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.

This open access book reflects on matters of social and ethical concern raised in the daily practices of those working in and around precision oncology. Each chapter addresses the experiences, concerns and issues at stake for people who work in settings where precision oncology is practiced, enacted, imagined or discussed. It subsequently discusses and analyses bioethical dilemmas, scientific challenges and economic trade-offs, the need for new policies, further technological innovation, social work, as well as phenomenological research. This volume takes a broad actor-centred perspective as, whenever cancer is present, the range of actors with issues at stake appears almost unlimited. This perspective and approach opens up the possibility for further in-depth and diverse questions, posed by the actors themselves, such as: How are cancer researchers navigating biological uncertainties? How do clinicians and policy-makers address ethical dilemmas around prioritisation of care? What are the patients' experiences with, and hopes for, precision oncology? How do policy-makers and entrepreneurs envisage precision oncology? These questions are of great interest to a broad audience, including cancer researchers, oncologists, policy-makers, medical ethicists and philosophers, social scientists, patients and health economists.

This book offers a unique description of how phenomenology can help professionals from medical, environmental and social fields to explore notions such as interaffectivity, empathy, epoche, reduction, and intersubjective encounter. Written by a group of top scholars, it uniquely covers the relationship between phenomenology and bioethics, and focuses not only on medical cases, but also on the environment and emerging technologies. This variety of themes, whilst including techno-ethics, environmental ethics, animal ethics, and medical ethics, is conducive to appreciating broadly how phenomenology can improve our quality of our life. Despite its difficult themes, the book appeals to an audience of both academics and professionals who are willing to understand how to increase the quality of care in their professional field. Chapter 8 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.

In America, in direct response to indefinite delays on the national transplantation waitlists and an inadequate supply of organs, a growing number of terminally ill Americans are turning to international underground markets and coordinators or brokers for organs. Chinese inmates on death-row and the economically disadvantaged in India and Brazil are the often compromised co-participants in the private negotiation process, which occurs outside the legal process - or in the shadows of law. These individuals supply kidneys and other organs for Americans and other Westerners willing to shop and pay in the private process. This book contends that exclusive reliance on the present altruistic tissue and organ procurement processes in the United States is not only rife with problems, but also improvident. The author explores how the altruistic approach leads to a 'black market' of organs being harvested from Third World individuals as well as compelled donations from children and incompetent persons.

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.

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.

Case Analysis in Clinical Ethics is an eclectic review from a team of leading ethicists covering the main methods for analysing ethical problems in modern medicine. Anneke Lucassen, a clinician, begins by presenting an ethically challenging genetics case drawn from her clinical experience. It is then analysed from different theoretical points of view. Each ethicist takes a particular approach, illustrating it in action and giving the reader a basic grounding in its central elements. Each chapter can be read on its own, but comparison between them gives the reader a sense of how far methodology in medical ethics matters, and how different theoretical starting points can lead to different practical conclusions. At the end, Anneke Lucassen gives a clinician's response to the various ethical methods described. Practising clinical ethicists and students on upper level undergraduate and Master's degree courses in medical ethics and applied philosophy will find this invaluable.

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.

Clinical decisions in modern medical practice are increasingly influenced by ethical and legal issues, but few doctors have been formally trained in medical law and ethics, and are unsure of potential sources of accessible information, which leaves them exposed to public criticism and the threat of legal action. Perioperative medicine and critical care are, by their very nature, subjects in which issues of autonomy, dignity, consent, confidentiality, medical research, life and death decision making, and the rationing of health care resources are ever-present. This book provides a straightforward but comprehensive one-stop reference and should be essential reading for all medical and allied health care professionals who encounter ethicolegal problems during their management of patients.

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.

In this important collection of essays Dennis Thompson argues for a more robust conception of responsibility in public life than prevails in contemporary democracies. He suggests that we should stop thinking so much about public ethics in terms of individual vices (such as selfishness or sexual misconduct) and start thinking about it more in terms of institutional vices (such as abuse of power and lack of accountability). Combining theory and practice with many concrete examples and proposals for reform, these essays could be used in courses in applied ethics or political theory and will be read by professionals and graduate students in schools of political science, public policy, law, public health, journalism and business.

What role does ethics play in the practice of psychoanalysis and psychotherapy? For most of its history, psychoanalysis has viewed ethics as a "side issue" in clinical work-occasionally relevant, but not central to therapeutic action. In Psychoanalysis as an Ethical Process, Robert Drozek highlights the foundational importance of ethical experience in the therapeutic relationship, as well as the role that ethical commitments have played in inspiring what has been called the "relational turn" in psychoanalysis. Using vivid clinical examples from the treatment of patients with severe personality disorders, Drozek sketches out an ethically grounded vision of analytic process, wherein analyst and patient are engaged in the co-construction of an intersubjective space that is progressively more consistent with their intrinsic worth as human beings. Psychoanalysis can thus be seen as a unique vehicle for therapeutic and ethical change, leading to a dramatic expansion of agency, altruism, and self-esteem for both participants. By bringing our analytic theories into closer contact with our ethical experiences as human beings, we can connect more fully with the fundamental humanity that unites us with our patients, and that serves as the basis for deep and lasting therapeutic change. This book will be of interest to psychotherapists and psychoanalysts, as well as scholars in ethical theory and philosophy.

Posthumous reproduction refers to the procedure that enables a child to be conceived using the gametes of a dead person. Advances in reproductive technology mean it is now possible to assist in creating a life after you die, and in recent years the number of women who have attempted to get pregnant using posthumous reproduction has increased. However, the law in many jurisdictions has not put regulations in place to deal with the ethical and legal consequences that arise as a result of posthumous reproduction. This is the first book to exclusively focus on posthumous reproduction. The book comprehensively explores the legal and ethical issues surrounding posthumous reproduction in a number of jurisdictions including the US, Israel, the UK and France. The book looks at a number of issues including: ascertaining the wishes of the dead and protecting the reproductive rights of men who have deposited frozen sperm in clinics prior to their deaths; cases involving people who want to acquire fresh sperm from deceased or incompetent men and determining who should have the right to accept the sperm; identifying the parents of the posthumously conceived child; and discussing the need to promote the best interests of the child. The book critically examines the current laws that are in place and proposes additional regulations and policies in order to effectively regulate posthumous reproduction.

This Handbook provides a contemporary and research-informed review of the topics essential to clinical psychological assessment and diagnosis. It outlines assessment issues that cross all methods, settings, and disorders, including (but not limited to) psychometric issues, diversity factors, ethical dilemmas, validity of patient presentation, psychological assessment in treatment, and report writing. These themes run throughout the volume as leading researchers summarize the empirical findings and technological advances in their area. With each chapter written by major experts in their respective fields, the text gives interpretive and practical guidance for using psychological measures for assessment and diagnosis.

To reveal the concrete threats to personal autonomy in long-term care, George Agich's book offers a framework for developing an ethic of long-term care within the complex environment in which many dependent and aged people find themselves. Previously published as Autonomy and Long-term Care (Oxford, 1993), this revised edition in paperback has wide appeal among bioethicists and health care professionals.

This book is a companion to Clinical Ethics on Film and deals specifically with the myriad of healthcare ethics dilemmas. While Clinical Ethics on Film focuses on bedside ethics dilemmas that affect the healthcare provider-patient relationship, Healthcare Ethics on Film provides a wider lens on ethics dilemmas that interfere with healthcare delivery, such as healthcare access, discrimination, organizational ethics, or resource allocation. The book features detailed and comprehensive chapters on the Tuskegee Study, AIDS, medical assistance in dying, the U.S. healthcare system, reproductive justice, transplant ethics, pandemic ethics and more. Healthcare Ethics on Film is the perfect tool for remote or live teaching. It's designed for medical educators and healthcare professionals teaching any aspect of bioethics, healthcare ethics or the health sciences, including medical humanities, history of medicine and health law. It is also useful to the crossover market of film buffs and other readers involved in healthcare or bioethics.

The growth of evidence-based medicine has occurred against a backdrop of health care reform, managed care, cost containment, and quality improvement. Clinicians have been urged to adopt the rigors of science while remaining true to their 'clinical judgment'. This incisive book reviews the history and conceptual origins of evidence-based practice and discusses key ethical issues that arise in clinical practice, public health, and health policy. It is essential reading for all physicians, and practitioners in epidemiology and public health.

Obwohl der Gewissenbegriff im Bewusstsein der meisten Medizinethiker durch den Strukturwandel im Gesundheitswesen in den letzten Jahrzehnten erheblich an Bedeutung verloren hat, bahnt sich im Zuge der fortschreitenden Pluralisierung des Wertempfindens in modernen Gesellschaften (nicht zuletzt durch das Wiedererstarken religioes-weltanschaulicher Positionen) eine erneute Diskussion um den Gewissensvorbehalt bei der Erbringung medizinischer Leistungen an. Der vorliegende Band nahert sich der Gewissenthematik bewusst aus interdisziplinarer Perspektive, um die verschiedenen Dimensionen einer Gewissenentscheidung auszuleuchten und die Folgen der fortschreitenden Verrechtlichung und OEkonomisierung fur die Gewissensfreiheit der verschiedenen im Gesundheitswesen tatigen Berufsgruppen kritisch zu reflektieren.

In diesem Band wird die neue Verknupfung von literarischem Familienroman mit Diskursen der Neurowissenschaften und Gerontologie anhand von Demenz-Erzahlungen textologisch entfaltet. Nach einer Archaologie des deutschsprachigen Begriffs "Demenz" in allgemeinsprachlichen und medizinischen Nachschlagewerken werden literarische Texte zwischen Autobiografie und Psychothriller (von Arno Geiger, Helga Koenigsdorf, Tilman Jens, Roswitha Quadflieg, Martin Suter, Ulrike Draesner, J. Bernlef und Helene Cixous) bezuglich des genus als Geschlecht, Gender bzw. Genre untersucht. Zwischen wissenschaftlichem und literarischem Diskurs stoert "Demenz" die Wissens-Ordnungen der Moderne. Der Band zeigt in Demenz-Romanen der Gegenwart die Produktivitat des Nichtwissens von Demenz fur die literaturwissenschaftliche Forschung auf.

Many books discuss the ethical treatment of human subjects in behavioral research, yet few talk about the equally important ethical issues that arise when the data are being analyzed and the study is being written up. All researchers need to be aware of their professional responsibilities and make sound choices after the subjects have left. This practical and easy-to-follow guide walks readers through often overlooked decision points in the research process. Drawing from his extensive experience as a teacher of research methods and a senior editorial advisor, and from well-established standards of practice - including the APA Ethics Code - Harris Cooper is the ideal mentor in this process. Readers of this book will learn how to: Collect and manage data in a way that does not compromise the confidentiality of subjects Avoid data fraud and misleading data analysis Assign research responsibilities and authorships to team members Avoid committing plagiarism and intellectual theft Navigate the journal submission and publication process Post-publication ethical considerations are also addressed, including researchers' obligations when communicating their findings to the media and the general public, and when engaging with the scientific community as a peer reviewer.

Can trust be restored by making people and institutions more accountable? Or do complex systems of accountability and control damage trust? Onora O'Neill challenges current approaches, investigates sources of deception in our society and re-examines questions of press freedom. This year's Reith Lectures present a philosopher's view of trust and deception and ask whether and how trust can be restored in modern democracy.

One of the most difficult problems confronting clinicians and medical professionals today is the application of ethical principles to real decisions affecting patients. In this even-handed book, Clare Foster examines the three main approaches to moral decision-making: goal-based, duty-based, and rights-based. She discusses the underlying philosophical arguments behind each approach, examines their relative strengths and weaknesses, and indicates how they can actually be applied. Is it ethical to experiment with new cures on people who are probably dying? How do you assess quality of consent? This book provides a thorough, nonpartisan grounding in what the ethical principles are and what informs them.

This volume covers a wide range of topics concerning methodological, epistemological, and regulatory-ethical issues around pharmacology. The book focuses in particular on the diverse sources of uncertainty, the different kinds of uncertainty that there are, and the diverse ways in which these uncertainties are (or could be) addressed. Compared with the more basic sciences, such as chemistry or biology, pharmacology works across diverse observable levels of reality: although the first step in the causal chain leading to the therapeutic outcome takes place at the biochemical level, the end-effect is a clinically observable result-which is influenced not only by biological actions, but also psychological and social phenomena. Issues of causality and evidence must be treated with these specific aspects in mind. In covering these issues, the book opens up a common domain of investigation which intersects the deeply intertwined dimensions of pharmacological research, pharmaceutical regulation and the related economic environment. The book is a collective endeavour with in-depth contributions from experts in pharmacology, philosophy of medicine, statistics, scientific methodology, formal and social epistemology, working in constant dialogue across disciplinary boundaries.

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.

The existing literature in medical ethics does not serve the practical needs of medical students and trainees very well. Medical students or junior doctors often have their own set of ethical concerns and the dilemmas that arise are generally beyond their direct control. The editors have addressed the gap in the literature by compiling a series of case studies from around the world and inviting an international team of leading ethicists and clinicians to comment on them. This volume includes over 80 actual cases that cover the range of possible problems a medical trainee may encounter on the ward.