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Books > Medicine > General issues > Medical ethics
The Abortion Act 1967 may be the most contested law in UK history, sitting on a fault line between the shifting tectonic plates of a rapidly transforming society. While it has survived repeated calls for its reform, with its text barely altered for over five decades, women's experiences of accessing abortion services under it have evolved considerably. Drawing on extensive archival research and interviews, this book explores how the Abortion Act was given meaning by a diverse cast of actors including women seeking access to services, doctors and service providers, campaigners, judges, lawyers, and policy makers. By adopting an innovative biographical approach to the law, the book shows that the Abortion Act is a 'living law'. Using this historically grounded socio-legal approach, this enlightening book demonstrates how the Abortion Act both shaped and was shaped by a constantly changing society.
The idea of a philosophy of palliative care emerged with Cicely Saunders' vision for 'a good death', and was developed further with the WHO definition of palliative care. It is now being applied not only to cancer patients, but to all patients in end of life situations. As this 'palliative care approach' advances, it is important to pause and comment on its effectiveness. It is a philosophy of patient care, and is therefore open to critique and evaluation. Using the Oxford Textbook of Palliative Medicine, 3rd edition as their basic reference, Randall and Downie present their argument that the palliative care approach has become too busy and over-professionalised, and that it therefore has significant weaknesses. They examine the framework of the specialty - quality of life, autonomy, dignity, patient-centredness, and the priority assigned to relatives in the remit of care - and the moral problems associated with implementing such a philosophy. The resource implications of various health care policies are also discussed in relation to the WHO definition. Whilst the authors defend the achievements of palliative care and those who work in the profession, they present suggestions for an alternative philosophy. Their philosophy prompts many ethical and philosophical questions about the future of palliative care.
Recent advances in the brain sciences have dramatically improved our understanding of brain function. As we find out more and more about what makes us tick, we must stop and consider the ethical implications of this new found knowledge. Will having a new biology of the brain through imaging make us less responsible for our behavior and lose our free will? Should certain brain scan studies be disallowed on the basis of moral grounds? Why is the media so interested in reporting results of brain imaging studies? What ethical lessons from the past can best inform the future of brain imaging? These compelling questions and many more are tackled by a distinguished group of contributors to this volume on neuroethics. The wide range of disciplinary backgrounds that the authors represent, from neuroscience, bioethics and philosophy, to law, social and health care policy, education, religion and film, allow for profoundly insightful and provocative answers to these questions, and open up the door to a host of new ones. The contributions highlight the timeliness of modern neuroethics today, and assure the longevity and importance of neuroethics for generations to come.
The Basics of Bioethics, Fourth Edition offers an easy-to-follow introduction to this dynamic field, intended for healthcare professionals, teachers, students, and anyone interested in bioethics. Accessible and enjoyable for readers of all backgrounds, the book contains numerous cases-including ones that recently have dominated international headlines-to help anchor the broader discussion. The text is suitable for use in short courses in schools of medicine, nursing, and other health professions; continuing professional education; various undergraduate departments; and adult education. Chapters are organized around common moral themes in order to help readers understand the values and other connections that tie together different positions in bioethics. This fourth edition adds a new chapter on alternative frameworks in bioethics, including narrative ethics and casuistry, feminist approaches, care ethics, and virtue ethics. Due to significant advances in genetics and reproductive possibilities, this new edition devotes a full chapter to each. The combined teaching, research, and clinical experience of the two authors helps make this edition current with the evolving field of bioethics, while still embedding the major issues in a systematic framework that allows readers easily to navigate the larger field. Key Changes to the Fourth Edition: * An added chapter on new and emerging approaches in bioethics, including those based on virtue ethics, casuistry and narrative ethics, feminist ethics, and care ethics * Updates throughout the book based on developments in ethical theory and new medical research * Revisions and updates to the Learning Objectives, Key Terms, Bibliographies, and URLs * The addition of multiple recent case studies, including: Jahi McMath an undocumented patient who needs a rule bent a pediatrician who turns away unvaccinated patients a minor eligible for pediatric bariatric surgery a daughter suing a hospital for non-disclosure of her father's Huntington's diagnosis CRISPR-edited newborn babies
The NHS has undergone substantial reform and investment since 1980,
yet demand for care still exceeds supply and difficult choices
remain between patients. Why is this so? On what basis should these
decisions be made and by whom? As patients become 'consumers' of
care, Who Should We Treat? puts patients' rights into their
political, economic, and managerial perspectives to consider one of
the most pressing problems in contemporary society.
Genetics promises to provide one of the most powerful approaches to
understanding the functional pathology of the human brain. This
book presents a critical review of the evidence for a genetic
contribution to common psychiatric conditions and the rarer
single-gene disorders that may have psychiatric presentations
The COVID-19 crisis has transformed the highly specialized issue of what constitutes reliable medical evidence into a topic of public concern and debate. This book interrogates the assumption that evidence means the same thing to different constituencies and in different contexts. Rather than treating various practices of knowledge as rational or irrational in purely scientific terms, it explains the controversies surrounding COVID-19 by drawing on a theoretical framework that recognizes different types of rationality, and hence plural conceptualizations of evidence. Debates within and beyond the medical establishment on the efficacy of measures such as mandatory face masks are examined in detail, as are various degrees of hesitancy towards vaccines. The authors demonstrate that it is ultimately through narratives that knowledge about medical and other phenomena is communicated to others, enters the public space, and provokes discussion and disagreements. This title is also available as Open Access on Cambridge Core.
This Element is a survey of the field of pathographies of mental illness. It explores classic texts in the field as well as other selected contemporary memoirs. In doing so, the reader is introduced to psychiatric information about various mental illnesses through a narrative lens, emphasizing experience. Because clinical research is evidenced-based and aims to produce generalizable knowledge (i.e., trends), the reading of pathographies can complement these findings with practical experiential insights. By pairing psychiatric information with pathographies, certain personal themes become apparent that are different from the empirical trends identified by scientific and medical researchers. Based on the survey presented here, this Element identifies seven such themes, laying the foundation for future research, inquiry, practice, and policy.
As one of the first researchers authorised to observe hearings and access court files at the Court of Protection, Jaime Lindsey offers an original account and analysis of the workings of this court. Using data collected with the approval from the senior judiciary of the Court of Protection and the Ministry of Justice, this innovative book combines empirical data with theoretical and normative analysis. It takes a socio-legal approach to understanding how the Mental Capacity Act operates in practice to achieve access to justice and situates current debates within an international context, showing how other jurisdictions have been guided by the United Nations Convention on the Rights of Persons with Disabilities. Furthering scholarship across several fields including access to justice, healthcare law and procedural justice theory, this is a timely and pioneering book that argues for a reimagining of the Court of Protection.
Hospice is the premiere end of life program in the United States, but its requirement that patients forgo disease-directed therapies and that they have a prognosis of 6 months or less means that it serves less than half of dying patients and often for very short periods of time. Palliative care offers careful attention to pain and symptom management, added support for patients and families, and assistance with difficult medical decision making alongside any and all desired medical treatments, but it does not include a comprehensive system of care as is provided by hospice. The practice of palliative care and hospice is filled with sometimes overt (requests for hastened death in an environment where such acts are legally prohibited) and other times covert (the delay in palliative care referral because the health care team believes it will undermine disease directed treatment) ethical issues. The contributors to this volume use a series of case presentations within each chapter to illustrate some of the palliative care and hospice challenges with significant ethical dimensions across the three overarching domains: 1) care delivery systems; 2) addressing the many dimensions of suffering; and 3) difficult decisions near the end of life. The contributors are among the most experienced palliative care, hospice and ethics scholars in North America and Western Europe. Each has been given relatively free reign to address what they feel are the most pressing ethical challenges within their domain, so a wide range of positions and vantage points are represented. As a result, the volume provides a very diverse ethical exploration of this relatively young field that can deepen, stretch, and at times confront any simple notion of the challenges facing patients, their families, professional caregivers, and policy makers.
Can religious arguments provide a reasonable, justified basis for restrictive (coercive) public policies regarding numerous ethically and politically controversial medical interventions, such as research with human embryos, pre-implantation genetic diagnosis, or using artificial wombs? With Rawls, we answer negatively. Liberally reasonable policies must address these controversial technologies on the basis of public reasons accessible to all, even if not fully agreeable by all. Further, public democratic deliberation requires participants to construct these policies as citizens who are agnostic with respect to the truth of all comprehensive doctrines, whether secular or religious. The goal of these deliberations is practical, namely, to identify reasonable policy options that reflect fair terms of cooperation in a liberal, pluralistic society. Further, religious advocates may participate in formal policymaking processes as reasonable liberal citizens. Finally, public reason evolves through the deliberative process and all the novel technological challenges medicine generates for bioethics and related public policies.
A CRITICAL NEW APPROACH FOR LEARNING AND THRIVING IN A FIELD OF CHANGE The scope and responsibilities of today's genetic counselors exceed the reasonable capacity of any one educational resource. While the field's first-year curriculum may be relatively fixed, the landscape of what comes after that - a dizzying mix of practice, ethics, research design, and professional competencies - is increasingly broad. Advanced Genetic Counseling offers an overdue extension of the field's core curriculum. From navigating ethical dilemmas and potential conflicts of interest to confronting the biases and patterns of thought that can limit counselors' interactions with clients, it prepares readers to face the profession's most challenging aspects with confidence. Drawing on techniques from psychotherapy, social psychology, and health behavior, Advanced Genetic Counseling is an essential resource for trainees and mid-career professionals. It offers a roadmap not just for addressing client needs, but for the future of genetic counseling education.
Cannabis is one of the oldest cultivated plants dating back 12,000 years and demonstrates medicinal properties including immune support, anti-inflammatory effects, and cancer-fighting potential. As cannabis receives regulatory approval in the United States, clinicians will need guidelines to prescribe medical marijuana for various health conditions. This book presents information to healthcare professionals focusing on medical cannabis. It is a science-based overview providing clinical recommendations and dosing guidelines for practitioners to advise patients appropriately. Features: Discusses the endocannabinoid system role in homeostasis, pain control, and regulatory function in health and disease Advises clinicians on cannabis use in patients with cancer; cardiovascular, brain, and liver function; mood disorders; and patients receiving palliative care Includes information on cannabis nutrition as well as the cannabis microbiome Features information on cannabis quality control for safe and effective delivery Cannabis: A Clinician's Guide is written for clinicians providing a resource guide to help them assess the medicinal value of cannabis, answer patient and consumer questions, and recommend its use optimally. The book is divided into three sections covering cannabis science, use in clinical practice, and regulations and standards. It includes practical information on dosing guidelines and dispensary insights, personal cannabis stories, and an in depth look at the nutritional benefits of cannabis and how to use it in daily life. From the Author: "As a clinical nutritionist, I have been involved in the use of cannabis since 1981 while researching diabetes in India. Ayurvedic medicine listed cannabis as a beneficial herb with curing properties. In 1983, a Chinese medicine doctor in the Peoples Republic of China gave me a cannabis herbal supplement for sleep that he claimed Chairman Mao took regularly. Upon returning to the United States, no one would even talk to me about cannabis because of its Schedule I status. During an Antioxidants class taught for Everglades University, I included information on cannabis, but was restricted from including it in the course description. Cannabis: A Clinician's Guide unveils deceit on this herbal medicine used for thousands of years providing insight into the science behind its use and how to incorporate cannabis into daily life, especially for those suffering from neurological disorders, cancer, and mood disorders."
Increasing quantities of information about our health, bodies, and biological relationships are being generated by health technologies, research, and surveillance. This escalation presents challenges to us all when it comes to deciding how to manage this information and what should be disclosed to the very people it describes. This book establishes the ethical imperative to take seriously the potential impacts on our identities of encountering bioinformation about ourselves. Emily Postan argues that identity interests in accessing personal bioinformation are currently under-protected in law and often linked to problematic bio-essentialist assumptions. Drawing on a picture of identity constructed through embodied self-narratives, and examples of people's encounters with diverse kinds of information, Postan addresses these gaps. This book provides a robust account of the source, scope, and ethical significance of our identity-related interests in accessing - and not accessing - bioinformation about ourselves, and the need for disclosure practices to respond appropriately. This title is also available as Open Access on Cambridge Core.
This Element traces the origins and development of bioethics, the principles and values involved in the discipline, and the roles of justice among these principles and values. The main tasks given to the concept of justice have since the late 1970s been nondiscrimination in research, prioritization in medical practice, and redistribution in healthcare. The Element argues that in a world challenged by planet-wide political and environmental threats this is not sufficient. The nature and meaning of justice has to be rethought. The Element does this by dissecting current bioethical approaches in the light of theories of justice as partly clashing interpretations of equality. The overall findings are twofold. Seen against the background of global concerns, justice in bioethics has become a silent guardian of economic sustainability. Seen against the same background, we should set our aims higher. Justice can, and must, be put to better use than it presently is. This title is also available as Open Access on Cambridge Core.
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.
Written by four internationally renowned bioethicists, From Chance to Choice is the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and practice. The book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late 19th and early 20th centuries. In addition, appendices explain the nature of genetic causation, gene-environment interaction, and expose widespread misconceptions of genetic determinism, as well as outlining the nature of the ethical analysis used in the book. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science.
This Element examines the main ethical aspects of consciousness It argues that consciousness is not intrinsically valuable but has value or disvalue for individuals depending on its phenomenology (what it is like to be aware) and content (what one is aware of). These two components of awareness shape normative judgments about how ordered, disordered, altered, restored, diminished and suppressed conscious states can benefit or harm individuals. They also influence moral judgments about whether intentionally causing these states is permissible or impermissible and how these states can affect behavior. After describing its neurobiological basis, this Element discusses ethical and legal issues in six categories of consciousness: phenomenal and access consciousness; intraoperative awareness; prolonged disorders of consciousness, dissociative disorders, the role of consciousness in determining death; and altering and suppressing awareness near the end of life.
This book provides a comprehensive review of ethical issues in clinical nephrology. With the advent of dialysis and kidney transplantation midway through the 20 Century, clinical nephrology was one of the first areas of medicine to deal with complex ethical issues such as rationing of health care and discontinuation of life-sustaining therapy. In the first section of the book this historical perspective is reviewed, followed by a consideration of legal issues. Specific ethical issues in nephrology are discussed in detail in the next section. These include problems in the allocation of chronic dialysis and in termination of that treatment. Also reviewed are issues in kidney transplantation, such as proposals for enhanced acquisition of kidneys, including a number of controversial proposals such as payment to donors and xenotransplantation; and equity in allocation of the supply of kidneys. Other chapters consider ethical issues in genetics; special problems in the care of children with kidney disease; and broad societal issues such as allocation of national resources for expensive therapies and economic issues in clinical practice. In the final part of the book ethical issues in the care of patients with kidney disease are discussed from an Asian and African perspective.
Health research around the world relies on access to data, and much of the most valuable, reliable, and comprehensive data collections are held by governments. These collections, which contain data on whole populations, are a powerful tool in the hands of researchers, especially when they are linked and analyzed, and can help to address "wicked problems" in health and emerging global threats such as COVID-19. At the same time, these data collections contain sensitive information that must only be used in ways that respect the values, interests, and rights of individuals and their communities. Sharing Linked Data for Health Research provides a template for allowing research access to government data collections in a regulatory environment designed to build social license while supporting the research enterprise.
From the mid-1950s through the mid-1970s, inmates of Philadelphia's Holmesburg Prison were used, in exchange for a few dollars, as guinea pigs in a host of medical experiments. Hornblum paints a disturbing portrait of abuse, moral indifference, and greed, as doctors, in conjunction with the University of Pennsylvania and prison officials, established the prison as a testing lab.
Providing a concise and accessible overview of the design, implementation and management of medical software, this textbook will equip students with a solid understanding of critical considerations for both standalone medical software (software as a medical device/SaMD) and software that is integrated into hardware devices. It includes: practical discussion of key regulatory documents and industry standards, and how these translate into concrete considerations for medical software design; detailed coverage of the medical software lifecycle process ; accessible introduction to quality and risk management systems in the context of medical software; succinct coverage of essential topics in data science, machine learning, statistics, cybersecurity, software engineering and healthcare bring readers up-to-speed; six cautionary real-world case studies illustrate the dangers of improper or careless software processes. Accompanied by online resources for instructors, this is the ideal introduction for undergraduate students in biomedical engineering, electrical engineering and computer science, junior software engineers, and digital health entrepreneurs.
This book is a companion to Clinical Ethics on Film and deals specifically with the myriad of healthcare ethics dilemmas. While Clinical Ethics on Film focuses on bedside ethics dilemmas that affect the healthcare provider-patient relationship, Healthcare Ethics on Film provides a wider lens on ethics dilemmas that interfere with healthcare delivery, such as healthcare access, discrimination, organizational ethics, or resource allocation. The book features detailed and comprehensive chapters on the Tuskegee Study, AIDS, medical assistance in dying, the U.S. healthcare system, reproductive justice, transplant ethics, pandemic ethics and more. Healthcare Ethics on Film is the perfect tool for remote or live teaching. It's designed for medical educators and healthcare professionals teaching any aspect of bioethics, healthcare ethics or the health sciences, including medical humanities, history of medicine and health law. It is also useful to the crossover market of film buffs and other readers involved in healthcare or bioethics.
Palliative care is a rapidly growing area within health care and one in which there are many ethical dilemmas. Chronically and terminally ill patients increasingly wish to take control of their own lives and deaths, resources are scarce and technology has created controversial life-prolonging treatment. This book has been written by a clinician and a teacher and writer of health care ethics to provide all those who care for the terminally ill - doctors, nurses, social workers, physiotherapists, clergy and other carers - with the concepts and principles to assist them in difficult decisions. A central theme, that technical expertise must be controlled by humane, non-technical judgements, runs through the challenging and thoughtful text. Palliative Care Ethics, in this second edition, is now more user- friendly and includes genuine case histories to illustrate ethical issues in the real world. The authors have expanded the section on rationing in respnse to the changing health care environment and confront the issues of patient rights to a far greater extent..There is also a new chapter covering terminally ill children. As the philosophy of palliation is increasingly recognised to be important from diagnosis, the coverage of more general cancer care ethics has been much increased. 'An excellent book' Palliative Medicine 'A thorough reference for practitioners of palliative care' Toronto Medical Journal 'The authors tackle many delicate concerns with professional and human integrity' Journal of Medical Ethic |
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