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Books > Medicine > General issues > Medical ethics
The question of whether abortion should or should not be permitted,
and under what circumstances, is among the most difficult and
sometimes anguished decisions for contemporary men and women. How
we feel about this issue, and what actions we take, help to define
our image of who we are as social beings. In the midst of the
surrounding political, ethical, and religious debate, people
everywhere are once again examining their conscience and their
beliefs, and turning to unutilized sources of information as they
seek to come to terms with this contentious issue. And as emotions
run high, it is helpful to step back from the highly charged arena
to reconsider the underlying scientific facts about human
development.
For sixty years genetic counselors have served as the messengers of important information about the risks, realities, and perceptions of genetic conditions. More than 2,500 certified genetic counselors in the United States work in clinics, community and teaching hospitals, public health departments, private biotech companies, and universities. "Telling Genes" considers the purpose of genetic counseling for twenty-first century families and society and places the field into its historical context. Genetic counselors educate physicians, scientific researchers, and prospective parents about the role of genetics in inherited disease. They are responsible for reliably translating test results and technical data for a diverse clientele, using scientific acumen and human empathy to help people make informed decisions about genomic medicine. Alexandra Minna Stern traces the development of genetic counseling from the eugenics movement of the early twentieth century to the current era of human genomics. Drawing from archival records, patient files, and oral histories, Stern presents the fascinating story of the growth of genetic counseling practices, principles, and professionals.
Reproductive health care professionals in fields such as Obstetrics and Gynecology, Family Medicine, and Pediatrics face difficult ethical issues because they work at the crossroads of patient decision-making, scientific advancement, political controversy, legal regulation, and profound moral considerations. The dilemmas these professionals face expose big-picture bioethics questions of interest to everyone. Yet for clinicians striving to deliver excellent patient care, the ethical questions that make daily practice challenging can be just as nuanced. This volume presents a carefully curated compilation of essays written by leading experts in the fields of medicine, ethics, and law, who address key issues at the forefront of reproductive ethics. It is organized into three main sections: I. Contraception and Abortion Ethics - Preventing Pregnancy and Birth, II. Assisted Reproduction Ethics - Initiating Pregnancy, and III. Obstetric Ethics - Managing Pregnancy and Delivery. Each section begins with a short introduction by the editors providing an overview of the area and contextualizing the essays that follow. This volume's primary aim is to be useful to practicing clinicians, students, and trainees by providing short and practical essays covering urgent topics-from race, religion and abortion, to legal liability, violations of confidentiality and maternal choices that risk future children's health. This collection provides clinicians at all levels of training with frameworks they need to approach the intimate and high-stakes encounters central to their profession.
Ethics for Psychotherapists and Counselors utilizes positive discussions accompanied by a variety of thought-provoking exercises, case scenarios, and writing assignments to introduce readers to all the major ethical issues in psychotherapy. First book designed to engage students and psychotherapists in the process of developing a professional identity that integrates their personal values with the ethics and traditions of their discipline Authors take a positive and proactive approach that encourages readers to go beyond following the rules and to strive for ethical excellence Utilizes a variety of thought-provoking exercises, case scenarios, and writing assignments Authors present examples from their own backgrounds to help clarify the issues discussed Text emphasizes awareness of one's own ethical, personal, and cultural backgrounds and how these apply to one's clinical practice
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.
In 1985, philosopher Samuel Gorovitz spent seven weeks at Boston's
Beth Israel, one of the nation's premier teaching hospitals, where
he was given free run as "Authorized Snoop and Irritant-at-Large."
In Drawing the Line, he provides an intense, disturbing, and
insightful account of his observations during those seven weeks.
In one form or another, health care now gets rationed. Not everything beneficial is done for every patient. For the individual the consequences are sometimes tragic. Rationing decisions thus raise a classic dilemma: how can we treat with dignity and genuine respect the person who gets short-changed by an efficient policy that seems best overall? Strong Medicine argues that we can, if those policies represent the hard trade-off preferences of patients controlling resources for their larger lives. Rationing is still strong medicine to swallow, but then it becomes what patients as well as the doctor ordered. Menzel develops this central idea and applies it to major issues of health policy and economics: the notion of pricing life, the long-run cost of prevention, measuring quality of life, imperiled newborns, adequate care for the poor, containing costs by market competition, malpractice suits, procuring organs for transplant, and dying expensively in old age. He provides a hard-hitting, critical philosophical discussion of these issues, in non-technical language accessible to a wide range of readers interested in policy questions the book takes up. The issues are fascinating, the arguments are careful, and the results often surprising.
Five years after publication of the third edition, and reflecting the dynamic nature of the pharmaceutical and medical device industries (as well as the many different areas of law that pertain to the management of these medical technologies), the Fourth Edition incorporates the latest legislative, regulatory, and judicial developments, describes recent scientific advances, and excerpts or references new scholarly contributions to this broad field (the wealth of citations should facilitate use in a seminar setting). Measured by volume, more than 20% of the previous edition has been replaced with new material. The latest edition retains the same basic thematic approach and modular structure of the original, which allows instructors to pick and choose the materials to cover based on their own tastes and areas of expertise.
Offering a compendium of case studies in bioethics, Choosing Well demonstrates real ethical dilemmas that can occur in health care settings. Instructors can draw upon the scenarios in this concise and highly effective resource to encourage analysis, critique, discussion, and debate of hot-button ethical issues.The authors present a diverse selection of complex case studies in bioethics to stimulate in-depth analysis on topics ranging from distributive justice, research ethics, reproductive technologies, abortion, and death and dying, to the health care professional-patient relationship and ethics in the workplace. The text also features case studies that move through time to reflect real-life decision making and cases that present multiple perspectives to illustrate the challenges that can arise from disputes in health care settings. Utilizing the DECIDED strategy for analyzing case studies, instructors can guide students through the steps needed to work through a wide variety of ethical dilemmas and encourage reflection on their own ethical assumptions. Accessible, practical, and highly engaging, Choosing Well offers a helpful and interesting way to explore central issues in contemporary bioethics, making it an indispensable resource for instructors and students of bioethics, biomedical ethics, and health care ethics.
Issues concerning patients' rights are at the center of bioethics, but the political basis for these rights has rarely been examined. In "Bioethics in a Liberal Society: The Political Framework of Bioethics Decision Making," Thomas May offers a compelling analysis of how the political context of liberal constitutional democracy shapes the rights and obligations of both patients and health care professionals. May focuses on how a key feature of liberal society--namely, an individual's right to make independent decisions--has an impact on the most important relational facets of health care, such as patients' autonomy and professionals' rights of conscience. Although a liberal political framework protects individual judgments, May asserts that this right is based on the assumption of an individual's competency to make sound decisions. May uses case studies to examine society's approach to medical decision making when, for reasons ranging from age to severe mental disorder, a person lacks sufficient competency to make independent and fully informed choices. To protect the autonomy of these vulnerable patients, May emphasizes the need for health care ethics committees and ethics consultants to help guide the decision-making process in clinical settings. "Bioethics in a Liberal Society" is essential reading for all those interested in understanding how bioethics is practiced within our society.
In this companion volume to their 1981 work, A Philosophical Basis of Medical Practice, Pellegrino and Thomasma examine the principle of beneficence and its role in the practice of medicine. Their analysis, which is grounded in a thorough-going philosophy of medicine, addresses a wide array of practical and ethical concerns that are a part of health care decision-making today. Among these issues are the withdrawing and withholding of nutrition and hydration, competency assessment, the requirements for valid surrogate decision-making, quality-of-life determinations, the allocation of scarce health care resources, medical gatekeeping, and for-profit medicine. The authors argue for the restoration of beneficence (re-interpreted as beneficence-in-trust) to its place as the fundamental principle of medical ethics. They maintain that to be guided by beneficence a physician must perform a right and good healing action which is consonant with the individual patient's values. In order to act in the patient's best interests, or the patient's good, the physician and patient must discern what that good is. This knowledge is gained only through a process of dialogue between patient and/or family and physician which respects and honors the patient's autonomous self-understanding and choice in the matter of treatment options. This emphasis on a dialogical discernment of the patient's good rejects the assumption long held in medicine that what is considered to be the medical good is necessarily the good for this patient. In viewing autonomy as a necessary condition of beneficence, the authors move beyond a trend in the medical ethics literature which identifies beneficence with paternalism. In their analysis of beneficence, the authors reject the current emphasis on rights- and duty-based ethical systems in favor of a virtue-based theory which is grounded in the physician-patient relationship. This book's provocative contributions to medical ethics will be of great interest not only to physicians and other health professionals, but also to ethicists, students, patients, families, and all others concerned with the relationship of professional to patient and patient to professional in health care today.
For the average person, genetic testing has two very different faces. The rise of genetic testing is often promoted as the democratization of genetics by enabling individuals to gain insights into their unique makeup. At the same time, many have raised concerns that genetic testing and sequencing reveal intensely personal and private information. As these technologies become increasingly available as consumer products, the ethical, legal, and regulatory challenges presented by genomics are ever looming. Assembling multidisciplinary experts, this volume evaluates the different models used to deliver consumer genetics and considers a number of key questions: How should we mediate privacy and other ethical concerns around genetic databases? Does aggregating data from genetic testing turn people into products by commercializing their data? How might this data reduce or exacerbate existing healthcare disparities? Contributing authors also provide guidance on protecting consumer privacy and safety while promoting innovation.
This book provides a bridge between the theory to practice gap in contemporary health care ethics. It explores the messiness of everyday ethical issues and validates the potential impacts on health care professionals as wounded healers who regularly experience close proximity to suffering and pain. This book speaks to why ethics matters on a personal level and how moral distress experiences can be leveraged instead of hidden. The book offers contributions to both scholarship and the profession. Nurses, physicians, social workers, allied health care professionals, as well as academics and students will benefit from this book.
This books gives guidance for doctors and other health
professionals who are involved in providing health care for
children and young people.
Respect for autonomy has become a fundamental principle in human research ethics. Nonetheless, this principle and the associated process of obtaining informed consent do have limitations. This can lead to some groups, many of them vulnerable, being left understudied. This book considers these limitations and contributes through legal and philosophical analyses to the search for viable approaches to human research ethics. It explores the limitations of respect for autonomy and informed consent both in law and through the examination of cases where autonomy is lacking (infants), diminished (addicts), and compromised (low socio-economic status). It examines alternative and complementary concepts to overcome the limits of respect for autonomy, including beneficence, dignity, virtue, solidarity, non-exploitation, vulnerability and self-ownership. It takes seriously the importance of human relationality and community in qualifying, tempering and complementing autonomy to achieve the ultimate end of human research - the good of humankind.
History will mark the twenty-first century as the dawn of the age of precise genetic manipulation. Breakthroughs in genome editing are poised to enable humankind to fundamentally transform life on Earth. Those familiar with genome editing understand its potential to revolutionize civilization in ways that surpass the impact of the discovery of electricity and the development of gunpowder, the atomic bomb, or the Internet. Significant questions regarding how society should promote or hinder genome editing loom large in the horizon. And it is up to humans to decide the fate of this powerful technology. Rewriting Nature is a compelling, thought-provoking interdisciplinary exploration of the law, science, and policy of genome editing. The book guides readers through complex legal, scientific, ethical, political, economic, and social issues concerning this emerging technology, and challenges the conventional false dichotomy often associated with science and law, which contributes to a growing divide between both fields.
History will mark the twenty-first century as the dawn of the age of precise genetic manipulation. Breakthroughs in genome editing are poised to enable humankind to fundamentally transform life on Earth. Those familiar with genome editing understand its potential to revolutionize civilization in ways that surpass the impact of the discovery of electricity and the development of gunpowder, the atomic bomb, or the Internet. Significant questions regarding how society should promote or hinder genome editing loom large in the horizon. And it is up to humans to decide the fate of this powerful technology. Rewriting Nature is a compelling, thought-provoking interdisciplinary exploration of the law, science, and policy of genome editing. The book guides readers through complex legal, scientific, ethical, political, economic, and social issues concerning this emerging technology, and challenges the conventional false dichotomy often associated with science and law, which contributes to a growing divide between both fields.
Over the past decades, public trust in medical professionals has steadily declined. This decline of trust and its replacement by ever tighter regulations is increasingly frustrating physicians. However, most discussions of trust are either abstract philosophical discussions or social science investigations not easily accessible to clinicians. The authors, one a surgeon-turned-philosopher, the other an analytical philosopher working in medical ethics, joined their expertise to write a book which straddles the gap between the practical and theoretical. Using an approach grounded in the methods of conceptual analysis found in analytical philosophy which also draws from approaches to medical diagnosis, the authors have conceived an internally coherent and comprehensive definition of trust to help elucidate the concept and explain its decline in the medical context. This book should appeal to all interested in the ongoing debate about the decline of trust - be it as medical professionals, medical ethicists, medical lawyers, or philosophers.
This book explores, through case studies, the interplay between religion, culture, government, and politics in diverse societies on questions arising in the domain of bioethics. The case studies draw from multiple disciplinary perspectives, including history, theology, law, bioethics, public policy, science, and medicine. The text's global perspective permits a comparison of the differing approaches adopted by countries facing similar bioethical quandaries and the extent to which religion has or has not been instrumental in addressing such dilemmas. Secular and religious societies across the globe are being confronted with complex questions involving religious belief and the extent to which specific religious perspectives have in the past or should in the future be adopted as official policy. Bioethical issues involving the interplay of religion and government have become particularly notable in recent years. How these issues are resolved has major implications for individuals, healthcare providers, and the future of medical research and medical care. Topics explored among the chapters include: Homosexuality: Sin, Crime, Pathology, Identity, Behavior Medical Error: Truthtelling, Apology, and Forgiveness Refusal of Medical Treatment Medical Deportation Case Study: Nazism, Religion, and Human Experimentation The New Frontier: Cloning Case Studies in Society, Religion, and Bioethics will find an engaged audience among researchers and scholars in history, religion/theology, medicine, and bioethics interested in the influence of religion on bioethical decision-making. Students-particularly upper-level undergraduate and graduate students interested in bioethics, humanities, and theology-will find the text helpful in understanding the processes through which religion may serve as a basis for both societal policy and law and individual decision-making in health-related matters.
This book focuses on justice and its demands in the way of providing people with medical care. Building on recent insights on the nature of moral perceptions and motivations from the neurosciences, it makes a case for the traditional medical ethic and examines its financial feasibility. The book starts out by giving an account of the concept of justice and tracing it back to the practices and tenets of Hippocrates and his followers, while taking into account findings from the neurosciences. Next, it considers whether the claim that it is just to limit medical care for everyone to some basic minimum is justifiable. The book then addresses finances and expenditures of the US health care system and shows that the growth of expenditures and the percentage of the gross national product spent on health care make for an unsustainable trajectory. In light of the question what should be changed, the book suggests that overdiagnosis and medicalizing normal behavior lead to harmful, costly and unnecessary interventions and are the result of unethical behavior on the part of the pharmaceutical industry and extensive ethical failures of the FDA. The book ends with suggestions about what can be done to put the U.S. health care system on the path to sustainability, better medical care, and compliance with the demands of justice.
This book provides occupational health (OH) professionals with a theoretical basis for addressing the ethical issues that they confront in their practice. There is often a lack of in-depth moral analysis of the issues that OH practitioners face on a daily basis. The ICOH Code of Ethics sets out the important principles that guide OH practice. This book builds on these core principles, starting from an application of moral theories in the OH context and illustrating how ethical conflicts could be resolved, by carrying out ethical analyses of several case studies. In this way, it aims to link ethical theory to OH practice.
The Irish health system is confronted by a range of challenges, both emerging and recurring. This collection provides a foundation for ongoing engagement with selected issues in contemporary Irish health contexts. It includes contributions from scholars and practitioners across a range of disciplines. The essays are theoretically informed and are grounded in the realities of the Irish health system, by drawing on contributors' contextual knowledge. The focus of the collection is interdisciplinary and the essays are situated at the intersection between ethics, law, medicine and policy. It draws out the interlinking themes of context and care, rights and responsibilities, regulating research and oversight of decision-making. This book makes an informed and balanced contribution to academic and broader public discourse. It will be of interest to academics and postgraduate students in ethics, law and health and those outside the academic sphere who must engage critically with the issues addressed. -- .
Mormonism, Medicine, and Bioethics provides the first comprehensive treatment of principles and positions on questions of bioethics encountered by members, professionals, and ecclesiastical leaders of The Church of Jesus Christ of Latter-day Saints (LDS or Mormon). The book addresses three fundamental features of a coherent religious bioethics: precepts for practical decision-making, general ethical principles, and core religious convictions that give a distinctive motivation for personal, communal, and professional integrity. LDS ethical principles of love, hospitality to strangers, covenantal solidarity, justice, and moral agency are integrated with central topics in bioethics including abortion, genetic testing and enhancements, in vitro fertilization, medical assisted death, medicinal marijuana, neonatal intensive care, organ donation, preventive health care, universal access to care, and vaccinations. This book uses first-person experiences to give voice to the lived moral realities of Latter-day Saints as they experience difficult and wrenching ethical questions and choices as persons, family members, community members, professionals, and as citizens within the context of their distinctive faith convictions. It situates these communal conversations within the broader discourse of bioethics and thereby supports both bioethics and religious literacy. Mormonism, Medicine, and Bioethics also examines circumstances in which The Church of Jesus Christ of Latter-day Saints engages in a moral witness of its values on matters of public policy, such as legalization of physician-assisted death, of elective abortion, and of medicinal marijuana. The book concludes with a distinctive normative argument on why LDS ethical principles and practices require support of universal access to an adequate level of health care for all persons. It provides an appendix of significant LDS ecclesiastical policies on medical, health, and moral issues, making it a definitive educational and reference compilation.
The Routledge Handbook of Neuroethics offers the reader an informed view of how the brain sciences are being used to approach, understand, and reinvigorate traditional philosophical questions, as well as how those questions, with the grounding influence of neuroscience, are being revisited beyond clinical and research domains. It also examines how contemporary neuroscience research might ultimately impact our understanding of relationships, flourishing, and human nature. Written by 61 key scholars and fresh voices, the Handbook's easy-to-follow chapters appear here for the first time in print and represent the wide range of viewpoints in neuroethics. The volume spotlights new technologies and historical articulations of key problems, issues, and concepts and includes cross-referencing between chapters to highlight the complex interactions of concepts and ideas within neuroethics. These features enhance the Handbook's utility by providing readers with a contextual map for different approaches to issues and a guide to further avenues of interest. Chapter 11 of this book is freely available as a downloadable Open Access PDF under a Creative Commons Attribution-Non Commercial-No Derivatives 3.0 license. https://www.routledgehandbooks.com/doi/10.4324/9781315708652.ch11
Biomedical ethics is a burgeoning academic field with complex and far-reaching consequences. Whereas in Western secular bioethics this subject falls within larger ethical theories and applications (utilitarianism, deontology, teleology, and the like), Islamic biomedical ethics has yet to find its natural academic home in Islamic studies. In this pioneering work, Abdulaziz Sachedina - a scholar with life-long academic training in Islamic law - relates classic Muslim religious values to the new ethical challenges that arise from medical research and practice. He depends on Muslim legal theory, but then looks deeper than juridical practice to search for the underlying reasons that determine the rightness or wrongness of a particular action. Drawing on the work of diverse Muslim theologians, he outlines a form of moral reasoning that can derive and produce decisions that underscore the spirit of the Shari'a. These decisions, he argues, still leave room to revisit earlier decisions and formulate new ones, which in turn need not be understood as absolute or final. After laying out this methodology, he applies it to a series of ethical questions surrounding the human life-cycle from birth to death, including such issues as abortion, euthanasia, and organ donation. The implications of Sachedina's work are broad. His writing is unique in that it aims at conversing with Jewish and Christian ethics, moving beyond the Islamic fatwa literature to search for a common language of moral justification and legitimization among the followers of the Abrahamic traditions. He argues that Islamic theological ethics be organically connected with the legal tradition of Islam to enable it to sit in dialogue with secular and scripture-based bioethics in other faith communities. A breakthrough in Islamic bioethical studies, this volume is welcome and long-overdue reading for anyone interested in facing the difficult questions posed by modern medicine not only to the Muslim faithful but to the ethically-minded at large. |
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