How ought the law to deal with novel challenges regarding the use and control of human biomaterials? As it stands the law is ill-equipped to deal with these. Quigley argues that advancing biotechnology means that the law must confront and move boundaries which it has constructed; in particular, those which delineate property from non-property in relation to biomaterials. Drawing together often disparate strands of property discourse, she offers a philosophical and legal re-analysis of the law in relation to property in the body and biomaterials. She advances a new defence, underpinned by self-ownership, of the position that persons ought to be seen as the prima facie holders of property rights in their separated biomaterials. This book will appeal to those interested in medical and property law, philosophy, bioethics, and health policy amongst others.

The case of Terri Schiavo, a young woman who spent 15 years in a persistent vegetative state, has emerged as a watershed in debates over end-of-life care. While many observers had thought the right to refuse medical treatment was well established, this case split a family, divided a nation, and counfounded physicians, legislators, and many of the people they treated or represented. In renewing debates over the importance of advance directives, the appropriate role of artificial hydration and nutrition, and the responsibilities of family members, the case also became one of history's most extensively litigated health care disputes. The Case of Terri Schiavo assembles a team of first-hand participants and content experts to provide thoughtful and nuanced analyses. In addition to a comprehensive overview, the book includes contributions by Ms. Schiavo's guardian ad litem, a neurologist and lawyer who participated in the case, and scholars who examine issues related to litigation, faith, gender, and disability. The volume also includes a powerful dissent from the views of many scholars in the bioethics community. The book is intended for students, health care professionals, policy makers, and other in search of carefully reasoned analyses of the case that will shape our view of death and end-of-life medical care for decades.

Bioethics: The Basics is an introduction to the foundational principles, theories and issues in the study of medical and biological ethics. Readers are introduced to bioethics from the ground up before being invited to consider some of the most controversial but important questions facing us today. Topics addressed include:

the range of moral theories underpinning bioethics

arguments for the rights and wrongs of abortion, euthanasia and animal research

health care ethics including the nature of the practitioner-patient relationship

public policy ethics and the implications of global and public health

‘3 parents’, enhancement, incidental findings and nudge approaches in health care.

This thoroughly revised second edition provides a concise, readable and authoritative introduction for anyone interested in the study of bioethics.

Table of Contents

CONTENTS

Preface

Abbreviations

1 What is bioethics?

What is bioethics?

History

What about the law?

Methods

Applications

How to use this book

Resources and further reading

2 Moral theories

Introduction

Counting the consequences

Doing one’s duty

Being a good person – virtue ethics

Brotherhood and sisterhood – communitarianism

Live free or die – libertarianism

A balancing act – the four principles

Resources and further reading

Exercise

3 Perspectives

Introduction

Gendered agendas – feminist approaches

To care or not to care?

Culture and religion

Conclusion

Resources and further reading

Exercises

4 Clinical ethics

Introduction

The clinical relationship – a conspiracy against the laity?

Life before birth

Transplantation and regenerative medicine

Mental health

The end of life

After death

Conclusions

Resources and further reading

Exercises

5 Research

Introduction

Research ethics

Research integrity

Research and the future

Conclusion

Resources and further reading

Exercises

6 Justice

Introduction

Public health ethics

Fair access and the paradox of health care

Global inequity in health

Global survival

Resources and further reading

Exercises

Appendix

Glossary

References

Index

Transplantation is a medically successful and cost-effective way to treat people whose organs have failed-but not enough organs are available to meet demand. Ethics and the Acquisition of Organs is concerned with the major ethical problems raised by policies for acquiring organs. The main topics are the rights of the dead, the role of the family, opt in and opt out systems, the conscription of organs, living organ donation from adults and children, directed donation and priority for donors, and the sale of organs. In this ground-breaking work, T. M. Wilkinson uses concepts from moral and political theory such as autonomy, rights, posthumous interests, justice, and well-being, in a context informed by the clinical, legal, and policy aspects of transplantation. The result is a rigorous philosophical exploration of real problems and options. He argues that the ethics of acquiring organs for transplantation is not only of great intellectual interest, but also of practical importance. As such, this book will be of profit not only to students and academics who work in applied ethics and bioethics, but also to the lawyers, policy-makers, clinicians, and lobby groups interested in transplantation.

'This book gives plenty of examples of ad hominem attacks, intimidation, slander, threats of litigation, deception, dishonesty, lies and other violations of good scientific practice. For some years I kept a folder labeled Dishonesty in breast cancer screening on top of my filing cabinet, storing articles and letters to the editor that contained statements I knew were dishonest. Eventually I gave up on the idea of writing a paper about this collection, as the number of examples quickly exceeded what could be contained in a single article.' From the Introduction The most effective way to decrease women's risk of becoming a breast cancer patient is to avoid attending screening. Mammography screening is one of the greatest controversies in healthcare, and the extent to which some scientists have sacrificed sound scientific principles in order to arrive at politically acceptable results in their research is extraordinary. In contrast, neutral observers increasingly find that the benefit has been much oversold and that the harms are much greater than previously believed. This groundbreaking book takes an evidence-based, critical look at the scientific disputes and the information provided to women by governments and cancer charities. It also explains why mammography screening is unlikely to be effective today. All health professionals and members of the public will find these revelations disturbingly illuminating. It will radically transform the way healthcare policy makers view mammography screening in the future. 'If Peter Gotzsche did not exist, there would be a need to invent him ...It may still take time for the limitations and harms of screening to be properly acknowledged and for women to be enabled to make adequately informed decisions. When this happens, it will be almost entirely due to the intellectual rigour and determination of Peter Gotzsche.' From the Foreword by Iona Heath, President, RCGP 'If you care about breast cancer, and we all should, you must read this book. Breast cancer is complex and we cannot afford to rely on the popular media, or on information from marketing campaigns from those who are invested in screening. We need to question and to understand. The story that Peter tells matters very much.' From the Foreword by Fran Visco, President, National Breast Cancer Coalition

As the practice of modern medicine becomes more and more pharmacology dependent, the role of pharmacy technicians is becoming more complex. This is true in terms of the medications they are required to deliver, as well as the legal responsibilities and ethical considerations that come with administering those medicines. Essentials of Law and Ethics for Pharmacy Technicians, now in its Third Edition, is designed specifically to provide technicians with the legal and ethical information they need to perform their jobs with absolute confidence. It covers all U.S. federal laws regarding pharmacy practice as well as other laws and regulations and their applicability to pharmacy technicians. It also addresses current issues such as herbal medications, privacy laws and rules, and drug pedigree. A unique section on ethics offers extensive discussion points and cases. Appendices provide extensive information on practice regulation in all states. Fully revised to address the latest procedural, ethical, and technological developments in this rapidly changing field, this third edition of a bestseller has been edited for clarity and provides a wealth of new material, including a new appendix on the legal status of electronic transmission of prescriptions. It covers the latest in state and federal regulations pertaining to the administration of new medications, including birth control and the morning-after pill, as well as new regulations on over-the-counter label claims. An essential resource for students and practicing technicians, this reference brings together the information that pharmacy technicians need to practice in a manner that is both legal and ethical. What's New in this Edition: Updated information on over-the-counter label claims Updated sections on drug samples and the Combat Methamphetamine Epidemic Act of 2005 New sections on drug pedigrees and United States Pharmacopoeia Chapter 797 Expanded discussion of state rules and ethics regarding dispensing the morning-after pill and birth control medications New appendix on the legal status of electronic transmission of prescriptions Pedagogical Features: Offers end-of-chapter discussion questions and examples Contains a chapter on ethics with discussion points and cases Presents information in an easy-to-read format

All human behaviour is, ultimately, a moral undertaking, in which each situation must be considered on its own merits. As a result ethical conduct is complex. Despite the proliferation of Codes of Conduct and other forms of professional guidance, there are no easy answers to most human problems. Mental Health Ethics encourages readers to heighten their awareness of the key ethical dilemmas found in mainstream contemporary mental health practice. This text provides an overview of traditional and contemporary ethical perspectives and critically examines a range of ethical and moral challenges present in contemporary 'psychiatric-mental' health services. Offering a comprehensive and interdisciplinary perspective, it includes six parts, each with their own introduction, summary and set of ethical challenges, covering: fundamental ethical principles; legal issues; specific challenges for different professional groups; working with different service user groups; models of care and treatment; recovery and human rights perspectives. Providing detailed consideration of issues and dilemmas, Mental Health Ethics helps all mental health professionals keep people at the centre of the services they offer.

There is an understandable tendency or desire to attribute blame when patients are harmed by their own healthcare. However, many cases of iatrogenic harm involve little or no moral culpability. Even when blame is justified, an undue focus on one individual often deflects attention from other important factors within the inherent complexity of modern healthcare. This revised second edition advocates a rethinking of accountability in healthcare based on science, the principles of a just culture, and novel therapeutic legal processes. Updated to include many recent relevant events, including the Keystone Project in the USA and the Mid Staffordshire scandal in the UK, this book considers how the concepts of a just culture have been successfully implemented so far, and makes recommendations for best practice. This book will be of interest to anyone concerned with patient safety, medical law and the regulation of healthcare.

Addressing global health is one of the largest challenges facing humanity in the 21st century, however, this task is becoming even more formidable with the accelerated destruction of the planet. Building on the success of the previous edition, the book outlines how progress towards improving global health relies on understanding its core social, economic, political, environmental and ideological aspects. A multi-disciplinary group of authors suggest not only theoretically compelling arguments for what we must do, but also provide practical recommendations as to how we can promote global health despite contemporary constraints. The importance of cross-cultural dialogue and utilisation of ethical tools in tackling global health problems is emphasised. Thoroughly updated, new or expanded topics include: mass displacement of people; novel threats, including new infectious diseases; global justice; and ecological ethics and planetary sustainability. Offering a diverse range of perspectives, this volume is essential for bioethicists, public health practitioners and philosophers.

In times of global economic and political crises, the notion of solidarity is gaining new currency. This book argues that a solidarity-based perspective can help us to find new ways to address pressing problems. Exemplified by three case studies from the field of biomedicine: databases for health and disease research, personalised healthcare, and organ donation, it explores how solidarity can make a difference in how we frame problems, and in the policy solutions that we can offer.

This valuable guide helps develop the critical thinking skills needed to become effective patient advocates. Pinpointing the systematic methods of reasoning through an ethical dilemma, this is the ultimate resource to resolving ethical issues in a system undergoing fundamental change. The fourth edition reflects contemporary issues such as informed consent, abortion, death and dying, and behavior control. Numerous case studies are also included. Nurses, nursing students, physicians and clergy.

Since its inception as an international principle to protect the welfare of patients and volunteers taking part in medical research, informed consent has become increasingly important within healthcare. Despite its ubiquitous status, there are a number of scholars who are beginning to question whether consent is adequate for contemporary biomedical research. The Limits of Consent considers a number of criticisms that have been levelled at the prominence given to autonomy, a central tenet underpinning the rationale for informed consent in Western bioethics. It raises questions about how quickly and easily this principle has been adopted, and how appropriate it is for those actively engaged in research. In the context of genetic research, for example, the individual's overriding right of autonomy to give consent to research could have huge implications for other members of their families.
The Limits of Consent questions the assumption that informed consent protects or facilitates individual autonomy, and discusses empirical studies which suggest that gaining a truly informed consent can be difficult to achieve in practice. With the expectation of treatment and guidance from the physician, how much is the process of consent governed by social norms and expectations? The Limits of Consent focuses upon three principal areas within biomedical research: clinical trials, genetic research, and research with those who may have impaired capacity to consent. It is a truly multi-disciplinary book, incorporating perspectives from medicine, law, philosophy and sociology.
The Limits of Consent is a fascinating exploration of the inadequacies of consent, and will appeal to those in the fields of bioethics, socio-legal studies, sociology, and health law. Policy makers, research ethics committee members, and those healthcare professionals with an interest in medical ethics, will also find the book of interest.

Medical ethics is the disciplined study of medical morality, with two goals: critically appraising current medical morality and identifying how it should be improved. Medical morality has three components. Physicians, patients, communities, and policy makers have beliefs about what is good and bad character, and right and wrong behavior, in patient care, biomedical research, medical education, and health policy. On the basis of these beliefs, physicians, patients, communities, and policy makers make judgments about how physicians ought to conduct themselves in patient care, research, education, and the formation and implementation of health policy. They then act on their judgments. This second edition of Historical Dictionary of Medical Ethics contains a chronology, an introduction, and an extensive bibliography. The dictionary section has over 1,000 cross-referenced entries on ethical reasoning and its key components; medical ethics, professional medical ethics, and bioethics; and topics in clinical ethics, research ethics, and healthcare policy ethics. This book is an excellent resource for students, researchers, and anyone wanting to know more about medical ethics.

Behind heart disease and cancer, medical error is now listed as one of the leading causes of death. Of the many medical errors that may lead to injury and death, diagnostic failure is regarded as the most significant. Generally, the majority of diagnostic failures are attributed to the clinicians directly involved with the patient, and to a lesser extent, the system in which they work. In turn, the majority of errors made by clinicians are due to decision making failures manifested by various departures from rationality. Of all the medical environments in which patients are seen and diagnosed, the emergency department is the most challenging. It has been described as a "wicked" environment where illness and disease may range from minor ailments and complaints to severe, life-threatening disorders. The Cognitive Autopsy is a novel strategy towards understanding medical error and diagnostic failure in 42 clinical cases with which the author was directly involved or became aware of at the time. Essentially, it describes a cognitive approach towards root cause analysis of medical adverse events or near misses. Whereas root cause analysis typically focuses on the observable and measurable aspects of adverse events, the cognitive autopsy attempts to identify covert cognitive processes that may have contributed to outcomes. In this clinical setting, no cognitive process is directly observable but must be inferred from the behavior of the individual clinician. The book illustrates unequivocally that chief among these cognitive processes are cognitive biases and other flaws in decision making, rather than knowledge deficits.

Simona Giordano presents the first full philosophical study of ethical issues in the treatment of anorexia and bulimia nervosa. Beginning with a comprehensive analysis of these conditions and an exploration of their complex causes, she then proceeds to address legal and ethical dilemmas such as a patient's refusal of life-saving treatment. Illustrated with many case-studies, Understanding Eating Disorders is an essential tool for anyone working with sufferers of these much misunderstood conditions, and for all those ethicists, lawyers, and medical practitioners engaged with the widely relevant issues they raise.

Effective palliative care that rests on a sound ethical foundation requires ongoing discussions about patient and family values and preferences. This is especially important when addressing care at end-of-life including artificial nutrition and hydration, withdrawal of life-sustaining therapies and palliative sedation as well as requests for assistance in hastening death. The eighth volume in the HPNA Palliative Nursing Manuals series, Legal and Ethical Aspects of Palliative Care, provides an overview of critical communication skills and formal organizational mechanisms, such as ethics committees and interdisciplinary rounds, required for decisions in ethical dilemmas which respect diversity in the views of colleagues, as well as patients. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice.

Although modern medicine enjoys unprecedented success in providing excellent technical care, many patients are dissatisfied with the poor quality of care or the unprofessional manner in which physicians sometimes deliver it.Recently, this patient dissatisfaction has led to quality-of-care and professionalism crises in medicine.

Inthis book, the author proposes a notion of virtuous physician to address these crises.He discusses the nature of the two crises and efforts by the medical profession to resolve them and then he briefly introduces the notion of virtuous physician and outlines its basic features.Further, virtue theory is discussed, along with virtue ethics and virtue epistemology, and specific virtues, especially as they relate to medicine.

The author also explores the ontological priority of caring as the metaphysical virtue for grounding the notion of virtuous physician, and two essential ontic virtues-care and competence.In addition to this, he examines the transformation of competence into prudent wisdom and care into personal radical love to forge the compound virtue of prudent love, which is sufficient for defining the virtuous physician.Lastly, two clinical case stories are reconstructed which illustrate the various virtues associated with medical practice, and it is discussed howthe notion of virtuous physician addresses the quality-of-care and professionalism crises.

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Who should have access to assisted reproductive technologies? Which one of many seriously ill patients should be offered the next available transplant organ? When may a surrogate decision maker decide to withdraw life-prolonging measures from an unconscious patient? Questions like these feature prominently in the field of health care ethics and in the education of health care professionals. This book provides a concise introduction to the major concepts, principles and issues in health care ethics, using case studies throughout to illustrate and analyse challenging ethical issues in contemporary health care. Topics range widely, from confidentiality and truthfulness to end-of-life care and research on human subjects. Ethics and Health Care will be a vital resource for students of applied ethics, bioethics, professional ethics, health law and medical sociology, as well as students of medicine, nursing and other health care professions.

Essential Philosophy of Psychiatry is a concise introduction to the growing field of philosophy of psychiatry. Divided into three main aspects of psychiatric clinical judgement, values, meanings and facts, it examines the key debates about mental health care, and the philosophical ideas and tools needed to assess those debates, in six chapters.
In addition to outlining the state of play, Essential Philosophy of Psychiatry presents a coherent and unified approach across the different debates, characterized by a rejection of reductionism and an emphasis on the ineliminability of uncodified skilled judgement.
The first part, Values, outlines the debate about whether diagnosis of mental illness is essentially value-laden and argues that the prospects for reducing illness or disease to plainly factual matters are poor. It also explains the important role of skilled contextual judgement, rather than a principles-based deduction, in ethical judgement.
The second part, Meanings, examines the central role of understanding and a shared first person perspective, both against attempts to reduce meaning to basic information-processing mechanisms and to explain away the difficulties of understanding psychopathology in recent models of delusion.
The third part, Facts, shows the importance of uncodified clinical judgements, both in assessing the validity of psychiatric taxonomy and in the application of Evidence Based Medicine. Despite advances in the codifaction of practice and operationalism of diagnosis, an element of judgement remains in the assessment both of what, at one level, is good evidence for diagnosis and treatment and what, at a higher level, is good evidence for thevalidity of classification overall.

Through the sobering story of Maggie Worthen and her mother, Nancy, this book tells of one family's struggle with severe brain injury and how developments in neuroscience call for a reconsideration of what society owes patients at the edge of consciousness. Drawing upon over fifty in-depth family interviews, the history of severe brain injury from Quinlan to Schiavo, and his participation in landmark clinical trials, such as the first use of deep brain stimulation in the minimally conscious state, Joseph J. Fins captures the paradox of medical and societal neglect even as advances in neuroscience suggest new ways to mend the broken brain. Responding to the dire care provided to these marginalized patients, after heroically being saved, Fins places society's obligations to patients with severe injury within the historical legacy of the civil and disability rights movements, offering a stirring synthesis of public policy and physician advocacy.

Described by The New York Times as 'Britain's foremost scholar of criminal law', Professor Glanville Williams was one of the greatest academic lawyers of the twentieth century. To mark the centenary of his birth in 2011, leading criminal law theorists and medical law ethicists from around the world were invited to contribute essays discussing the sanctity of life and criminal law while engaging with Williams' many contributions to these fields. In re-examining his work, the contributors have produced a provocative set of original essays that make a significant contribution to the current debate in these areas.

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.

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.

Despite its absence in the written text of the European Convention on Human Rights, the European Court of Human Rights now regularly uses the concept of autonomy when deciding cases concerning assisted dying, sexuality and reproductive rights, self-determination, fulfilment of choices and control over body and mind. But is the concept of autonomy as expressed in the ECtHR reasoning an appropriate tool for regulating reproduction or medical practice? Caring Autonomy reveals and evaluates the type of individual the ECtHR expresses and shapes through its autonomy-based case law. It claims that from a social and ethical perspective, the current individualistic interpretation of the concept of autonomy is inadequate, and proposes a new reading of the concept that is rooted in the acknowledgment and appreciation of human interdependence and the importance of interpersonal trust and care.