A wide variety of ambitions and measures to slow, stop, and reverse phenomena associated with aging have been part of human culture since early civilization. From alchemy to cell injections to dietary supplements, the list of techniques aimed at altering the processes of aging continues to expand. Charlatans, quacks, and entrpreneurs proffering anti-aging products and practices have always exploited uniformed customers and instilled doubt and apprehension toward practices intended to extend life. Recently, however, the pursuit of longevity has developed into a respectable scientific activity. Many biologists are substantially funded by the government and the private sector to conduct research that they believe will lead to effective anti-aging interventions.
While many embrace this quest for "prolongevity"--extended youth and long life--others fear its consequences. If effective anti-aging interventions were achieved, they would likely bring about profound alterations in the experiences of individual and collective life. What if aging could be decelerated to the extent that both average life expectancy and maximum life span would increase by forty percent? What if all humans could live to be centenarians, free of the chronic diseases and disabilities now commonly associated with old age? What if modern scientists could find the modern equivalent to the Fountain of Youth that Ponce de Leon sought?
This book addresses these questions by exploring the ramifications of possible anti-aging interventions on both individual and collective life. Through a series of essays, it examines the biomedical goal of prolongevity from cultural, scientific, religious, and ethical perspectives, offering a sweeping view into the future of aging.

This book offers a comprehensive roadmap for determining when and how to regulate risky reproductive technologies on behalf of future children. First, it provides three benchmarks for determining whether a reproductive practice is harmful to the children it produces. This framework synthesizes and extends past efforts to make sense of our intuitive, but paradoxical, belief that reproductive choices can be both life-giving and harmful. Next, it recommends a process for reconciling the interests of future children with the reproductive liberty of prospective parents. The author rejects a blanket preference for either parental autonomy or child welfare and proposes instead a case-by-case inquiry that takes into account the nature and magnitude of the proposed restrictions on procreative liberty, the risk of harm to future children, and the context in which the issue arises. Finally, he applies this framework to four past and future medical treatments with above average risk, including cloning and genetic engineering. Drawing lessons from these case studies, Peters criticizes the current lack of regulatory oversight and recommends both more extensive pre-market testing and closer post-market monitoring of new reproductive technologies. His moderate, pragmatic approach will be widely appreciated.

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.

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.

No developed nation relies exclusively on the private sector to finance health care for citizens. This book begins by exploring the deficiencies in private health insurance that account for this. It then recounts the history and legal character of America's public health care entitlements - Medicare, Medicaid, and tax subsidies for employment-related health benefits. These programs are increasingly embattled, attacked by those advocating privatization (replacing public with private insurance), individualization (replacing group and community-based insurance with approaches based on individual choice within markets) and devolution (devolving authority over entitlements to state governments and to private entities).

The book critically analyzes this movement toward disentitlement. He also examines the primary models for structuring health care entitlements in other countries - general taxation-funded national health insurance and social insurance, and considers what we can learn from these models. The book concludes by describing what an American entitlement-based health care system could look like, and in particular how the legal characteristics of our entitlement programs could be structured to support the long-term sustainability of these vital programs.

The concept of reproductive health promises to play a crucial role in improving health care provision and legal protection for women around the world. This is an authoritative and much-needed introduction to and defence of the concept of reproductive health, which though internationally endorsed, is still contested. The authors are leading authorities on reproductive medicine, women's health, human rights, medical law, and bioethics. They integrate their disciplines to provide an accessible but comprehensive picture. They analyse 15 cases from different countries and cultures, and explore options for resolution. The aim is to equip readers to fashion solutions in their own health care circumstances, compatibly with ethical, legal and human rights principles.

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 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.

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.

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.

In this book, the authors discuss cord blood banks and banking, the ethical issues involved and the risks and benefits. Topics include the virological risks and benefits of cord blood banking; mesenchymal stem cells and their role in regenerative medicine applications; osteogenic potential of human umbilical cord-derived mesenchymal stromal cells; public versus private cord blood banking; CCR5 deficient cord blood as a means of treatment for HIV-1 infection; and the therapeutic use of umbilical cord blood.

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.

This volume brings together an unusually broad range of experts from reproductive medicine, medical ethics, and law to address the important ethical problems in maternal-fetal medicine which impact directly on clinical practice. The book is divided into parts by the stages of pregnancy, within which the authors cover four main areas: the balance of power in the doctor-patient relationship and the justifiable limits of paternalism and autonomy; the impact of new technologies and new diseases; disability and enhancement; and difference--to what extent should the clinician respect the tenets of other faiths in a multicultural society.

Das geltende Transplantationsrecht wirft neue Probleme an den Grenzen des Lebens auf. 1st der Himtod allgemeinverbindlich als juristischer Tod des Menschen anzuerkennen oder spielt er nur als formelles Entnahmekriterium eine Rolle? Konnte auch ein Teilhirntodkriterium als sicheres Todeszeichen anerkannt werden? Die Arbeit ist eine Suche nach verbindlichen Richtlinien insbesondere am Lebensende in Form einer juristischen Todesdefinition. Dabei wird im Rahmen der Sterbehilfediskussion die Frage untersucht, ob das Leben naturnotwendig als das hochste Gut angesehen werden mub, oder ob dem Selbstbestimmungsrecht moglicherweise der hohere Rang gebuhrt. Welche Antworten konnen Lebensrecht und Menschenwurde auf die Frage geben, ob Embryonen bei der Gewinnung von Stammzellen zu Forschungszwecken verbraucht werden durfen oder nicht? All diese offenen Fragen fuhren im Grunde zu der einen: Wie sicher ist das Strafrecht an den Grenzen des Lebens? Aus dem Inhalt: Strafrechtssicherheit an Lebensbeginn und Lebensende - Organtransplantation, Sterbehilfe, Embryonenforschung - Was ist der Mensch im Spannungsfeld von Lebensschutz, Selbstbestimmungsrecht und Menschenwurde im Zeitalter von Reanimations-, Transplantationsmedizin und Humanexperiment?

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

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.

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.

The possibility that human beings may soon be cloned has generated enormous anxiety and fueled a vigorous debate about the ethics of contemporary science. Unfortunately, much of this debate about cloning has treated cloning as singular and revolutionary. The essays in Cloning and the Future of Human Embryo Research place debates about cloning in the context of reproductive technology and human embryo research. Although novel, cloning is really just the next step in a series of reproductive interventions that began with in vitro fertilization in 1978. Cloning, embryo research, and reproductive technology must therefore be discussed together in order to be understood. The authors of this volume bring these topics together by examining the status of preimplantation embryos, debates about cloning and embryo research, and the formulation of public policy. The book is distinctive in framing cloning as inextricably tied to embryo research and in offering both secular and religious perspectives on cloning and embryo research.

In Morality, Mortality, Volume II, Kamm continues to explore questions of life and death as illustrations of general issues in moral theory. Resuming her development of non- consequentialist ethical theory and its application to practical ethical problems, she explores the distinction between killing and letting die, between harming and not aiding, and between intending and foreseeing harm. Throughout this examination, she focues on the methodology used in analyzing these questions. Kamm develops a principled account of when harming some to save others is permissable and impermissable. In the process, she discusses the "Survival Lottery and Trolley Problem," and other related dilemmatic situations.

Many people do not realize that the Germans were methodically killing fellow Germans before they were killing Jews, gypsies, and dissidents. 'Action T4' was a medical program that quietly whisked disabled and mentally ill people for extermination. Germans of all ages were targeted. Hundreds of thousands received 'treatment.' Fewer people know that the philosophical foundations for the Nazi actions were laid many years earlier, even before the National Socialist party was created. In a sober, academic discussion, professors Karl Binding and Alfred Hoche argued that there were 'lives unworthy of life' and for the good of society, and indeed, out of compassion for the worthless individuals, such people could be ethically killed. Binding and Hoche's book was a turning point in German culture and served as a catalyst for the T4 program, which itself was a precursor to the Holocaust. In this new translation by Dr. Cristina Modak, commissioned by the Policy Intersections Research Center, readers are able to examine the philosophical basis that Germany's doctors relied on in the 1920s and 1930s. A foreword by PIRC's director prompts the reader to consider just how far away modern medical ethics is from Binding and Hoche's arguments.

Historically and across societies people with disabilities have been stigmatized and excluded from social opportunities on a variety of culturally specific grounds. In this collection, the authors explore the impact that the philosophical framing of disability can have on public policy questions, in the clinic, in the courtroom, and elsewhere. They examine the implications of this understanding for legal and policy approaches to disability, strategies for allocating and accessing health care, the implementation of the Americans with Disabilities Act, health care rights, and other legal tools designed to address discrimination. This volume should be read by anyone seeking a balanced view of disability and an understanding of the connection between the framing of disability and policies that have a real-world impact on individuals.

The majority of patients in need of organ transplants do not survive long enough for a suitable human organ to become available. Xenotransplantation, the transplant of animal organs into humans, has attracted substantial media attention. If, as appears likely, it proves possible to "humanize" animal organs and evade the problems of rejection, in the coming few years there will be a tremendous increase in this procedure, mostly using organs from animals specifically for their harvestable organs. This book will lay out the potential and promise of the technique, the history of organ transplantation, the technical problems and breakthroughs in overcoming immune rejection, and typing and humanizing donor organs for transplantation. The ethical question of growing animals specifically for organ harvest, and the substantial public health concern from the certainty that animal viruses will pass into humans with the donated organs, will be fully discussed. The authors are among the leaders in the field of Xenotransplantation.

Mary Anne Warren investigates a theoretical question that is at the centre of practical and professional ethics: what are the criteria for having moral status? That is: what does it take to be an entity towards which people have moral considerations? Warren argues that no single property will do as a sole criterion, and puts forward seven basic principles which establish moral status. She then applies these principles to three controversial moral issues: voluntary euthanasia, abortion, and the status of non-human animals.