Knowledge of the genetic basis of human diseases is growing rapidly, with important implications for pre-conceptional, prenatal, and predictive testing. While new genetic testing offers better insight into the causes of and susceptibility for heritable diseases, not all inherited diseases that can be predicted on the basis of genetic information can be treated or cured. Should we test everyone who wants to know his or her genetic status, even when there are no possibilities for treatment? What is the role of the "right-not-to-know?" Do we test children for adult onset disorders because the parents just "have to know" or do we respect the children's right to choose when they are older? Do we allow commercial companies to offer genetic tests directly to consumers without the proper oversight regarding what the test results will mean?
By using a creative approach that focuses on a single extended family as a case example to illustrate each chapter's key point, the authors elucidate ethical issues arising in the genetics clinic and laboratory surrounding many timely issues, including:
. prenatal and pre-implantation genetic diagnosis
. assisted reproductive technologies
. incidental findings in genetic testing
. gene patenting
. testing children for adult onset disorders
. direct to consumer testing
Ethical Dilemmas in Genetic Counseling: Principles through Case Scenarios is essential reading for anyone interested in the ethical issues surfacing in common genetics practice. Written exclusively by genetic counselors, it makes a significant contribution to the field of ethics in genetics and thus will appeal not only to genetic counselors but to physicians, nurses, and all those concerned with bioethics and social science."

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.

How liberal democracies in the late twentieth century have sought to resolve public concerns over charged issues in medicine and science. Ethics boards have become obligatory passage points in today's medical science, and we forget how novel they really are. The use of humans in experiments is an age-old practice that records show goes back to at least the third century BC, and it has been popular as a practice since the early modern period. Yet in most countries around the world, hardly any formal checks and balances existed to govern the communal oversight of experiments involving human subjects until at least the 1960s. Ethics by Committee traces the rise of ethics boards for human experimentation in the second half of the twentieth century. Using the Netherlands as a case study, historian Noortje Jacobs shows how the authority of physicians to make decisions about clinical research in this period gave way in most developed nations to formal mechanisms of communal decision-making that served to regiment the behavior of individual researchers. This historically unprecedented change in scientific governance came out of the growing international wariness of medical research in the decades after World War II and was meant to solidify a new way of reasoning together in liberal democracies about medicine and science. But what reasoning together meant, and who was invited to participate, changed drastically over time. In detailing this history, Jacobs shows that research ethics committees were originally intended not only to make human experimentation more ethical but also to raise its epistemic quality and intensify the use of new clinical research methods. By examining complex negotiations over the appropriate governance of human subjects research, Ethics by Committee is an important contribution to our understanding of the randomized controlled trial and the history of research ethics and bioethics more generally.

Tod und Sterben gelten in unserer Gesellschaft immer noch als Tabu. Zum Sterben wird gerne auf Institutionen wie Krankenhaus oder Pflegeheim zuruckgegriffen. Durch die Palliativmedizin und den immer starkeren Einfluss der Hospizbewegung andert sich mittlerweile das Bewusstsein fur die letzte Phase des Lebens. Diese Studie betrachtet den Umgang mit den Begriffen Tod und Sterben in der Medizin. Auch werden die damit in Zusammenhang stehenden Begriffe Lebensqualitat, Sterbehilfe und Sterbebegleitung in ihrer historischen Entwicklung thematisiert. Den Abschluss der Arbeit bildet eine ausfuhrliche Betrachtung der historischen und aktuellen Bedingungen einer Kommunikation mit Sterbenden.

This important work takes as its subject one of medicine 's most pressing arenas of ethical debate. There has been a consistent interest in ethical issues arising in the context of HIV research. Ongoing international and multi-site studies and the continuing search for an HIV vaccine continue to prompt examination of how this research is conducted. Also examined are how participants are engaged in the studies and the obligations of the researchers to individual participants and their communities during the course of and following the conclusion of the research. Each chapter of this book is authored primarily by one of the editors (secondarily by the other) and is accompanied by one to two case studies.

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.

Nearly 120,000 people are in need of healthy organs in the United States. Every ten minutes a new name is added to the list, while on average twenty people die each day waiting for an organ to become available. Worse, our traditional reliance on cadaveric organ donation is becoming increasingly insufficient, and in recent years there has been a decline in the number of living donors as well as in the percentage of living donors relative to overall kidney donors. Some transplant surgeons and policy advocates have responded to this shortage by arguing for the legalization of the sale of organs among living donors. Andrew Flescher objects to this approach by going beyond concerns traditionally cited about social justice, commodification, and patient safety, and moving squarely onto the terrain of discussing what motivates major and costly acts of human selflessness. What is the most efficacious means of attracting prospective living kidney donors? Flescher, drawing on literature in the fields of moral psychology and economics, as well as on scores of interviews with living donors, suggests that inculcating a sense of altruism and civic duty is a more effective means of increasing donor participation than the resort to financial incentives. He encourages individuals to spend time with patients on dialysis in order to become acquainted with their plight and, as an alternative to lump-sum payments, consider innovative solutions that positively impact living donor participation that do not undermine the spirit of the National Organ Transplant Act of 1984. This book not only re-examines the important debate over whether to allow the sale of organs; it is also the first volume in the field to take a close look at alternative solutions to the organ shortage crisis.

Abortion in Judaism presents a complete Jewish legal history of abortion from the earliest relevant biblical references through the end of the twentieth century. For the first time, almost every Jewish text relevant to the abortion issue is explored in detail. These texts are investigated in historical sequence, thereby elucidating the development inherent within the Jewish approach to abortion. The work considers the insights that this thematic history provides into Jewish ethical principles, as well as into the role of halakhah within Judaism.

Abortion in Judaism presents a complete Jewish legal history of abortion from the earliest relevant biblical references through the end of the twentieth century. For the first time, almost every Jewish text relevant to the abortion issue is explored in detail. These texts are investigated in historical sequence, thereby elucidating the development inherent within the Jewish approach to abortion. The work considers the insights that this thematic history provides into Jewish ethical principles, as well as into the role of halakhah within Judaism.

The issue of rights to genetic information is considered in this study from the standpoint of individuals, their relatives, employers, insurers and the state. Graeme Laurie provides a concept of privacy and property rights for the person, and argues for stronger legal protection following new developments in genetics. This book will interest lawyers, philosophers and doctors concerned with genetic information and issues of privacy, as well as genetic counselors, researchers and policy makers worldwide for its practical position on dilemmas in modern genetic medicine.

Ranging from the beginning of the nineteenth century to the 1980s, this book focuses on the evolution of the law and medical practice of abortion in England. Little academic attention has hitherto been given to the development and scope of abortion law in England, the formative influence of the medical profession, and the impact of the law on medical practice. Consequently, Dr Keown considers the performance of abortion by doctors, and the influence the medical profession had on the restriction of the law in the nineteenth century and on its relaxation in the twentieth. The book does not deal directly with the legal status of the unborn child, the rights and duties of its parents and of the doctors involved in the provision of abortion or the question of the desirability of reform. Rather, adopting a socio-legal perspective, it considers what the scope of the prohibition of abortion has been and focuses on aspects of professional influence on the evolution of that prohibition, and of professional practice thereunder.

Biosecurity Dilemmas examines conflicting values and interests in the practice of "biosecurity," the safeguarding of populations against infectious diseases through security policies. Biosecurity encompasses both the natural occurrence of deadly disease outbreaks and the use of biological weapons. Christian Enemark focuses on six dreaded diseases that governments and international organizations give high priority for research, regulation, surveillance, and rapid response: pandemic influenza, drug-resistant tuberculosis, smallpox, Ebola, plague, and anthrax. The book is organized around four ethical dilemmas that arise when fear causes these diseases to be framed in terms of national or international security: protect or proliferate, secure or stifle, remedy or overkill, and attention or neglect. For instance, will prioritizing research into defending against a rare event such as a bioterrorist attack divert funds away from research into commonly occurring diseases? Or will securitizing a particular disease actually stifle research progress owing to security classification measures? Enemark provides a comprehensive analysis of the ethics of securitizing disease and explores ideas and policy recommendations about biological arms control, global health security, and public health ethics.

Ever since the rise of Adolf Hitler, mental health professionals have sought to use their knowledge of human psychology to understand - and intervene in - political developments. From Barry Goldwater to Donald Trump, psychiatrists have commented, sometimes brashly, on public figures' mental health. But is the practice ethical? While the American Psychiatric Association prohibits psychiatric comment on public figures under its 'Goldwater Rule', others disagree. Diagnosing from a Distance is the first in-depth exploration of this controversy. Making extensive use of archival sources and original interviews, John Martin-Joy reconstructs the historical debates between psychiatrists, journalists, and politicians in an era when libel law and professional standards have undergone dramatic change. Charting the Goldwater Rule's crucial role in the current furor over Trump's fitness for office, Martin-Joy assesses the Rule's impact and offers a more liberal alternative. This remarkable book will change the way we think about psychiatric ethics and public life.

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.

When the new HIPAA privacy rules regarding the release of health information took effect, medical historians suddenly faced a raft of new ethical and legal challenges - even in cases where their subjects had died years, or even a century, earlier. In Privacy and the Past, medical historian Susan C. Lawrence explores the impact of these new privacy rules, offering insight into what historians should do when they research, write about, and name real people in their work. Lawrence offers a wide-ranging and informative discussion of the many issues involved. She highlights the key points in research ethics that can affect historians, including their ethical obligations to their research subjects, both living and dead, and she reviews the range of federal laws that protect various kinds of information. The book discusses how the courts have dealt with privacy in contexts relevant to historians, including a case in which a historian was actually sued for a privacy violation. Lawrence also questions who gets to decide what is revealed and what is kept hidden in decades-old records, and she examines the privacy issues that archivists consider when acquiring records and allowing researchers to use them. She looks at how demands to maintain individual privacy both protect and erase the identities of people whose stories make up the historical record, discussing decisions that historians have made to conceal identities that they believed needed to be protected. Finally, she encourages historians to vigorously resist any expansion of regulatory language that extends privacy protections to the dead. Engagingly written and powerfully argued, Privacy and the Past is an important first step in preventing privacy regulations from affecting the historical record and the ways that historians write history.

The ethical theories employed in health care today assume, in the main, a modern Western philosophical framework. Yet the diversity of cultural and religious assumptions regarding human nature, health and illness, life and death, and the status of the individual suggest that a cross-cultural study of health care ethics is needed.

"A Cross-Cultural Dialogue on Health Care Ethics" provides this study. It shows that ethical questions can be resolved by examining the ethical principles present in each culture, critically assessing each value, and identifying common values found within all traditions, It encourages the development of global awareness and sensitivity to and respect for the diversity of peoples and their values and will advance understanding as well as help to foster a greater balance and a fuller truth in consideration of the human condition and what makes for health and wholeness.

Medical issues affecting health care have become everyday media events. In response to mounting public concern, growing numbers of bioethicists are being appointed to medical school faculties and public policy panels. However the ideas voiced in these forums are seldom informed by feminist perspectives. In this important book, a distinguished group of feminist scholars and activists discuss crucial bioethics topics in a feminist light. Among the subjects explored are the care/justice debates, transforming bioethics, practice, and reproduction. The book also covers less commonly discussed issues, such as culturally appropriate responses to reproductive health problems in developing countries.

Readings in Health Care Ethics provides a wide-ranging selection of important and engaging contributions to the field of health care ethics. The second edition adds a chapter on health care in Canada, and the introduction has been expanded to include discussion of a new direction in feminist naturalised ethics. The book presupposes no prior knowledge, only an interest in the bioethical issues that are shaping our world.

This book demonstrates how popular culture can be successfully incorporated into medical and health science curriculums, capitalising on the opportunity fictional media presents to humanise case studies. Studies show that the vast majority of medical and nursing students watch popular medical television dramas and comedies such as Grey's Anatomy, ER, House M.D. and Scrubs. This affords us with a unique opportunity to engage and inform not only students but the general public and patients further downstream. This volume analyses examples of medical-themed popular culture and offers various strategies and methods for educators in this field to integrate this material into their teaching. The result is a fascinating read and original resource for medical professionals and teachers alike.

Donor insemination or DI is the oldest and most widely practiced form of assisted conception. Until now, it has been assessed largely from a medical perspective. This book brings together an international group of social scientists to discuss the social, cultural, political and practical dimensions of DI, relating it to the wider debates about fertility treatment. Contributors consider the experience of DI from the viewpoints of all the parties involved, including those treated, the donors, the clinicians, and the children of DI.

Patients have personal strategies in solving the problems concerning their illness. Doctors have personal and professional strategies in solving the problems with their patients. This book explores the problematic triangle between doctors, patients and the illness, using illustrations from internal medicine, nephrology, cardiology, oncology and neurology. Enhancement of the doctor-patient interaction is an important contribution to the mutual reduction of stress and therefore the improvement of the course of (long-term) illness. The first part of the book describes reasons why the partnership between doctor and patient should be improved. The second part offers concrete and practical options to achieve that improvement.

It is estimated that up to thirteen percent of hospital admissions result from the adverse effects of diagnosis or treatment, and that anywhere from 44,000 to 98,000 hospital deaths annually are the result of errors. The obligation to "do no harm" has been central to medical conduct since ancient times, yet iatrogenic illness and medical error have now come to be recognized as significant risk factors in health care delivery. This book integrates history, philosophy, medical ethics and empirical data to examine the concept and phenomenon of medical harm. Issues covered include medical error, appropriateness of care, acceptable risk and practitioner accountability, and recommendations for limiting iatrogenic harm.

Scientific research involving human embryos was a major topic of public debate in Britain during the 1980s. Despite strong support from the scientific community, embryo research was initially condemned by many ordinary people as well as by special interest groups, and came close to being banned by Act of Parliament. Michael Mulkay describes the dynamics of the parliamentary struggle over the future of embryo research, focusing on such issues as: the clash between the anti-abortion and pro-research lobbies; the tactics of the Government; political ideology; the media's role; the importance of gender; religion; the impact of science fiction; the lure of medical advance; and the difficulty of maintaining ethical control. He explains how the advocates of embryo research eventually triumphed, and ends with an examination of the cultural tensions which linger after the debate.

This book provides a nontechnical account of the debate concerning human embryo research, concentrating on the British parliamentary debates of 1984-1990. It traces the debates' origins back to conflicts over abortion and moral reform in the 1960s, and examines reactions in the 1990s to sex selection and the use of eggs from human fetuses for research. Michael Mulkay shows how embryo research develops within a complex social environment, writing for anyone interested in the relationship between science-based assisted reproduction and society.

We all have beliefs, even strong convictions, about what is just and fair in our social arrangements. How should these beliefs and the theories of justice that incorporate them guide our thinking about practical matters of justice? This wide-ranging collection of essays by one of the foremost medical ethicists in the United States explores the claim that justification in ethics, whether concerning matters of theory or practice, involves achieving coherence or "reflective equilibrium" (as Rawls has called it) between our moral and nonmoral beliefs. Among the practical issues the volume addresses are the design of health-care institutions, the distribution of goods between the old and the young, and fairness in hiring and firing practices. In combining ethical theory and practical ethics this volume will prove especially valuable to philosophers concerned with ethics and applied ethics, political theorists, bioethicists, and others involved in the study of public policy.