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Books > Medicine > General issues > Medical ethics
The concept of deviance is complex, given that norms vary considerably across groups, times, and places. Society tends to primarily recognize traditional portraits of deviants such as street-offenders and drug addicts. The label "deviant" is commonly cast upon society's undesirables, but this socially constructed image often overlooks subtler-and arguably more dangerous-deviance. Physician malfeasance is an especially problematic form, given that medical professionals garner trust, autonomy, and prestige from society, which allows them to operate outside of the public eye. This book responds to a growing number of concerns regarding deviant physician actions such as physically and sexually abusive behaviors, fabricating medical findings and records, and taking advantage of patients (e.g., filing fraudulent Medicaid claims). It explores theoretical explanations for physician deviance, and goes on to consider potential responses such as Medicaid Fraud Control Units, the Questionable Doctors database, and the ability of doctors to police themselves. The unique perspective offered in this book informs discussions of white-collar crime and deviance and has important implications for researchers, policymakers, and students involved in criminal justice and public policy.
An authoritative introduction to bioethics, "Life Choices "examines a comprehensive range of ethical questions and brings together some of the most probing and instructive essays published in the field. Some of the articles are classics in the literature of bioethics, while others address current issues. Topics include moral decision making, abortion, euthanasia and assisted suicide, life-sustaining technologies, organ transplantation, reproductive technologies, and the allocation of health care resources. This second edition features new sections on the goals and allocation of medicine and on the cloning of human beings. It also includes new articles on genetics, the duty to die, and ethical theory. Written by the foremost authorities in bioethics, "Life Choices" provides a comprehensive introduction to the field. Instructors who have used the first edition as a text will welcome this new, updated edition. Scholars and health care practitioners will find it useful as a valuable reference on a wide range of bioethical issues.
Anyone who has been diagnosed with breast cancer or knows someone who has been diagnosed with breast cancer recognizes that cancer raises a host of questions concerning its nature and how we treat it. Such questions frame the difficult decisions that patients must make about their treatment and care. Thinking Through Breast Cancer is a philosophical investigation of how breast cancer is described, explained, evaluated, and socialized in medicine. Written by a breast cancer survivor, the book interweaves personal experience with a systematic breakdown of key and highly pertinent philosophical concepts, and brings to light insights that emerge in metaphysics, epistemology, ethics, social and political philosophy, and bioethics. Further, it is an investigation of the ethical implications of understanding breast cancer. Cutter seamlessly combines clinical information with philosophical analysis and makes recommendations as to how we can navigate the complex and, at times, uncertain terrain of breast cancer knowledge and care. In this way, the book is not simply a survey of what we know about breast cancer, but a personal search for guidance about navigating the complex, confusing, and frightening terrain of breast cancer diagnosis, treatment, and survival.
In the wake of the Charlie Gard and Alfie Evans cases, a wide-ranging international conversation was started regarding alternative thresholds for intervention and the different balances that can be made in weighing up the rights and interests of the child, the parent's rights and responsibilities and the role of medical professionals and the courts. This collection provides a comparative perspective on these issues by bringing together analysis from a range of jurisdictions across Europe, North and South America, Africa and Asia. Contextualising the differences and similarities, and drawing out the cultural and social values that inform the approach in different countries, this volume is highly valuable to scholars across jurisdictions, not only to inform their own local debate on how best to navigate such cases, but also to foster inter-jurisdictional debate on the issues. The book brings together commentators from the fields of law, medical ethics, and clinical medicine across the world, actively drawing on the view from the clinic as well as philosophical, legal and sociological perspectives on the crucial question of who should decide about the fate of a child suffering from a serious illness. In doing so, the collection offers comprehensive treatment of the key questions around whether the current best interests approach is still appropriate, and if not, what the alternatives are. It engages head-on with the concerns seen in both the academic and popular literature that there is a need to reconsider the orthodoxy in this area.
Reproductive health care professionals in fields such as Obstetrics and Gynecology, Family Medicine, and Pediatrics face difficult ethical issues because they work at the crossroads of patient decision-making, scientific advancement, political controversy, legal regulation, and profound moral considerations. The dilemmas these professionals face expose big-picture bioethics questions of interest to everyone. Yet for clinicians striving to deliver excellent patient care, the ethical questions that make daily practice challenging can be just as nuanced. This volume presents a carefully curated compilation of essays written by leading experts in the fields of medicine, ethics, and law, who address key issues at the forefront of reproductive ethics. It is organized into three main sections: I. Contraception and Abortion Ethics - Preventing Pregnancy and Birth, II. Assisted Reproduction Ethics - Initiating Pregnancy, and III. Obstetric Ethics - Managing Pregnancy and Delivery. Each section begins with a short introduction by the editors providing an overview of the area and contextualizing the essays that follow. This volume's primary aim is to be useful to practicing clinicians, students, and trainees by providing short and practical essays covering urgent topics-from race, religion and abortion, to legal liability, violations of confidentiality and maternal choices that risk future children's health. This collection provides clinicians at all levels of training with frameworks they need to approach the intimate and high-stakes encounters central to their profession.
Prenatal diagnosis, especially noninvasive prenatal testing (NIPT), has changed the experience of pregnancy, prenatal care and responsibilities in Israel and Germany in different ways. These differences reflect the countries' historical legacies, medico-legal policies, normative and cultural identities. Building on this observation, the contributors of this book present conversations between leading scholars from Israel and Germany based on an empirical bioethical perspective, analyses about the reshaping of 'life' by biomedicine, and philosophical reflections on socio-cultural claims and epistemic horizons of responsibilities. Practices and discussions of reproductive medicine transform the concepts of responsibility and irresponsibility.
A comprehensive textbook for athletic training students, educators, and practitioners, Professional Ethics in Athletic Training: Practicing and Leading With Integrity, Second Edition provides a framework for understanding and applying ethical principles across the career span of an athletic training professional. Esteemed authors Gretchen A. Schlabach and Kimberly S. Peer explain the necessity of practicing and leading with integrity across one's athletic training career. The text explores issues related to cultural competence and professional behavior as well as ethical leadership and decision-making skills that both inform and transcend the athletic training profession. Each chapter is accompanied by frameworks that lead to both analysis and awareness of legal statutes, ethical principles, regulatory practice acts, and professional practice standards that encourage responsible reasoning and conduct. Contemporary journal articles can also be found in every chapter to help readers make connections between content and clinical practice. The text also includes assessment tools, sample models for ethical decision making, writing about moral issues, and sample course design and delivery for teaching ethics. Included in the instructor's materials are nearly 50 cases to promote critical thinking as well as learning activities for each chapter. Instructors in educational settings can visit www.efacultylounge.com for additional materials to be used for teaching in the classroom. Covering all levels of ethical practice-from the entry-level student to the experienced athletic trainer-Professional Ethics in Athletic Training synthesizes and integrates ethical theory and practical application for those who practice and lead with integrity.
Health systems need to set priorities fairly. In one way or another, part of this important task will fall to physicians. How do they make judgments about resource stewardship, and how should they do so? How can they make such decisions in a manner that is compatible with their clinical duties to patients? In this book, philosophers, bioethicists, physicians, lawyers and health policy experts make the case that priority setting and rationing contribute significantly to the possibility of affordable and fair healthcare and that clinicians play an indispensable role in that process. The book depicts the results of a survey of European physicians about their experiences with rationing and other cost containment strategies, and their perception of scarcity and fairness in their health care systems. Responding to and complementing these findings, commentators discuss why resource allocation and bedside rationing is necessary and justifiable. The book explores how bedside rationing relates to clinical judgments about medical necessity and medical indications, marginal benefits, weak evidence based medicine, off-label use. The book highlights how comparative studies of health care systems can advance more effective and fair bedside rationing through learning from one another. From a practical standpoint, the book offers a number of strategies for health care systems and clinicians to work in tandem to allocate and ration resources as fairly as possible: how to foster more attention to fairness when rationing at the bedside, how to avoid exacerbating health disparities when allocating resources, how to teach about bedside rationing to students, how to discuss rationing more explicitly in the public arena and in the doctor's office.
Although the subject of federally mandated Institutional Review Boards (IRBs) has been extensively debated, we actually do not know much about what takes place when they convene. The story of how IRBs work today is a story about their past as well as their present, and "Behind Closed Doors "is the first book to meld firsthand observations of IRB meetings with the history of how rules for the treatment of human subjects were formalized in the United States in the decades after World War II. Drawing on extensive archival sources, Laura Stark reconstructs the daily lives of scientists, lawyers, administrators, and research subjects working--and "warring"--on the campus of the National Institutes of Health, where they first wrote the rules for the treatment of human subjects. Stark argues that the model of group deliberation that gradually crystallized during this period reflected contemporary legal and medical conceptions of what it meant to be human, what political rights human subjects deserved, and which stakeholders were best suited to decide. She then explains how the historical contingencies that shaped rules for the treatment of human subjects in the postwar era guide decision making today--within hospitals, universities, health departments, and other institutions in the United States and across the globe. Meticulously researched and gracefully argued, "Behind Closed Doors" will be essential reading for sociologists and historians of science and medicine, as well as policy makers and IRB administrators.
This book analyses the concept of legal dignity employed in current bioethical debate and corresponding legal instruments. It develops a view of human dignity in existing regulation of activities such as pre-natal genetic selection, commodification of the human body, cloning, and euthanasia.
Nursing Law and Ethics explores a variety of key legal and ethical issues in nursing practice using a thought-provoking and holistic approach. It addresses both what the law requires and what is right, and explores whether these two are always the same. The book provides an overview of the legal, ethical and professional dimensions of nursing, followed by exploration of key issues in greater depth. This edition features updated legislation and new material on patient safety. Key topics are accompanied by both a legal and an ethical perspective, covering both law and ethics Case examples throughout place concepts in a real-life context. It is written by experts in the field and includes contributions from leading nurses, lawyers and ethicists. Accessible, relevant, and comprehensive, this title is ideal for pre- and post-registration nurses.
Transhumanists advocate for the development and distribution of technologies that will enhance human intellectual, physical, and psychological capacities, even eliminate aging. What if the dystopian futures and transhumanist utopias found in the pages of science journals, Margaret Atwood novels, films like "Gattaca," and television shows like "Dark Angel" are realized? What kind of world would humans have created? Maxwell J. Mehlman considers the promises and perils of using genetic engineering in an effort to direct the future course of human evolution. He addresses scientific and ethical issues without choosing sides in the dispute between transhumanists and their challengers. However, "Transhumanist Dreams and Dystopian Nightmares" reveals that radical forms of genetic engineering could become a reality much sooner than many people think, and that we need to encourage risk-management efforts. Whether scientists are dubious or optimistic about the prospects for directed evolution, they tend to agree on two things. First, however long it takes to perfect the necessary technology, it is inevitable that humans will attempt to control their evolutionary future, and second, in the process of learning how to direct evolution, we are bound to make mistakes. Our responsibility is to learn how to balance innovation with caution.
Many counselors learn about ethics in graduate school by applying formal, step-by-step ethical decision-making models that require counselors to be aware of their values and refrain from imposing personal values that might harm clients. However, in the real world, counselors often make split-second ethical decisions based upon personal values. Values and Ethics in Counseling illustrates the ways in which ethical decisions are values-but more than that, it guides counselors through the process of examining their own values and analyzing how these values impact ethical decision making. Each chapter presents ethical decision making as what it is: a very personal, values-laden process, one that is most effectively illustrated through the real-life stories of counselors at various stages of professional development-from interns to seasoned clinicians-who made value-based decisions. Each story is followed by commentary from the author as well as analysis from the editors to contextualize the material and encourage reflection.
Solving intractable biotechnological questions of evolution, medicine, and genetics is now easier due to methods permitting the rapid analysis of molecular sequence data. These advances have exposed ethical and policy concerns. How would genomic information be used and by whom? Should individuals be able to make decisions regarding their own genomic data? How accurate are these genetic tests and how should they be regulated? These and other ethical conundrums are the subject of this book. Bioethicists, biomedical policy experts and lawyers, physicians, nursing and allied health students as well as science educators will find this book helpful and engaging in exploring the complexities of modern evolutionary, genetic and biomedical data.
Solving intractable biotechnological questions of evolution, medicine, and genetics is now easier due to methods permitting the rapid analysis of molecular sequence data. These advances have exposed ethical and policy concerns. How would genomic information be used and by whom? Should individuals be able to make decisions regarding their own genomic data? How accurate are these genetic tests and how should they be regulated? These and other ethical conundrums are the subject of this book. Bioethicists, biomedical policy experts and lawyers, physicians, nursing and allied health students as well as science educators will find this book helpful and engaging in exploring the complexities of modern evolutionary, genetic and biomedical data.
This book examines the circumstances that lead up to sexual boundary violations (SBVs) in psychotherapy. It also considers how such behavior affects clients and therapists, as well as the broader effects on colleagues, institutions, families, and others. Numerous case illustrations are included, and the editors emphasize the importance of education and consultation with mentors and peers in helping therapists maintain a professional frame for the therapeutic relationship, which ensures a safe environment for clients.
Suppose that in an emergency evacuation of a hospital after a flood, not all of the patients can make it out alive. You are the doctor faced with the choice between abandoning these patients to die alone and in pain, or injecting them with a lethal dose of drugs, without consent, so that they die peacefully. Perhaps no one will be able to blame you whatever you decide, but, whichever action you choose, you will remain burdened by guilt. What happens, in cases like this, when, no matter what you do, you are destined for moral failure? What happens when there is no available means of doing the right thing? Human life is filled with such impossible moral decisions. These choices and case studies that demonstrate them form the focus of Lisa Tessman's arresting and provocative work. Many philosophers believe that there are simply no situations in which what you morally ought to do is something that you can't do, because they think that you can't be required to do something unless it's actually in your power to do it. Despite this, real life presents us daily with situations in which we feel that we have failed morally even when no right action would have been possible. Lisa Tessman boldly argues that sometimes we feel this way because we have encountered an 'impossible moral requirement.' Drawing on philosophy, empirical psychology, and evolutionary theory, When Doing the Right Thing Is Impossible explores how and why human beings have constructed moral requirements to be binding even when they are impossible to fulfill.
Autobiography of a Disease documents, in experimental form, the experience of extended life-threatening illness in contemporary US hospitals and clinics. The narrative is based primarily on the author's sudden and catastrophic collapse into a coma and long hospitalization thirteen years ago; but it has also been crafted from twelve years of research on the history of microbiology, literary representations of illness and medical treatment, cultural analysis of MRSA in the popular press, and extended autoethnographic work on medicalization. An experiment in form, the book blends the genres of storytelling, historiography, ethnography, and memoir. Unlike most medical memoirs, told from the perspective of the human patient, Autobiography of a Disease is told from the perspective of a bacterial cluster. This orientation is intended to represent the distribution of perspectives on illness, disability, and pain across subjective centers-from patient to monitoring machine, from body to cell, from caregiver to cared-for-and thus makes sense of illness only in a social context.
Metastatic cancer and costly precision medicines generate extremely complex problems of health care justice. Targeted cancer therapies yield only very marginal gains in life expectancy for most patients at very great cost, thereby threatening the just allocation of limited health care resources. Philosophers have high hopes for the utility of their theories of justice in addressing the challenges of resource allocation; however, none of these theories can address adequately the "wicked" ethical problems that have resulted from these targeted therapies. What we need instead, bioethicist Leonard M. Fleck argues, is a political conception of health care justice, following Rawls, and a fair and inclusive process of rational democratic deliberation governed by public reason. His account makes the basic assumption that we have only limited health care resources to meet unlimited health care needs generated by emerging medical technologies. The primary ethical and political virtue of rational democratic deliberation is that it allows citizens to fashion autonomously shared understandings of how to fairly address the complex problems of health care justice generated by precision medicine. While ideally just outcomes are a moral and political impossibility, "wicked" problems can metastasize if rationing decisions are made invisibly-in ways effectively hidden from those affected by those decisions. As Fleck demonstrates, a fair and inclusive process of democratic deliberation could make these "wicked" problems visible, and subject, to public reason.
Health and Human Rights in a Changing World is a comprehensive and contemporary collection of readings and original material examining health and human rights from a global perspective. Editors Grodin, Tarantola, Annas, and Gruskin are well-known for their previous two volumes (published by Routledge) on this increasingly important subject to the global community. The editors have contextualized each of the five sections with foundational essays; each reading concludes with discussion topics, questions, and suggested readings. This book also includes Points of View sections originally written perspectives by important authors in the field. Section I is a Health and Human Rights Overview that lays out the essential knowledge base and provides the foundation for the following sections. Section II brings in notions of concepts, methods, and governance framing the application of health and human rights, in particular the Human Rights-based Approaches to Health. Section III sheds light on issues of heightened vulnerability and special protection, stressing that the health and human rights record of any nation, any community, is determined by what is being done and not done about those who are most in need. Section IV focuses on addressing system failures where health and human rights issues have been documented, recognized, even at times proclaimed as priorities, and yet insufficiently attended to as a result of State denial, unwillingness, or incapacity. Section V examines the relevance of the health and human rights paradigm to a changing world, underscoring contemporary global challenges and responses. Finally, a Concluding Note brings together the key themes of this set of articles and attempts to project a vision of the future.
Ethics is commonly assumed to be the one realm in which luck and
risk do not "Risk and Luck in Medical Ethics" examines the 'moral luck'
paradox in greater The book concludes with an examination of the relevance of risk
and luck in
This book is the British Medical Association's statement on the ethics related to care of the elderly, written and reviewed by a panel of renowned medical ethicists. As such it is an authoritative and considered reference, written in an accessible, non jargon so as to be useful for anyone charged with looking after the elderly. The book includes useful case examples so that it can be used by a range of health professionals and carers who need to know the law and ethics of looking after older people. The authors focus on practical issues such as helping older people stick to their treatment regimes, the sort of information they should be given to give valid consent, and their rights to confidentiality, as well as discussion about where they want to end their lives when it comes to that point.
What role does ethics play in the practice of psychoanalysis and psychotherapy? For most of its history, psychoanalysis has viewed ethics as a "side issue" in clinical work-occasionally relevant, but not central to therapeutic action. In Psychoanalysis as an Ethical Process, Robert Drozek highlights the foundational importance of ethical experience in the therapeutic relationship, as well as the role that ethical commitments have played in inspiring what has been called the "relational turn" in psychoanalysis. Using vivid clinical examples from the treatment of patients with severe personality disorders, Drozek sketches out an ethically grounded vision of analytic process, wherein analyst and patient are engaged in the co-construction of an intersubjective space that is progressively more consistent with their intrinsic worth as human beings. Psychoanalysis can thus be seen as a unique vehicle for therapeutic and ethical change, leading to a dramatic expansion of agency, altruism, and self-esteem for both participants. By bringing our analytic theories into closer contact with our ethical experiences as human beings, we can connect more fully with the fundamental humanity that unites us with our patients, and that serves as the basis for deep and lasting therapeutic change. This book will be of interest to psychotherapists and psychoanalysts, as well as scholars in ethical theory and philosophy. |
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