Recent advances in techniques and understanding in the fields of genetics, embryology and reproductive biology have opened up new ways to treat a wide range of medical problems. They range from new options for infertility treatment and pre-implantation genetic diagnosis to stem-cell-based therapies for debilitating diseases. Since all these approaches involve the manipulation of human gametes, embryos or embryonic cells, and could also permit more contentious uses, they have stimulated a controversial debate as to what aims are desirable and to what extent experiments on human embryos are morally permissible, if permissible at all. The situation is further complicated by the fact that scientific projects are increasingly realized through international co-operation and that patients are increasingly ready to seek morally contentious medical treatment wherever it is available and thus to bypass national legislation. In view of this situation the Europaische Akademie assembled a temporary interdisciplinary project group in which scientists from universities and non-university research organizations in Europe working on the relevant subjects were brought together and charged with establishing a knowledge base and providing suggestions for long-term solutions that would be acceptable for society. Presented here are the results of this project, ranging from a discussion of the theoretical and practical possibilities in human-embryo experimentation and its alternatives in research on adult stem cells, a comparison of the situations and prospects of regulation of embryo research in Europe, a survey of European public attitudes, and a philosophical analysis of the arguments and argumentative strategies used in the debate."

Handing envelopes containing money or gifts to doctors in public health care is often seen as a remnant of socialism that continues as an integral part of the Lithuanian health care system. Rima Praspaliauskiene uses the envelope to explore complex doctor-patient interactions that go beyond notions of the gift or the bribe. She reshapes our definition of corruption and encourages seeing these practices as emerging forms of care that impede the neoliberal health care reforms effected in the post-Soviet era. Enveloped Lives extends the analytical categories of gift, care, money, and transparency, shifting attention away from material transactions by prioritizing relations and practices that transcend economic rationality. At a time when health care reforms and the costs of care are being widely debated, this book is a contribution to the larger discussion about the ethics and future of health care around the world.

This practical guide summarizes the principles of working with dying patients and their families as influenced by the commoner world religions and secular philosophies. It also outlines the main legal requirements to be followed by those who care for the dying following the death of the patient. The first part of the book provides a reflective introduction to the general influences of world religions on matters to do with dying, death and grief. It considers the sometimes conflicting relationships between ethics, religion, culture and personal philosophies and how these differences impact on individual cases of dying, death and loss. The second part describes the general customs and beliefs of the major religions that are encountered in hospitals, hospices, care homes and home care settings. It also includes discussion of non-religious spirituality, humanism, agnosticism and atheism. The final part outlines key socio-legal aspects of death across the UK. Death, Religion and Law provides key knowledge, discussion and reflection for dealing with the diversity of the everyday care of dying and death in different religious, secular and cultural contexts. It is an important reference for practitioners working with dying patients, their families and the bereaved.

This book-first published a decade before the COVID-19 pandemic erupted-is the first authored volume on ethical issues in infectious disease, "monumental" for its competence and comprehensiveness. It is augmented here with a new Preface on COVID-19. The book develops an ethical framework for exploring contagious infectious disease, the patient-as-victim-and-vector view, grounded in the biological fact that a person with a communicable infectious disease is not only a victim of that disease, but at the same time also a potential vector. The patient may be both threatened, someone made ill or facing death, but also a threat, someone who may transmit an illness that will sicken or kill others. Clinical medicine has tended to see one part of this duality and public health the other; the victim-AND-vector view insists on both, at one and the same time. Against a background of methods from the long human history of contagious infectious disease-quarantine, isolation, cordon sanitaire, surveillance and contact tracing, testing by both archaic and modern methods, lockdown, and immunization-the victim-and-vector view spotlights ethical challenges for clinical medicine, research, public health, and health policy. These insights are probed in the new Preface on COVID-19 and are essential in our continuing struggle to address not only the current coronavirus pandemic, but the next, and the next after that.

A cutting-edge analysis of the global issues surrounding modern reproductive technologies Advances in assisted reproductive technologies have sparked global policy debates since the birth of the first so-called "test tube baby" in 1978. Today, mitochondrial replacement therapies represent the most recent advancement in assisted reproductive technologies, allowing some women with mitochondrial diseases to birth babies without those diseases. In the past decade, mitochondrial replacement therapies have captured public sentiment, reigniting debates around social views of reproductive rights and the appropriate legal and political response. Reproduction Reborn guides readers through the history and science of mitochondrial replacement therapies and the various attempts to control them. Leading experts from medicine, genetics, ethics, law, and policy explore the influence of public debate on the evolving shape of these technologies and their subsequent regulation. They highlight case studies from both developed and developing countries across the globe, including recent legislation in Australia and China. They further identify the ethical, legal, and societal norms that need to be addressed by policymakers and communities as more and more people seek to gain access to these treatments. Given the importance of reproduction in family life and cultural identity, clinicians and policymakers must understand how regulatory regimes around mitochondrial replacement therapies have evolved to illuminate the processes and challenges of governing reproduction in a fast-moving world. Informative and global in scope, Reproduction Reborn explores how advancements in assisted reproductive technologies challenge core values surrounding the rights and responsibilities of modern-day family units.

This text provides an investigation into how the Human Genome Project (HGP) is likely to affect future generations. It examines the implications these effects hold for evaluating HGP and other research efforts like it.

The Basics of Bioethics, Fourth Edition offers an easy-to-follow introduction to this dynamic field, intended for healthcare professionals, teachers, students, and anyone interested in bioethics. Accessible and enjoyable for readers of all backgrounds, the book contains numerous cases-including ones that recently have dominated international headlines-to help anchor the broader discussion. The text is suitable for use in short courses in schools of medicine, nursing, and other health professions; continuing professional education; various undergraduate departments; and adult education. Chapters are organized around common moral themes in order to help readers understand the values and other connections that tie together different positions in bioethics. This fourth edition adds a new chapter on alternative frameworks in bioethics, including narrative ethics and casuistry, feminist approaches, care ethics, and virtue ethics. Due to significant advances in genetics and reproductive possibilities, this new edition devotes a full chapter to each. The combined teaching, research, and clinical experience of the two authors helps make this edition current with the evolving field of bioethics, while still embedding the major issues in a systematic framework that allows readers easily to navigate the larger field. Key Changes to the Fourth Edition: * An added chapter on new and emerging approaches in bioethics, including those based on virtue ethics, casuistry and narrative ethics, feminist ethics, and care ethics * Updates throughout the book based on developments in ethical theory and new medical research * Revisions and updates to the Learning Objectives, Key Terms, Bibliographies, and URLs * The addition of multiple recent case studies, including: Jahi McMath an undocumented patient who needs a rule bent a pediatrician who turns away unvaccinated patients a minor eligible for pediatric bariatric surgery a daughter suing a hospital for non-disclosure of her father's Huntington's diagnosis CRISPR-edited newborn babies

"Will the future confront us with human GMOs? Greely provocatively declares yes, and, while clearly explaining the science, spells out the ethical, political, and practical ramifications."-Paul Berg, Nobel Laureate and recipient of the National Medal of Science Within twenty, maybe forty, years most people in developed countries will stop having sex for the purpose of reproduction. Instead, prospective parents will be told as much as they wish to know about the genetic makeup of dozens of embryos, and they will pick one or two for implantation, gestation, and birth. And it will be safe, lawful, and free. In this work of prophetic scholarship, Henry T. Greely explains the revolutionary biological technologies that make this future a seeming inevitability and sets out the deep ethical and legal challenges humanity faces as a result. "Readers looking for a more in-depth analysis of human genome modifications and reproductive technologies and their legal and ethical implications should strongly consider picking up Greely's The End of Sex and the Future of Human Reproduction... [It has] the potential to empower readers to make informed decisions about the implementation of advancements in genetics technologies." -Dov Greenbaum, Science "[Greely] provides an extraordinarily sophisticated analysis of the practical, political, legal, and ethical implications of the new world of human reproduction. His book is a model of highly informed, rigorous, thought-provoking speculation about an immensely important topic." -Glenn C. Altschuler, Psychology Today

Like many novel ideas, the idea for this volume and its predecessor arose over lunch in the cafeteria of the old Wellcome Institute. On an atternoon in Sept- ber 1988, Dorothy and Roy Porter, and I, sketched out a plan for a set of conf- ences in which scholars from a variety of disciplines would explore the emergence of modern medical ethics in the English-speaking world: from its pre-history in the quarrels that arose as gentlemanly codes of etiquette and honor broke down under the pressure of the eighteenth-century "sick trade," to the Enlightenment ethics of John Gregory and Thomas Percival, to the American appropriation process that culminated in the American Medical Association's 1847 Code of Ethics, and to the British turn to medical jurisprudence in the 1858 Medical Act. Roy Porter formally presented our idea as a plan for two back-to-back c- ferences to the Wellcome Trust, and I presented it to the editors of the PHI- LOSOPHY AND MEDICINE series, H. Tristram Engeihardt, Jr. and Stuart Spicker. The reception from both parties was enthusiastic and so, with the financial backing of the former and a commitment to publication from the latter, Roy Porter, ably assisted by Frieda Hauser and Steven Emberton, - ganized two conferences. The first was held at the Wellcome Institute in - cember 1989; the second was sponsored by the Wellcome, but was actually held in the National Hospital, in December 1990.

Well and Good presents a combination of classic and little-known cases in health care ethics. These cases, accompanied by information about the major ethical theories, give students a chance to grapple with the ethical challenges faced by health care practitioners, policy makers, and recipients. The authors' narrative style and leading questions provoke interest and engagement, while allowing readers to work through complicated issues for themselves. This fourth edition includes an expanded discussion of feminist ethics, as well as new cases addressing pandemic ethics, humanitarian aid, the social determinants of health, research and Aboriginal communities, and a number of other emerging issues.

This book discusses contemporary issues in medical ethics from a Buddhist perspective. Drawing on ancient and modern sources, Damien Keown shows how Buddhist ethical principles can be applied consistently to a range of bioethical problems, including abortion, embryo research, and euthanasia.

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.

No other cluster of medical issues affects the genders as differently as those related to procreation--contraception, sterilization, abortion, artificial insemination, in vitro fertilization, surrogate motherhood, and genetic screening. Yet, the moral diversity among feminists has led to political fragmentation, foiling efforts to create policies that are likely to serve the interests of the largest possible number of women. In this remarkable book, Rosemarie Tong offers an approach to feminist bioethics that serves as a catalyst, bringing together the varied perspectives on choice, control, and connection. Emphasizing the complexity of feminist debates, she guides feminists toward consensus in thought, cooperation in action, and a world that would have no room for domination and subordination.Tong fairly and comprehensively presents the traditions of both feminist and non-feminist ethics. Although feminist approaches to bioethics derive many insights from nonfeminist ethics and bioethics, Tong shows that their primary source of inspiration is feminist ethics, leading them to ask the so-called "woman question" in order to raise women's consciousness about the systems, structures, and relationships that oppress them. Feminist bioethicists are, naturally, focused on acting locally in the worlds of medicine and science. Their different feminist voices must be raised at the policy table with one message in order to actually "do" something to make gender equity a present reality rather than a mere future possibility. Inability to define a plan that "guarantees" liberation for all women must not prevent feminists from offering a plan that promises to improve the estates of many women. Otherwise, a perspective less appealing to women may fill the gap.

Bioethics and Disability provides tools for understanding the concerns, fears, and biases that have convinced some people with disabilities that the health care setting is a dangerous place and some bioethicists that disability activists have nothing to offer bioethics. It wrestles with the charge that bioethics as a discipline devalues the lives of persons with disabilities, arguing that reconciling the competing concerns of the disability community and the autonomy-based approach of mainstream bioethics is not only possible, but essential for a bioethics committed to facilitating good medical decision making and promoting respect for all persons, regardless of ability. Through in-depth case studies involving newborns, children, and adults with disabilities, Bioethics and Disability proposes a new model for medical decision making that is both sensitive to and sensible about the fact of disability in medical cases. Disability-conscious bioethics will bring together disability experts and bioethicists to identify and mitigate disability bias in our health care systems.

Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug).
Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct.
Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change.

This authoritative new handbook offers a comprehensive and cutting-edge overview of the state of the medical humanities globally, showing how clinically oriented medical humanities, the critical study of medicine as a global historical and cultural phenomenon, and medicine as a force for cultural change can inform each other. Composed of eight parts, the Routledge Handbook of the Medical Humanities looks at the medical humanities as: a network and system therapeutic provocation forms of resistance a way of reconceptualising the medical curriculum concerned with performance and narrative mediated by artists as diagnosticians of culture through public engagement. This book describes how the medical humanities can be used in and out of clinical settings, acting as a point of resistance, redistributing medicine's capital amongst its stakeholders, embracing the complexity of medical instances, shaping medical education, promoting interdisciplinary understandings and recognising an identity for the medical humanities as a network effect. This book is an essential read for all students, scholars and practitioners with an interest in the medical humanities.

This book provides healthcare and legal practitioners and students at all levels with the theory and practical application necessary to understand and apply bioethics, human rights and health law to their present and future work. The topics of bioethics, human rights and health law are part of the core curriculum for all students in Health Sciences in South Africa. Bioethics, Health Law and Human Rights: Principles and Practice, therefore, comes at no better time.

As the book is a guide, it does not deal exhaustively with the topics discussed. Instead, it aims to give healthcare and legal practitioners some general guidelines which it is hoped will be of practical use to them.

"A remarkable collection of scholarly essays, philosophical discussions, and ethical arguments concerning reproductive choices."
--"Choice"

It seems as if every week there is a new case involving reproductive technologies that raises provocative, often painful questions: What policies should be followed by centers that preserve human embryos? Are such innovations as Norplant improvements over established methods of contraception? Should R.U. 486 be available in the U.S.? Is prenatal diagnosis an ethically acceptable step to limiting the number of disabled people?

These are just some of the vital questions explored in this timely work which offers incisive analysis of the plethora of issues raised by advances in reproductive medicine. The book's major section cover abortion, contraception, cryopreservation of gametes and embryos, surrogate motherhood, and psychosocial issues of in-vitro fertilization.

In each section, introductory essays by recognized authorities such as Elizabeth Bartholet and Andrea L. Bonnicksen are followed by critical articles by professionals in such fields as women's health, medicine, biology, sociology, politics, and philosophy. In assessing a technology, the authors present well-argued analyses of problems created by that technology, including views from advocates and practitioners that raise attendant ethical and practical issues.

In the last fifty years, average overall health status has increased more or less in parallel with a much celebrated decline in mortality, attributed mostly to poverty reduction, sanitation, nutrition, housing, immunization, and improved medical care. It is becoming increasingly clear, however, that these achievements were not equally distributed. In most countries, while some social groups have benefited significantly, the situation of others has stagnated or may even have worsened. If health is a prerequisite to a person functioning as an agent, inequalities in health constitute inequalities in people's capability to function - a denial of equality of opportunity. So why should a concern with health equity be singled out from the pursuit of social justice more generally? Can existing theories of justice provide an adequate account of health equity? And what ethical problems arise in evaluating health inequalities? These are some of the important questions that this book addresses in building an interdisciplinary understanding of health equity. With contributions from distinguished philosophers, anthropologists, economists, and public-health specialists, it centres on five major themes: what is health equity?; health equity and social justice; responsibilities for health; ethical issues in health evaluation; and anthropological perspectives.

This collection contains twenty-one thought-provoking essays on the controversies surrounding the moral and legal distinctions between euthanasia and "letting die." Since public awareness of this issue has increased this second edition includes nine entirely new essays which bring the treatment of the subject up-to-date. The urgency of this issue can be gauged in recent developments such as the legalization of physician-assisted suicide in the Netherlands, "how-to" manuals topping the bestseller charts in the United States, and the many headlines devoted to Dr. Jack Kevorkian, who has assisted dozens of patients to die. The essays address the range of questions involved in this issue pertaining especially to the fields of medical ethics, public policymaking, and social philosophy. The discussions consider the decisions facing medical and public policymakers, how those decisions will affect the elderly and terminally ill, and the medical and legal ramifications for patients in a permanently vegetative state, as well as issues of parent/infant rights. The book is divided into two sections. The first, "Euthanasia and the Termination of Life-Prolonging Treatment" includes an examination of the 1976 Karen Quinlan Supreme Court decision and selections from the 1990 Supreme Court decision in the case of Nancy Cruzan. Featured are articles by law professor George Fletcher and philosophers Michael Tooley, James Rachels, and Bonnie Steinbock, with new articles by Rachels, and Thomas Sullivan. The second section, "Philosophical Considerations," probes more deeply into the theoretical issues raised by the killing/letting die controversy, illustrating exceptionally well the dispute between two rival theories of ethics, consequentialism and deontology. It also includes a corpus of the standard thought on the debate by Jonathan Bennet, Daniel Dinello, Jeffrie Murphy, John Harris, Philipa Foot, Richard Trammell, and N. Ann Davis, and adds articles new to this edition by Bennett, Foot, Warren Quinn, Jeff McMahan, and Judith Lichtenberg.

The work looks at all human aspects of new prenatal technology. It includes the view of both parents involved in making difficult decisions about their pregnancy, and clinicians and counsellors involved in diagnosis and discussion of results of investigations, as well as the view of prenatal diagnosis by society as a whole - the ethical, legal and public health aspects. As genetic and ultrasound technology is developing rapidly, it is likely that more couples, their clinicians and counsellors will be faced with complex decisions and that the debate about ethics, legal aspects and rationing of health services will increase. This book aims to lay the foundation to those debates.;This book should be of interest to ultrasonographers; midwives; genetic counsellors; doctors specialising in obstetrics; genetic nurses; genetic social workers; clinical geneticists; general practitioners; psychotherapists; public health doctors; and purchasing managers.

The realities and misconceptions of long-term care and the challenges it presents for the ethics of autonomy are analyzed in this perceptive work. While defending the concept of autonomy, the author argues that the standard view of autonomy as non-interference and independence has only a limited applicability for long-term care. He explains that autonomy should be understood as a comprehensiveness that defines the overall course of a person's life rather than as a way of responding to an isolated situation. Agich distinguishes actual and ideal autonomy and argues that actual autonomy is better revealed in the everyday experiences of long-term care than in dramatic, conflict-ridden paradigm situations such as decisions to institutionalize, to initiate aggressive treatments, or to withhold or to withdraw life-sustaining treatments. Through a phenomenological analysis of long-term care, he develops an ethical framework for it by showing how autonomy is actually manifest in certain structural features of the social world of long-term care. Throughout this timely work, the rich sociological and anthropological literature on aging and long-term care is referenced and the practical ethical questions of promoting and enhancing the exercise of autonomy are addressed.

This book describes, in fascinating detail, a variety of experiments sponsored by the U.S. government in which people were exposed to radiation without their knowledge. After reviewing hundreds of thousands of documents from the Atomic Energy Commission and other agencies, the Advisory Committee appointed by President Clinton in January 1994 found that nearly 4,000 human radiation experiments--most involving very low doses of radioactive tracers--were sponsored by the federal government between 1944-1974. This book documents these findings to provide a fascinating if not disturbing reminder of both the shocking standards for human experimentation and the shrouded practice of government secrecy in recent history. Carried out at the height of the Cold War, experiments included feeding radioactive cereal to teenagers at a school for the mentally retarded, irradiating the testicles of prison inmates, injecting plutonium into hospital patients, and intentional releases of radiation into the environment. The book places these experiments within their historical context, and a review of the relevant government policies and ethics standards at the time is included. The analysis is then applied to contemporary research on human subjects. The book concludes with a discussion of the Committee's key findings and a set of recommendations for changes in in institutional review boards, the interpretation of ethics rules and policies, the conduct of research involving military personnel, the oversight and accountability for ethical violations, compensation for research injuries, and balancing national securities interests with the rights of the public. This compelling volume will prove to be a landmark in the development of standards for human experimentation. Ethicists, public health professionals and those interested in the history of medicine and Cold War history will be intrigued by the findings in this volume.

The books published about nursing ethics usually discuss issues that start with the patient. This book addresses the nurse's personal and ethical development as a prerequisite to patient care.;The authors start with the assumption that most people want and need to care for others. The act of caring then places the individual in a position where issues such as honesty, faithfulness, compassion, fortitude and respect for others are central concerns. The role of the professional carer is elaborated and explored in relation to the development of personal integrity.;Key features of this volume include an investigation into ethical issues related to caring; the replacement of the notion of service and dedication with personal and ethical development; and central issues of abortion, euthanasia and suicide addressed from the nurse's and the patient's point of view.;This book is designed both as a challenge and a comfort to those in the caring professions who aim to recognize and resolve their every day dilemmas. The challenge is to achieve the highest standard of care - the comfort is in the acknowledgement of the problems arising from the choice between sometimes unwelcome possibilities.