Physicians, philosophers, and theologians consider how to address death and dying for a diverse population in a secularized century. Most of us are generally ill-equipped for dying. Today, we neither see death nor prepare for it. But this has not always been the case. In the early fifteenth century, the Roman Catholic Church published the Ars moriendi texts, which established prayers and practices for an art of dying. In the twenty-first century, physicians rely on procedures and protocols for the efficient management of hospitalized patients. How can we recapture an art of dying that can facilitate our dying well? In this book, physicians, philosophers, and theologians attempt to articulate a bioethical framework for dying well in a secularized, diverse society. Contributors discuss such topics as the acceptance of human finitude; the role of hospice and palliative medicine; spiritual preparation for death; and the relationship between community, and individual autonomy. They also consider special cases, including children, elderly patients with dementia, and death in the early years of the AIDS epidemic, when doctors could do little more than accompany their patients in humble solidarity. These chapters make the case for a robust bioethics-one that could foster both the contemplation of finitude and the cultivation of community that would be necessary for a contemporary art of dying well. Contributors Jeffrey P. Bishop, Lisa Sowle Cahill, Daniel Callahan, Farr A. Curlin, Lydia S. Dugdale, Michelle Harrington, John Lantos, Stephen R. Latham, M. Therese Lysaught, Autumn Alcott Ridenour, Peter A. Selwyn, Daniel Sulmasy

Every one of us will die, and the processes we go through will be our own unique to our own experiences and life stories. It is reasonable to reflect on what kinds of dying processes may be better or worse for us as we move toward our end. Such consideration, however, can raise troubling ethical concerns for patients, families, and healthcare providers. Even after forty years of concerted focus on biomedical ethics, these moral concerns persist in the care of lethally impaired, terminally ill, and inured patients. End-of-Life Care and Pragmatic Decision Making provides a pragmatic philosophical framework based on a radically empirical attitude toward life and death. D. Micah Hester takes seriously the complexities of experiences and argues that when making end-of-life decisions healthcare providers ought to pay close attention to the narratives of patients and the communities they inhabit so that their dying processes embody their life stories. He discusses three types of end-of-life patient populations adults with decision-making capacity, adult without capacity, and children (with a strong focus on infants) to show the implications of pragmatic empiricism and the scope of decision making at the end of life for different types of patients.

While neuroscience has provided insights into the structure and function of nervous systems, hard questions remain about the nature of consciousness, mind, and self. Perhaps the most difficult questions involve the meaning of neuroscientific information, and how to pursue and utilize neuroscientific knowledge in ways that are consistent with some construal of social 'good'. Written for researchers and graduate students in neuroscience and bioethics, Scientific and Philosophical Perspectives in Neuroethics explores important developments in neuroscience and neurotechnology, and addresses the philosophical, ethical, and social issues and problems that such advancements generate. It examines three core questions. First, what is the scope and direction of neuroscientific inquiry? Second, how has progress to date affected scientific and philosophical ideas, and finally, what ethical issues and problems does this progress and knowledge incur, both now and in the future?

Should we make people healthier, smarter, and longer-lived if genetic and medical advances enable us to do so? Matti Hayry asks this question in the context of genetic testing and selection, cloning and stem cell research, gene therapies and enhancements. The ethical questions explored include parental responsibility, the use of people as means, the role of hope and fear in risk assessment, and the dignity and meaning of life. Taking as a starting point the arguments presented by Jonathan Glover, John Harris, Ronald M. Green, Jurgen Habermas, Michael J. Sandel, and Leon R. Kass, who defend a particular normative view as the only rational or moral answer, Matti Hayry argues that many coherent rationalities and moralities exist in the field, and that to claim otherwise is mistaken.

Public attention on embryo research has never been greater. Modern reproductive medicine technology and the use of embryos to generate stem cells ensure that this will continue to be a topic of debate and research across many disciplines. This multidisciplinary book explores the concept of a 'healthy' embryo, its implications on the health of children and adults, and how perceptions of what constitutes child and adult health influence the concept of embryo 'health'. The concept of human embryo health is considered from preconception to pre-implantation genetic diagnosis to recent foetal surgical approaches. Burgeoning capacities in both genetic and reproductive science and their clinical implications have catalysed the necessity to explore the concept of a 'healthy' embryo. The authors are from five countries and 13 disciplines in the social sciences, humanities, biological sciences and medicine, ensuring that the book has a broad coverage and approach.

This volume offers a theoretical and practical overview of the ethics of pediatric medicine. It serves as a fundamental handbook and resource for pediatricians, nurses, residents in training, graduate students, and practitioners of ethics and healthcare policy. Written by a team of leading experts, Pediatric Bioethics addresses those difficult ethical questions concerning the clinical and academic practice of pediatrics, including an approach to recognizing boundaries when confronted with issues such as end of life care, life-sustaining treatment, extreme prematurity, pharmacotherapy, and research. Thorny topics such as what constitutes best interests, personhood, or distributive justice and public health concerns such as immunization and newborn genetic screening are also addressed.

This thoroughly and substantially revised second edition explores the full scope and content of secular bioethics. Abortion, infanticide, euthanasia, genetic engineering, informed consent, advance directives, triage decisions, health care reform, and distributive justice are given new and provocative treatments within a systematic reassessment of bioethics as a whole.

Children in precarious health present particular problems for healthcare professionals because of their intimate relation to their family, and because of the family's need to provide major long-term source of support and to be actively involved in the decisions about their children's care. This collection of cases and commentaries in pediatrics highlights the difficult ethical dilemmas that can arise during high-tech hospital care of children in precarious circumstances. It serves as a teaching tool for clinical ethics and as an introduction for medical students and residents. Clinical cases are described in detail by the physicians involved, who focus on the ethical issues arising during treatment. Each case is then commented on in detail by a philosopher or other bioethicist. It thus serves well as an introduction to contemporary clinical bioethics, but with a firm grounding in the practicalities of real-life pediatric care in the hospital setting.

During the last thirty years we have witnessed sweeping changes in health care worldwide, including new and expensive biomedical technologies, an increasingly powerful and influential pharmaceutical industry, steadily increasing health care costs in industrialised nations, and new threats to medical professionalism. The essays collected in this book concern costs and profits in relation to just health care, the often controversial practices of pharmaceutical companies, and corruption in the professional practice of medicine. Leading experts discuss justice in relation to business-friendly strategies in the delivery of health care, access to life saving drugs, the ethics of pharmaceutical company marketing practices, exploitation in drug trials, and undue industry influence over medicine. They offer guidance regarding the ethical delivery of health care products and services by profit-seeking organisations operating in a global marketplace, and recommend pragmatic solutions to enhance organisational integrity and curb medical corruption in the interest of patient welfare.

During the last thirty years we have witnessed sweeping changes in health care worldwide, including new and expensive biomedical technologies, an increasingly powerful and influential pharmaceutical industry, steadily increasing health care costs in industrialised nations, and new threats to medical professionalism. The essays collected in this book concern costs and profits in relation to just health care, the often controversial practices of pharmaceutical companies, and corruption in the professional practice of medicine. Leading experts discuss justice in relation to business-friendly strategies in the delivery of health care, access to life saving drugs, the ethics of pharmaceutical company marketing practices, exploitation in drug trials, and undue industry influence over medicine. They offer guidance regarding the ethical delivery of health care products and services by profit-seeking organisations operating in a global marketplace, and recommend pragmatic solutions to enhance organisational integrity and curb medical corruption in the interest of patient welfare.

Is it acceptable from an ethical point of view to use stem cells from human embryos for scientific research and clinical therapy? And what are the weaknesses and strengths of various opinions and positions when they are critically evaluated? These are the main problems dealt with in this book. The various chapters as a whole give a comprehensive, many-sided and balanced discussion of the subject. The book contains contributions from biological, medical, social, political, philosophical and theological perspectives. The authors have been chosen because of their professional competence, many of them being respected scholars on a top international level. They give an updated contribution from their own discipline in order to enlighten the different aspects of the common theme. The authors cover various positions and evaluations with regard to the question of the use of embryonic stem cells for research and therapy. The book is written for several audiences: a) scholars and professionals working with stem cell research or with the ethical questions arising from this field (people from biology, medicine, law, philosophy, theology etc.), b) advanced and graduate students within the same professional disciplines and c) politicians and the general public interested in the burning ethical problems which are intensively debated in many countries.

A daughter gets tested to see if she's a match to donate a kidney to her father. The test reveals that she is not the man's biological daughter. Should the doctor tell the father? Or the daughter? A deaf couple prefers a deaf baby. Should they be allowed to use medical technology to ensure they have a child who can't hear? Who should get custody of an embryo created through IVF when a couple divorces? Or, when you or a loved one is on life support, Who says you're dead? In short, engaging scenarios, Dr. Appel takes on hot-button issues that many of us will confront: genetic screening, sexuality, privacy, doctor-patient confidentiality. He unpacks each hypothetical with a brief reflection drawing from science, philosophy, and history, explaining how others have approached these controversies in real-world cases. Who Says You're Dead? is designed to defy easy answers and to stimulate thought and even debate among professionals and armchair ethicists alike.

The 'sorting society' expresses what many people believe will be the outcome of advances in genetic technology: a society in which many characteristics of children are no longer the result of genetic chance but of deliberate selection. This book focuses on the ethical, legal and social issues raised by this technology. Is the prospect of a sorting society something that we should welcome or deplore? Do concerns about how parents or societies might exercise the choice given to them by genetic technology give us reason to restrain its creation or use? Would a sorting society increase the freedom of parents and the well being of children, or would it undermine values that are central to a liberal democratic society? These are questions of the most profound significance, bearing on the world in which our children, grandchildren, and great-grandchildren will live. This is a must-read for everyone interested in the forefront of genetics and bioethics.

A distinguished team of contributors from the fields of medicine, philosophy and law address some of the issues which arise over the provision of care for dependent elderly patients. Some of the chapters are concerned with the challenge of achieving good quality medical care, the chronic inadequacies of policy making in the UK context, and the prospects for improvement in the medium term. Other chapters look at some of the threats to dependent elderly patients posed by longer-term social and ideological trends which find expression in proposals for age-limits to health care, advocacy of living wills and euthanasia, arguments for withdrawing tube-feeding from certain categories of patient, and certain proposals for resource allocation. This interdisciplinary volume will have a wide appeal to those involved in care of the dependent elderly, to health policy analysts and health care economists, and to bioethicists.

The result of two key social developments in recent years are examined here: the partial dismantling of the welfare state and the progress of genetics. Genetic insights are increasingly valuable for risk assessment, and insurers would like to use these insights to help determine premiums. Combined with the fact that social welfare is being curtailed, this could potentially create an uninsured high-risk population. Along with considerations of autonomy and privacy, this is the basis for an ethical critique of insurer's access to information. The result has often been regulation of such information; but the authors argues that due to adverse selection, regulation will not solve these problems, and this may jeopardize the survival of private personal insurance. Instead, we should look towards the resurrection of social insurance, a key component of the welfare state. This will interest academic researchers as well as professionals involved with genetics and insurance.

The phenomenon of the New Genetics raises complex social problems, particularly those of privacy. This book offers ethical and legal perspectives on the questions of a right to know and not to know genetic information from the standpoint of individuals, their relatives, employers, insurers and the state. Graeme Laurie provides a unique definition of privacy, including a concept of property rights in the person, and argues for stronger legal protection of privacy in the shadow of developments in human genetics. He challenges the role and the limits of established principles in medical law and ethics, including respect for patient autonomy and confidentiality. This book will interest lawyers, philosophers and doctors concerned both with genetic information and issues of privacy; it will also interest genetic counsellors, researchers, and policy makers worldwide for its practical stance on dilemmas in modern genetic medicine.

Does a competent person suffering from a terminal illness or enduring an otherwise burdensome existence, who considers his life no longer of value but is incapable of ending it, have a right to be helped to die? Should someone for whom further medical treatment would be futile be allowed to die regardless of expressing a preference to be given all possible treatment? These are some of the questions that are asked and answered in this wide-ranging discussion of both the morality of medically assisted death and the justifiability of making certain instances legal. A case is offered in support of the moral and legal permissibility of specified instances of medically assisted death, along with responses to the main objections that have been levelled against it. The philosophical argument is bolstered by empirical evidence from The Netherlands and Oregon where voluntary euthanasia and physician-assisted suicide are already legal.

Does a competent person suffering from a terminal illness or enduring an otherwise burdensome existence, who considers his life no longer of value but is incapable of ending it, have a right to be helped to die? Should someone for whom further medical treatment would be futile be allowed to die regardless of expressing a preference to be given all possible treatment? These are some of the questions that are asked and answered in this wide-ranging discussion of both the morality of medically assisted death and the justifiability of making certain instances legal. A case is offered in support of the moral and legal permissibility of specified instances of medically assisted death, along with responses to the main objections that have been levelled against it. The philosophical argument is bolstered by empirical evidence from The Netherlands and Oregon where voluntary euthanasia and physician-assisted suicide are already legal.

David M. Craig traveled across the United States to assess health care access, delivery and finance in this country. He interviewed religious hospital administrators and interfaith activists, learning how they balance the values of economic efficiency and community accountability. He met with conservatives, liberals, and moderates, reviewing their ideas for market reform or support for the Affordable Care Act. He discovered that health care in the US is not a private good or a public good. Decades of public policy and philanthropic service have made health care a shared social good.

"Health Care as a Social Good: Religious Values and the American Democracy" argues that as escalating health costs absorb more and more of family income and government budgets, we need to take stock of the full range of health care values to create a different and more affordable community-based health care system. Transformation of that system is a national priority but Americans have failed to find a way to work together that bypasses our differences. Craig insists that community engagement around the common religious conviction that healing is a shared responsibility can help us achieve this transformation -- one that will not only help us realize a new and better system, but one that reflects the ideals of American democracy and the common good.

Neuroscience has dramatically increased understanding of how mental states and processes are realized by the brain, thus opening doors for treating the multitude of ways in which minds become dysfunctional. This book explores questions such as when is it permissible to alter a person's memories, influence personality traits or read minds? What can neuroscience tell us about free will, self-control, self-deception and the foundations of morality? The view of neuroethics offered here argues that many of our new powers to read, alter and control minds are not entirely unparalleled with older ones. They have, however, expanded to include almost all our social, political and ethical decisions. Written primarily for graduate students, this book will appeal to anyone with an interest in the more philosophical and ethical aspects of the neurosciences.

Extreme Prematurity examines the controversial issues surrounding the clinical management of this group of neonates by the intervention of modern neonatal intensive care. The foregoing of life-sustaining treatment is of particular importance. The subject matter is very relevant because of the alarming increase in multiple and preterm births, due to the increase in women who are undergoing assisted reproductive procedures, and the large increase in premature labor. No recent book covers the subject in such comparable breadth. The first section of this very timely monograph covers the epidemiology and practices in different parts of the world; the second section covers bioethics considerations, including ethical theories, moral principles and quality of life issues; the third section covers national and international guidelines; the last section covers medical law aspects in the US and around the world.

Is inheritable genetic modification the new dividing line in gene therapy? The editors of this searching investigation, representing clinical medicine, public health and biomedical ethics, have established a distinguished team of scientists and scholars to address the issues from the perspectives of biological and social science, law and ethics, including an intriguing Foreword from Peter Singer. Their purpose is to consider how society might deal with the ethical concerns raised by inheritable genetic modification, and to re-examine prevailing views about whether these procedures will ever be ethically and socially justifiable. The book also provides background to define the field, and discusses the biological and technological potential for inheritable genetic modification, its limitations, and its connection with gene therapy, cloning, and other reproductive interventions. For scientists, bioethicists, clinicians, counsellors and public commentators, this is an essential contribution to one of the critical debates in current genetics.

Despite the pharmaceutical industry's notable contributions to human progress, including the development of miracle drugs for treating cancer, AIDS, and heart disease, there is a growing tension between the industry and the public. Debates are raging over how the industry can and should be expected to act. In this volume leading figures in industry, government, NGOs, the medical community, and academia discuss and propose solutions to the ethical dilemmas of drug industry behavior. They examine such aspects as the role of intellectual property rights and patent protection, the moral and economic requisites of research and clinical trials, drug pricing, marketing and advertising. . Michael Santoro is Associate Professor with tenure in the Business Environment Department at Rutgers Business School, where he teaches courses on business ethics, public policy, labor and human rights, law, ethical issues in the pharmaceutical industry and China business strategy. As a Research Associate at Harvard Business School, he wrote or co-authored nearly thirty case studies and teaching notes on ethical and legal topics such as global protection of intellectual property, insider trading, the Federal Sentencing Guidelines and Fair Credit Reporting Act. Thomas Gorrie is Corporate Vice President, Government Affairs & Policy, at Johnson & Johnson, with responsiblity for all federal, state and international government affairs and policy. He completed post-doctoral studies at the Swiss Federal Institute of Technology in Zurich, following the receipt of his doctorate at Princeton University. Gorrie has over 30 years of worldwide health care experience and has worked with various Johnson & Johnson companies inresearch and development, marketing and sales, business development, strategic planning, general management, international, venture capital, and health policy.

Many people think human reproductive cloning should be a crime-some states have even outlawed it and Congress is working to enact a national ban. However, if reproductive cloning soon becomes a reality, it will be impossible to prevent infertile couples and others from choosing the technology, even if they have to break the law. While most books on cloning cover the advantages and disadvantages of cloning technology, Illegal Beings describes the pros and cons of laws against human reproductive cloning. Kerry Lynn Macintosh, an attorney with expertise in the area of law and technology, argues that the most common objections to cloning are false or exaggerated, inspiring laws that stigmatize human clones as subhuman and unworthy of existence. She applies the same reasoning that was used to invalidate racial segregation to show how anti-cloning laws, by reinforcing negative stereotypes, deprive human clones of their equal protection rights under the law. Her book creates a new topic within constitutional law: existential segregation, or the practice of discriminating by preventing the existence of a disfavored group or class. This comprehensive and novel work looks at how anti-cloning laws will hurt human clones in a fresh perspective on this controversial subject. Kerry Lynn Macintosh is a member of the Law and Technology faculty at Santa Clara University School of Law. She is the author of papers, articles, and book chapters on the law and technology and has contributed to the Harvard Journal of Law and Technology, Boston University Journal of Science and Technology Law, and Berkeley Technology Law Journal.

This instant gold standard title is a major contribution to the field of clinical medical ethics and will be used widely for reference and teaching purposes for years to come. Throughout his career, Mark Siegler, MD, has written on topics ranging from the teaching of clinical medical ethics to end-of-life decision-making and the ethics of advances in technology. With more than 200 journal publications and 60 book chapters published in this area over the course of his illustrious career, Dr. Siegler has become the pre-eminent scholar and teacher in the field. Indeed his work has had a profound impact on a range of therapeutic areas, especially internal medicine, pediatrics, surgery, oncology, and medical education. Having grown steadily in importance the last 30 years, clinical ethics examines the practical, everyday ethical issues that arise in encounters among patients, doctors, nurses, allied health workers, and health care institutions. The goal of clinical ethics is to improve patient care and patient outcomes, and almost every large hospital now has an ethics committee or ethics consultation service to help resolve clinical ethical problems; and almost every medical organization now has an ethics committee and code of ethics. Most significantly, clinical ethics discussions have become a part of the routine clinical discourse that occurs in outpatient and inpatient clinical settings across the country. This seminal collection of 46 landmark works by Dr. Siegler on the topic is organized around five themes of foundational scholarship: restoring and transforming the ethical basis of modern clinical medicine, the doctor-patient relationship, education and professionalism, end-of-life care, and clinical innovation. With introductory perspectives by a group of renowned scholars in medicine, Clinical Medical Ethics: Landmark Works of Mark Siegler, MD explains the field authoritatively and comprehensively and will be of invaluable assistance to all clinicians and scholars concerned with clinical ethics.