This title was first published in 2003. Xenotransplantation - the transplantation of animal organs into humans - poses a fascinating moral dilemma. Should this ability to extend the lives of millions of older people be permitted given that it might trigger a new pandemic similar to AIDS? This study examines the moral dilemma from a combination of humanistic, legalistic, bioethical, economical and technological perspectives. The first part of the book demonstrates that xenografts are the only realistic near-term technological answer to the organ shortage problem. The balance of the book is devoted to assessing whether doctrines such as the 'right to health care' trump the moral and ethical conundrums posed by xenotransplantation. The book concludes with a 'geoethical' solution that proposes authorization of xenotransplantation subject to the prior implementation of a new international organization for epidemiology and basic health care. It also suggests that the costs of operating such an organization could be covered by a global tax on xenografts.

Public Health Policy and Ethics brings together philosophers and practitioners to address the foundations and principles upon which public health policy may be advanced. What is the basis that justifies public health in the first place? Why should individuals be disadvantaged for the sake of the group? How do policy concerns and clinical practice work together and work against each other? Can the boundaries of public health be extended to include social ills that are amenable to group-dynamic solutions? These are some of the crucial questions that form the core of this volume of original essays sure to cause practitioners to engage in a critical re-evaluation of the role of ethics in public health policy.

This volume is unique because of its philosophical approach. It develops a theoretical basis for public health and then examines cutting-edge issues of practice that include social and political issues of public health. In this way the book extends the usual purview of public health. Public Health Policy and Ethics is of interest to those working in public health policy, ethics and social philosophy. It may be used as a textbook for courses on public health policy and ethics, medical ethics, social philosophy and applied or public philosophy.

Lainie Ross presents a rigorous critical investigation of the development of policy governing the involvement of children in medical research. She examines the shift in focus from protection of medical research subjects, enshrined in post-World War II legislation, to the current era in which access is assuming greater precedence. Infamous studies such as Willowbrook (where mentally retarded children were infected with hepatitis) are evidence that before the policy shift protection was not always adequate, even for the most vulnerable groups. Additional safeguards for children were first implemented in many countries in the 1970s and 1980s; more recent policies and guidelines are trying to promote greater participation. Ross considers whether the safeguards work, whether they are fair, and how they apply in actual research practice. She goes on to offer specific recommendations to modify current policies and guidelines. Ross examines the regulatory structures (e.g. federal regulations and institutional review boards), the ad hoc policies (e.g. payment in pediatric research and the role of schools as research venues), the actual practices of researchers (e.g. the race/ethnicity of enrolled research subjects or the decision to enroll newborns) as well as the decision-making process (both parental permission and the child's assent), in order to provide a broad critique. Some of her recommendations will break down current barriers to the enrolment of children (e.g. permitting the payment of child research subjects; allowing healthy children to be exposed to research that entails more than minimal risk without requiring recourse to 407 panels); whereas other recommendations may create new restrictions (e.g., the need for greater protection for research performed in schools; restrictions on what research should be done in the newborn nursery). The goal is to ensure that medical research is done in a way that promotes the health of current and future children without threatening, to use the words of Hans Jonas, 'the erosion of those moral values whose loss . . . would make its most dazzling triumphs not worth having'.

This book takes the conversation between bioethics and health policy to a new level. Moving beyond principles and normative frameworks, bioethicists writing in the volume consider the actual policy problems faced by health care systems, while policy-makers reflect on the moral values inherent in both the process and content of health policy. The result is a vigorous dialogue with some of the nation's leading experts at the interface of ethics and health policy. the book provides a history of the values implicit in U.S. health policy, a discussion of the federal and state roles in policy making, an ethical examination of the social goals expressed through various policies, an analysis of the role of public opinion in the creation of health policy, and an exploration of the value of the private sector in health policy. In addition, the authors examine some of the major ethical controversies in health policy, such as the challenge of balancing ethical concerns with economic realities, the need to allocate scarce health resources, the call for heightened accountability, and the impact of various policies on vulnerable populations. The book concludes with an examination of the ethical issues in health services research, including the threats to privacy that arise in such research. To a greater extent than any previous volume, it establishes a strong connection between the disciplines of medical ethics and health policy.

In general, the history of virtue theory is well-documented (Sherman, 1997; O'Neill, 1996). Its relationship to medicine is also recorded in our work and in that of others (Pellegrino and Thomasma, 1993b; 1996; Drane, 1994; Ellos, 1990). General publications stress the importance of training the young in virtuous practices. Still, the popularity of education in virtue is widely viewed as part of a conservative backlash to modern liberal society. Given the authorship of some of these works by professional conservatives like William Bennett (1993; 1995), this concern is authentic. One might correspondingly fear that greater adoption of virtue theory in medicine will be accompanied by a corresponding backward-looking social agenda. Worse yet, does reaffirmation of virtue theory lacquer over the many challenges of the postmodern world view as if these were not serious concerns? After all, recreating the past is the "retro" temptation of our times. Searching for greater certitude than we can now obtain preoccupies most thinkers today. One wishes for the old clarity and certitudes (Engelhardt, 1991). On the other hand, the same thinkers who yearn for the past, like Engelhardt sometimes seems to do, might stress the unyielding gulf between past and present that creates the postmodern reaction to all systems of Enlightenment thought (1996).

This book presents an up to date ethical framework for radiological protection in medicine. It is consistent with the requirements of the system of radiation protection and with the expectations of medical ethics. It presents an approach rooted in the medical tradition, and alert to contemporary social expectations. It provides readers with a practical framework against which they can assess the safety and acceptability of medical procedures, including patients' concerns. It will be an invaluable reference for radiologists, radiation oncologists, regulators, medical physicists, technologists, other practitioners, as well as academics, researchers and students of radiation protection in medicine. Features: An authoritative and accessible guide, authored by a team who have contributed to defining the area internationally Includes numerous practical examples/clinical scenarios that illustrate the approach, presenting a pragmatic approach, rather than dwelling on philosophical theories Informed by the latest developments in the thinking of international organizations

The definitive guide to the law that all nurses need to know. Written specifically for student nurses as well as those already in practice, Dimond's Legal Aspects of Nursing is your essential practical guide to the legal principles you need to be aware of in your everyday nursing practice. Building on previous editions of the book by Bridgit Dimond, this 8th edition has been significantly reworked by a new author team with extensive experience in teaching nursing law. It has also been fully updated and revised in line with recent legal developments and the new Nursing standards to ensure it continues to meet the requirements of nursing law modules. New to this edition: Introduction of new and updated Nursing Midwifery Council (NMC) Fitness to Practise procedures Reference to the NMC Code 2015 (updated 2018) including Duty of candour Data Protection legislation updated including reference to the General Data Protection Regulation 2016 Greater reference to the devolved UK administrations Updated overview of a nurses' duty of care Reference to the new NMC approved curriculum, and the introduction of nursing associates Introduction of upcoming changes to the Mental Capacity Act 2005 Comprehensive discussion of the practice implications of the Supreme Court Decisions in Montgomery v Lanarkshire Health Board [2015] Consideration of the revised Health and Social Care Act 2008 (regulated activities) regulations 2014 Updated consideration of gross negligence manslaughter Practical implications of the extension of the crimes of ill treatment and willful neglect under the Criminal Justice and Courts Act 2015 section 20 and 21

When two human ova fail to fully separate during pregnancy, the result is conjoined twins. The twins may be connected by ligament, bone, or just flesh, and they often share organs, but what captures most people's interest is whether the twins share sensations, thoughts and even souls. This encyclopedia presents entries on conjoined twins throughout history, the biological causes and effects of twins being born conjoined, and ethical issues such as self-support and separation surgery. It also includes entries on the modern standardized terminology used when discussing conjoined twins, the categories into which conjoined twins have been sorted, doctors past and present who have performed separation surgeries, and hospitals, such as Children's Hospital of Philadelphia, that are known for the separation of conjoined twins. This book even covers fraudulent conjoined twins and fictional ones in books written by such authors as Mark Twain, Vladimir Nabakov, and Katherine Dunn. Other entries cover relevant films, websites, and institutions.

Susan Sontag once described illness as "the night-side of life." When we or our loved ones fall ill, our world is thrown into darkness and disarray, our routines are interrupted, our deepest beliefs shaken. The modern regime of hyper-logical biomedicine offers little solace when it comes to the effects of ill health on our inner lives. By exploring the role of desire in illness, Eros and Illness offers an alternative: an unconventional, deeply human exploration of what it means to live with, and live through, disease. When we face down illness, something beyond biomedicine's extremely valuable advances in treatment and prevention is sorely needed. Desire in its many guises plays a crucial part in illness, David Morris shows. Emotions, dreams, and stories-even romance and eroticism-shape our experiences as patients and as caregivers. Our perception of the world we enter through illness-including too often a world of pain-is shaped by desire. Writing from his own heartbreaking experience as a caretaker for his wife, Morris relates how desire can worsen or, with care, mitigate the heavy weight of disease. He looks to myths, memoirs, paintings, performances, and narratives to understand how illness is intertwined with the things we value most dearly. Drawing on cultural resources from many centuries and media, Eros and Illness reaches out a hand to guide us through the long night of illness, showing us how to find productive desire where we expected only despair and defeat.

Is it lawful for a doctor to give a patient life-shortening pain relief? Can treatment be lawfully provided to a child under 16 on the basis of her consent alone? Is it lawful to remove food and water provided by tube to a patient in a vegetative state? Is a woman's refusal of a caesarean section recommended for the benefit of the fetus legally decisive? These questions were central to the four focal cases revisited in this book. This book revisits nine landmark cases. For each, a new leading judgment is attributed to an imagined judge, Athena, who operates within the constraints of the legal system of England and Wales. Her judgments accord with an innovative legal theory, referred to as 'modified law as integrity', and are linked as a line of precedent. The result is a re-spinning of extant judicial threads into a web of legal principles with a greater claim to coherence and defensibility than those in the original cases. The book will be of great interest to scholars and students of medical law, criminal law, bioethics, legal theory and moral philosophy.

What is wrong with selecting and implanting a deaf embryo? What are 'designer babies' and why can't we choose to have them? Is there a right to know one's genetic origins? Should we allow a market in transplant organs? Are doctors justified in refusing to perform treatments on conscientious grounds? These and many other diverse questions are considered in this collection of essays on cutting-edge topics in medical ethics. Leading philosophers give in-depth accounts of some of the most pressing questions and challenge our most basic assumptions in this area of academic as well as public interest. Provocative and original, the contributions to this volume are bound to change the way we think about medical ethics.

Donor insemination or DI is the oldest and most widely practiced form of assisted conception. Until now, it has been assessed largely from a medical perspective. This book brings together an international group of social scientists to discuss the social, cultural, political and practical dimensions of DI, relating it to the wider debates about fertility treatment. Contributors consider the experience of DI from the viewpoints of all the parties involved, including those treated, the donors, the clinicians, and the children of DI.

Palliative Care Within Mental Health: Ethical Practice explores the comprehensive concerns and dilemmas that occur surrounding people experiencing mental health problems and disorders. Working beyond narrow, stereotypical definitions of palliative care as restricted to terminal cancer patients, this balanced and thought-provoking volume examines the many interrelated issues that face the individual, families, and caregivers, setting the groundwork for improved, ethical relationships and interventions. Chapters by experts and experienced practitioners detail the challenges, concerns, and best practices for ethical care and responses in a variety of individual and treatment contexts. This is an essential and thoughtful new resource for all those involved in the fast-developing field of palliative mental health.

It is estimated that up to thirteen percent of hospital admissions result from the adverse effects of diagnosis or treatment, and that anywhere from 44,000 to 98,000 hospital deaths annually are the result of errors. The obligation to "do no harm" has been central to medical conduct since ancient times, yet iatrogenic illness and medical error have now come to be recognized as significant risk factors in health care delivery. This book integrates history, philosophy, medical ethics and empirical data to examine the concept and phenomenon of medical harm. Issues covered include medical error, appropriateness of care, acceptable risk and practitioner accountability, and recommendations for limiting iatrogenic harm.

Perhaps no medical breakthrough in the twentieth century is more spectacular, more hope-giving, or more fraught with ethical questions than organ transplantation. Each year some 25,000 Americans are pulled back from the brink of death by receiving vital new organs. Another 5,000 die while waiting for them. And what distinguishes these two groups has become the source of one of our thorniest ethical questions.
In Raising the Dead, Ronald Munson offers a vivid, often wrenchingly dramatic account of how transplants are performed, how we decide who receives them, and how we engage the entire range of tough issues that arise because of them. Each chapter begins with a detailed account of a specific case--Mickey Mantle's controversial liver transplant, for example--followed by careful analysis of its surrounding ethical questions (the charges that Mantle received special treatment because he was a celebrity, the larger problems involving how organs are allocated, and whether alcoholics should have an equal claim on donor livers). In approaching transplant ethics through specific cases, Munson reminds us of the complex personal and emotional dimension that underlies such issues. The book also ranges beyond our present capabilities to explore the future possibilities in xenotransplantation (transplanting animal organs into humans) and stem cell technology that would allow doctors to grow new organs from the patient's own cells.
Based on extensive scientific research, but written with a novelist's eye for the human condition, Raising the Dead shows readers the reality of organ transplantation now, the possibility of what it may become, and how we might respond to the ethical challenges it forces us to confront.

We invest more in health care than ever before, yet we are more anxious about doctors, hospitals, and the NHS in general. As perceptions of patients' rights have expanded, so has the transparency of the difficult choices that are routine. Government has become more critical of the NHS and the public less willing to wait for treatment. Why does demand for health care consistently exceed supply and how should Government manage the problem? There is a danger that improved rights for the strong and articulate will ignore less visible, or unpopular interests. How should the rights of elderly patients, or children, or those with terminal illnesses be balanced? Who should decide: the government, doctors, NHS managers, citizens, or the courts? How should decision-makers be held accountable, and by whom? How should governance regulate the NHS? As patients become 'consumers' of medical care, what choice do they have as to how, where, and when they will be treated; and should this include hospitals abroad? This completely revised new edition puts patients' rights into their political, economic and managerial contexts. It considers the implications of the Bristol Inquiry and the rhetoric of patients as 'consumers' of care. In balancing the rights of individuals with those of the community as a whole, it deals with one of the most pressing problems in contemporary society.

As the state of the natural world declines, environmentally related health problems will increasingly shape the landscape of human health and disease. The confluence of several global trends - rapid population growth combined with an even more dramatic increase in natural resource consumption - drives ecological deterioration, and this in turn poses serious challenges to health. U.S. medicine and bioethics have too long ignored the relevance of these global trends to health care. This groundbreaking work is a call to attention. It brings bioethics and health care squarely into the 21st century.

The book shows how environmental decline relates to human health and to health care practices in the U.S. and other industrialized countries. It outlines the environmental trends that will strongly affect health, and challenges us to see the connections between ways of practicing medicine and the very envrionmental problems that damage ecosystems and make people sick. In addition to philosophical analysis of the converging values of bioethics and environmental ethics, the book offers case studies as well as a number of practical suggestions for moving health care toward sustainability. The exploration of a hypothetical Green Health Center, in particular, offers an intellectual and moral framework for talking about environmental values in health care. Engaging and challenging, this book will appeal not only to health professionals and philosophers, but to anyone concerned about how to preserve and promote both human health and the health of the natural world.

Genetics research with stored human tissues provides many benefits and holds much promise. Yet how this critical research is conducted sometimes raises serious ethical, legal, and social concerns, and it is difficult to balance the promise of biomedical research with our time-honored commitments to individual choice in such fundamental matters as control over personal health information and the disposition of our bodily tissues.
Weir and Olick provide a thorough analysis of this critical phase in the era of genomic medicine. While strongly supportive of the biomedical research enterprise, they develop a critique of many common research practices with banked tissues, DNA, and genetic data. Noting numerous examples of beneficial human tissue research, they focus on problematic research practices, controversial cases, and federal and institutional policies that limit the informed choices of patients and research participants. The authors offer a series of recommendations intended to limit the risks of inadequate informed consent to research for individuals, families, and groups, and to strengthen the bonds of trust between the research enterprise and the public upon which biomedical progress depends.
This book offers a wealth of information plus well-reasoned recommendations that will be of keen interest to geneticists, other biomedical scientists, research institutions, policymakers, students and others. It will serve as a clarion call to move beyond traditional policies and practices toward a richer understanding of partnership between patients and research participants and the biomedical research enterprise - a partnership for the benefit of all.

Scientific research involving human embryos was a major topic of public debate in Britain during the 1980s. Despite strong support from the scientific community, embryo research was initially condemned by many ordinary people as well as by special interest groups, and came close to being banned by Act of Parliament. Michael Mulkay describes the dynamics of the parliamentary struggle over the future of embryo research, focusing on such issues as: the clash between the anti-abortion and pro-research lobbies; the tactics of the Government; political ideology; the media's role; the importance of gender; religion; the impact of science fiction; the lure of medical advance; and the difficulty of maintaining ethical control. He explains how the advocates of embryo research eventually triumphed, and ends with an examination of the cultural tensions which linger after the debate.

This book provides a nontechnical account of the debate concerning human embryo research, concentrating on the British parliamentary debates of 1984-1990. It traces the debates' origins back to conflicts over abortion and moral reform in the 1960s, and examines reactions in the 1990s to sex selection and the use of eggs from human fetuses for research. Michael Mulkay shows how embryo research develops within a complex social environment, writing for anyone interested in the relationship between science-based assisted reproduction and society.

A wide variety of ambitions and measures to slow, stop, and reverse phenomena associated with aging have been part of human culture since early civilization. From alchemy to cell injections to dietary supplements, the list of techniques aimed at altering the processes of aging continues to expand. Charlatans, quacks, and entrpreneurs proffering anti-aging products and practices have always exploited uniformed customers and instilled doubt and apprehension toward practices intended to extend life. Recently, however, the pursuit of longevity has developed into a respectable scientific activity. Many biologists are substantially funded by the government and the private sector to conduct research that they believe will lead to effective anti-aging interventions.
While many embrace this quest for "prolongevity"--extended youth and long life--others fear its consequences. If effective anti-aging interventions were achieved, they would likely bring about profound alterations in the experiences of individual and collective life. What if aging could be decelerated to the extent that both average life expectancy and maximum life span would increase by forty percent? What if all humans could live to be centenarians, free of the chronic diseases and disabilities now commonly associated with old age? What if modern scientists could find the modern equivalent to the Fountain of Youth that Ponce de Leon sought?
This book addresses these questions by exploring the ramifications of possible anti-aging interventions on both individual and collective life. Through a series of essays, it examines the biomedical goal of prolongevity from cultural, scientific, religious, and ethical perspectives, offering a sweeping view into the future of aging.

Offering a format that is significantly different than that offered by other books, Ethical Health Care beings by asking what is meant by health and how it is achieved. The book then proceeds to explore with care and context the nature of the relationship between patients and clinicians, health care providers and the societies in which they inhabit, and finally the relationship between the health care enterprise and the international community. By emphasizing the ethical issues that arise in the broad quest to foster human health, and appreciating that health is not primarily a function of medical interventions, Ethical Health Care introduces students to problems such as the international distribution of pharmaceuticals and the dangers of reemerging infections. To a far greater extent than is done traditionally, Ethical Health Care provides an interdisciplinary perspective to bioethics, relying heavily upon the teachings of economics, law, and public health.

We all have beliefs, even strong convictions, about what is just and fair in our social arrangements. How should these beliefs and the theories of justice that incorporate them guide our thinking about practical matters of justice? This wide-ranging collection of essays by one of the foremost medical ethicists in the United States explores the claim that justification in ethics, whether concerning matters of theory or practice, involves achieving coherence or "reflective equilibrium" (as Rawls has called it) between our moral and nonmoral beliefs. Among the practical issues the volume addresses are the design of health-care institutions, the distribution of goods between the old and the young, and fairness in hiring and firing practices. In combining ethical theory and practical ethics this volume will prove especially valuable to philosophers concerned with ethics and applied ethics, political theorists, bioethicists, and others involved in the study of public policy.

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

Hospice is the premiere end of life program in the United States, but its requirement that patients forgo disease-directed therapies and that they have a prognosis of 6 months or less means that it serves less than half of dying patients and often for very short periods of time. Palliative care offers careful attention to pain and symptom management, added support for patients and families, and assistance with difficult medical decision making alongside any and all desired medical treatments, but it does not include a comprehensive system of care as is provided by hospice. The practice of palliative care and hospice is filled with sometimes overt (requests for hastened death in an environment where such acts are legally prohibited) and other times covert (the delay in palliative care referral because the health care team believes it will undermine disease directed treatment) ethical issues. The contributors to this volume use a series of case presentations within each chapter to illustrate some of the palliative care and hospice challenges with significant ethical dimensions across the three overarching domains: 1) care delivery systems; 2) addressing the many dimensions of suffering; and 3) difficult decisions near the end of life. The contributors are among the most experienced palliative care, hospice and ethics scholars in North America and Western Europe. Each has been given relatively free reign to address what they feel are the most pressing ethical challenges within their domain, so a wide range of positions and vantage points are represented. As a result, the volume provides a very diverse ethical exploration of this relatively young field that can deepen, stretch, and at times confront any simple notion of the challenges facing patients, their families, professional caregivers, and policy makers.