Daniel Callahan---whose cofounding of The Hastings Center in 1969 was one of the most important milestones in the history of bioethics--has written on an uncommonly wide range of issues over a long career. They have moved back and forth between clinical care of individual patients and the ethical problems of health care research and delivery. Through his many writings, four core problems have recurred in all of his work, and influence each of the others. What is health and how has its understanding been shaped by medical progress and the culture of medicine and society? What is progress, a deep value in modern health care and how should we judge it? What kinds of technological innovations that come out of the drive for progress are really good for us-and what do we do when there is a clash between individual good and social good in the use of expensive technologies, a problem now evident in the unsustainable high costs of health care? How should our understanding of the place of an inevitable death in all our lives, and its place in medicine, help us to better think of the goals of medicine and the goals of our life in seeking a good death? Those four questions have been with bioethics from its beginning and will remain with it for the indefinite future. They are the roots of bioethics.

This work sets the stage regarding debates about paternalism and health care for years to come. The anthology is organized around four parts: i) The concept of paternalism and theoretical issues regarding the idea of anti-paternalism, ii) strategies for justifying different forms of paternalism, iii) paternalism in psychiatry and psychotherapy, iv) paternalism and public health, and v) paternalism and reproductive medicine. Medical paternalism was arguably one of the main drivers of debates in medical ethics and has led to a wide acknowledgement of the value of patient autonomy. However, more recent developments in health care, such as the increasing significance of public health measures and the commercialization of medical services, have led to new social circumstances and hence to the need to rethink issues regarding paternalism. This work provides an invaluable source for many scholars and practitioners, since it deals in new and original ways with one of the main and oldest issue in health care ethics.

This book explores implicit choices made by researchers, policy makers, and funders regarding who benefits from society's investment in health research. The authors focus specifically on genetic research and examine whether such research tends to reduce or exacerbate existing health disparities. Using case examples to illustrate the issues, the authors trace the path of genetics research from discovery, through development and delivery, to health outcomes. Topics include breast cancer screening and treatment, autism research, pharmacogenetics, prenatal testing, newborn screening, and youth suicide prevention. Each chapter emphasizes the societal context of genetic research and illustrates how science might change if attention were paid to the needs of marginalized populations. Written by experts in genetics, health, and philosophy, this book argues that the scientific enterprise has a responsibility to respond to community needs to assure that research innovations achieve much needed health impacts.

A growing number of both established and newly developed doctoral programs are focusing on the preparation of practitioners rather than career researchers. Professional doctorates such as the Doctor of Nursing Practice (DNP), Doctor of Education (EdD), Doctor of Pharmacy (PharmD), Doctor of Professional Studies (DProf or DPS), and the Doctor of Psychology (PsyD) are, in fact, just a few of the professional doctorates being offered today. Professional doctorates are the fastest growing segment of doctoral education. The nature of the dissertation and the process of completing a dissertation can be quite different in a professional practice doctoral program but there are few resources for both students and faculty involved in completing and mentoring such dissertations. This book was written specifically for students and faculty involved in professional practice dissertation work. It addresses both the tasks and procedures that professional practice dissertations have in common with dissertations in ""research"" doctoral programs as well as the tasks and issues that are more common in professional practice doctoral programs. For example, negotiating entry into applied settings and securing the cooperation of practicing professionals is covered, as are alternative models for the dissertation (e.g., the ""three article dissertation"" or ""TAD""). The book also covers tasks such as getting IRB approval for applied dissertation research conducted in the field and how to propose and carry out studies based on applied and professional models of research. This book, written by three experienced mentors of professional practice dissertation students, is the comprehensive guide for both students and faculty. --This text refers to the Paperback edition.

This volume focuses on the ethical and philosophical issues that arise in an aging society, and the implications of these issues for healthcare and social policy. After a brief overview of biomedicine's changing approach of ageing and longevity and of the new expectations that these changes generate, various ethical, social, and policy issues that surround aging and longevity are discussed. First, the images and social meanings of aging and old age in our society are explored, including their normative dimensions and implications for policy. Next, ethical issues in the care for frail elderly are discussed, as well as notion of good care and end-of-life decisions. Finally, the ethical and social implications of emerging possibilities for anti-aging and lifespan extension are considered. The book concludes with an overview of the relevance of the issues discussed for policy making on professional, national and international levels. "

Mainstream philosophical discussions of ethics usually involve either a search for a problem-solving theory (such as utilitarianism), or an exploration of ontological status (of things like obligations or reasons). This book will argue that such efforts are often misplaced. Instead, the proper starting point should always be the actual words and deeds of ordinary people in ordinary disagreements; for the ethical concepts in play can only derive their full meaning within the context of ordinary human lives. This will require a better understanding of the 'ordinary', and of what it means to lead a life.

"The Advances in Bioethics" series is devoted to publishing collections of original papers and multi-authored volumes that advance the field of bioethics either by exploring new areas, or by taking new approaches to traditional areas. Although the series is published in English, its scope is international, and manuscripts are welcome from authors throughout the world. This volume adopts a more personal view of bioethics by examining the physician. It discusses character formation, ethics, professional character, and other concepts and addresses the interpersonal aspects of physicians as well as the importance of character.

The outsourcing of clinical trials to Latin America by the transnational innovative pharmaceutical industry began about twenty years ago. Using archival information and field work in Argentina, Brazil, Costa Rica, Mexico and Peru, the authors discuss the regulatory contexts and the ethical dimensions of human experimentation in the region. More than 80% of all clinical trials in the region take place in these countries, and the European Medicines Agency has defined them as priority countries in Latin America. The authors raise questions about the quality of data obtained from the trials and the violation of human rights during their implementation. Their findings are presented in this volume, the first in-depth analysis of clinical trials in the region.

aCahn explores the relationships that underpin artificial reproductive technology: parenting, donating, and becoming (those who are the children brought to life through this process). . . . Much about assisted reproduction are the relationships that are fostered and challenged by the use of the technology, whether donor to potential parent, potential parent to state, surrogate to intended mother, or embryo to clinic, and after it is all adone, a child to parent.a
--Michele Goodwin, author of "Black Markets: The Supply and Demand of Body Parts"

The birth of the first test tube baby in 1978 focused attention on the sweeping advances in assisted reproductive technology (ART), which is now a multi-billion-dollar business in the United States. Sperm and eggs are bought and sold in a market that has few barriersto its skyrocketing growth. While ART has been an invaluable gift to thousands of people, creating new families, the use of someone elseas genetic material raises complex legal and public policy issues that touch on technological anxiety, eugenics, reproductive autonomy, identity, and family structure. How should the use of gametic material be regulated? Should recipients be able to choose the abesta sperm and eggs? Should a child ever be able to discover the identity of her gamete donor? Who can claim parental rights?

Naomi R. Cahn explores these issues and many more in Test Tube Families, noting that although such questions are fundamental to the new reproductive technologies, there are few definitive answers provided by the law, ethics, or cultural norms. The regulatory void outside of minimal requirements for gametic testing and limited protection against deceptivemarketing techniques used by fertility clinics creates thorny problems for all involved in the egg and sperm business.

As a new generation of adonor kidsa comes of age, Test Tube Families calls for better regulation of ART. It exhorts legal and policy-making communities to cease applying piecemeal laws and instead create laws that sustain the fertility industry, yet protect the interests of donors, recipients, and the children that result from successful transfers.

Incorporating real-life stories to illustrate her arguments, Cahn provides specific suggestions for legal reforms. The book sets out a series of controversial proposals, including an end to donor anonymity and a plea for states to clarify parentage decisions. She also calls for the federal government to regulate ART processes to ensure that donors are adequately protected against exploitation, that recipients receive the gametes they have been promised, and that the market functions ethically as well as efficiently.

Human information and communication technology (ICT) implants have developed for many years in a medical context. Such applications have become increasingly advanced, in some cases modifying fundamental brain function. Today, comparatively low-tech implants are being increasingly employed in non-therapeutic contexts, with applications ranging from the use of ICT implants for VIP entry into nightclubs, automated payments for goods, access to secure facilities and for those with a high risk of being kidnapped. Commercialisation and growing potential of human ICT implants have generated debate over the ethical, legal and social aspects of the technology, its products and application. Despite stakeholders calling for greater policy and legal certainty within this area, gaps have already begun to emerge between the commercial reality of human ICT implants and the current legal frameworks designed to regulate these products. This book focuses on the latest technological developments and on the legal, social and ethical implications of the use and further application of these technologies.

The research field of biobanks and tissue research is highly promising. Many projects around the globe are involved in the collection of human tissue and health data for research purposes. These initiatives are driven by the perspective of decisive breakthroughs in the knowledge of the genetic pathways involved in widespread diseases. However, there are considerable ethical and legal challenges to be considered as well. These challenges encompass the use of body material for research purposes, the misuse of genetic and other health data by third parties, trust in science and medicine, concerns regarding privacy, use of genetic data for forensic applications by the state and the police, and regulatory issues. This volume is divided into three parts: the inclusion of the public, the rights of donors and patients, examples and recommendations for the future of tissue research. It presents a comprehensive overview of the most important topics in the field by renowned scholars in medical ethics and biolaw.

This book departs from the usual principles-based approach and instead takes a predominantly consequentialist (harms and benefits) approach. It aims to be free of abstract philosophy, but will use the analysis of cases and a reasoned approach to examine alternative arguments. Whilst the book deals with issues in some depth it uses plain language and many clear examples of good and less good practice to illustrate points. It is at a level useful to both beginning and more experienced researchers.Real world approach Covers research governance from an international perspective Practical guidance on ethical committee procedures Direct examples of good and less good practice Clear, outcomes-based approach

This is a valuable, up-to-date, and newly revised collection of articles by noted experts to address all aspects of the stem cell controversy.

After the Nancy Cruzan case was decided by the Supreme Court in 1990, and ultimately resolved by the Courts of the State of Missouri, the decision to withhold or withdraw life-prolonging nutrition and hydration appeared to many to be as noncontroversial as decisions to refuse respirators or dialysis. Even the Catholic Church held that, although there should be a presumption in favor of providing nutrition and hydration, the patient or the patient's surrogate could overrule this presumption, if either believed the treatment was disproportionate or burdensome. The Schiavo case changed all that. Although the decision to remove Terri Schiavo's nutrition and hydration was made by her husband - her legal surrogate - based on his wife's belief that such treatment was disproportionate, Schiavo's immediate family protested so much that the case took years to resolve. It eventually involved all branches of government at both the state and federal levels. The ethical dilemmas that such cases pose continue to stir great controversy. This in-depth examination of these dilemmas provides information and documentation from many perspectives. The editors have included a foreword by Dr. Jay Wolfson, Terri Schiavo's court-appointed guardian ad litem, as well as Dr. Wolfson's report to Gov. Jeb Bush on the case and Gov. Bush's reply; public statements by President George Bush and Senators David Weldon, Rick Santorum, Tom DeLay, Bill Frist, and Barney Frank; statements by the pope and other representatives of the Catholic Church on this issue; plus much medical and legal background material on both precedents to the Schiavo case and its aftermath, including the results of the autopsy report. For anyone wishing an in-depth understanding of these complex ethical issues, issues many of us will have to confront in our own families, this volume is indispensable.

The increase in new medical technology and experimental treatments has made the study of medical ethics essential for practitioners on all levels. This book brings together experts in the fields of pediatric hemotology/oncology, ethics, and law to examine legal and ethical issues surrounding the treatment of children with cancer or blood disease. The contributors present thoughtful discussions of ethical considerations of such practices as bone marrow transplantation, caring for hemophiliacs, preventing sickle cell disease, informing patients of treatment side effects, the statistical design of clinical trials, and the activities of the Institutional Review Board.

In the last few decades, as new reproductive technologies have been developed, couples desiring children have increasingly turned to various medical interventions when natural conception has been unsuccessful. These new technologies have raised ethical concerns from various quarters, including medical ethics committees, the American Fertility Society, and the Roman Catholic Congregation for the Doctrine of the Faith. In this informative overview of the ethical implications of reproductive technologies, philosopher Richard T Hull offers a cross-section of the thinking of individuals specialising in the ethical and legal problems involved in this new area of medicine. The contributors reflect interests as varied as those of the enthusiastic proponent of the new reproductive technologies, the feminist opposing the exploitation of women, the social critic worrying about erosion of the responsibilities of parenting, and the traditionalist concerned with the transformation of the fundamental moral fabric and social character of the family. Many of the chapters include cases for further discussion and reflection.;Also included are three speculative scenarios: selections from Margaret Atwood's "The Handmaid's Tale", Aldous Huxley's "Brave New World", and Gena Corea's report of the drive to develop an artificial womb. New to this edition are a glossary, which provides succinct definitions of highly technical terms and Web sites for further information, and a thorough index. This excellent collection of expert articles will stimulate appreciation of the complex and muti-tiered character of moral decision-making as it is experienced by patients, medical professionals, and legislators and jurists charged with preserving, protecting, and applying justly the principles of society.

This book addresses the debate usually tagged as being about 'markets in human body parts' which is antagonistically divided into pro-market and anti-market positions. The author provides a set of propositions about how to approach this and shows a way out of the concrete impasse of it. Assumptions about markets and bodies that characterize this debate are analyzed and described while the author argues that these assumptions are in fact constitutive for exchanges of human bodily material - but in unacknowledged ways. It is concluded that what we need is a different analytical approach to better understand the mechanisms at play when organizations exchange organs, tissues and cells for use in transplantation and fertility medicine.

Every day, newspapers and television news programs present stories on the latest controversies over healthcare and medical advances, but they do not have the space to provide detailed background on the issues. Websites and weblogs provide information from activists and partisans intent on presenting their side of a story. But where can students - or even ordinary citizens - go to obtain unbiased, detailed background on the medical issues affecting their daily lives? This volume in the Health and Medical Issues Today series provides readers and researchers a balanced, in-depth introduction to the medical, scientific, legal, and cultural issues surrounding organ tranplants and its import in today's world of healthcare. Organ Transplantation is organized to provide readers with easy access to the information they need: BLSection 1 provides overview chapters on the background information needed to intelligently understand the issues and controversies surrounding organ transplants, such as how organs are procured and who determines who gets an organ. BLSection 2 offers capsule examinations of the contemporary issues and debates that provoke the most heated disagreements and misunderstandings, such as controversies over who deserves to get an organ, and the concerns over xenotransplantation BLSection 3 includes reference material on organ transplantation, including primary source documents from important players in the debates, a timeline of important events, and an annotated bibliography of useful print and electronic resources. This volume in the Health and Medicine Today series provides everything a student requires to understand the issues involved in organ transplantation and provides aspringboard for further research into the issue

What is a just way of spending public resources for health and health care? Several significant answers to this question are under debate. Public spending could aim to promote greater equality in health, for example, or maximize the health of the population, or provide the worst off with the best possible health. Another approach is to aim for each person to have "enough" so that her health or access to health care does not fall under a critical level. This latter approach is called sufficientarian. Sufficientarian approaches to distributive justice are intuitively appealing, but require further analysis and assessment. What exactly is sufficiency? Why do we need it? What does it imply for the just distribution of health or healthcare? This volume offers fresh perspectives on these critical questions. Philosophers, bioethicists, health policy-makers, and health economists investigate sufficiency and its application to health and health care in fifteen original contributions.

Ideal for quick reference, this pocket-sized (120x80mm), spiral-bound book in the popular Nursing & Health Survival Guide series puts all the crucial information about patient consent at your fingertips. There is an obligation for practitioners to obtain valid consent from their patients before examination, routine personal care or therapeutic treatment. However, the law relating to consent is complex. Situations may arise where a patient requires urgent treatment, yet is either unwilling or unable to give their consent, or there are concerns over the form and context of the consent. All you need to know on: the underlying principles of consent; consent and the adult patient; consent and the adult who lacks capacity; children and consent; young people and consent.

The contributions to this volume grew out of papers presented at an international conference Individual, Community & Society: Bioethics in the Third Millennium, held in Hong Kong, Special Administrative Region of the People's Republic of China, between 25-28 May 1999. The conference was organized by the Centre for Comparative Public Management and Social Policy, and Ethics in Contemporary China Research Group, in the Faculty of Humanities and Social Sciences at the City University of Hong Kong. The conference brought together scholars from east and west to investigate the challenges to caring and to traditional moral authorities that would confront bioethics in the third millennium. They explored the implications of moral loss and moral diversity in post-traditional and post-modern societies, and how these would shape the character of medical care and bioethics discourse in the new era. A proceedings volume under the same title of Individual, Community & Society: Bioethics in the Third Millennium, was published in May 1999 for the conference meeting.

Medicine and Money: A Study of the Role of Beneficence in Health Care Cost Containment is a frank discussion of the moral problems associated with the need to control health care costs. The book provides a base for physicians to address these concerns and examines the events leading to America's current health care crisis, diminishing beneficence. After a brief definition of the problem, Frank H. Marsh and Mark Yarborough continue by describing the threat of cost containment and justifying beneficence-based health care system. Special importance is given to Medicine and Money by the lengthy suggestions on implementing beneficence in the health care system. Marsh and Yarborough address the problem of eroding morality and rising cost concerns of our present health care system. They argue that if the central role of beneficence is abandoned, the medical profession will be unable to properly meet the challenge it faces. Medicine and Money divides its argument into two sections. In the first section, the current crisis in health care is examined and a justification for beneficence is given. The second section describes how beneficence can be implemented in the health care system as a means to control health care costs. Medicine and Money is written for every member of the medical and philosophical communities.