A cutting-edge analysis of the global issues surrounding modern reproductive technologies Advances in assisted reproductive technologies have sparked global policy debates since the birth of the first so-called "test tube baby" in 1978. Today, mitochondrial replacement therapies represent the most recent advancement in assisted reproductive technologies, allowing some women with mitochondrial diseases to birth babies without those diseases. In the past decade, mitochondrial replacement therapies have captured public sentiment, reigniting debates around social views of reproductive rights and the appropriate legal and political response. Reproduction Reborn guides readers through the history and science of mitochondrial replacement therapies and the various attempts to control them. Leading experts from medicine, genetics, ethics, law, and policy explore the influence of public debate on the evolving shape of these technologies and their subsequent regulation. They highlight case studies from both developed and developing countries across the globe, including recent legislation in Australia and China. They further identify the ethical, legal, and societal norms that need to be addressed by policymakers and communities as more and more people seek to gain access to these treatments. Given the importance of reproduction in family life and cultural identity, clinicians and policymakers must understand how regulatory regimes around mitochondrial replacement therapies have evolved to illuminate the processes and challenges of governing reproduction in a fast-moving world. Informative and global in scope, Reproduction Reborn explores how advancements in assisted reproductive technologies challenge core values surrounding the rights and responsibilities of modern-day family units.

This book provides an account of the ethics of chronic illness. Chronic illness differs from other illnesses in that it is often incurable, patients can live with it for many years, and its day-to-day management is typically carried out by the patient or members of their family. These features problematise key distinctions that underlie much existing work in medical ethics including those between beneficence and autonomy, between treatment and prevention, and between the recipient and provider of treatment. The author carries out a detailed reappraisal of the roles of both autonomy and beneficence across the different stages of treatment for a range of chronic illnesses. A central part of the author's argument is that in the treatment of chronic illness, the patient and/or the patient's family should be seen as acting with healthcare professionals to achieve a common aim. This aspect opens up unexplored questions such as what healthcare professionals should do when patients are managing their illness poorly, the ethical implications of patients being responsible for parts of their treatment, and how to navigate sharing information with those directly involved in patient care without violating privacy or breaching confidentiality. The author addresses these challenges by engaging with philosophical work on shared commitments and joint action, responsibility and justice, and privacy and confidentiality. The Ethics of Chronic Illness provides a new, and much needed, critical reappraisal of healthcare professionals' obligations to their patients. It will be of interests to academics working in bioethics and medical ethics, philosophers interested in the topics of autonomy, responsibility, and consent, and medical practitioners who treat patients with chronic illness.

Recent years have seen a growing interest in the questions of ethics and aging. Advances in medical technology have created dilemmas for physicians, nurses, and other health care professionals over such questions as the allocation of resources and a patient's "right to die." At the same time, the aging of the American population raises concerns about social policies that involve the role of government. In "Ethics in an Aging Society" Harry R. Moody examines both the clinical and the policy issues that center around aging.

Moody pays special attention to the ethical problems associated with two particularly timely concerns--Alzheimer's disease and the increasingly controversial issue of "rational suicide" for reasons of age. He also focuses on the rights of patients in long-term care and on the question of justice between generations (Are older patients using more than their "fair share" of scarce health care dollars?).

"These ethical questions," Moody emphasizes, "are not abstract ones. They arise in the specific historical and political context of America in the closing decade of the twentieth century... This book can best be understood as a meditation on two compelling liberal ideas--autonomy and justice--that have inspired our thinking about ethics and the aging society. The story which unfolds in the book is a story both about the power of those ideals and also about inescapable facts of old age that make those ideals problematic."

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.

David Rothman gives us a brilliant, finely etched study of medical practice today. Beginning in the mid-1960s, the practice of medicine in the United States underwent a most remarkable--and thoroughly controversial--transformation. The discretion that the profession once enjoyed has been increasingly circumscribed, and now an almost bewildering number of parties and procedures participate in medical decision making.

Well into the post-World War II period, decisions at the bedside were the almost exclusive concern of the individual physician, even when they raised fundamental ethical and social issues. It was mainly doctors who wrote and read about the morality of withholding a course of antibiotics and letting pneumonia serve as the old man's best friend, of considering a newborn with grave birth defects a "stillbirth" thus sparing the parents the agony of choice and the burden of care, of experimenting on the institutionalized the retarded to learn more about hepatitis, or of giving one patient and not another access to the iron lung when the machine was in short supply. Moreover, it was usually the individual physician who decided these matters without formal discussions with patients, their families, or even with colleagues, and certainly without drawing the attention of journalists, judges, or professional philosophers.

The impact of the invasion of outsiders into medical decision-making, most generally framed, was to make the invisible visible. Outsiders to medicine--that is, lawyers, judges, legislators, and academics--have penetrated its every nook and cranny, in the process giving medicine exceptional prominence on the public agenda and making it the subject of popular discourse. The glare of the spotlight transformed medical decision making, shaping not merely the external conditions under which medicine would be practiced (something that the state, through the regulation of licensure, had always done), but the very substance of medical practice--the decisions that physicians made at the bedside.

One of the most difficult issues that confronts veterinarians and staff today concerns the profession's obligation to the animal and the sometimes conflicting demands from clients, peers and society. The veterinarian's role has become more complex with new ethical challenges posed by issues such as growing public awareness regarding animal welfare, increasing economic value of companion animals, growth of veterinary specialization, experimentation with alternative and complementary medicine, and concern for pain management and mental well-being of animals.

Written by an acknowledged pioneer in veterinary ethics, "An Introduction to Veterinary Medical Ethics "addresses the ethical challenges that veterinarians face daily as they seek to balance obligations to animal, client, peers, society and self. The book offers a highly readable and approachable introduction to the nature of ethical theory, reasoning and decision-making, and its practical application to veterinary medicine. Now with over 100 real-life veterinary case histories and analysis, this edition also includes new discussions of animal pain, distress and happiness, ethics of critical care, alternative medicine, legal status and value of animals, and Aesculapian authority.

"An Introduction to Veterinary Medical Ethics: Theory and Cases, Second Edition" is recommended as essential reading for all veterinary students and practitioners, as well as those interested in general animal welfare.
New edition from an acknowledged pioneer in veterinary ethics
Addresses ethical challenges that veterinary medicine, with over 100 real-life cases
Includes new discussion of legal status and value of animals, alternative medicine, Aesculapian authority, ethics and critical care, and animal pain, distress and happiness
Ideal for veterinary students and practitioners

Rapid advances in modern medicine have revolutionized the way we think about death and the processes of dying. Once death was defined as the absence of respiration or heartbeat; today patients hooked up to a respirator and feeding tube can be kept alive for months or years. Ivan and Melrose carefully explain the various medical processes involved in death and dying. In doing so they also confront the many ethical, moral and legal dilemmas that face doctors today, as well as the decisions that must be taken by relatives.

The foundations of research ethics are riven with fault lines emanating from a fear that if research is too closely connected to weighty social purposes an imperative to advance the common good through research will justify abrogating the rights and welfare of study participants. The result is an impoverished conception of the nature of research, an incomplete focus on actors who bear important moral responsibilities, and a system of ethics and oversight highly attuned to the dangers of research but largely silent about threats of ineffective, inefficient, and inequitable medical practices and health systems. In For the Common Good: Philosophical Foundations of Research Ethics, Alex John London defends a conception of the common good that grounds a moral imperative with two requirements. The first is to promote research that generates the information necessary to enable key social institutions to effectively, efficiently, and equitably safeguard the basic interests of individuals. The second is to ensure that research is organized as a voluntary scheme of social cooperation that respects its various contributors' moral claims to be treated as free and equal. Connecting research to the goals of a just social order grounds a framework for assessing and managing research risk that reconciles these requirements and justifies key oversight practices in non-paternalistic terms. Reconceiving research ethics as resolving coordination problems and providing credible assurance that these requirements are being met expands the issues and actors that fall within the purview of the field and provides the foundation for a more unified and coherent approach to domestic and international research. This is an open access title available under the terms of a CC BY-NC-ND 4.0 license. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations.

Every day, doctors are faced with the challenge of keeping the people they treat safe and free from harm. Patient safety is a relatively new field of study, but the field is expanding and there is now better understanding of what is needed to measure and achieve safety for patients. The Handbook of Patient Safety will empower doctors, nurses and other professionals to be able to develop safe clinical processes that allow proactive management and minimisation of risk, so that people are not harmed when they receive clinical care. It gives the rationale for patient safety, the theories behind the science of patient safety and then the practical methods that frontline staff can use on a daily basis to decrease harm. Pocket sized and practical, this handbook is the ideal guide to support frontline staff and trainees, as well as all allied professionals in the name of patient safety. It reflects the World Health Organization's Patient Safety Curriculum and is written by international experts in their field who have specialist interests and direct expertise in dealing with patient safety issues. This book will demystify what is often seen as a complex topic, helping doctors understand the methods needed to provide safe care.

Common morality has been the touchstone of medical ethics since the publication of Beauchamp and Childress's Principles of Biomedical Ethics in 1979. Rosamond Rhodes challenges this dominant view by presenting an original and novel account of the ethics of medicine, one deeply rooted in the actual experience of medical professionals. She argues that common morality accounts of medical ethics are unsuitable for the profession, and inadequate for responding to the particular issues that arise in medical practice. Instead, Rhodes argues that medicine's distinctive ethics should be explained in terms of the trust that society allows to the profession. Trust is the core and starting point of Rhodes' moral framework, which states that the most basic duty of doctors is to "seek trust and be trustworthy." Building from this foundation, Rhodes explicates the sixteen specific duties that doctors take on when they join the profession, and demonstrates how her view of these duties is largely consistent with the codes of medical ethics of medical societies around the world. She then explains why it is critical for physicians to develop the attitudes or "doctorly" virtues that comprise the character of trustworthy doctors and buttress physicians' efforts to fulfil their professional obligations. Her book's presentation of physicians' duties and the elements that comprise a doctorly character, together add up to a cohesive and comprehensive description of what medical professionalism really entails. Rhodes's analysis provides a clear understanding of medical professionalism as well as a guide for doctors navigating the ethically challenging situations that arise in clinical practice

While paternalism has been a long-standing philosophical issue, it has recently received renewed attention among scholars and the general public. The Routledge Handbook of the Philosophy of Paternalism is an outstanding reference source to the key topics, problems and debates in this exciting subject and is the first collection of its kind. Comprising twenty-seven chapters by a team of international contributors the handbook is divided into five parts: * What is Paternalism? * Paternalism and Ethical Theory * Paternalism and Political Philosophy * Paternalism without Coercion * Paternalism in Practice Within these sections central debates, issues and questions are examined, including: how should paternalism be defined or characterized? How is paternalism related to such moral notions as rights, well-being, and autonomy? When is paternalism morally objectionable? What are the legitimate limits of government benevolence? To what extent should medical practice be paternalistic? The Routledge Handbook of the Philosophy of Paternalism is essential reading for students and researchers in applied ethics and political philosophy. The handbook will also be very useful for those in related fields, such as law, medicine, sociology and political science.

The Oxford Handbook of Medical Ethics and Law is the definitive guide to the legal and ethical issues around medical and surgical practice. It is written with the busy clinician in mind who will not have time to read lengthy and complex legal or philosophical documents but requires the key information presented without technical jargon in a handy quick-reference style. The handbook also includes a substantial number of examples taken from a wide variety of specialties with the relevant legal and ethical issues clearly explained, so that the reader can see how these principles play out in day-to-day patient care. Both medical students and current professionals will find this an essential practical resource.

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 ancient Rome parents would consult the priestess Carmentis shortly after birth to obtain prophecies of the future of their newborn infant. Today, parents and doctors of critically ill children consult a different oracle. Neuroimaging provides a vision of the child's future, particularly of the nature and severity of any disability. Based on the results of brain scans and other tests doctors and parents face heart-breaking decisions about whether or not to continue intensive treatment or to allow the child to die. Paediatrician and ethicist Dominic Wilkinson looks at the profound and contentious ethical issues facing those who work in intensive care caring for critically ill children and infants. When should infants or children be allowed to die? How accurate are predictions of future quality of life? How much say should parents have in these decisions? How should they deal with uncertainty about the future? He combines philosophy, medicine and science to shed light on current and future dilemmas.

This volume explores the ethics of making or expanding families through adoption or technologically assisted reproduction. For many people, these methods are separate and distinct: they can choose either adoption or assisted reproduction. But for others, these options blend together. For example, in some jurisdictions, the path of assisted reproduction for same-sex couples is complicated by the need for the partner who is not genetically related to the resulting child to adopt this child if she wants to become the child's legal parent. The essays in this volume critically examine moral choices to pursue adoption, assisted reproduction, or both, and highlight the social norms that can distort decision-making. Among these norms are those that favour people having biologically related children ('bionormativity') or that privilege a traditional understanding of family as a heterosexual unit with one or more children where both parents are the genetic, biological, legal, and social parents of these children. As a whole, the book looks at how adoption and assisted reproduction are morally distinct from one another, but also emphasizes how the two are morally similar. Choosing one, the other, or both of these approaches to family-making can be complex in some respects, but ought to be simple in others, provided that one's main goal is to become a parent.

This book delves into risks that can easily bedevil any psychotherapist and what can happen if they are ignored. Dramatic storytelling, based on actual incidents from the author's experiences as a member of ethics committees and as an ethics teacher and consultant, explores actions prompting clients to issue formal complaints. Set in the context of an ethics committee meeting over the course of a weekend, twelve psychologists face their peers who will stand in judgment. Issues include the fallout from losing one's temper with a difficult client, a personal disclosure gone terribly wrong, a bartering arrangement that literally falls apart, a private life revealed in a most public way, a vengeful act that sullies the reputation of an entire department, breaking confidentiality when a client threatened harm, and the slippery slope to sexual exploitation. The stories are absorbing, enlightening, sometimes shocking, and often stranger than fiction. Narrative nonfiction puts human faces and emotions on what would otherwise be cursory statistics. What led to the formal complaint from both the vantage point of the complainant and the psychologist offers insights not otherwise available unless the dynamics of their private lives leading up to the conflict are revealed. An author's commentary and discussion questions follow every story. Both new and seasoned practitioners, as well as those still in training, will find this to be an invaluable resource.

This book is a collection of articles about communication and ethics in the field of medicine and health care. Common to all the articles is that they are not directly based on empirical investigations. The discussions refer to research, but this is research that has already been carried out and documented in existing literature. In this sense the articles belong to what is often called applied philosophy. All the articles address communicative and ethical challenges in patient interaction on the basis of assumptions in modern moral philosophy and philosophy of language. There is a great need for literature that deals more comprehensively with the themes in this book than many introductory books do. It is particularly difficult to find suitable reading material that can be used in teaching at graduate and master levels. This book is designed to meet this need. It is suitable for use in all higher-level courses where the aim is to give students a theoretical understanding of ethical dilemmas and communicative challenges in health care.

When Ivan Illich published Medical Nemesis in 1975, he offered a withering critique of the medical profession and the medical model. 'The medical establishment has become a major threat to health,' he said. Nearly half a century has elapsed since then, and things have got worse. In the UK, only 5 per cent of the health budget is spent on prevention. The system is so strained that the rule is often 'one problem per consultation'. Disease management takes precedence over disease prevention, and a wider perspective on health and wellbeing is largely absent. At least once a month, one third of GPs consider leaving the profession. Patients are referred to secondary care simply because primary care cannot cope. But doctors want to practise differently. People also want more. The global health and wellness industry has stepped into the gap. It offers more holistic and whole-person approach that people seek. And it's big business. It is now estimated to be worth $4.2 trillion per annum. In this book, David Beaumont proposes a better approach. The current healthcare system is a deficit model. It attempts to address and correct the absence of health, so it is therefore more correctly termed a disease-care system. Positive medicine is an abundance model. It aims not only to help people manage illness and disease, but to enhance their health. Although this book is very specifically about doctors and patients, it will resonate with all healthcare professionals.

Recent surveys demonstrate a high and possibly increasing prevalence of mental disorders in prisoners. They have an increased risk of suffering from a mental disorder that transcends countries and diagnoses. Ethical dilemmas in prison psychiatry arise from resource allocation and include issues of patient choice and autonomy in an inherently coercive environment. Ethical conflicts may arise from the dual role of forensic psychiatrists giving raise to tensions between patient care/protection of the public.This book describes models and ethical issues of psychiatric healthcare in prison in several countries. Relevant issues are: the professional medical role of a psychiatrist and/or psychotherapist working in prison, the involvement of psychiatrists in disciplinary or coercive measures; consent to treatment, the use of coercion in forcing a prisoner to undergo treatment, hunger strike, confidentiality. The book ends with consensus guidelines concerning good practice in Prison Psychiatry.

Advances in medical technology force us to struggle with new and often gut-wrenching decisions. How do we know when someone is dead and not just in a coma? Should a convicted felon qualify for a new heart? In The Woman Who Decided to Die, novelist and medical ethicist Ronald Munson takes readers to the very edges of medicine, where treatments fail and where people must cope with helplessness, mortality, and doubt. Using personal narratives that place us right next to doctors, patients, and care givers as they make decisions, Munson explores ten riveting case-based stories, told with a writer's eye for illuminating detail. These include a young woman with terminal leukemia more worried about her family than herself, a stepfather asked to donate a liver segment to his stepson, a student who believes she is being controlled by invisible Agents, and a psychiatrist-patient who prizes his autonomy until the end. Raising fundamental questions about human relationships, this is an essential book about the very nature of life and death.

Disorders of Consciousness (DoCs) raise difficult and complex questions about the value of life for persons with impaired consciousness, the rights of persons unable to make medical decisions, and our social, medical, and ethical obligations to patients whose personhood has frequently been challenged and neglected. Recent neuroscientific discoveries have led to enhanced understanding of the heterogeneity of these disorders, and focused renewed attention on the medical and ethical problem of misdiagnosis. This book examines the entanglement of epistemic and ethical uncertainty in DoCs and other medical contexts, and how they interact to create both epistemic and ethical risks. Philosopher and bioethicist L. Syd M Johnson pulls together multiple threads in this work: the ontological mysteries of consciousness, medical uncertainty about unconsciousness, ableist bias, withdrawal of treatment in neurointensive care, and the rarely questioned view that consciousness is essential to personhood and moral status. Johnson challenges longstanding bioethical dogmas about DoC patients, and argues for an ethics of uncertainty for contexts where there is a need for decisive action in the presence of unavoidable uncertainty. The ethics of uncertainty refocuses ethical inquiry concerning persons with DoCs, placing less emphasis on their contested personhood, and more on inductive risk and uncertainty, on respect for autonomy, and especially on epistemic justice. With applications to various decisional contexts where uncertainty and ethical risk interact, this ethical approach enables surrogate decision makers facing fraught and risky choices to fulfill their obligations as moral and epistemic agents.

"Will the future confront us with human GMOs? Greely provocatively declares yes, and, while clearly explaining the science, spells out the ethical, political, and practical ramifications."-Paul Berg, Nobel Laureate and recipient of the National Medal of Science Within twenty, maybe forty, years most people in developed countries will stop having sex for the purpose of reproduction. Instead, prospective parents will be told as much as they wish to know about the genetic makeup of dozens of embryos, and they will pick one or two for implantation, gestation, and birth. And it will be safe, lawful, and free. In this work of prophetic scholarship, Henry T. Greely explains the revolutionary biological technologies that make this future a seeming inevitability and sets out the deep ethical and legal challenges humanity faces as a result. "Readers looking for a more in-depth analysis of human genome modifications and reproductive technologies and their legal and ethical implications should strongly consider picking up Greely's The End of Sex and the Future of Human Reproduction... [It has] the potential to empower readers to make informed decisions about the implementation of advancements in genetics technologies." -Dov Greenbaum, Science "[Greely] provides an extraordinarily sophisticated analysis of the practical, political, legal, and ethical implications of the new world of human reproduction. His book is a model of highly informed, rigorous, thought-provoking speculation about an immensely important topic." -Glenn C. Altschuler, Psychology Today

The pressing and universally relevant issue of euthanasia is debated in this volume. Euthanasia has become increasingly contentious as populations age, and medical and scientific advances continue to transform and extend life. Euthanasia - Choice and Death examines the key philosophical arguments that have underpinned thinking and practice up till now: * The centrality of choice to our notion of the human being; * The challenge of changes to our concept of death in the face of medical, scientific and technological advances. Gail Tulloch develops a conception of dignity that does not depend on religious assumptions and can promote a broad ethical consensus in a liberal democracy. Examination of landmark cases and the approaches adopted by key countries - the U.S.A., the U.K., the Netherlands, and Australia - ground the book.