With advances in personalised medicine, the field of medical law is being challenged and transformed. The nature of the doctor-patient relationship is shifting as patients simultaneously become consumers. The regulation of emerging technologies is being thrown into question, and we face new challenges in the context of global pandemics. This volume identifies significant questions and issues underlying the philosophy of medical law. It brings together leading philosophers, legal theorists, and medical specialists to discuss these questions in two parts. The first part deals with key foundational theories, and the second addresses a variety of topical issues, including euthanasia, abortion, and medical privacy. The wide range of perspectives and topics on offer provide a vital introduction to the philosophical underpinnings of medical law.

How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness.
How Doctors Think is divided into four parts. Part one introduces the concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment.

Medical and ethical decision concerning treatment for handicapped newborns have always been difficult. Despite technological advances, parents and health-care professionals still search for criteria that will address treatment categories from an ethical standpoint. Richard A. McCormick, a leading Roman Catholic moral theologian, has proposed a patient-centered, quality-of-life approach to treatment decision that appears to meet the needs of decision-makers.Peter A. Clark applies McCormick's ethical approach to five categories of handicapped newborns as a practical demonstration of the treatment decision process. "Clark constructs, analyzes, and criticizes McCormick's developing methodology which McCormick himself never explicitly elaborated in his own writings." -Charles E. Curran, Southern Methodist University"Modern neonatology has worked wonders in the care of the newborn. Some of its successes have however resulted in the most difficult clinical and ethical dilemmas. Physicians, families and nurses will need and appreciate Fr. Peter Clark's judicious, sensitive and practical guidance through both the philosophical and the theological issues." - Edmund D. Pellegrino, Georgetown University Medical Center

The authors of this study emphasize the effectiveness of collectively funded public insurances as opposed to genetic information regulation within the private insurance sector. Genetics has provided tools to determine individuals' risk of future disease, which is of key interest for insurance companies in determining insurance premiums; but persons with high enough risk may remain uninsured. For this reason, genetic information has been regulated. But, regulation may not be the solution, according to the authors, and they call for the resumption of social insurance, a key element of the welfare state.

This text focuses on areas of public health practice in which the systematic application of epidemiologic methods can have a large and positive impact. It describes how best to apply traditional epidemiologic methods for determining disease etiology to "real-life" problems in public health and health services research. Brownson and Petitti's much-needed book bridges the gap between theoretical epidemiology and public health practice, and covers a number of topics not addressed by other epidemiology texts with a focus on methods. This second edition contains a new chapter on the development and use of systematic reviews and one on epidemiology and the law. Each chapter includes one or more case studies intended to illustrate major points from the chapter and to provide a basis for teaching exercises. All of the chapters are authored by leading experts in the fields of epidemiology and public health, and all are fully revised and updated.
The book is intended for practitioners in epidemiology as well as for students in epidemiology and related disciplines that rely on epidemiologic methods and reasoning. It is a practical and informative book for use in academic institutions, federal agencies which have significant educational missions, state and local public health agencies, and health care organizations. By providing a resource of immense accessibility to several key audiences, this edition of Applied Epidemiology: Theory to Practice further extends the fields ability to make a real difference on behalf of better health for all.

of UB's medical school, that UB developed its School of Arts and Sciences, and thus, assumed its place among the other institutions of higher education. Had Fillmore lived throughout UB's first seventy years, he would probably have been elated by the success of his university, and he should have been satisfied and pleased that UB remained intrinsically bonded to its community while at the same time engrafting the values and standards important to higher education's mission in the region. UB and its medical school have undergone many challenging transitions since 1846. Included among them were: (1) the completion of an academic campus in the far northeast comer of the City of Buffalo while leaving its medical, dental and law schools firmly situated in the core of downtown Buffalo; (2) the eventual relocation, after the second world war, of the law school to the newer campus in Amherst, and the medical and dental school to the original academic campus: and (3) the merger with the State University of New York System in 1962. Despite these significant transitions, any one of which could have changed the intrinsic integrity of UB and disrupted the bonding between community and university, that did not happen. To this day, the ties between community and academe persist. Fillmore and White should celebrate their success and important contribution to Buffalo and Western New York.

The perfect textbook for healthcare students who want a fresh, innovative way to understand how law and ethics relate to their studies, placements, and professional practice. By using a unique format made up of frequently asked questions and corresponding answers, Key Questions in Healthcare covers the what, why, where and how in legal and ethical issues related to healthcare. Its easy-to-use layout helps you quickly find informative yet straightforward answers to over 150 questions, helping you to feel confident in your legal and ethical knowledge, without leaving you overwhelmed or confused. All answers are written in-line with Nursing and Healthcare regulations and its conversational writing style will make you feel like you are talking with a lecturer, instructor, or knowledgeable colleague, rather than reading a textbook. The book is appropriate for all levels, from healthcare students in the initial stages of their education, to the advanced practitioner who wishes to refresh their knowledge, or maybe learn something new.

Freud promised his patients absolute confidentiality, regardless of what they revealed, but privacy in psychotherapy began to erode a half-century ago. Psychotherapists now seem to serve as "double agents" with a dual and often conflicting allegiance to patient and society. Some therapists even go so far as to issue Miranda-type warnings, advising patients that what they say in therapy may be used against them. Confidentiality and Its Discontents explores the human stories arising from this loss of confidentiality in psychotherapy. Addressing different types of psychotherapy breaches, Mosher and Berman begin with the the story of novelist Philip Roth, who was horrified when he learned that his psychoanalyst had written a thinly veiled case study about him. Other breaches of privacy occur when the so-called duty to protect compels a therapist to break confidentiality by contacting the police. Every psychotherapist has heard about "Tarasoff," but few know the details of this story of fatal attraction. Nor are most readers familiar with the Jaffee case, which established psychotherapist-patient privilege in the federal courts. Similiarly, the story of Robert Bierenbaum, a New York surgeon who was brought to justice fifteen years after he brutally murdered his wife, reveals how privileged communication became established in a state court. Meanwhile, the story of New York Chief Judge Sol Wachtler, convicted of harassing a former lover and her daughter, shows how the fear of the loss of confidentiality may prevent a person from seeking treatment, with potentially disastrous results. While affirming the importance of the psychotherapist-patient privilege, Confidentiality and Its Discontents focuses on both the inner and outer stories of the characters involved in noteworthy psychotherapy breaches and the ways in which psychiatry and the law can complement but sometimes clash with each other.

In the last two decades, more than ever before dentists must determine how to properly maintain their focus on ethics and professionalism in the face of powerful commercial pressures. While there is encouragement for ethical conduct within the dental profession, there is still relatively little assistance available to dentists and dental students for judging what conduct is ethically best in concrete situations. For many years, Dental Ethics at Chairside has served as an invaluable resource for tens of thousands of dentists and dentistry students, and this third edition of the gold standard in the field is thoroughly revised and updated. In addition to exploring ongoing and critical issues such as the patient-professional relationship, patients with compromised capacity, confidentiality, justice and the inadequacies of society's health care systems, and dentistry as a business, the third edition addresses emerging ethical issues related to conflicts of interest, dental professionalism, advertising and social media, the serious indebtedness of graduating dental students, bad outcomes and bad work, the explosion of aesthetic dentistry, acquiring new skills and new technology, the impact of the market on the professional-patient relationship, and many others. The book includes fourteen realistic cases and commentary about dilemmas in dentistry, as well as online resources for further research and study.

This new edition of a highly regarded standard text continues to focus on an ethic of care, while significantly enhancing and strengthening its theoretical basis. Extensively revised and updated in both content and approach, the third edition: o addresses many of the current pressing issues in nursing o emphasises the importance of relationships in health care o examines the process of decision making o uses an four-questions model for ethical decision making o offers material to stimulate discussion o considers the international dimensions of nursing ethics o includes the newly published NMC Code of Professional Conduct 2002 For nurses who practise primary nursing and who are therefore in a special relationship with their patients, this book is particularly appropriate. However, any nurse, whether qualified or in training, will find it easy to read, constructive and thought-provoking.Places ethics within the caring context of nursing

Beyond Brain Death offers a provocative challenge to one of the most widely accepted conclusions of contemporary bioethics: the position that brain death marks the death of the human person. Eleven chapters by physicians, philosophers, and theologians present the case against brain-based criteria for human death. Each author believes that this position calls into question the moral acceptability of the transplantation of unpaired vital organs from brain-dead patients who have continuing function of the circulatory system. One strength of the book is its international approach to the question: contributors are from the United States, the United Kingdom, Liechtenstein, and Japan. This book will appeal to a wide audience, including physicians and other health care professionals, philosophers, theologians, medical sociologists, and social workers.

Andrew Thompson, Norman J. Temple We humans are an extraordinary species. One of our finest achievements is the development of morality, of a sense of right and wrong. We articulate and then impose this sensitivity upon ourselves in the form of ethical guidelines, rules, regulations, and laws. We have, regrettably, also developed marvelously clever ways of justifying our behavior whenever it runs afoul of these prescriptions. We have, for example, developed the concept of objectivity to guide scientific pursuits and subsequently established rights which undermine the possibility of ever coming close to attaining the goal of being objective -- rights which entitle participating scientists to gain personal, tangible profits from scientific discoveries. Formerly, we envisaged gods who kept us in place, who reminded us that we were not all-powerful or especially wise. Now we tend to worship our achievements, especially our technological ones, and ourselves. Mary Midgley' aptly names this phenomenon, "humanolatry." We have lost our respect for nature in our enthusiasm for changing it to that which suits our shortsighted ends. We must, as she says, "unlearn" this way of thinking.

Ethics, Culture, and Psychiatry: International Perspectives is a textbook that explores the best ways to promote the use of the Declaration of Madrid, which outlines ethical standards for psychiatric practice throughout the world. The book is written with two questions in mind, both easy to pose and difficult to answer: - Is it possible to formulate a set of principles that will be valid for all psychiatrists, regardless of the cultures to which they belong or in which they live and practice, or are there as many sets of ethical principles as there are cultures?- If there is such a set of principles, what should we do to ensure that psychiatry as a discipline makes a significant contribution to societal good without helping the evil?

To facilitate the exploration of this territory, 15 experts from a variety of cultures examine the most pressing ethical issues prevalent within the current practice of psychiatry. Many of the dilemmas probed in this book are routinely encountered by clinicians who work in increasingly multicultural societies. The text covers issues that are broadly relevant to clinical practice and research, including: - An overview of ethics and societies around the world- Discussions of ethical practices and dilemmas specific to various cultural regions- Transcultural debate on overarching issues, such as incompetent patients, informed consent, and mental health law reform- The complete copy of The Declaration of Madrid printed in the appendix

Readers will find that this is a textbook that stimulates and supports, rather than closes, the debate on ethical aspects of professional psychiatric behavior. Ethics, Culture, and Psychiatry: International Perspectives is much more than just a book on ethics -- it is a major contribution to understanding the impact of culture and history on the ethical practice of medicine around the world, and a continuous search for a consensus on how to live together and make contributions to the well-being of people with mental illness, their families, and the family of humans on our planet.

University researchers in the United States seeking to observe, survey, or interview people are required first to complete ethical training courses and to submit their proposals to an institutional review board (IRB). Under current rules, IRBs have the power to deny funding, degrees, or promotion if their recommended modifications to scholars' proposals are not followed. This volume explains how this system of regulation arose and discusses its chilling effects on research in the social sciences and humanities.

Zachary M. Schrag draws on original research and interviews with the key shapers of the institutional review board regime to raise important points about the effect of the IRB process on scholarship. He explores the origins and the application of these regulations and analyzes how the rules--initially crafted to protect the health and privacy of the human subjects of medical experiments--can limit even casual scholarly interactions such as a humanist interviewing a poet about his or her writing. In assessing the issue, Schrag argues that biomedical researchers and bioethicists repeatedly excluded social scientists from rule making and ignored the existing ethical traditions in nonmedical fields. Ultimately, he contends, IRBs not only threaten to polarize medical and social scientists, they also create an atmosphere wherein certain types of academics can impede and even silence others.

The first work to document the troubled emergence of today's system of regulating scholarly research, "Ethical Imperialism" illuminates the problems caused by simple, universal rule making in academic and professional research. This short, smart analysis will engage scholars across academia.

Advances in genetic technology in general and medical genetics in particular will enable us to intervene in the process of human biological development which extends from zygotes and embryos to people. This will allow us to control to a great extent the identities and the length and quality of the lives of people who already exist, as well as those we bring into existence in the near and distant future. "Genes and Future People" explores two general philosophical questions, one metaphysical, the other moral: (1) How do genes, and different forms of genetic intervention (gene therapy, genetic enhancement, presymptomatic genetic testing of adults, genetic testing of preimplantation embryos), affect the identities of the people who already exist and those we bring into existence? and (2) How do these interventions benefit or harm the people we cause to exist in the near future and those who will exist in the distant future by satisfying or defeating their interest in having reasonably long and disease-free lives?"Genes and Future People" begins by explaining the connection between genes and disease, placing genetic within a framework of evolutionary biology. It then discusses such topics as how genes and genetic intervention influence personal identity, what genetic testing of individuals and the knowledge resulting from it entails about responsibility to others who may be at risk, as well as how gene therapy and genetic enhancement can affect the identities of people and benefit or harm them. Furthermore, it discusses various moral aspects of cloning human beings and body parts. Finally, it explores the metaphysical and moral implications of genetic manipulation of the mechanisms of aging to extend the human life span.The aim "Genes and Future People" is to move philosophers, bioethicists, and readers in general to reflect on the extent to which genes determine whether we are healthy or diseased, our identities as persons, the quality of our lives, and our moral obligations to future generations of people.

Giving Voice to Values as a Professional Physician provides students with the theoretical background and practical applications for acting on their values in situations of ethical conflict. It is the first medical ethics book that utilizes the Giving Voice to Values methodology to instruct students in medical ethics and professionalism. In doing so, it shifts the focus of ethics education from intellectually examining ethical theories and conflicts to emphasizing moral action. Each section of the book explains how moral decision-making and action can be implemented in the healthcare arena. Medical ethics cases are provided throughout in order to assist students in giving voice to their values and developing skills for professional action. The Giving Voice to Values methodology, and the cases in this book, do not focus on the big questions of academic ethics, but rather on the ethics of the everyday, even if the challenges presented are difficult. In other words, the ethical questions students will have to face, in this book and in medical education and practice, are about how to interact with others, whether they be patients or colleagues, who might have different ethical positions. The book provides a unique guide for professional identity formation and the teaching of ethics in medical schools.

The ultimate goals of human genome research are the treatment, cure and eventual prevention of genetic disorders but treatment and cure lag behind the ability to detect disease or increased suceptibility to disease. Most genetic services today deliver diagnosis and counseling, effective treatment is rare. As more genes are identified there is growing pressure to implement new testing programs or broaden existing programs and otherwise increase both the number of available genetic tests and the amount of genetic information. The main issues concerned among others are: voluntariness of services, freedom of choices, patient autonomy, informed consent, confidentiality of genetic information, privacy, testing of minors, social discrimination and stigmatization.

In times of global economic and political crises, the notion of solidarity is gaining new currency. This book argues that a solidarity-based perspective can help us to find new ways to address pressing problems. Exemplified by three case studies from the field of biomedicine: databases for health and disease research, personalised healthcare, and organ donation, it explores how solidarity can make a difference in how we frame problems, and in the policy solutions that we can offer.

This is the first textbook of surgical ethics. It is a practical, clinically comprehensive, well-organized guide to ethical issues in surgical practice, research, and educatio written by leading figures in surgery and bioethics. The authors cover the surgeon-patient relationship, the full range of surgical patients, surgical education and research and surgery and managed care. Their chapters are not abstract discussions of ethical principles; rather, they connect directly with the everyday concerns of practising surgeons.

claim was that he had faced a conflict of duties pitting his legal duty not to kill against his duty as a physician to relieve his patient's unbearable suffering. He was acquitted on the important grounds of conflict of duty. These grounds are based on a concept in Dutch law called "force majeure" 4 which recognizes extenuating circumstances such as conflicts of duty. The acquittal was upheld by the Lower Court of Alkmaar, but revoked by an Amsterdam court of appeal. The case went on to the Supreme Court, but before the Supreme Court's decision was issued, the Royal Dutch Medical Association (RDMA) attempted to clarify the criteria for euthanasia that many within the profession already accepted. The RDMA proposed that physicians be permitted to perform euthanasia provided that a set of procedures had been met. Variously stated, the guidelines contain the following central provisions: Voluntary, competent, explicit, and persistent requests on the part of the * patient; Requests based on full information; * The patient is in a situation of intolerable and hopeless suffering (either * physical or mental); No further acceptable alternatives to euthanasia. All alternatives * acceptable to the patient for relief of suffering having been tried; Consultation with at least one other physician whose judgment can be * 5 expected to be independent. Indirectly, these guidelines became the criteria prosecutors used to decide whether or not to bring charges.

"Globalizing Feminist Bioethics" is a collection of new essays on the topic of international bioethics that developed out of the Third World Congress of the International Association of Bioethics in 1996. Rosemarie Tong is the primary editor of this collection, in which she, Gwen Anderson, and Aida Santos look at such international issues as female genital cutting, fatal daughter syndrome, use of reproductive technologies, male responsibility, pediatrics, breast cancer, pregnancy, and drug testing.

When Joseph Murray performed the first successful living kidney donor transplant in 1954, he thought this would be a temporary stopgap. Today, we are no closer to the goal of adequate organ supply without living donors-if anything, the supply-demand ratio is worse. While most research on the ethics of organ transplantation focuses on how to allocate organs as a scarce medical resource, the ethical treatment of organ donors themselves has been relatively neglected. In The Living Organ Donor as Patient: Theory and Practice, Lainie Friedman Ross and J. Richard Thistlethwaite, Jr. argue that living donor organ transplantation can be ethical provided that we treat living solid organ donors as patients in their own right. Ross and Thistlethwaite develop a five-principle framework to examine some of the attempts to increase living donation. It uses the three principles of the Belmont Report: respect for persons, beneficence, and justice modified to organ transplantation, as well as the principles of vulnerability and special relationships creating special obligations. Their approach requires that the transplant community fully embrace current and prospective living organ donors as patients to whom we have special obligations. Only when living organ donors are regarded as patients in their own right and have a living donor advocate team dedicated to their well-being can the moral limits of living solid organ donation be realized and living donors be given the full respect and care they deserve.

In 1995 the People's Republic of China passed a controversial Eugenics Law, which, after a torrent of international criticism, was euphemistically renamed the Maternal and Infant Health Law. Aimed at "the implementation of premarital medical checkups" to ensure that neither partner has any hereditary, venereal, reproductive, or mental disorders, the ordinance implies that those deemed "unsuitable for reproduction" should undergo sterilization or abortion or remain celibate in order to prevent "inferior births." Using this recent statute as a springboard, Frank Dik?tter explores the contexts and history of eugenics in both Communist China and Taiwan. Dik?tter shows how beginning in Late Imperial China, Western eugenics was imported and combined with existing fears of cultural, racial, or biological degeneration in Chinese society, leading to government regulation of sexual reproduction.

"Imperfect Conceptions" is a revealing look at the cultural history of medical explanations of birth defects that demonstrates how Chinese assumptions about the relationship of the individual to society form the very core of their attitudes toward procreation. Dik?tter explains the patrilineal model of descent, where a person is viewed as the culmination of his or her ancestors and is held responsible for the health of all future generations. By this logic, a pregnant woman's behavior and attitude directly influence the well-being of her baby, and a deformed or retarded child reflects a moral failing on the part of the parents. Dik?tter also shows how the holistic medicine practiced in China blurs any distinction between individual and environment so that people are held responsible for illness.

Drawing on cultural, social, economic, and political approaches, Dik?tter goes beyond a simple authoritarian model to provide a more complex view of eugenic policy, showing how a variety of voices including those of popular journalists, social reformers, medical writers, sex educators, university professors, and politicians all disseminate information that supports rather than questions the state's program.

"Imperfect Conceptions" reveals how Chinese cultural currents -- fear and fascination with the deviant and the urge to draw clear boundaries between the normal and the abnormal -- have combined with medical discourse to form a program of eugenics that is viewed with alarm by the rest of the world.

The landscape of the religion and health literature is littered with a plethora of models so large and so unwieldy that they are impossible to estimate empirically. Neal Krause strikes out in a different direction, developing a core conceptual scheme that is evidence-based and can be verified empirically. The relationships in it are based on empirical findings from prior studies or, when no empirical support exists, these relationships can be bolstered by a convincing theoretical rationale. As a result, the relationships he posits can be supported, refuted, or modified. This is a necessary first step toward cumulative knowledge building. In Religion, Virtues, and Health: New Directions in Theory Construction and Model Development, Krause suggests that religion may operate, in part, by bolstering physical health as well as psychological well-being. The book is designed to explain how these health-related benefits arise. The main conceptual thrust of his model is that people learn to adopt key virtues from fellow church members, including forgiveness, compassion, and beneficence. These virtues, in turn, promote a deeper sense of meaning in life. Then, meaning in life exerts a beneficial effect on health and well-being. This ambitious work, the capstone of Krause's long and distinguished career, makes a number of signal contributions: First, his theory construction and model development strategy are unique-there simply is nothing like it in the literature. Second, his work constitutes a groundbreaking effort to bridge the gap between theoretical discussions of communities of faith and the actual assessment of this core religious entity in practice. Third, the approach he advocates to study religion and health is generic because it can be readily adopted by researchers in unrelated social and behavioral science fields. And fourth, by showing how he practices his craft, he provides a pragmatic approach to conducting research that will be of great interest to established researchers, emerging investigators, and students alike.

This is the first book of case studies on animal ethics. It deals with important social controversies involving the human use of animals and analyses the moral issues involved. An excellent introduction to ethical theory provides a framework to the 16 original case studies, which include the use of animals in research, testing, and education, as food, as companion animals, and in religious rites.