic and political moorings. A newer tradition, which developed in the late 19th century following the acceptance of the germ theory in medicine, created positivist transitions in epidemiology. In the form of risk factors, a reductionist model of health and disease became pervasive in clinical and molecular epidemiology. The author shows how positivism and the concept of individualism removed from public health thinking the consideration of historical, social and economic influences that shape disease occurrence and the interventions chosen for a population. He states that the neglect of the multifactorial approach in contemporary public health thought has led to growing health inequalities in both the developed and the developing world. He further suggests that the concept of 'social capital' in public health, which is being hailed as a resurgence of holism, is in reality a sophisticated and extended version of individualism. The author presents the negative public policy consequences and implications of adopting methodological individualism through a discussion on AIDS policies. The book strongly argues for a holistic understanding and the incorporation of a rights perspective in public health to bring elements of social justice and fairness in policy formulations.

Information technology is transforming the practices of medicine, nursing, and biomedical research. Computers can now render diagnoses and prognoses more accurately than humans. The concepts of privacy and confidentiality are evolving as data moves from paper to silicon to clouds. Big data promises financial wealth, as well as riches of information and benefits to science and public health. Online access and mobile apps provide patients with an unprecedented connection to their health and health records. This transformation is as unsettling as it is exhilarating. This unique new book is essential for anyone who uses computers in health care, biomedical research or public health, and cares about the ethical issues that arise in their work. With chapters spanning issues from professionalism and quality to mobile health and bioinformatics, it establishes what will become the 'core curriculum' in ethics and health informatics, a growing field which encourages truly inter- and multidisciplinary inquiry.

This workbook is a companion to Clinical Ethics Consultation: A Practical Guide to Changing Culture, Building Capacity and Solving Problems Case by Case. The Toolkit lays out the process for clinical ethics consultation in a series of steps within five phases: Pre-Consult, Interviews, Mid-Consult, Consult meeting(s), and Post-Consult. For each step, the Toolkit provides directions for how to complete it, tips for success, and worksheets for capturing data and analysis. The Clinical Ethics Consultation Toolkit is the playbook from which clinical ethics consultants can draw methods and strategies for effectively delivering ethics consultation.

Touch may well be one of the least understood or talked about subjects in the helping professions. A discussion on the importance and ethics of positive, caring, and appropriate touch in professions such as teaching, nursing and counselling is long overdue. Touch in the Helping Professions delivers just that, weaving together scholarly evidence, research and clinical practice from a wide range of perspectives encompassing philosophy, theology, psychology, and anthropology to challenge assumptions about the role of touch in the helping professions. The contributors to the volume focus not only on the overarching roles of gender, age, culture and life experience, but go beyond to encompass canine-assisted therapy, touch deprivation, sacred objects, as well as key ethical considerations. The prevailing lack of dialogue, due to fear of contravening ethical boundaries, has stood in the way of an open and responsible discussion on the use of touch in therapy. Touch in the Helping Professions is a welcome and much needed contribution to the field-a window onto a fundamental need. This book is published in English. - Cet ouvrage offre un ensemble de donnees probantes et de resultats cliniques a l'appui du toucher dans le developpement physique et emotionnel. Il est structure selon trois axes : la theorie sur le toucher; la pratique du toucher dans un contexte de therapie, et les questions ethiques. Il aborde la question du role du genre, de l'age, de la culture et de l'experience de vie, des sujets comme la zootherapie, la privation sensorielle, des objets sacres, et des considerations d'ordre ethique. Les approches variees - philosophie, theologie, psychologie, anthropologie - remettent en question les presuppositions, offrent un contexte historico-culturelprofessionnel, et font appel a des donnees primaires. Les collaborateurs soutiennent que le toucher sain et non sexuel n'est pas suffisamment enseigne dans le cadre de la formation professionnelle. Cette absence de dialogue - engendree par la crainte de depasser des bornes ethiques, fait en sorte qu'une discussion ouverte et responsable sur l'utilisation du toucher dans un cadre therapeutique ne peut avoir lieu, alors meme qu'elle contribuerait aux balises theoriques de notre comprehension de cet enjeu fondamental. Ce livre est publie en anglais.

Text, Cases and Materials on Medical Law and Ethics presents a valuable collection of materials relating to often controversial areas of the law. Comprising extracts from statutes, cases and scholarly articles alongside expert author commentary and guidance which signposts the key issues and principles, this book is an ideal companion to this increasingly popular subject. Fully revised, this new edition incorporates expanded content, including: updated coverage of consent and decision making, including the the Montgomery v Lanarkshire Health Board (2015) judgment; the impacts of the EC directive for clinical trials and GDPR on the research use of patient data; and discussion of other recent developments in the case law, including the 2017 Charlie Gard litigation, the 2016 Privy Council decision in Williams v Bermuda on negligence causation, and the UK Supreme Court judgment in A & B v SS for Health (2017) on funding for patients from Northern Ireland seeking terminations elsewhere. Providing a comprehensive and up-to-date resource on this topical area of the law, this textbook is an invaluable reference tool for students of medical law as well as those studying medicine.

This book provides a careful and comprehensive, step-by-step method for providing clinical ethics consultation. This Guide can be applied in almost any healthcare setting and takes the reader from establishing an intake process and developing strategies for interviewing those involved in the situation, to undertaking a consultation meeting and following up on a clinical consult. The book is an invaluable resource to any clinical ethicist, or committee or consult team member who is seeking to provide their service with rigour and quality. Written in simple language, the book explores ideas and concepts that will help the reader to understand, think through, and ultimately offer useful ethical consultation when facing ethically challenging issues.

Medical professionals are expected to act in the interest of patients, the public, and the pursuit of medical knowledge. But what happens when doctors' supposed impartiality comes under fire? Helen Kang examines three moments in the history of the medical profession in Canada, spanning more than 150 years, when doctors' moral and scientific authority was questioned. She shows that the profession was compelled to re-examine its priorities, strategize in order to regain credibility, and redefine what it means to be a good doctor. Medicine and Morality reveals that the moral and scientific standards in medicine are determined in direct relation to, not in spite of, conflict of interest.

Through the sobering story of Maggie Worthen and her mother, Nancy, this book tells of one family's struggle with severe brain injury and how developments in neuroscience call for a reconsideration of what society owes patients at the edge of consciousness. Drawing upon over fifty in-depth family interviews, the history of severe brain injury from Quinlan to Schiavo, and his participation in landmark clinical trials, such as the first use of deep brain stimulation in the minimally conscious state, Joseph J. Fins captures the paradox of medical and societal neglect even as advances in neuroscience suggest new ways to mend the broken brain. Responding to the dire care provided to these marginalized patients, after heroically being saved, Fins places society's obligations to patients with severe injury within the historical legacy of the civil and disability rights movements, offering a stirring synthesis of public policy and physician advocacy.

This book explores a rapidly growing area of discussion in the health care industry, disruptive behavior in medical providers. The presence of disruptive behavior adversely impacts the providers of all disciplines: paraprofessional personnel, nurses, physicians and administrators. But more importantly, there may be a greater detrimental effect on quality and patient safety. This has led to mandated regulatory requirements that assist healthcare institutions in developing programs to address the problem. The book presents an evidence-based analysis of the disruptive provider behavior that defines the incidence, demographics, and profile of the behavior; discusses the specialties and work locations predisposed, as well as the interface with residents and nurses. The importance of patient safety, economic, and legal issues are addressed by a comprehensive, management strategy to effect positive, sustainable culture change in healthcare.

This book offers a new argument for the ancient claim that well-being as the highest prudential good - eudaimonia -consists of happiness in a virtuous life. The argument takes into account recent work on happiness, well-being, and virtue, and defends a neo-Aristotelian conception of virtue as an integrated intellectual-emotional disposition that is limited in both scope and stability. This conception of virtue is argued to be widely held and compatible with social and cognitive psychology. The main argument of the book is as follows: (i) the concept of well-being as the highest prudential good is internally coherent and widely held; (ii) well-being thus conceived requires an objectively worthwhile life; (iii) in turn, such a life requires autonomy and reality-orientation, i.e., a disposition to think for oneself, seek truth or understanding about important aspects of one's own life and human life in general, and act on this understanding when circumstances permit; (iv) to the extent that someone is successful in achieving understanding and acting on it, she is realistic, and to the extent that she is realistic, she is virtuous; (v) hence, well-being as the highest prudential good requires virtue. But complete virtue is impossible for both psychological and epistemic reasons, and this is one reason why complete well-being is impossible.

Community-based participatory research (CBPR) emerged in response to the longstanding tradition of "top-down" research-studies in which social scientists observe social phenomena and community problems as outsiders, separate from the participants' daily lives. CBPR is more immersive, fostering partnerships between academic and community organizations that increase the value and consequence of the research for all partners. The current perspectives gleaned from this school of research have been wildly well-received, in no small part because they address the complexity of the human experience in their conclusions. HANDBOOK OF COMMUNITY-BASED PARTICIPATORY RESEARCH codifies the methods and theories of this research approach and articulates an expansive vision of health that includes gender equality, safe and adequate housing, and freedom from violence. Topic-based chapters apply the theory and methods of CBPR to real world problems affecting women, ethnic and racial minorities, and immigrant communities such as sexual violence, exposure to environmental toxins, and lack of access to preventive care as well as suggesting future directions for effective, culturally sensitive research. HANDBOOK OF COMMUNITY-BASED PARTICIPATORY RESEARCH is required reading for academics, policy makers, and students seeking meaningful social change through scholarship.

The general practitioner is required to make hundreds of decisions every day and each must be tailored to the specific needs of the individual patient.
This first book on decision making in general practice is an invaluable reference for all concerned with providing quality care. Using over 200 real life cases, it analyses the difficulties arising in:
Diagnosis, investigation, management, follow up, outcome, prevention, practice organization.
A body of rules that can be applied to these wide ranging issues provides a framework to improve decision making skills in ways that are ethical, cost-effective, safe, and acceptable for GPs, trainees, trainers and medical students. Here is an essential guide to understanding this critical element of general practice.

One of modern healthcare's most controversial areas, reproductive medicine is an emerging discipline that fosters hugely divergent opinions on topics such as laboratory techniques, clinical management and ethical considerations. Highlighting over 50 contentious topics in reproductive medicine, this book presents expertly argued opinions are presented for and against, often with diametrically opposing views about management. Debates such as these are being increasingly used as learning tools, helping participants develop their critical thinking skills and showing that context is vital when making decisions. Issues discussed include limits on IVF provision, ethical queries about sex selection, embryology, and ovarian stimulation. Authors are authorities in their field, combining years of experience with fresh and innovative ideas to structure their arguments. Readers will gain an insight into topical controversies, critically evaluating the different sides to enhance their own clinical practice.

Having children is probably as old as the first successful organism. It is often done thoughtlessly. This book is an argument for giving procreating some serious thought, and a theory of how, when, and why procreation may be permissible. Rivka Weinberg begins with an analysis of the kind of act procreativity is and why we might be justifiably motivated to engage in it. She then proceeds to argue that, by virtue of our ownership and control of the hazardous material that is our gametes, we are parentally responsible for the risks we take with our gametes and for the persons that develop when we engage in activity that allows our gametes to unite with others and develop into persons. Further argument establishes that when done respectfully, and in cases where the child's chances of leading a life of human flourishing are high, procreation may be permissible. Along the way, Weinberg argues that the non-identity problem is a curiously common mistake. Arguments intending to show that procreation is impermissible because life is bad for people and imposed on them without their consent are shown to have serious flaws. Yet because they leave us with lingering concerns, Weinberg argues that although procreation is permissible under certain conditions, it is not only a welfare risk but also a moral risk. Still, it is a risk that is often permissible for us to take and impose, given our high level of legitimate interest in procreativity. In order to ascertain when the procreative risk is permissible to impose, contractualist principles are proposed to fairly attend to the interests prospective parents have in procreating and the interests future people have in a life of human flourishing. The principles are assessed on their own merits and in comparison with rival principles. They are then applied to a wide variety of procreative cases. Choice Outstanding Titles for Philosophy "Weinberg's The Risk of a Lifetime treats underappreciated ethical issues of procreation with philosophical intelligence, insight, and flair." -Stephen Darwall, Andrew Downey Orrick Professor of Philosophy, Yale University "...a well-argued, insightful, and lively discussion of the issues surrounding this underappreciated topic." -Notre Dame Philosophical Reviews Online "Weinberg's The Risk of a Lifetime is a must-read for anyone interested in procreative ethics generally or in understanding how a contractualist approach might be applied in the context of procreative ethics. Moreover, I can't think of a recent book that would be more valuable, more fun, or more engaging for students-or their instructors-in any mid-or upper-level course or seminar or in any graduate course in applied or normative ethics or in population ethics." -Ethics

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.

This book examines the issue of ethics in the context of the provision of military health care in an epidemic. Outbreaks of epidemics like Ebola trigger difficult ethical challenges for civilian and military health care personnel. This book offers theoretical reflections combined with reports from recent military and NGO missions in the field. The authors of this volume focus on military medical ethics adding a distinct voice to the topic of epidemics and infectious diseases. While military health care personnel are always crucially involved during disaster relief operations and large-scale public health emergencies, most of the current literature treats ethical issues during epidemics from a more general perspective without taking into account the specifics of the military context. The contributions in this volume provide first-hand insights into some of the ethical issues encountered by military health care personnel in missions during the Ebola outbreak in 2014/2015. This practical perspective is complimented by academic analyses and theoretical reflections on ethical issues associated with epidemics. This book will be of much interest to students of military studies, ethics and African politics.

In this volume Allen Buchanan collects ten of his most influential essays on justice and healthcare and connects the concerns of bioethicists with those of political philosophers, focusing not just on the question of which principles of justice in healthcare ought to be implemented, but also on the question of the legitimacy of institutions through which they are implemented. With an emphasis on the institutional implementation of justice in healthcare, Buchanan pays special attention to the relationship between moral commitments and incentives.
The volume begins with an exploration of the difficulties of specifying the content of the right to healthcare and of identifying those agents and institutions that are obligated to help ensure that the right thus specified is realized, and then progresses to an examination of the problems that arise in attempts to implement the right through appropriate institutions. In the last two essays Buchanan pursues the central issues of justice in healthcare at the global level, exploring the idea of healthcare as a human right and the problem of assigning responsibilities for ameliorating global health disparities.
Taken together, the essays provide a unique and consistent position on a wide range of issues, including conflicts of interest in clinical practice and the claims of medical professionalism, the nature and justification for the right to health care, the relationship between responsibility for healthcare and the nature of the healthcare system, and the problem of global health disparities. The result is an approach to justice in healthcare that will facilitate more productive interaction between the normative analysis of philosophers and the policy work of economists, lawyers, and political scientists.

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.

This volume contains the proceedings of the 10th International Symposium on Circumcision, Genital Integrity, and Human Rights. Authors are international experts in their fields, and the book contains the most up-to-date information on the issue of genital cutting of infants and children from medical, legal, bioethical, and human rights perspectives.

Currently and for centuries past, sickness has been understood to be primarily the physical result of bodily disease. Yet this definition of illness is out-of-date and untrue to life at a time when chronic illness and the problems of disability and aging are increasingly common. When persons are sick, it pervades their whole being. The Nature of Healing is based on a different definition of sickness, one that recognizes persons as sick when they cannot achieve their goals and purposes because of impairments of function, ranging from the molecular to the spiritual, which they believe to fall under the scope of medicine. Such impairments may result from disease, but certainly not all.
As the sick person has increasingly become the focus of medicine, there have been repeated but mostly failed attempts to achieve both technological and humanistic goals in caring for patients. This approach is flawed because there is only one ultimate goal -- the well-being of the patient. Whether it involves the personal action of the clinician or the use of technology, everything done toward the goal of well-being is part of the healing enterprise. In this book, Eric Cassell explores what sickness is, what persons are, and how to understand function and its impairments. He explains healing skills and actions, as well as the nature of healing for sick and suffering patients. This book concludes with a discussion of the moral basis of the relationship between patient and healer, as well as the goals of healing.

This book addresses the debate usually tagged as being about 'markets in human body parts' which is antagonistically divided into pro-market and anti-market positions. The author provides a set of propositions about how to approach this and shows a way out of the concrete impasse of it. Assumptions about markets and bodies that characterize this debate are analyzed and described while the author argues that these assumptions are in fact constitutive for exchanges of human bodily material - but in unacknowledged ways. It is concluded that what we need is a different analytical approach to better understand the mechanisms at play when organizations exchange organs, tissues and cells for use in transplantation and fertility medicine.

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.