Narratives have always played a prominent role in both bioethics and medicine; the fields have attracted much storytelling, ranging from great literature to humbler stories of sickness and personal histories. And all bioethicists work with cases--from court cases that shape policy matters to case studies that chronicle sickness. But how useful are these various narratives for sorting out moral matters? What kind of ethical work can stories do--and what are the limits to this work? The new essays in "Stories and Their Limits" offer insightful reflections on the relationship between narratives and ethics.

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Reflective Bioethics

This book explores the issues that surround medically assisted reproduction. It addresses the place of destiny, including how to think about individual destinies in an age of increasingly accessible gene sequencing paired with a growing link between procreation and prediction.

This book is an attempt to address the ethical issues raised by mental illness and its treatment by focusing on the question of autonomy. The mentally ill may be regarded as non-autonomous by virtue of irrationality, which may result in treatment models which deny them a voice. As a counter to this, some have moved to the other extreme and argued that the mentally ill must be regarded as fully autonomous in all circumstances, and consequently that all their wishes regarding treatment must be respected. This book examines the ethical consequences of such simplistic approaches towards autonomy and mental illness, and considers the ethical issues raised by specific forms of treatment. It is suggested in conclusion that improvement in the care and treatment of the mentally ill requires not only a fundamental change in social attitudes but also a less impoverished conception of autonomy than some of those currently employed.

Drawing on postmodernist analyses, Leaky Bodies and Boundaries presents a feminist investigation into the marginalization of women within western discourse that denies both female moral agency and embodiment. With reference to contemporary and historical issues in biomedicine, the book argues that the boundaries of both the subject and the body are no longer secure. The aim is both to valorise women and to suggest that 'leakiness' may be the very ground for a postmodern feminist ethic.
The contribution made by Leaky Bodies and Boundaries is to go beyond modernist feminisms to radically displace the mechanisms by which women are devalued. The anxiety that postmodernism cannot yield an ethics, nor advance feminist concerns is addressed. This book will provide invaluable reading for those studying sociology, women's studies and cultural studies.

This book examines the question of what parental obligations procreators incur by bringing children into being. Prusak argues that parents, as procreators, have obligations regarding future children that constrain the liberty of would-be parents to do as they wish. Moreover, these obligations go beyond simply respecting a child's rights. He addresses in turn the ethics of adoption, child support, gamete donation, surrogacy, prenatal genetic enhancement, and public responsibility for children.

Though the current political climate might lead one to suspect that religion and medicine make for uncomfortable bedfellows, the two institutions have a long history of alliance. From religious healers and religious hospitals to religiously informed bioethics and research studies on the impact of religious and spiritual beliefs on physical and mental well-being, religion and medicine have encountered one another from antiquity through the present day. In Religion and Medicine, Dr. Jeff Levin outlines this longstanding history and the multifaceted interconnections between these two institutions. The first book to cover the full breadth of this subject, it documents religion-medicine alliances across religious traditions, throughout the world, and over the course of history. Levin summarizes a wide range of material in the most comprehensive introduction to this emerging field of scholarship to date.

Commodified Bodies examines the social practice of organ transplantation and trafficking and scrutinises the increasingly neoliberal tendencies in the medical system. It analyses phenomena such as the denomination of human body parts as "raw materials" and "commodities," or the arguments used by the proponents for a free market solution. Moreover, it argues that modern medicine is still linked with its religious roots. The commodification of body parts is seen not as an imperialistic act of the market, but as the end of a historical process as the notion of "fetishism" links the market with the body. Marx's concept of commodity fetishism and Sigmund Freud's theory of the perverted use of objects are modified and adapted to the reconstruction of the joint beginnings of market and medicine.

Studies involving children with mental, emotional, or behavioral problems--or their families--have to meet certain standards of research ethics. This book contains chapters on the kinds of ethical dilemmas that typically occur in different types of studies of children, and then presents 65 real-world cases from experts who study children's mental health. These experts offer practical suggestions for how to handle these dilemmas. Chapters on the perspectives of parents, regulators, and bioethicists provide additional points of view on these issues. Written in down-to-earth language, this book will be useful for professionals who study children, for those who train students in research methods, and for parents who are thinking about participating in research studies.
In attempting to bridge the apparent gap between ethics and science, the editors close this volume on a note commonly sounded by researchers: more research is needed. Yet in this area, a new kind of research is required. The science of scientific ethics must be developed and expanded, and better understanding of the determinants and circumstances under which children can comprehend and evaluate risks and benefits is needed. Likewise, fuller knowledge of the contextual factors affecting children's and families' consent to participate in research is essential. In particular, development of scales to assess children's ability to comprehend risk-benefit issues, studies of families' reactions to research procedures, and empirical data on the impact of various forms of participant reimbursement will advance both science and ethics. This volume should spur further research, serving as a guide for current investigators, participating families, institutional review boards, and policymakers who shape the research enterprise.

The rhetoric of "needs" has been used to legitimate all major turns in UK health policy since 1938. This study identifies the ethical, policy, and technical issues arising from the concept of needs. In the first part a theory of needs is developed, which takes into account both the philosophical traditions and the practical problems arising in daily health care. In a second part, health systems throughout the world are described and compared, addressing ethical as well as economic querstions. Its interdisciplinary approach will make "The Need for" "Health Care" important reading not only for students of philosophy, but also for those interested in or employed in the health sector.

This unique collection focuses on the legal and ethical issues surrounding the medico-legal management of death. Each chapter throws up new and unusual problems in this area, highlighting the tension between personal autonomy and medical responsibility. The book thus charts a way through the moral minefield.

Phil Fennell's tightly argued study traces the history of treatment of mental disorder in Britain over the last 150 years. He focuses specifically on treatment of mental disorder without consent within psychiatric practice, and on the legal position which has allowed it.
Treatment Without Consent examines many controversial areas: the use of high-strength drugs and Electro Convulsive Therapy, physical restraint and the vexed issue of the sterilisation of people with learning disabilities. Changing notions of consent are discussed, from the common perception that relatives are able to consent on behalf of the patient, to present-day statutory and common law rules, and recent Law Commission recommendations.
This work brings a complex and intriguing area to life; it includes a table of legal sources and an extensive bibliography. It is essential reading for historians, lawyers and all those who are interested in the treatment of mental disorder.

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This volume is the result of a symposium titled "Constructivist Approaches to Atypical Development and Developmental Psychopathology." What emerges from the work included here is a record of innovative extensions, refinements, and applications of the concept of constructivism. The chapters not only demonstrate the compatibility of constructivism with investigations of atypicality, but also the generation of a constructivist perspective for a wide array of problems in developmental psychology.

This is a unique and valuable work, which traces the experiences of over 100 parents who have lived through the loss of a baby. It follows them from pregnancy through to13 months after the death. Based on rigorous scientific research it describes their feelings when crucial decisions are made on behalf of their child, and examines their capacity to take responsibility for such decisions. By analysing those factors which help or hinder them, the book provides guidance to health professionals on how the services they offer may be improved. Neonatologists, paediatricians, midwives and neonatal nurses will find it an essential and enlightening read. Primary care clinicians, intensive care staff and hospital chaplains will discover insights which help them to support a wider group of patients and relatives.

There has been a remarkable growth of interest in the ethical dimension of economic affairs. Whilst the interest in business ethics has been long-standing, it has been given renewed emphasis by high profile scandals in the world of business and finance. At the same time many economists, dissatisfied with the discipline's emphasis on self-interest and individualism, and by the asocial nature of much economic theory, have sought to enlarge the scope of economics by looking at ethical questions.
In this volume a group of interdisciplinary scholars provide contributions which include evaluations of work in business ethics, empirical studies of such issues as social and ethical investing, the place of ethics in the new economics and perspectives from other disciplines.

This is the first book to take nursing ethics beyond stock 'moral concepts' to a critical examination of the fundamental assumptions underlying the very nature of nursing. It takes as its point of departure the difficulties nurses experience practising within the confines of a bioethical model of health and illness and a hierarchical, technocratic health care system. The contributors go on to deal openly and honestly with controversial issues faced by nurses, such as euthanasia and HIV.

This book examines major ethical issues in nursing practice. It eschews the abstract approaches of bioethics and medical ethics, and takes as its point of departure the difficulties nurses experience practising within the confines of a biomedical model and a hierarchical health care system. It breaks out of the rigid categories of mainstream health care ethics (autonomy, beneficence, quality of life, utilitarianism) and provides case studies, experiences and challenging lines of thought for the new professional nurse. The contributors examine the role of the nurse in relation to themes such as informed consent, privacy and dignity, and confidentiality. Nursing accountability is also considered in relation to the contemporary Western health care system as a whole. New and critical essays examine the nature of professional codes, care, medical judgement, nursing research and the law. Controversial issues, such as feeding those who cannot or will not eat, the epidemiology of HIV and dilemmas of choice and risk in the care of the elderly are tackled honestly and openly.

To understand the ethical issues raised by genetic counselling, it is necessary for the practitioner, the detached observer and the student to be aware of different perspectives. This work includes contributions from health professionals engaged in genetic counselling, and also from observers and critics of genetic counselling who have backgrounds in law, philosophy, biology, social science, and in advocacy on behalf of those with mental handicap. This diversity is designed to assist health professionals in examining their activities with a fresh eye; it may also help the observer-critic to understand the ethical problems that arise in genetic counselling practice. It is natural for health professionals to focus their concern on the immediate questions raised by individual clients, and for detached observers to consider the broader social implications of the subject.

To understand the ethical issues raised by genetic counselling, it is necessary for the practitioner, the detached observer and the student to be aware of different perspectives. This work includes contributions from health professionals engaged in genetic counselling, and also from observers and critics of genetic counselling who have backgrounds in law, philosophy, biology, social science, and in advocacy on behalf of those with mental handicap. This diversity is designed to assist health professionals in examining their activities with a fresh eye; it may also help the observer-critic to understand the ethical problems that arise in genetic counselling practice. It is natural for health professionals to focus their concern on the immediate questions raised by individual clients, and for detached observers to consider the broader social implications of the subject.

As a mental health nurse, possessing an ethical sensibility and developing ethical reasoning is vital. This book is a practical introduction to the skills and knowledge the mental health nurse is professionally required to develop in their journey towards effectively managing complex ethical decisions. Written with the training mental health nurse in mind, this book is a clear and concise guide on how to approach common, ethically-complex situations mental health nurses will eventually find themselves faced with. It includes textboxes which take the reader into a 'real world' scenario to help them explore the moral and ethical issues discussed throughout the chapter. To ensure professional currency, the content of this book is mapped to the Nursing and Midwifery Council's pre-registration education standards of 2010, and uses a scenario-based approach in order to provide a pragmatic and robust resource. A Practical Introduction to Mental Health Ethics is essential reading for pre-registration mental health nursing students, while also being of value to registered mental health nurses working in ethically challenged areas such as dementia care, psychiatric intensive care units.

Enter the world of organ transplantation and develop a new understanding of processes and techniques for working effectively with patients in this increasing medical population. This multidisciplinary overview of organ transplantation contains chapters by major figures in the medical arena, internationally known bioethics writers, and experienced chaplains from the clinical setting of transplantation, as well as respected pastoral theologians. The authors, who include Art Caplan, Donald Capps, and Jack Copeland, explain transplantation completely for the nonmedical person and delve into the myriad ethical and religious issues and controversies surrounding organ donation and transplantation. Enlightening chapters clarify issues and help readers better understand the transplantation process, making them more effective in their work with transplant patients. Organ Transplantation in Religious, Ethical and Social Context is divided into three sections. The first emphasizes transplantation as a team effort. Chapters focus on the various roles of chaplains and other team members.Section two addresses ethical questions which arise from transplantation and organ donation and includes interfaith perspectives. The third section is dedicated to theological and pastoral views concerning transplantation. Some specific topics discussed in this book include: a surgeon's perspective of the role of the chaplain influence of psychosocial factors in the heart transplantation decision process ministry to organ recipients and their families the special relationship between the transplant coordinator and the transplant patient Catholic and interfaith perspectives on organ donation using the Psalms as a pastoral resource with transplant patients Hospital chaplains, transplant social workers, transplant coordinators, and other professionals interested or involved in the process of organ transplantation will find this book to be full of interesting and thought-provoking insights and information.

This collection of essays emphasizes society's increasingly responsible engagement with ethical challenges in emerging medical technology. Expansion of technological capacity and attention to patient safety have long been integral to improving healthcare delivery but only relatively recently have concepts like respect, distributive justice, privacy, and autonomy gained some power to shape the development, use, and refinement of medical tools and techniques. Medical ethics goes beyond making better medicine to thinking about how to make the field of medicine better. These essays showcase several ways in which modern ethical thinking is improving safety, efficacy and efficiency of medical technology, increasing access to medical care, and empowering patients to choose care that comports with their desires and beliefs. Included are complimentary ethical approaches as well as compelling counter-arguments. Together, the articles demonstrate how improving the quality of medical technology relies on every stakeholder -- not just medical researchers and scientists -- to assess each given technology's strengths and pitfalls. This collection also portends one of the next major issues in the ethics of medical technology: developing the requisite moral framework to accompany shifts toward patient-centred personalized healthcare.

This collection of essays, with an extended commentary by the editor, is concerned with developments in reproductive technology and the possibilities of genetic engineering. The volume provides a forum for debate between science and society. Leading scientists in the field explain the nature and goals of "test tube" reproduction and genetic engineering, and their eugenic implications. Other papers draw out the legal and ethical problems raised by these developments. The ethical dilemmas are discussed both from the point of view of secular moral philosophy and from a theological perspective. The extended commentary attempts to place these questions in the context of a social ethic, rather than an individualist one, in contrast to the approach adopted by the Warnock Report.

In his famous seminar on ethics, Jacques Lacan uses this question as his departure point for a re-examination of Freud's work and the experience of psychoanalysis in relation to ethics. Delving into the psychoanalyst's inevitable involvement with ethical questions, Lacan clarifies many of his key concepts. During the seminar he discusses the problem of sublimation, the paradox of jouissance, the essence of tragedy, and the tragic dimension of analytical experience. One of the most influential French intellectuals of this century, Lacan is seen here at the height of his powers.

Paternalistic intervention, especially in the context of modern medicine and health care, is the issue of this monograph, which aims to define and morally assess paternalistic interventions through a defined conceptual background. The method employed for this purpose is that of applied philosophical ethics in the analytic tradition. It is argued that there is a marked distinction between strong and weak paternalism. Strong paternalism is defined as the violation of the autonomy of a patient, when that person is capable of autonomous decision-making. Weak paternalism is the violation of autonomy when a person is temporarily incapable of self-determined decision-making.