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.

Stories Matter examines the many ways that narrative methods of analysis and interpretation are transforming the work of medicine and ethics. The contributors-philosophers, literary scholars, psychologists, and physicians-offer new understandings of the implications of stories for the ethical practice of medicine. The book's double attention to theory and practice provides both clear conceptual content and a practical guide to using narrative ethics in the service of patients and their families.

The trial of the "German doctors" exposed atrocities of Nazi medical science and led to the Nuremberg Code governing human experimentation. In Japan, Unit 731 carried out hideous experiments on captured Chinese and downed American pilots. In the United States, stories linger of biological experimentation during the Korean War. This collection of essays looks at the dark medical research conducted during and after World War II. Contributors describe this research, how it was brought to light, and the rationalizations of those who perpetrated and benefited from it; look at the response to the revelations of this horrific research and its implications for present-day medicine and ethics; and offer lessons about human experimentation in an age of human embryo research and genetic engineering.

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.

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.

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.

Medical professionals are expected to act in the interest of patients, the public, and the pursuit of medical knowledge. But what happens when doctors' supposed impartiality comes under fire? Helen Kang examines three moments in the history of the medical profession in Canada, spanning more than 150 years, when doctors' moral and scientific authority was questioned. She shows that the profession was compelled to re-examine its priorities, strategize in order to regain credibility, and redefine what it means to be a good doctor. Medicine and Morality reveals that the moral and scientific standards in medicine are determined in direct relation to, not in spite of, conflict of interest.

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.

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.

In Better than Human?, noted bioethicist Allen Buchanan grapples with the ethical dilemmas of the medical revolution now upon us. Biomedical enhancements, he writes, can make us smarter, have better memories, be stronger, quicker, have more stamina, live much longer, be more resistant to disease and to the frailties of aging, and enjoy richer emotional lives. They can even improve our character, or at least strengthen our powers of self-control. In spite of the benefits that biomedical enhancements may bring, many people instinctively reject them. Some worry that we will lose something important-our appreciation for what we have or what makes human beings distinctively valuable. To think clearly about enhancement, Buchanan argues, we have to acknowledge that nature is a mixed bag and that our species has many "design flaws". We should be open to the possibility of becoming better than human, while never underestimating the risk that our attempts to improve may backfire.

Ethics is commonly assumed to be the one realm in which luck and risk do not
intrude. It has been said that 'While one can be lucky in one's business, in
one's married life, and in one's health, one cannot, so it is commonly
assumed, be subject to luck as far as one's moral worth is concerned.' But
although we do not normally hold people responsible for outcomes beyond
their control, a serious examination of the role of luck and risk may lead
us to conclude that very few outcomes are really within people's control.
This is the paradox of 'moral luck'. "

"Risk and Luck in Medical Ethics" examines the 'moral luck' paradox in greater
detail, relating it to Kantian, consequentialist, and virtue-based
approaches to ethics. Dickenson applies the paradoxes of risk and
luck to medical ethics, including timely discussion of risk and luck in the
allocation of scarce health care resources, informed consent to treatment,
decisions about withholding life-sustaining treatment, psychiatry,
reproductive ethics, genetic testing, and medical research and
evidence-based medicine.

The book concludes with an examination of the relevance of risk and luck in
a medical context to the study of global ethics. If risk and luck are taken
seriously, it would seem to follow that we cannot develop any definite moral
standards at all, that we are doomed to moral relativism. However, Dickenson
offers strong counter-arguments to this view that enable us to think in
terms of universal standards for judging ethical systems. This claim has
direct practical relevance for practitioners as well as philosophers.

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.

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.

This collection features comprehensive overviews of the various ethical challenges in organ transplantation. International readings well-grounded in the latest developments in the life sciences are organized into systematic sections and engage with one another, offering complementary views. All core issues in the global ethical debate are covered: donating and procuring organs, allocating and receiving organs, as well as considering alternatives. Due to its systematic structure, the volume provides an excellent orientation for researchers, students, and practitioners alike to enable a deeper understanding of some of the most controversial issues in modern medicine.

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.

A portion of the revenue from this book's sales will be donated to Doctors Without Borders to assist in the fight against COVID-19.The rapid spread of COVID-19 has had an unprecedented impact on modern health-care systems and has given rise to a number of complex ethical issues. This collection of readings and case studies offers an overview of some of the most pressing of these issues, such as the allocation of ventilators and other scarce resources, the curtailing of standard privacy measures for the sake of public health, and the potential obligations of health-care professionals to continue operating in dangerous work environments.

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.

Surgery inevitably inflicts some harm on the body. At the very least, it damages the tissue that is cut. These harms often are clearly outweighed by the overall benefits to the patient. However, where the benefits do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery. When, if ever, do the benefits of these surgeries outweigh their costs? May a surgeon perform dangerous procedures that are not clearly to the patient's benefit, even if the patient consents to them? May a surgeon perform any surgery on a minor patient if there are no clear benefits to that child? These and other related questions are the core themes of this collection of essays.

To its proponents, the ultrasound scanner is a safe, reliable, and indispensable aid to diagnosis. Its detractors, on the other hand, argue that its development and use are driven by the technological enthusiasms of doctors and engineers (and the commercial interests of manufacturers) and not by concern to improve the clinical care of women. In some U.S. states, an ultrasound scan is now required by legislation before a woman can obtain an abortion, adding a new dimension to an already controversial practice. "Imaging and Imagining the Fetus" engages both the development of a modern medical technology and the concerted critique of that technology.

Malcolm Nicolson and John Fleming relate the technical and social history of ultrasound imaging--from early experiments in Glasgow in 1956 through wide deployment in the British hospital system by 1975 to its ubiquitous use in maternity clinics throughout the developed world by the end of the twentieth century. Obstetrician Ian Donald and engineer Tom Brown created ultrasound technology in Glasgow, where their prototypes were based on the industrial flaw detector, an instrument readily available to them in the shipbuilding city. As a physician, Donald supported the use of ultrasound for clinical purposes, and as a devout High Anglican he imbued the images with moral significance. He opposed abortion--decisions about which were increasingly guided by the ultrasound technology he pioneered--and he occasionally used ultrasound images to convince pregnant women not to abort the fetuses they could now see.

"Imaging and Imagining the Fetus" explores why earlier innovators failed where Donald and Brown succeeded. It also shows how ultrasound developed into a "black box" technology whose users can fully appreciate the images they produce but do not, and have no need to, understand the technology, any more than do users of computers. These "images of the fetus may be produced by machines," the authors write, "but they live vividly in the human imagination."

Mental illness is the poor, and somehow "damaged," cousin to physical ailments in the eyes of too many in our society. Compare the difference in how people would respond to someone who had fallen and broken their leg on the street, to how most react to those mentally ill among us, on those same streets, who spend their winters on steam grates and forage for food in dumpsters. " Rationing Sanity "is a provocative analysis of the mental health care system in the United States, dealing with issues of justice and access to mental health care.

How should a decent society, affluent but facing many serious calls on its resources, best care for citizens afflicted with severe and persistent mental illnesses? James Lindemann Nelson brings together, for the first time, scholars of the ethics of mental health care and top managed care policy analysts to address this crucial problem. "Rationing Sanity" integrates those perspectives with the thoughtful practice-based experience of physicians well versed in the actual care of people with emotional and behavioral problems. Over a period of years, the contributors met face-to-face to engage each other on the ethics of managed mental health care -- the result is a unique, collaborative effort that provides a wealth of important new insights on not only how Americans can readjust their attitudes toward the mentally ill -- but also how we may find more just and humane treatment for those afflicted.

In this age of increasing headlines about drug addiction and prescription drug abuse, this book is a timely revelation of how the nursing profession is also impacted by substance abuse. It allows nurses, who are the most trusted profession in society, who have been hidden within their profession and living with substance use disorders, to openly voice their personal experiences with addiction. Seven nurses detail their journey through family dynamics, early use as nursing students and later career nurses as they traveled deeper and deeper into their addiction. They discuss their shame, humiliation and dejection under the throes of the compelling forces of drugs and alcohol. They also describe how their family, other nurses, the healthcare system, and society assisted them in perpetuating their deception and denial about their disease. They explain how they lied, stole and cheated those around them to maintain their addiction. Each explains in detail the confrontations and the "jolt" and "wake up call" it took for them to awaken, become sober and truly enter recovery. They are all candid and forthright in order to help others that are impacted by this horrific and complex disease. They each share how recovery is possible when appropriate attitudes and tools are put in place to support nurses suffering from the devastation of addiction. Their stories bring attention to the importance of intervention, treatment, and recovery communities within the nursing profession. Recovery is emphasized as a "gift" by each of these nurses. The nurses and the researcher provide suggestions and recommendations to assist the healthcare community in addressing addiction in nursing. This book reveals how recovery for nurses is a major public health benefit.

This book is designed to consolidate the relevant literature as well as the thoughts of professionals currently working in the field into a practical and accessible reference for the emergency medical technician, student, nurse, resident, and attending emergency physician. Each chapter is divided into four sections: case presentation, discussion, review of the current literature, and recommendations. Designed to serve simultaneously as a learning and reference tool, each chapter begins with a real case that was encountered in an ED setting. The case presentation is followed by a short discussion of the case, as if at a morbidity and mortality conference, by a panel of experienced attending physicians explaining how they would approach the ethical dilemmas associated with the case, and a review of the existing literature.

What roles do different kinds of knowledge play in medicine? What roles should they play? What standards (epistemic, ethical, practical) should be met before knowledge is used to develop policy or practice? Medical decision-making, whether in the clinic or at the policy level, can have serious and far-reaching consequences. It is therefore important to base decisions on the best available knowledge. Yet deciding what should count as the best available knowledge is not easy. This important book addresses philosophical questions about what kinds of knowledge should be taken into account, and how knowledge should inform practice and policy. The chapters in this volume examine the relationship between knowledge and action in medical research, practice, and policy. "Knowledge" is broadly construed to include knowledge from clinical, laboratory, or social science research, and from the clinical encounter, as well as broader background assumptions prevalent in society that inform both the kinds of knowledge that are taken to be relevant to medicine and how that knowledge is interpreted in decision-making. Such knowledge may be relevant not only to clinical decision-making with regard to the care of individual patients, but also to the practice of scientific research, the development of policy and practice guidelines, and decisions made by patients or by patient advocacy groups.

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.