Ethics and Law in Modern Medicine is a unique book that explores the field of medical ethics and health care decision-making through hypothetical case studies. The truly unique feature of this volume is that each chapter sets forth a hypothetical fact pattern which includes role assignments to encourage participants to actively take part in group discussions and debate the controversial and cutting-edge topics that are presented. Each chapter includes in-depth discussion questions which thoroughly explore issues raised by the hypothetical fact patterns, and suggested readings provide background for participants. Additionally, the volume contains excerpts from key statutes and case law which govern the decision-making process presented in each chapter. The volume covers a wide variety of issues including HIV, the health care rights of minors, consent and confidentiality, assisted reproductive technology, property rights in bodily organs, research ethics, religious freedom and the right to refuse care, rationing of scarce resources, surrogate decision-making, and several other traditional as well as unique ethical, legal, and social issues.

Medicine in the United States is big business. We spend 50 percent more on health care per capita than other developed countries, but a multitude of measures indicate that we are not getting health-care value for our money. In Too Big to Succeed, author Dr. Russell J. Andrews details why health care in America has become more expensive but less effective and outlines a new paradigm for health-care delivery.

Too Big to Succeed describes how American medicine is on an unsustainable course: costs are increasing while benefits are deteriorating in comparison with other developed nations. Beginning with the Hippocratic Oath and the the premedical student, Andrews traces the myriad ways in which the profit motive has infiltrated American medicine--including medical school training, current models of health-care delivery, medical professional societies, medical research, and medical drug and device development.

Presenting an insider's look into the current crisis in health care, Andrews demonstrates that until both the physician and the patient return to the relationship that underlies medicine, physicians will not experience the joy of healing those who seek their help and patients will not appreciate that a good physician is a permanent part of their lives.

Patient autonomy is a much discussed and debated subject in medical ethics, as well as in healthcare practice, medical law, and healthcare policy. This book provides a detailed and nuanced analysis of both the concept of autonomy and the principle of respect for autonomy, in an accessible style. The unique feature of this book is that it combines empirical research into hospital practice with thorough philosophical analyses. As such, it is an example of a new movement in applied ethics, that of 'empirical ethics'.

The key themes are informed consent and medical decision making, personal well-being, competence, paternalism and decision making for incompetent patients. Much attention is also devoted to autonomy in non-decision making situations - patient control over small everyday aspects of care, authenticity and existential aspects of illness, autonomy and the 'ethics of care', and the relationship between autonomy and trust in the physician-patient relationship.

This book will be of interest to those working or studying in the field of medical ethics and applied ethics but also to healthcare professionals and health policy makers.

Doctors and Rules is a unique and immensely scholarly book. It draws on material which has informed our civilization, including many of the social sciences-history, sociology, and psychology, as well as law. The author accesses the current importance of the Hippocratic tradition within medicine, and puts forward various models of its practice. He seeks to expose the often inarticulated foundation of contemporary debates about the law, medicine, and health, and to question some common assumptions of the functionsand structures of social and legal order. The book challenges the idea that legal rules should be respected merely because they exist and because they play a part in centralizing the organization of society. It rejects the notion that the courts always, or even often, offer useful mechanisms for defining and settling disputes. On the contrary, the author sees in their formalism many things which hinder the common cause of humanity. Only a skeptic trained in law but also deeply concerned by our fate and circumstances could have produced it. It also contributes both to the sociology of law and the sociology of medicine. Out of a reassertion of old ways, this book presents a new blueprint for future professional conduct. It is rich in questions and ideas for researchers, teachers, and professionals in the fields of law, medical sociology, and medicine and generally for those concerned with the place of professional conduct.

Leading physicians and scientists from around the world critically examine the pharmacological and molecular basis of the therapeutic properties of marihuana and its active ingredient, THC. They detail the broad array of marihuana's effects on brain function, the immune system, male and female reproductive functions, and cardiac and pulmonary functions, as well as evaluate its clinical applications in psychiatry, glaucoma, pain management, cancer chemotherapy, and AIDS treatment. Their studies indicate that marihuana persistently impairs the brain and reproductive function, and that marihuana smoke is more toxic and damaging to the lung than tobacco smoke. Marihuana and Medicine's reports of the latest findings on the pharmacological and molecular mechanisms of marihuana and of its clinical manifestations will be essential reading for physicians, psychiatrists, pharmacologists, health-care professionals, policy makers, public health officials, and attorneys.

This book explores the development of hybrid corn, the history of eugenics, human genetics, the nature-nurture debate, the origins of the Marxian concept of proletarian science, the shift in the meaning of "fitness" in evolutionary theory, the practice of normal science in Nazi Germany, and the making and selling of science textbooks. While the topics are diverse, a common theme unites them -- each explores links between biological science, social power, and public policy.

Andrew Thompson, Norman J. Temple We humans are an extraordinary species. One of our finest achievements is the development of morality, of a sense of right and wrong. We articulate and then impose this sensitivity upon ourselves in the form of ethical guidelines, rules, regulations, and laws. We have, regrettably, also developed marvelously clever ways of justifying our behavior whenever it runs afoul of these prescriptions. We have, for example, developed the concept of objectivity to guide scientific pursuits and subsequently established rights which undermine the possibility of ever coming close to attaining the goal of being objective -- rights which entitle participating scientists to gain personal, tangible profits from scientific discoveries. Formerly, we envisaged gods who kept us in place, who reminded us that we were not all-powerful or especially wise. Now we tend to worship our achievements, especially our technological ones, and ourselves. Mary Midgley' aptly names this phenomenon, "humanolatry." We have lost our respect for nature in our enthusiasm for changing it to that which suits our shortsighted ends. We must, as she says, "unlearn" this way of thinking.

Decisions at the End of Life is the last volume in a trilogy on Aging conceived for the International Library of Ethics, Law, and the New Medicine. Leading scholars from a range of disciplines examine some of the most emotive topics in the study of aging: assessing quality of life, improving end-of-life care, palliative care, euthanasia, and consent to research.

The present volume is the result of a conference devoted to the topic of Rationing in Medicine, which was organized by the Europäische Akademie zur Erforschung von Folgen wissenschaftlich-technischer Entwicklungen Bad Neuenahr-Ahrweiler GmbH. One of the purposes of this volume is to contribute to a clarification of the concept of rationing and its possible implementations and thereby to help the participants in the debate to avoid further unnecessary confusion. Authors from the disciplines of medicine, philosophy, economics and law as well as practitioners of health care itself and from the field of health-care financing have contributed to this volume.

Positive conceptions of healthy aging are rightly displacing negative ageist perceptions of older members of our society. Nevertheless, at some stage, most elderly citizens will require some form of assistance from other members of society. When the body or mind begins to fail, a legitimate need for intervention and care will arise. This second volume on Aging discusses this theme.

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.

This fifth edition of Where Medicine Fails, like previous editions, argues for a broader definition of society's responsibilities to the ill than is commonly perceived to be the case. The authors examine the moral and economic implications of medical technology, especially in regard to fetal tissue transplant, cancer survival, childbirth, and dying, and provide a thoughtful assessment of the issues and challenges facing American hospitals. Seventeen chapters are new to this edition. The aim of this volume is to encourage serious examination of the current structure of health services and of the complicated facets of health care reform.

In this book, Carl Elliott draws on philosophy and psychiatry to develop a conceptual framework for judging the moral responsibility of mentally ill offenders.

Develop a practical and comprehensive view of professional ethics In the newly updated Second Edition of Positive Ethics for Mental Health Professionals: A Proactive Approach, distinguished psychologists Drs. Sharon K. Anderson and Mitchell M Handelsman deliver an insightful guide for mental health professionals and trainees to stregthen and/or develop their professional and ethical identities. Utilizing the same informal and inviting tone of the first edition, Anderson and Handelsman share the literature and provide positive discussions, exercises, case scenarios, and writing assignments, to help you explore and develop your ethical core. You'll also develop your self-reflective skills to learn how to make excellent ethical choices regarding psychotherapy and couseling. This edition of the book also offers: An introduction of the idea of "tripping points", or predictable pitfalls, when making ethical choices. Discussions of nonrational factors in ethical decision-making, including biases, heuristics, and emotional influences. A renewed focus on ethical acculturation, which emphasizes the importance of your own background in the development of your ethical identity. Perfect for undergraduate and graduate students studying psychotherapy and mental health counseling, Positive Ethics for Mental Health Professionals, will also earn a place in the libraries of mental health practitioners seeking a primer on the complicated ethical issues that inevitably arise in their practices- and how to prepare for them and navigate them.

The question of whether a young woman should be allowed to terminate a pregnancy without her parents' knowledge has been one of the most contentious issues of the post Roe v. Wade era. Parental involvement laws reach to the core of the parent-teen relationship in the highly contested realm of adolescent sexuality. This is the first book to examine in thorough detail the decision-making experiences of teens considering abortion. Shoshanna Ehrlich evaluates the Supreme Court's efforts to reconcile the historically based understanding of teens as dependent persons in need of protection with a more contemporary understanding of them as autonomous individuals with adult-like claims to constitutional recognition. Arriving at a compromise, the Court has made clear that, like adult women, teens have a protected right of choice, but that states may impose a parental involvement requirement. However, so that parents are not vested with veto power over their daughters' decisions, young women must be allowed to seek a waiver of the requirement. Integrating a wealth of social science literature, including in-depth interviews with 26 young women from Massachusetts who obtained court authorization for an abortion, the book raises important questions about the logic of a legal approach that requires young women to involve adults when they seek to terminate a pregnancy, but that allows them to make a decision to become mothers on their own.

Bioethicists, moral philosophers and social policy analysts have long debated about how we should decide who shall be saved with scarce, lifesaving resources when not all can be saved. It is often claimed that it is fairer to save younger persons and that age is an ethically relevant consideration in such tragic decisions. Medical benefit should be maximized and final selection should aim to minimize the contaminating influence of chance. These claims are challenged by Duff R. Waring in Medical Benefit and the Human Lottery, one of the few books that attempts a sustained defence of random patient selection.

This book combines ethics and political philosophy in its novel and strict egalitarian approach to patient selection for transplantable organs. Waring addresses the question of whether we should choose between lives on the basis of fair chances or best outcomes. He argues that final selection criteria should be based on fair chances that equalize opportunity as opposed to best outcomes. His defence of "hardy" egalitarianism aims to show that random selection by lottery can affirm both a common humanity and the equal value of lives. The notion of patient selection by lottery has not fared well in bioethics and has been regarded by some as a moral affront. Waring argues that a human selection lottery may be neither as crude nor as ethically anomalous as some have supposed. Indeed, it can reflect a familiar conception of equality as a political and moral ideal. This conception abstracts from many undeniable differences between patients and claims that scarce resources should be allocated on the principled assumption that each of their lives is equally worth saving. The book isalso notable for its critiques of some recent utilitarian notions of medical benefit which can have an age-biased impact on elderly patients. Waring then argues against the leading, contemporary age-based approaches to patient selection. He explores the way random selection by lottery can affirm his egalitarian ethos in cases where eligible transplant candidates have each passed a threshold level of prospective medical benefit that has been set by democratic deliberation. Taming chance with a human lottery is defended as the most lucid means of ensuring equal opportunity. In so doing, Waring argues that we give the principle of equal concern and respect a radical expression: above a noncomparative threshold of medical benefit, each candidate can have an equal claim to life.

Can medical ethics be legislated? Can a complex bioethical question be definitively answered through legislation? In July 1987 the New York State legislature experimented with legislating medical ethics by amending the state's public health law to regulate Do Not Resuscitate' orders. The consequent law was complex and remains controversial. This volume reviews both the background bioethical debates and the elements of the public policy making process that are essential to understanding New York's experience with the DNR law. It features debates between leading exponents and critics of the law; case studies that examine the impact of New York's DNR law on clinicians, hospitals and patients; and a review of all empirical studies of the law by their lead authors. Appended to the volume is the New York State DNR law and a comprehensive set of background documents. The co-editors, Robert Baker and Martin A. Strosberg, are both professors at Union College, Schenectady, New York. They have collaborated on many projects including, Rationing America's Medical Care: The Oregon Plan and Beyond (Brookings, 1992).

According to popular belief, technical skill is far more important for surgeons than thoughtful deliberation. Nothing could be further from the truth. Although surgeons must sometimes make decisions rapidly on the basis of incomplete evidence and must respond to unexpected catastrophes in the operating room rapidly, those events are intermittent - most of the time surgeons deliberate on diagnostic problems and thoughtfully manage postoperative care, which is often intellectually challenging. The relationship of surgeons with their patients is, in a real sense, far more intimate and trusting than that of any other professional, a claim that is supported by the fact that patients surrender their bodies to their surgeons in a state of total helplessness and vulnerability when they undergo anesthesia. Because of that responsibility, no other professional group has a greater sense of dedication to the welfare of their patients than surgeons. Surgical culture is deeply steeped in ethics, and surgeons confront and resolve ethical dilemmas as much or more than most other professionals, although they often may not recognize the situations they resolve are problems in ethics - they are just part of the daily routine. This book is a compendium of articles from the recent surgical literature that address ethical issues chosen by surgeons because they are controversial and pertinent to the practice of surgery. The reader will not find a great deal of sophisticated dissection of fine philosophical distinctions in these discussions of ethical conflicts and controversies in surgery. Instead, they will discover differing viewpoints from thoughtful essayists, mostly surgeons, whose feet are firmly in contact with the ground and who have extensive experience in the real world of surgery, medicine, and law.

The question of whether there might be a duty to die was first raised by Margaret Battin in 1987 in her ground-breaking essay, "Age Distribution and the Just Distribution of Health Care: Is There a Duty to-Die?" In 1997 the issue was reprised when two new articles appeared on the topic written by John Hardwig and the other by former Colorado Governor Richard D. Lamm. Given the renewed interest in the topic, as well as its undeniable importance, Biomedical Ethics Re views sought to initiate an in-depth discussion of the issue by soliciting articles and issuing a general call for papers on the topic "Is There a Duty to Die?" The twelve articles in this volume represent the ultimate fruits of those initiatives. The first seven essays in this text are sympathetic to the claim that there is a duty to die. They argue either: (a) that some form of a duty to die exists, or (b) that arguments that might be offered against the existence of such a duty cannot be sustained. By way of contrast, the last five articles in the text are critical of duty-to-die claims: The authors of the first three of these five articles attempt to cast doubt on the existence of a duty to die, and the writers of the last two essays argue that if such a duty did exist, severe problems would arise when ever we attempted to implement it."

Should parents aim to make their children as normal as possible to increase their chances to "fit in"? Are neurological and mental health conditions a part of children's identity and if so, should parents aim to remove or treat these? Should they aim to instill self-control in their children? Should prospective parents take steps to insure that, of all the children they could have, they choose the ones with the best likely start in life? This volume explores all of these questions and more. Against the background of recent findings and expected advances in neuroscience and genetics, the extent and limits of parental responsibility are increasingly unclear. Awareness of the effects of parental choices on children's wellbeing, as well as evolving norms about the moral status of children, have further increased expectations from (prospective) parents to take up and act on their changing responsibilities. The contributors discuss conceptual issues such as the meaning and sources of moral responsibility, normality, treatment, and identity. They also explore more practical issues such as how responsibility for children is practiced in Yoruba culture in Nigeria or how parents and health professionals in Belgium perceive the dilemmas generated by prenatal diagnosis.

In this original and compelling book, Jeffrey P. Bishop, a philosopher, ethicist, and physician, argues that something has gone sadly amiss in the care of the dying by contemporary medicine and in our social and political views of death, as shaped by our scientific successes and ongoing debates about euthanasia and the "right to die"-or to live. The Anticipatory Corpse: Medicine, Power, and the Care of the Dying, informed by Foucault's genealogy of medicine and power as well as by a thorough grasp of current medical practices and medical ethics, argues that a view of people as machines in motion-people as, in effect, temporarily animated corpses with interchangeable parts-has become epistemologically normative for medicine. The dead body is subtly anticipated in our practices of exercising control over the suffering person, whether through technological mastery in the intensive care unit or through the impersonal, quasi-scientific assessments of psychological and spiritual "medicine." The result is a kind of nihilistic attitude toward the dying, and troubling contradictions and absurdities in our practices. Wide-ranging in its examples, from organ donation rules in the United States, to ICU medicine, to "spiritual surveys," to presidential bioethics commissions attempting to define death, and to high-profile cases such as Terri Schiavo's, The Anticipatory Corpse explores the historical, political, and philosophical underpinnings of our care of the dying and, finally, the possibilities of change. This book is a ground-breaking work in bioethics. It will provoke thought and argument for all those engaged in medicine, philosophy, theology, and health policy.

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Medical experimentation on human subjects during the Third Reich raises deep moral and ethical questions. This volume features prominent voices in the filed of bioethics reflecting on a wide rang of topics and issues. Amid all contemporary discussions of ethical in science, many ethicists, historians, Holocaust specialists and medical professionals strongly feel that we should understand the past in order to make more enlightened ethical decisions.

In general, the history of virtue theory is well-documented (Sherman, 1997; O'Neill, 1996). Its relationship to medicine is also recorded in our work and in that of others (Pellegrino and Thomasma, 1993b; 1996; Drane, 1994; Ellos, 1990). General publications stress the importance of training the young in virtuous practices. Still, the popularity of education in virtue is widely viewed as part of a conservative backlash to modern liberal society. Given the authorship of some of these works by professional conservatives like William Bennett (1993; 1995), this concern is authentic. One might correspondingly fear that greater adoption of virtue theory in medicine will be accompanied by a corresponding backward-looking social agenda. Worse yet, does reaffirmation of virtue theory lacquer over the many challenges of the postmodern world view as if these were not serious concerns? After all, recreating the past is the "retro" temptation of our times. Searching for greater certitude than we can now obtain preoccupies most thinkers today. One wishes for the old clarity and certitudes (Engelhardt, 1991). On the other hand, the same thinkers who yearn for the past, like Engelhardt sometimes seems to do, might stress the unyielding gulf between past and present that creates the postmodern reaction to all systems of Enlightenment thought (1996).