This volume addresses some of the most prominent questions in contemporary bioethics and philosophy of medicine: 'liberal' eugenics, enhancement, the normal and the pathological, the classification of mental illness, the relation between genetics, disease and the political sphere, the experience of illness and disability, and the sense of the subject of bioethical inquiry itself. All of these issues are addressed from a "continental" perspective, drawing on a rich tradition of inquiry into these questions in the fields of phenomenology, philosophical hermeneutics, French epistemology, critical theory and post-structuralism. At the same time, the contributions engage with the Anglo-American debate, resulting in a fruitful and constructive conversation that not only shows the depth and breadth of continental perspectives in bioethics and medicine, but also opens new avenues of discussion and exploration. For decades European philosophers have offered important insights into the relation between the practices of medicine, the concept of illness, and society more broadly understood. These interventions have generally striven to be both historically nuanced and accessible to non-experts. From Georges Canguilhem's seminal The Normal and the Pathological, Michel Foucault's lectures on madness, sexuality, and biopolitics, Hans Jonas's deeply thoughtful essays on the right to die, life extension, and ethics in a technological age, Hans-Georg Gadamer's lectures on The Enigma of Health, and more recently Jurgen Habermas's carefully nuanced interventions on the question of liberal eugenics, these thinkers have sought to engage the wider public as much as their fellow philosophers on questions of paramount importance to current bioethical and social-political debate. The essays contained here continue this tradition of engagement and accessibility. In the best practices of European philosophy, the contributions in this volume aim to engage with and stimulate a broad spectrum of readers, not just experts. In doing so the volume offers a showcase of the richness and rigor of continental perspectives on medicine and society.

The human microbiome is the bacteria, viruses, and fungi that cover our skin, line our intestines, and flourish in our body cavities. Work on the human microbiome is new, but it is quickly becoming a leading area of biomedical research. What scientists are learning about humans and our microbiomes could change medical practice by introducing new treatment modalities. This new knowledge redefines us as superorganisms comprised of the human body and the collection of microbes that inhabit it and reveals how much we are a part of our environment. The understanding that microbes are not only beneficial but sometimes necessary for survival recasts our interaction with microbes from adversarial to neighborly. This volume explores some of the science that makes human microbiome research possible. It then considers ethical, legal, and social concerns raised by microbiome research. Chapters explore issues related to personal identity, property rights, and privacy. The authors reflect on how human microbiome research challenges reigning views on public health and research ethics. They also address the need for thoughtful policies and procedures to guide the use of the biobanked human samples required for advancing this new domain of research. In the course of these explorations, they introduce examples from the history of biomedical science and recent legal cases that shed light on the issues and inform the policy recommendations they offer at the end of each topic's discussion. This volume is the product of an NIH Human Microbiome Project grant. It represents three years of conversations focused on consensus formation by the twenty-seven members of the interdisciplinary Microbiome Working Group. "The microbiome is a relatively new area of medical attention. Ethical issues related to the microbiome have barely been identified, much less carefully analyzed. This volume is an excellent start toward that ethical analysis. Many of the arguments are persuasive and provocative. In particular, some contributors challenge the ethical need for anonymizing microbiome specimens as well as the need for individual informed consent for specific uses of these specimens. I highly recommend this volume for all those interested in the microbiome and in new frontiers in medical ethics." -Leonard M. Fleck, Michigan State University

Organ transplantation is one of the most dramatic interventions in modern medicine. Since the 1950s thousands of people have lived with 'new' hearts, kidneys, lungs, corneas, and other organs and tissues transplanted into their bodies. From the beginning, though, there was simply a problem: surgeons often encountered shortages of people willing and able to give their organs and tissues. To overcome this problem, they often brokered financial arrangements. Yet an ethic of gift exchange coexisted with the 'commodification of the body'. The same duality characterized the field of blood transfusion, which was essential to the development of modern surgery.
This book will be the first to bring together the histories of blood transfusion and organ transplantation. It will show how these two fields redrew the lines between self and non-self, the living and the dead, and humans and animals. Drawing on newspapers, magazines, legal cases, films and the papers and correspondence of physicians and surgeons, Lederer will challenge the assumptions of some bioethicists and policymakers that popular fears about organ transplantation necessarily reflect timeless human concerns and preoccupations with the body. She will show how notions of the body- intact, in parts, living and dead- are shaped by the particular culture in which they are embedded.

Ross presents an original and controversial examination of the moral principles that guide parents in making health care decisions for their children, and the role of children in the decision-making process. She argues against the current movement to increase child autonomy, in favour of respect for family autonomy, and proposes significant changes in what informed consent allows and requires for paediatric health care decisions.

This book provides an assessment of some ethical implications of increasing life spans. Taking as a starting point the idea that to increase longevity is a form of medical enhancement, it examines the value of living longer; the means for extending life spans; the consequences of greater longevity for the fair distribution of resources and healthcare in particular.

This book discusses and provides insight on the legal and ethical dilemmas of managing those with Fetal Alcohol Spectrum Disorder (FASD). This book provides a clear perspective for those clinicians and legal professionals who are working with those with this disorder, and correspondingly increases their understanding when arranging effective supports for this population. Historically, the primary focus on FASD has been on children. However, this is a lifelong disorder and the implications of this disorder become even more prominent and complex in adulthood. Those with this condition can struggle with impulsiveness, and a host of cognitive difficulties. This correspondingly impacts their independence and employability, and produces an elevated risk for homelessness and other residential issues, involvement in substance use, being exploited, development of behavioural issues, and subsequent legal difficulties. Their cognitive difficulties result in challenges for legal systems around the world to understand their issues, and to design appropriate remedial strategies, recommendations for treatments and supports, and even for understanding the failure of many of these individuals to be able to change their behaviours effectively. This produces various legal and ethical dilemmas, which are discussed in detail in this volume by 28 authors from Europe, New Zealand and North America. These include discussions regarding the rights of the unborn child, the alcohol industry's duty to warn, whether small amounts of alcohol during pregnancy can be condoned, and even the current use of involuntary hospitalization for addicted mothers. Other chapters discuss the need for training on FASD for front line officers, use of lies during interrogation of those with FASD, medical and legal interventions for offenders with FASD, access to diagnostic services and follow-up supports, and whether FASD can be considered a mitigating factor for sentencing. Furthermore, caregivers also provide their stories regarding the daily dilemmas that are faced in raising those with FASD.

Biobank research and genomic information are changing the way we look at health and medicine. Genomics challenges our values and has always been controversial and difficult to regulate. In the future lies the promise of tailored medical treatments and pharmacogenomics but the borders between medical research and clinical practice are becoming blurred. We see sequencing platforms for research that can have diagnostic value for patients. Clinical applications and research have been kept separate, but the blurring lines challenges existing regulations and ethical frameworks. Then how do we regulate it? This book contains an overview of the existing regulatory landscape for biobank research in the Western world and some critical chapters to show how regulations and ethical frameworks are developed and work. How should international sharing work? How design an ethical informed consent? An underlying critique: the regulatory systems are becoming increasingly complex and opaque. The international community is building systems that should respond to that. According to the authors in fact, it is time to turn the ship around. Biobank researchers have a moral responsibility to look at and assess their work in relation to the bigger picture: the shared norms and values of current society. Research ethics shouldn't only be a matter of bioethicists writing guidelines that professionals have to follow. Ethics should be practiced through discourse and regulatory frameworks need to be part of that public discourse. Ethics review should be then not merely application of bureaucracy and a burden for researchers but an arena where researchers discuss their projects, receive advice and practice their ethics skills.

Shocked by the fact that, in the Netherlands, psychiatric patients are considered potentially appropriate candidates for physician-assisted suicide, Olevitch examines the research and data and finds that, even in the United States, the situation is threatening. She describes how the rhetoric of the assisted-suicide movement can confuse potential suicide victims and their helpers, and how surrogate medical decisions are a growing threat in the lives of incompetent patients. Olevitch argues the assisted-suicide movement is based not on the level-headed realism its advocates claim, but on a lack of information about up-to-date ways of bringing about psychological wellness, on a misguided panic about finances, a phobic view of medical procedures, a lack of understanding of the support needed by average medical patients, and a misguided belief in superficial safeguards.

Olevitch describes how Rational Emotive Behavior Therapy and Cognitive Behavior Therapy can be used to help terminally ill or disabled people overcome their profound depression. Another cognitive focus is added as she presents material answering questions including what patients are really thinking when they request assisted suicide or when they decline medical procedures. Well-known psychologist Albert Ellis says of the volume, Carefully read this unusual book and see how it can be useful to you, whether you are a physician, a mental health professional, or an unfortunate patient

This volume brings together a set of critical essays on the thought of Professor Doctor H. Tristram Engelhardt Junior, Co-Founding Editor of the Philosophy and Medicine book series. Amongst the founders of bioethics, Professor Engelhardt, Jr. looms large. Many of his books and articles have appeared in multiple languages, including Italian, Romanian, Portuguese, Spanish, and Chinese. The essays in this book focus critically on a wide swath of his work, in the process elucidating, critiquing, and/or commending the rigor and reach of his thought. This volume compasses analyses of many different aspects of Engelhardt's work, including social and political philosophy, biopolitics, the philosophy of medicine, and bioethics. It brings together internationally known scholars to assess key elements of Engelhardt's work.

This book is a multi-disciplinary collection of essays from leading researchers and practitioners, exploring legal, ethical, social, psychological and practical aspects of surrogate motherhood in Britain and abroad. It highlights the common themes that characterise debates across countries as well as exploring the many differences in policies and practices. Surrogacy raises questions for medical and welfare practitioners and dilemmas for policy makers as well as ethical issues of concern to society as a whole. The international perspective adopted by this book offers an opportunity for questions of law, policy and practice to be shared and debated across countries. The book links contemporary views from research and practice with broader social issues and bio-ethical debates. The book will be of interest to an international audience of academics and their students (in law, social policy, reproductive medicine, psychology and sociology), practitioners (including doctors, counsellors, midwives and welfare professionals) as well as those involved in policy-making and implementation.

The Legal and Ethical Issue, Guest Edited by Dana Bjarnason and Michele A. Carter, focuses on: Moral Accountability and Integrity in Nursing Practice; Care and Meaning in War Zone Nursing; Reflections on Delegation; Transcultural Nursing Practices; Information Technology; Science, Art or Both; Health Care Equity; Trust, Power and Vulnerability; Moral Certitude; and Nursing Responsibilities in Clinical Research.

This textbook considers the medical, surgical, legal and ethical aspects of establishing and maintaining an office-based egg donation programme. Chapters discuss: indications and success rates; screening and demographics of recipients and donors; preparation of the endometrium; synchronization of cycles; obstetrical outcomes; risks and complications; gestational carriers; consents and contracts; and ethics.

What is it like to be a psychologist or a psychiatrist today? Professionals with different kinds of practices and training from around the country talk candidly about their work, the effect that clients have upon them, and the various professional problems they face. They discuss how they have been trained, how they handle ethical questions, and how they feel about the profession. This short collection of interview material, based upon a national survey, provides a revealing and honest insider's view for clinicians, counselors, educators, and all those interested or touched by the mental health profession.

There is a growing conflict in medicine between the research imperative, with its implicit goal of overcoming death itself, and the re-emergent clinical imperative to treat death as a part of life, and to make the process of dying as tolerable as possible. Central to this conflict is the rise of scientific medicine and the decline of religious and associated moral discourses. Many of the Anglo Saxon countries are also marked by a moral and religious pluralism which breeds controversy over bioethical issues such as euthanasia.
It seems that modern medicine has put the cure of bodies before the care of persons. Some scholars attribute this to a metaphysical heritage of dualism and reductionism. This heritage has become problematic in the modern age when waning belief in a divine order leaves the individual self as the bearer of meaning. At the same time, knowledge about nature and society has been increasing at such an accelerated pace, it has become even more difficult to develop a unified secular worldview. When the dying self contemplates its own disintegration in this context, the search for meaning may rest heavy indeed.
Chapters one and two address these larger issues. Chapter three focuses on medicine's approach to cancer as a prime example of the strengths and weaknesses of the research imperative. Chapter four looks at the diffusion of the theory and practice of palliative care throughout the Anglo Saxon world. The fifth chapter discusses the development of effective pain control, essential to palliative care and one of modern medicine's unsung triumphs. The sixth chapter addresses the changing meaning of euthanasia in Western history in the past century, as ittransitioned from a philosophical position to a widely-debated policy proposal.
This book is for palliative care practitioners, and all health care professionals with an interest in end-of-life care. It is also for students in palliative care and the history of medicine, and for anyone interested in the history of this intriguing field.

Public policy surrounding the hotly debated issue of physician-assisted suicide is examined in detail. You ll find an analysis of the current legal standing and practice of physician-assisted suicide in several countries. Authors discuss the ethical principles underlying its legal and professional regulation. Personal narratives provide important first-hand accounts from professionals who have been involved in end-of-life issues for many years.

In this title, drawing on insights from Continental, Feminist and Religious thought, an international team of leading scholars explore alternative approaches to medical ethics. Exploring alternative approaches to medical ethics emerging from the latest research in a broad range of philosophical disciplines and traditions, "Reconceiving Medical Ethics" brings together an international team of leading scholars to explore some of the most important topics in the field. Drawing on insights from Continental, Feminist and Religious thought that are often neglected in discussions of the field, the book takes as its focus a philosophical exploration of the doctor-patient relationship that lies at the heart of any consideration of medical ethics. From this starting point the book goes on to consider such important subjects as attitudes to the body, informed consent, paternalism and the role of the law in medicine. Including discussion of case studies in each chapter, "Reconceiving Medical Ethics" opens up new avenues for discussion of this crucial topic in practical ethics today. "Continuum Studies in Philosophy" presents cutting-edge scholarship in all the major areas of research and study. The wholly original arguments, perspectives and research findings in titles in this series make it an important and stimulating resource for students and academics from a range of disciplines across the humanities and social sciences.

This new book provides a clear and accessible analysis of the various ways in which human reproduction is regulated. A comprehensive exposition of the law relating to birth control,abortion, pregnancy, childbirth, surrogacy and assisted conception is accompanied by an exploration of some of the complex ethical dilemmas that emerge when one of the most intimate areas of human life is subjected to regulatory control. Throughout the book, two principal themes recur. First, particular emphasis is placed upon the special difficulties that arise in regulating new technological intervention in all aspects of the reproductive process. Second, the concept of reproductive autonomy is both interrogated and defended. This book offers a readable and engaging account of the complex relationships between law, technology and reproduction. It will be useful for lecturers and students taking medical law or ethics courses. It should also be of interest to anyone with a more general interest in women's bodies and the law, or with the profound regulatory consequences of new technologies.

What is it like to be sued for medical malpractice? Bad medical outcomes traumatize patients but they also traumatize physicians. The litigation that often follows is a profoundly human, rather than just a legal experience. Although every physician's case is different, this book shows how each case goes through the same judicial stages of complaint, discovery, depositions, motions, and delays that lead to trial, settlement, or being dropped. It also gives doctors an understanding of how lawyers think and work to help defendants. Written by a physician and a lawyer, the book provides unique insights - through real-life stories - into the personal experience of litigation as well as recommendations for dealing with each of the legal process. It also includes up-to-date reviews of HIPAA legislation, the controversial subject of disclosure, and recent developments in the law affecting medical practitioners. Only about thirty percent of plaintiffs win their cases against doctors, but the journey from bedside to witness stand tests both the personal character and the professional skills of those accused. This well-documented book will help doctors understand and navigate the legal system while honouring their own ideals and emerging changed but stronger from the experience.

Daniel Callahan---whose cofounding of The Hastings Center in 1969 was one of the most important milestones in the history of bioethics--has written on an uncommonly wide range of issues over a long career. They have moved back and forth between clinical care of individual patients and the ethical problems of health care research and delivery. Through his many writings, four core problems have recurred in all of his work, and influence each of the others. What is health and how has its understanding been shaped by medical progress and the culture of medicine and society? What is progress, a deep value in modern health care and how should we judge it? What kinds of technological innovations that come out of the drive for progress are really good for us-and what do we do when there is a clash between individual good and social good in the use of expensive technologies, a problem now evident in the unsustainable high costs of health care? How should our understanding of the place of an inevitable death in all our lives, and its place in medicine, help us to better think of the goals of medicine and the goals of our life in seeking a good death? Those four questions have been with bioethics from its beginning and will remain with it for the indefinite future. They are the roots of bioethics.

This work sets the stage regarding debates about paternalism and health care for years to come. The anthology is organized around four parts: i) The concept of paternalism and theoretical issues regarding the idea of anti-paternalism, ii) strategies for justifying different forms of paternalism, iii) paternalism in psychiatry and psychotherapy, iv) paternalism and public health, and v) paternalism and reproductive medicine. Medical paternalism was arguably one of the main drivers of debates in medical ethics and has led to a wide acknowledgement of the value of patient autonomy. However, more recent developments in health care, such as the increasing significance of public health measures and the commercialization of medical services, have led to new social circumstances and hence to the need to rethink issues regarding paternalism. This work provides an invaluable source for many scholars and practitioners, since it deals in new and original ways with one of the main and oldest issue in health care ethics.

This book explores implicit choices made by researchers, policy makers, and funders regarding who benefits from society's investment in health research. The authors focus specifically on genetic research and examine whether such research tends to reduce or exacerbate existing health disparities. Using case examples to illustrate the issues, the authors trace the path of genetics research from discovery, through development and delivery, to health outcomes. Topics include breast cancer screening and treatment, autism research, pharmacogenetics, prenatal testing, newborn screening, and youth suicide prevention. Each chapter emphasizes the societal context of genetic research and illustrates how science might change if attention were paid to the needs of marginalized populations. Written by experts in genetics, health, and philosophy, this book argues that the scientific enterprise has a responsibility to respond to community needs to assure that research innovations achieve much needed health impacts.

A growing number of both established and newly developed doctoral programs are focusing on the preparation of practitioners rather than career researchers. Professional doctorates such as the Doctor of Nursing Practice (DNP), Doctor of Education (EdD), Doctor of Pharmacy (PharmD), Doctor of Professional Studies (DProf or DPS), and the Doctor of Psychology (PsyD) are, in fact, just a few of the professional doctorates being offered today. Professional doctorates are the fastest growing segment of doctoral education. The nature of the dissertation and the process of completing a dissertation can be quite different in a professional practice doctoral program but there are few resources for both students and faculty involved in completing and mentoring such dissertations. This book was written specifically for students and faculty involved in professional practice dissertation work. It addresses both the tasks and procedures that professional practice dissertations have in common with dissertations in ""research"" doctoral programs as well as the tasks and issues that are more common in professional practice doctoral programs. For example, negotiating entry into applied settings and securing the cooperation of practicing professionals is covered, as are alternative models for the dissertation (e.g., the ""three article dissertation"" or ""TAD""). The book also covers tasks such as getting IRB approval for applied dissertation research conducted in the field and how to propose and carry out studies based on applied and professional models of research. This book, written by three experienced mentors of professional practice dissertation students, is the comprehensive guide for both students and faculty. --This text refers to the Paperback edition.

This volume focuses on the ethical and philosophical issues that arise in an aging society, and the implications of these issues for healthcare and social policy. After a brief overview of biomedicine's changing approach of ageing and longevity and of the new expectations that these changes generate, various ethical, social, and policy issues that surround aging and longevity are discussed. First, the images and social meanings of aging and old age in our society are explored, including their normative dimensions and implications for policy. Next, ethical issues in the care for frail elderly are discussed, as well as notion of good care and end-of-life decisions. Finally, the ethical and social implications of emerging possibilities for anti-aging and lifespan extension are considered. The book concludes with an overview of the relevance of the issues discussed for policy making on professional, national and international levels. "

Mainstream philosophical discussions of ethics usually involve either a search for a problem-solving theory (such as utilitarianism), or an exploration of ontological status (of things like obligations or reasons). This book will argue that such efforts are often misplaced. Instead, the proper starting point should always be the actual words and deeds of ordinary people in ordinary disagreements; for the ethical concepts in play can only derive their full meaning within the context of ordinary human lives. This will require a better understanding of the 'ordinary', and of what it means to lead a life.