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Books > Medicine > General issues > Medical ethics
Biotech Juggernaut: Hope, Hype, and Hidden Agendas of Entrepreneurial BioScience relates the intensifying effort of bioentrepreneurs to apply genetic engineering technologies to the human species and to extend the commercial reach of synthetic biology or "extreme genetic engineering." In 1980, legal developments concerning patenting laws transformed scientific researchers into bioentrepreneurs. Often motivated to create profit-driven biotech start-up companies or to serve on their advisory boards, university researchers now commonly operate under serious conflicts of interest. These conflicts stand in the way of giving full consideration to the social and ethical consequences of the technologies they seek to develop. Too often, bioentrepreneurs have worked to obscure how these technologies could alter human evolution and to hide the social costs of keeping on this path. Tracing the rise and cultural politics of biotechnology from a critical perspective, Biotech Juggernaut aims to correct the informational imbalance between producers of biotechnologies on the one hand, and the intended consumers of these technologies and general society, on the other. It explains how the converging vectors of economic, political, social, and cultural elements driving biotechnology's swift advance constitutes a juggernaut. It concludes with a reflection on whether it is possible for an informed public to halt what appears to be a runaway force.
The issue of physician-assisted death is now firmly on the American public agenda. Already legal in five states, it is the subject of intense public opinion battles across the country. Driven by an increasingly aging population, and a baby boom generation just starting to enter its senior years, the issue is not going to go away anytime soon. In Physician-Assited Death L.W. Sumner equips readers with everything they need to know to take a reasoned and informed position in this important debate. The book provides needed context for the debate by situating physician-assisted death within the wider framework of end-of-life care and explaining why the movement to legalize it now enjoys such strong public support. It also reviews that movement's successes to date, beginning in Oregon in 1994 and now extending to eleven jurisdictions across three continents. Like abortion, physician-assisted death is ethically controversial and the subject of passionately held opinions. The central chapters of the book review the main arguments utilized by both sides of the controversy: on the one hand, appeals to patient autonomy and the relief of suffering, on the other the claim that taking active steps to hasten death inevitably violates the sanctity of life. The book then explores both the case in favor of legalization and the case against, focusing in the latter instance on the risk of abuse and the possibility of slippery slopes. In this context the experience of jurisdictions that have already taken the step of legalization is carefully reviewed to see what lessons might be extracted from it. It then identifies some further issues that lie beyond the boundaries of the current debate but will have to be faced sometime down the road: euthanasia for patients who are permanently unconscious or have become seriously demented and for severely compromised newborns. The book concludes by considering the various possible routes to legalization, both political and judicial. Readers will then be prepared to decide for themselves just where they stand when they confront the issue both in their own jurisdiction and in their own lives.
Recent years have seen a growing interest in the questions of ethics and aging. Advances in medical technology have created dilemmas for physicians, nurses, and other health care professionals over such questions as the allocation of resources and a patient's "right to die." At the same time, the aging of the American population raises concerns about social policies that involve the role of government. In "Ethics in an Aging Society" Harry R. Moody examines both the clinical and the policy issues that center around aging. Moody pays special attention to the ethical problems associated with two particularly timely concerns--Alzheimer's disease and the increasingly controversial issue of "rational suicide" for reasons of age. He also focuses on the rights of patients in long-term care and on the question of justice between generations (Are older patients using more than their "fair share" of scarce health care dollars?). "These ethical questions," Moody emphasizes, "are not abstract ones. They arise in the specific historical and political context of America in the closing decade of the twentieth century... This book can best be understood as a meditation on two compelling liberal ideas--autonomy and justice--that have inspired our thinking about ethics and the aging society. The story which unfolds in the book is a story both about the power of those ideals and also about inescapable facts of old age that make those ideals problematic."
In the early 1970s, well before the field ofbioethics had established itself in medicine or anywhere else, the Hastings Center organized a small meeting of law school professors. The question we put to them was: what could or should be done to stimulate legal interest in the field? The answer we got was a wise one. We should do nothing to forcefeed the interest. It should simply be allowed to develop on its own, by the ordinary route of attracting a following because of its inherent importance. That is just what happened, and one of the first young legal scholars drawn to what remains (oddly enough) a relatively small field was George Annas. The idea of a column on law and ethics for the Hastings Center Report was not by 1976 a particularly bold one. It had been clear to us from the outset of the Center in 1969, and the establishment of the Report in 1971, that the rapidly emerging moral problems in medicine and biology would have enormous legal and policy implications. Even so, we were hardly prepared for the large and steady number of cases that were to come before the courts during the 1970s and that were to continue unabated in the 1980s. But our concern about a column on the subject was of a more pedestrian kind.
Provides up-to-date coverage of current thinking on rationing. The first part of the book consists of a series of debates between leading authorities putting forward their views for and against some of the most controversial issues in healthcare, such as rationing by age, and the role of central government. The second part makes suggestions for action, drawing comparisons with health care systems overseas, on the ethical uses of resources, the rationing of drugs by hospitals, and the role of citizens' juries. The book should be of interest to healthcare workers, managers, public health physicians and health economists.
The rapid development of reproductive technologies has questioned many essential concepts belonging to our symbolic universe, such as human reproduction, motherhood and fatherhood; the transmission of the biological and cultural inheritance of mankind and the constitution of the psychic subject. These concepts, however, are supported by ideologies and value systems which hide that they are but theoretical constructions; consequently, they are taken as describing the "natural" function of reproduction. In this sense, the technological development takes the form of an increasing medicalization of the human body, of the life, sexuality and desire of people, especially of women. All this requires that we think critically about the conditions of possibility of these technologies and their psychological and ethical implications. In this book the author provides a detailed and rigorous analysis which locates the reproductive technologies in the historical context of the progressive technification of the management of human life, and their relation to the social and medical discourses on femininity, maternity and infertility. From a psychoanalytic point of view, culture and its discontents, violence, domination, are related intimately to the problematic character of sexuality, which includes the uncertainties of our desires. Social, medical, anthropological and literary discourses try to define "maternal desire" in order to control it: the definitions which capture it in their nets are means to dominate desire as an object and to "construct" the desiring subject. But psychoanalysis (through the associations of the subjects in question) shows that we face here an impossible question: one thing is the enunciated "demand", what is said about one's own desire ("I want a child"), and a very different one is the unconscious desire which disturbs the conscious discourse and shows that there can be psychological obstacles that interfere with the accomplishment of conscious wishes, conflicts and contradictions emerging through the women's words. In this book, the circulation of representations between the individual imaginary and collective myths is the basis of a multidisciplinary complex and original point of view, which confronts a variety of discourses arising from psychoanalysis, medicine, journalism, ethnology, mythology and literature.
As a mental health nurse, possessing an ethical sensibility and developing ethical reasoning is vital. This book is a practical introduction to the skills and knowledge the mental health nurse is professionally required to develop in their journey towards effectively managing complex ethical decisions. Written with the training mental health nurse in mind, this book is a clear and concise guide on how to approach common, ethically-complex situations mental health nurses will eventually find themselves faced with. It includes textboxes which take the reader into a 'real world' scenario to help them explore the moral and ethical issues discussed throughout the chapter. To ensure professional currency, the content of this book is mapped to the Nursing and Midwifery Council's pre-registration education standards of 2010, and uses a scenario-based approach in order to provide a pragmatic and robust resource. A Practical Introduction to Mental Health Ethics is essential reading for pre-registration mental health nursing students, while also being of value to registered mental health nurses working in ethically challenged areas such as dementia care, psychiatric intensive care units.
How influential has the Nazi analogy been in recent medical debates
on euthanasia? Is the history of eugenics being revived in modern
genetic technologies? And what does the tragic history of
thalidomide and its recent reintroduction for new medical
treatments tell us about how governments solve ethical dilemmas?
Posthumous reproduction refers to the procedure that enables a child to be conceived using the gametes of a dead person. Advances in reproductive technology mean it is now possible to assist in creating a life after you die, and in recent years the number of women who have attempted to get pregnant using posthumous reproduction has increased. However, the law in many jurisdictions has not put regulations in place to deal with the ethical and legal consequences that arise as a result of posthumous reproduction. This is the first book to exclusively focus on posthumous reproduction. The book comprehensively explores the legal and ethical issues surrounding posthumous reproduction in a number of jurisdictions including the US, Israel, the UK and France. The book looks at a number of issues including: ascertaining the wishes of the dead and protecting the reproductive rights of men who have deposited frozen sperm in clinics prior to their deaths; cases involving people who want to acquire fresh sperm from deceased or incompetent men and determining who should have the right to accept the sperm; identifying the parents of the posthumously conceived child; and discussing the need to promote the best interests of the child. The book critically examines the current laws that are in place and proposes additional regulations and policies in order to effectively regulate posthumous reproduction.
Sterben, Sterbehilfe (Beschaftigung mit "Dignitas") und Tod sind in den letzten Jahren - (auch) durch die Thematisierung in den Medien - verstarkt zu Objekten kontroverser Diskussionen in Deutschland geworden. Im Kontext dieser Entwicklung differenziert diese Arbeit elementare Wortbedeutungen, ordnet diese Begriffe in die aktuelle Debatte um unterschiedliche Formen der Sterbehilfe ein und entwickelt hieraus eine eigene Perspektive zum individuellen und gesellschaftlichen Umgang mit Sterben und Tod. Die Arbeit mit Sterbenden und deren Angehoerigen stellt unter anderem fur AErzte, Juristen, Theologen und Sozialarbeiter eine besondere Aufgabe dar. Trotz der oeffentlichen Diskussion uber Sterben, Sterbehilfe und Tod werden diese Themen im gesellschaftlichen und privaten Zusammenleben meist tabuisiert. Dieses Buch dient der Professionalisierung zuvor genannter Berufsgruppen und moechte einen Teil zur gesellschaftlichen Enttabuisierung von Sterben und Tod beitragen.
Surgical ethics is the application of ethics to issues specific to surgery. This volume provides a collection of clinical case studies representing a wide range of the ethical issues surgeons confront today. It is an excellent text for teaching surgical ethics to surgical residents and medical students and a fascinating read for practicing surgeons. It is intended to engage the reader into participating in evidence-based ethical conflicts. The authors escort us through 71 brief, realistic, and ethically complex problems, offering a series of five possible resolutions to each and guiding us through the relative benefits and weaknesses of the options until a best ethical choice is defended. The volume includes sections on Consent and Disclosure, Self-Regulation, Research and Innovation, Conflicts of Interest, Business Dealings, and End of Life Issues, each with a brief introduction by the authors.
'You, the reader, whoever you are, are not a complete novice in ethics. You understand the meaning of 'good' and 'bad' and 'right' and 'wrong' and you know that some actions are right while others are wrong and that some things are good while others are bad. These aspects are precisely what ethics as a subject of systematic study deals with' (Ewing: 1995). Ethics in Healthcare approaches the topic of ethics from the perspective of the nurse and offers a viewpoint on the many ethical questions he or she has to deal with every day. This established and accessible text takes a fresh look at the question of cultural diversity and explains why the profession of nursing has to adhere to a common value system. A brand new chapter covering the teaching of ethics has been added to explore the question of the moral development of the student.
This volume is a collection of essays concerned with the morality of hu man treatment of nonhuman animals. The contributors take very different approaches to their topics and come to widely divergent conclusions. The goal of the volume as a whole is to shed a brighter light upon an aspect of human life-our relations with the other animals-that has recently seen a great increase in interest and in the generation of heat. The discussions and debates contained herein are addressed by the contributors to each other, to the general public, and to the academic world, especially the biological, philosophical, and political parts of that world. The essays are organized into eight sections by topics, each sec tion beginning with a brief introduction linking the papers and the sec tions to one another. There is also a general introduction and an Epilog that suggests alternate possible ways of organizing the material. The first two sections are concerned with the place of animals in the human world: Section I with the ways humans view animals in literature, philosophy, and other parts of human culture, and Section II with the place of animals in human legal and moral community. The next three sections concern comparisons between human and nonhuman animals: Section III on the rights and wrongs of killing, Section IV on the humanity of animals and the animality of humans, and Section V on questions of the conflict of human and animal interests."
Civil Dialogue on Abortion provides a cutting-edge discussion between two philosophy scholars on each side of the abortion debate. Bertha Alvarez Manninen argues for her pro-choice view, but also urges respect for the life of the fetus, while Jack Mulder argues for his pro-life view, but recognizes that for the pro-life movement to be consistent, it must urge society to care more for the vulnerable. Coming together to discuss their views, but also to seek common ground, the two authors show how their differing positions nevertheless rest upon some common convictions. The book helps to provide a way forward for a divide that has only seemed to widen the aisle of public discourse in recent years. This engaging book will prove essential reading for students across multiple disciplines, including applied ethics, medical ethics, and bioethics, but will also be of interest to students of religious studies and women's studies.
Assisted dying is still an extremely contested topic in Bioethics. Despite the strongly influential role human dignity plays in this debate, it still has not received the appropriate, multi-faceted treatment it deserves. Studies show that the notion of dignity already plays an important role in medical contexts: it is frequently used by health care professionals as well as patients. However, its use in these contexts needs to be analyzed and explained in more detail. Moreover, a review of the available literature clearly shows that the general, highly fruitful academic debate on human dignity is more than ready to take the next step into applied ethics: in particular, into the even more controversial area of assisted death. This book offers a detailed philosophical analysis of dignity and how it relates to assisted death. Its audience will benefit both from the general discussion of human dignity it offers as well as from the specific bioethical context to which it is applied.
Women most fully experience the consequences of human reproductive technologies. Men who convene to evaluate such technologies discuss "them": the women who must accept, avoid, or even resist these technologies; the women who consume technologies they did not devise; the women who are the objects of policies made by men. So often the input of women is neither sought nor listened to. The privileged insights and perspectives that women bring to the consideration of technologies in human reproduction are the subject of these volumes, which constitute the revised and edited record of a Workshop on "Ethical Issues in Human Reproduction Technology: Analysis by Women" (EIRTAW), held in June, 1979, at Hampshire College in Amherst, Massachusetts. Some 80 members of the workshop, 90 percent of them women (from 24 states), represented diverse occupations and personal histories, different races and classes, varied political commitments. They included doctors, nurses, and scientists, lay midwives, consumer advocates, historians, and sociologists, lawyers, policy analysts, and ethicists. Each session, however, made plain that ethics is an everyday concern for women in general, as well as an academic profession for some.
Parents in the US and other societies are increasingly refusing to vaccinate their children, even though popular anti-vaccine myths - e.g. 'vaccines cause autism' - have been debunked. This book explains the epistemic and moral failures that lead some parents to refuse to vaccinate their children. First, some parents have good reasons not to defer to the expertise of physicians, and to rely instead upon their own judgments about how to care for their children. Unfortunately, epistemic self-reliance systematically distorts beliefs in areas of inquiry in which expertise is required (like vaccine immunology). Second, vaccine refusers and mainstream medical authorities are often committed to different values surrounding health and safety. For example, while vaccine advocates stress that vaccines have low rates of serious complications, vaccine refusers often resist vaccination because it is 'unnatural' and because they view vaccine-preventable diseases as a 'natural' part of childhood. Finally, parents who refuse vaccines rightly resist the utilitarian moral arguments - 'for the greater good' - that vaccine advocates sometimes make. Unfortunately, vaccine refusers also sometimes embrace a pernicious hyper-individualism that sanctions free-riding on herd immunity and that cultivates indifference to the interpersonal and social harms that unvaccinated persons may cause.
In recent times, the phrase 'personalised medicine' has become the symbol of medical progress and a label for better health care in the future. However, a controversial debate has developed around whether these promises of better, more personal and more cost-efficient medicine are realistic. This book brings together leading researchers from across Europe and North America, from both normative and empirical disciplines, who take a more critical view of the often encountered hype associated with personalised medicine. Partially drawing on a four year collaborative research project funded by the German Ministry for Education and Research, the book presents a multidisciplinary debate on the current state of research on the ethical, legal and social implications of personalised medicine. At a time when future health care is a topic of much discussion, this book provides valuable policy recommendations for the way forward. This study will be of interest to researchers from various disciplines including philosophy, bioethics, law and social sciences.
As prenatal tests proliferate, the medical and broader communities perceive that such testing is a logical extension of good prenatal care -- it helps parents have healthy babies. But prenatal tests have been criticized by the disability rights community, which contends that advances in science should be directed at improving their lives, not preventing them. Used primarily to decide to abort a fetus that would have been born with mental or physical impairments, prenatal tests arguably reinforce discrimination against and misconceptions about people with disabilities. In these essays, people on both sides of the issue engage in an honest and occasionally painful debate about prenatal testing and selective abortion. The contributors include both people who live with and people who theorize about disabilities, scholars from the social sciences and humanities, medical geneticists, genetic counselors, physicians, and lawyers. Although the essayists don't arrive at a consensus over the disability community's objections to prenatal testing and its consequences, they do offer recommendations for ameliorating some of the problems associated with the practice.
Bioethics: The Basics is an introduction to the foundational principles, theories and issues in the study of medical and biological ethics. Readers are introduced to bioethics from the ground up before being invited to consider some of the most controversial but important questions facing us today. Topics addressed include: the range of moral theories underpinning bioethics arguments for the rights and wrongs of abortion, euthanasia and animal research health care ethics including the nature of the practitioner-patient relationship public policy ethics and the implications of global and public health '3 parents', enhancement, incidental findings and nudge approaches in health care. This thoroughly revised second edition provides a concise, readable and authoritative introduction for anyone interested in the study of bioethics.
Many intellectuals today embrace a postmodern view of the social construction of ethical values, which reduces to a form of ethical relativism. It is currently fashionable to avoid rights language, reject the central place of individual autonomy, and focus instead on the importance of community, while many people at the interface of ethics, medicine, and the social sciences in the developing world champion autonomy and individual rights in response to past or present authoritarian governments and paternalistic practices of physicians. Macklin advances this debate by examining the evidence and arguments on either side, and by presenting her view that ethical universals do exist but that they are compatible with a variety of culturally relative interpretations. |
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