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Books > Medicine > General issues > Medical ethics
This book discusses contemporary issues in medical ethics from a Buddhist perspective. Drawing on ancient and modern sources, Damien Keown shows how Buddhist ethical principles can be applied consistently to a range of bioethical problems, including abortion, embryo research, and euthanasia.
The work looks at all human aspects of new prenatal technology. It includes the view of both parents involved in making difficult decisions about their pregnancy, and clinicians and counsellors involved in diagnosis and discussion of results of investigations, as well as the view of prenatal diagnosis by society as a whole - the ethical, legal and public health aspects. As genetic and ultrasound technology is developing rapidly, it is likely that more couples, their clinicians and counsellors will be faced with complex decisions and that the debate about ethics, legal aspects and rationing of health services will increase. This book aims to lay the foundation to those debates.;This book should be of interest to ultrasonographers; midwives; genetic counsellors; doctors specialising in obstetrics; genetic nurses; genetic social workers; clinical geneticists; general practitioners; psychotherapists; public health doctors; and purchasing managers.
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 contains twenty-one thought-provoking essays on the controversies surrounding the moral and legal distinctions between euthanasia and "letting die." Since public awareness of this issue has increased this second edition includes nine entirely new essays which bring the treatment of the subject up-to-date. The urgency of this issue can be gauged in recent developments such as the legalization of physician-assisted suicide in the Netherlands, "how-to" manuals topping the bestseller charts in the United States, and the many headlines devoted to Dr. Jack Kevorkian, who has assisted dozens of patients to die. The essays address the range of questions involved in this issue pertaining especially to the fields of medical ethics, public policymaking, and social philosophy. The discussions consider the decisions facing medical and public policymakers, how those decisions will affect the elderly and terminally ill, and the medical and legal ramifications for patients in a permanently vegetative state, as well as issues of parent/infant rights. The book is divided into two sections. The first, "Euthanasia and the Termination of Life-Prolonging Treatment" includes an examination of the 1976 Karen Quinlan Supreme Court decision and selections from the 1990 Supreme Court decision in the case of Nancy Cruzan. Featured are articles by law professor George Fletcher and philosophers Michael Tooley, James Rachels, and Bonnie Steinbock, with new articles by Rachels, and Thomas Sullivan. The second section, "Philosophical Considerations," probes more deeply into the theoretical issues raised by the killing/letting die controversy, illustrating exceptionally well the dispute between two rival theories of ethics, consequentialism and deontology. It also includes a corpus of the standard thought on the debate by Jonathan Bennet, Daniel Dinello, Jeffrie Murphy, John Harris, Philipa Foot, Richard Trammell, and N. Ann Davis, and adds articles new to this edition by Bennett, Foot, Warren Quinn, Jeff McMahan, and Judith Lichtenberg.
The books published about nursing ethics usually discuss issues that start with the patient. This book addresses the nurse's personal and ethical development as a prerequisite to patient care.;The authors start with the assumption that most people want and need to care for others. The act of caring then places the individual in a position where issues such as honesty, faithfulness, compassion, fortitude and respect for others are central concerns. The role of the professional carer is elaborated and explored in relation to the development of personal integrity.;Key features of this volume include an investigation into ethical issues related to caring; the replacement of the notion of service and dedication with personal and ethical development; and central issues of abortion, euthanasia and suicide addressed from the nurse's and the patient's point of view.;This book is designed both as a challenge and a comfort to those in the caring professions who aim to recognize and resolve their every day dilemmas. The challenge is to achieve the highest standard of care - the comfort is in the acknowledgement of the problems arising from the choice between sometimes unwelcome possibilities.
Well and Good presents a combination of classic and little-known cases in health care ethics. These cases, accompanied by information about the major ethical theories, give students a chance to grapple with the ethical challenges faced by health care practitioners, policy makers, and recipients. The authors' narrative style and leading questions provoke interest and engagement, while allowing readers to work through complicated issues for themselves. This fourth edition includes an expanded discussion of feminist ethics, as well as new cases addressing pandemic ethics, humanitarian aid, the social determinants of health, research and Aboriginal communities, and a number of other emerging issues.
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.
This interdisciplinary text is the first to address the many questions and controversies surrounding the use of children as research subjects. Experts in the field of biomedical and behavioural research with children consider the issues in terms of biomedical science, child psychology, ethics, and the law, providing a careful balance between individual and societal benefits. This practical guide will be invaluable to everyone involved in performing or reviewing research involving children.
The Vatican insists that human embryos must be treated as persons. This would block almost all "in vitro" fertilization and associated biomedical techniques. Moreover this demand is presented as a matter of natural justice, binding on Catholics and non-Catholics alike, and therefore to be incorporated into civil law. The author explores the basis on which the Vatican presumes to proclaim universally binding prescriptions, paying particular attention to those concerning the value of human life. Against this backgroud, the demand that the embryo be treated as a person is assessed. It is argued that the case in natural justice has not been made out, and that in persisting with its demand the Vatican is departing from the fundementals of the Catholic tradition.
A sharp expose of the roots of the cost-exposure consensus in American health care that shows how the next wave of reform can secure real access and efficiency. The toxic battle over how to reshape American health care has overshadowed the underlying bipartisan agreement that health insurance coverage should be incomplete. Both Democrats and Republicans expect patients to bear a substantial portion of health care costs through deductibles, copayments, and coinsurance. In theory this strategy empowers patients to make cost-benefit tradeoffs, encourages thrift and efficiency in a system rife with waste, and defends against the moral hazard that can arise from insurance. But in fact, as Christopher T. Robertson reveals, this cost-exposure consensus keeps people from valuable care, causes widespread anxiety, and drives many patients and their families into bankruptcy and foreclosure. Marshalling a decade of research, Exposed offers an alternative framework that takes us back to the core purpose of insurance: pooling resources to provide individuals access to care that would otherwise be unaffordable. Robertson shows how the cost-exposure consensus has changed the meaning and experience of health care and exchanged one form of moral hazard for another. He also provides avenues of reform. If cost exposure remains a primary strategy, physicians, hospitals, and other providers must be held legally responsible for communicating those costs to patients, and insurance companies should scale cost exposure to individuals' ability to pay. New and more promising models are on the horizon, if only we would let go our misguided embrace of incomplete insurance.
This practical guide summarizes the principles of working with dying patients and their families as influenced by the commoner world religions and secular philosophies. It also outlines the main legal requirements to be followed by those who care for the dying following the death of the patient. The first part of the book provides a reflective introduction to the general influences of world religions on matters to do with dying, death and grief. It considers the sometimes conflicting relationships between ethics, religion, culture and personal philosophies and how these differences impact on individual cases of dying, death and loss. The second part describes the general customs and beliefs of the major religions that are encountered in hospitals, hospices, care homes and home care settings. It also includes discussion of non-religious spirituality, humanism, agnosticism and atheism. The final part outlines key socio-legal aspects of death across the UK. Death, Religion and Law provides key knowledge, discussion and reflection for dealing with the diversity of the everyday care of dying and death in different religious, secular and cultural contexts. It is an important reference for practitioners working with dying patients, their families and the bereaved.
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
Freud promised his patients absolute confidentiality, regardless of what they revealed, but privacy in psychotherapy began to erode a half-century ago. Psychotherapists now seem to serve as "double agents" with a dual and often conflicting allegiance to patient and society. Some therapists even go so far as to issue Miranda-type warnings, advising patients that what they say in therapy may be used against them. Confidentiality and Its Discontents explores the human stories arising from this loss of confidentiality in psychotherapy. Addressing different types of psychotherapy breaches, Mosher and Berman begin with the the story of novelist Philip Roth, who was horrified when he learned that his psychoanalyst had written a thinly veiled case study about him. Other breaches of privacy occur when the so-called duty to protect compels a therapist to break confidentiality by contacting the police. Every psychotherapist has heard about "Tarasoff," but few know the details of this story of fatal attraction. Nor are most readers familiar with the Jaffee case, which established psychotherapist-patient privilege in the federal courts. Similiarly, the story of Robert Bierenbaum, a New York surgeon who was brought to justice fifteen years after he brutally murdered his wife, reveals how privileged communication became established in a state court. Meanwhile, the story of New York Chief Judge Sol Wachtler, convicted of harassing a former lover and her daughter, shows how the fear of the loss of confidentiality may prevent a person from seeking treatment, with potentially disastrous results. While affirming the importance of the psychotherapist-patient privilege, Confidentiality and Its Discontents focuses on both the inner and outer stories of the characters involved in noteworthy psychotherapy breaches and the ways in which psychiatry and the law can complement but sometimes clash with each other.
Who decides, and on what basis, how to treat a child with severe birth defects? Any decisions made on such cases are painful and complex, and have far-reaching consequences for society at large. Addressing the medical, legal, and ethical aspects of the issue, Robert Weir presents the first serious survey of the major arguments regarding selective non-treatment, which have been advanced by physicians, attorneys, and the judicial system.
In the early 1970s, well before the field ofbioethics had established itself in medicine or anywhere else, the Hastings Center organized a small meeting of law school professors. The question we put to them was: what could or should be done to stimulate legal interest in the field? The answer we got was a wise one. We should do nothing to forcefeed the interest. It should simply be allowed to develop on its own, by the ordinary route of attracting a following because of its inherent importance. That is just what happened, and one of the first young legal scholars drawn to what remains (oddly enough) a relatively small field was George Annas. The idea of a column on law and ethics for the Hastings Center Report was not by 1976 a particularly bold one. It had been clear to us from the outset of the Center in 1969, and the establishment of the Report in 1971, that the rapidly emerging moral problems in medicine and biology would have enormous legal and policy implications. Even so, we were hardly prepared for the large and steady number of cases that were to come before the courts during the 1970s and that were to continue unabated in the 1980s. But our concern about a column on the subject was of a more pedestrian kind.
The landscape of the religion and health literature is littered with a plethora of models so large and so unwieldy that they are impossible to estimate empirically. Neal Krause strikes out in a different direction, developing a core conceptual scheme that is evidence-based and can be verified empirically. The relationships in it are based on empirical findings from prior studies or, when no empirical support exists, these relationships can be bolstered by a convincing theoretical rationale. As a result, the relationships he posits can be supported, refuted, or modified. This is a necessary first step toward cumulative knowledge building. In Religion, Virtues, and Health: New Directions in Theory Construction and Model Development, Krause suggests that religion may operate, in part, by bolstering physical health as well as psychological well-being. The book is designed to explain how these health-related benefits arise. The main conceptual thrust of his model is that people learn to adopt key virtues from fellow church members, including forgiveness, compassion, and beneficence. These virtues, in turn, promote a deeper sense of meaning in life. Then, meaning in life exerts a beneficial effect on health and well-being. This ambitious work, the capstone of Krause's long and distinguished career, makes a number of signal contributions: First, his theory construction and model development strategy are unique-there simply is nothing like it in the literature. Second, his work constitutes a groundbreaking effort to bridge the gap between theoretical discussions of communities of faith and the actual assessment of this core religious entity in practice. Third, the approach he advocates to study religion and health is generic because it can be readily adopted by researchers in unrelated social and behavioral science fields. And fourth, by showing how he practices his craft, he provides a pragmatic approach to conducting research that will be of great interest to established researchers, emerging investigators, and students alike.
How influential has the Nazi analogy been in recent medical debates
on euthanasia? Is the history of eugenics being revived in modern
genetic technologies? And what does the tragic history of
thalidomide and its recent reintroduction for new medical
treatments tell us about how governments solve ethical dilemmas?
The field of global health is expanding rapidly. An increasing number of trainees are studying and working with marginalized populations, often within low and middle-income countries. Such endeavours are beset by ethical dilemmas: mitigating power differentials, addressing cultural differences in how health and illness are viewed, and obtaining individual and community consent in research. This introductory textbook supports students to understand and work through key areas of concern, assisting them in moving towards a more critical view of global health practise. Divided into two sections covering the theory and practice of global health ethics, the text begins by looking at definitions of global health and the field s historical context. It draws on anti-colonial perspectives concepts, developing social justice and solidarity as key principles to guide students. The second part focuses on ethical challenges students may face in clinical experiences or research. Topics such as working with indigenous communities, the politics of global health governance, and the ethical challenges of advocacy are explored using a case study approach. " An Introduction to Global Health Ethics" includes recommended resources and further readings, and is ideal for students from a range of disciplines including public health, medicine, nursing, law and development studies who are undertaking undergraduate and graduate courses in ethics or placements overseas.
This volume is a collection of essays concerned with the morality of hu man treatment of nonhuman animals. The contributors take very different approaches to their topics and come to widely divergent conclusions. The goal of the volume as a whole is to shed a brighter light upon an aspect of human life-our relations with the other animals-that has recently seen a great increase in interest and in the generation of heat. The discussions and debates contained herein are addressed by the contributors to each other, to the general public, and to the academic world, especially the biological, philosophical, and political parts of that world. The essays are organized into eight sections by topics, each sec tion beginning with a brief introduction linking the papers and the sec tions to one another. There is also a general introduction and an Epilog that suggests alternate possible ways of organizing the material. The first two sections are concerned with the place of animals in the human world: Section I with the ways humans view animals in literature, philosophy, and other parts of human culture, and Section II with the place of animals in human legal and moral community. The next three sections concern comparisons between human and nonhuman animals: Section III on the rights and wrongs of killing, Section IV on the humanity of animals and the animality of humans, and Section V on questions of the conflict of human and animal interests."
Biotech Juggernaut: Hope, Hype, and Hidden Agendas of Entrepreneurial BioScience relates the intensifying effort of bioentrepreneurs to apply genetic engineering technologies to the human species and to extend the commercial reach of synthetic biology or "extreme genetic engineering." In 1980, legal developments concerning patenting laws transformed scientific researchers into bioentrepreneurs. Often motivated to create profit-driven biotech start-up companies or to serve on their advisory boards, university researchers now commonly operate under serious conflicts of interest. These conflicts stand in the way of giving full consideration to the social and ethical consequences of the technologies they seek to develop. Too often, bioentrepreneurs have worked to obscure how these technologies could alter human evolution and to hide the social costs of keeping on this path. Tracing the rise and cultural politics of biotechnology from a critical perspective, Biotech Juggernaut aims to correct the informational imbalance between producers of biotechnologies on the one hand, and the intended consumers of these technologies and general society, on the other. It explains how the converging vectors of economic, political, social, and cultural elements driving biotechnology's swift advance constitutes a juggernaut. It concludes with a reflection on whether it is possible for an informed public to halt what appears to be a runaway force.
Ethical medical practice and treatment in psychiatry are based on the concept of first do no harm. However, this cannot, and does not, apply to forensic cases where there is no doctor-patient relationship and the forensic psychiatrist may indeed cause harm to the examinee. In this book, Robert Sadoff analyzes the ethical issues affecting forensic psychiatric practice, especially those promulgated by the American Academy of Psychiatry and the Law. Within those guidelines, he looks at individual bias, vulnerability of the examinee, and potential harm to the mental health professional. The book discusses each of the procedures of the forensic expert separately with respect to minimizing harm. It has been written with an international audience in mind and features chapters reviewing the European and UK perspectives, by Emanuele Valenti and John Baird, respectively. Robert Sadoff addresses the long-term harm that can be either avoided or minimized through careful planning and application of ethical principles. He is not advocating that the harm can be totally eliminated, because that is impossible in the adversarial system in which forensic psychiatrists work. However, there are means by which harm may be minimized if care is taken during the assessment, the report writing, and the testimony phase of the proceedings. The book develops the scope of forensic psychiatry from the standpoint of administrative, civil and criminal cases. It presents the practical issues involved in conducting forensic psychiatric assessments under various conditions plus special considerations, such as bias, minimizing harm, developing a therapeutic approach, and elaborating on various vulnerable individuals who are frequently examined in forensic cases. These include juveniles, mentally retarded, autistic, sexual assault victims, the elderly, the organically damaged, the psychotic, and mentally disabled prisoners. Immigrants are covered in a chapter by Solange Margery Bertoglia. The ethical issues in conducting forensic psychiatric examinations and presenting psychiatric testimony in court are examined and discussed. Cases illustrating the difficulties involved punctuate the presentation. The book closes with a fascinating account of the legal perspective by Donna Vanderpool. In summary, this book illustrates the ethical and practical issues that affect forensic psychiatric practice. The question is not what we do, but how we do it, and which standards, ethical guidelines and personal values contribute to the total picture. Despite the fact that we cannot always adhere to the doctrine of "primum non nocere," we can minimize the harm caused inherently by the adversarial system in which we participate. Praise for "Ethical Issues in Forensic Psychiatry" "One of the founding giants of the forensic psychiatric field has written here far more than a "mere" ethics textbook. Instead, this compendium serves multiple purposes: it is a valuable primer on forensic techniques of examination and testimony, a model of best forensic practices, and an instruction on the most appropriately civilized way in which to conduct oneself as a forensic psychiatrist. The success of these multiple accomplishments clearly derives
from characteristics of the author. In both sage advice to
practitioners and in many revealing case examples, Dr. Sadoff
displays the tact, good manners and sensitivity of a consummate
gentleman - a term not always associated with the hurly-burly of
courtroom work. The book's primary focus on avoiding harm to all
the parties involved in the work places it on the moral high ground
of the legal system in which participating clinicians must find a
place."
Historically and across societies people with disabilities have been stigmatized and excluded from social opportunities on a variety of culturally specific grounds. In this collection, the authors explore the impact that the philosophical framing of disability can have on public policy questions, in the clinic, in the courtroom, and elsewhere. They examine the implications of this understanding for legal and policy approaches to disability, strategies for allocating and accessing health care, the implementation of the Americans with Disabilities Act, health care rights, and other legal tools designed to address discrimination. This volume should be read by anyone seeking a balanced view of disability and an understanding of the connection between the framing of disability and policies that have a real-world impact on individuals.
Women most fully experience the consequences of human reproductive technologies. Men who convene to evaluate such technologies discuss "them": the women who must accept, avoid, or even resist these technologies; the women who consume technologies they did not devise; the women who are the objects of policies made by men. So often the input of women is neither sought nor listened to. The privileged insights and perspectives that women bring to the consideration of technologies in human reproduction are the subject of these volumes, which constitute the revised and edited record of a Workshop on "Ethical Issues in Human Reproduction Technology: Analysis by Women" (EIRTAW), held in June, 1979, at Hampshire College in Amherst, Massachusetts. Some 80 members of the workshop, 90 percent of them women (from 24 states), represented diverse occupations and personal histories, different races and classes, varied political commitments. They included doctors, nurses, and scientists, lay midwives, consumer advocates, historians, and sociologists, lawyers, policy analysts, and ethicists. Each session, however, made plain that ethics is an everyday concern for women in general, as well as an academic profession for some.
This book-first published a decade before the COVID-19 pandemic erupted-is the first authored volume on ethical issues in infectious disease, "monumental" for its competence and comprehensiveness. It is augmented here with a new Preface on COVID-19. The book develops an ethical framework for exploring contagious infectious disease, the patient-as-victim-and-vector view, grounded in the biological fact that a person with a communicable infectious disease is not only a victim of that disease, but at the same time also a potential vector. The patient may be both threatened, someone made ill or facing death, but also a threat, someone who may transmit an illness that will sicken or kill others. Clinical medicine has tended to see one part of this duality and public health the other; the victim-AND-vector view insists on both, at one and the same time. Against a background of methods from the long human history of contagious infectious disease-quarantine, isolation, cordon sanitaire, surveillance and contact tracing, testing by both archaic and modern methods, lockdown, and immunization-the victim-and-vector view spotlights ethical challenges for clinical medicine, research, public health, and health policy. These insights are probed in the new Preface on COVID-19 and are essential in our continuing struggle to address not only the current coronavirus pandemic, but the next, and the next after that. |
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