In a world of rapid technological advances, the moral issues raised by life and death choices in healthcare remain obscure. Life and Death in Healthcare Ethics provides a concise, thoughtful and extremely accessible guide to these moral issues.
Helen Watt examines, using real-life cases, the range of choices taken by healthcare professionals, patients and clients which lead to the shortening of life. The topics looked at include:
* euthanasia and withdrawal of treatment
* the persistent vegetative state
* abortion
* IVF and cloning
* life-saving treatment of pregnant women
Clearly written and insightful, Life and Death in Healthcare Ethics: A Short Introduction presupposes no prior knowledge of philosophy. It will be of interest to anyone confronting healthcare ethics for the first time, or seeking to develop his or her understanding of some core topics in the field.

eBook available with sample pages: 0203135970

The purpose of public and community health is to improve the health of populations or groups rather than concentrating on individuals. This book examines the ethical issues associated with public and community health.
The contributors analyse the major ethical issues in public health - prioritisation, public participation, health promotion and screening - all of which reflect current practice in the UK. They examine what health services should be available, who should have access to which health services, what are the best strategies for preventing disease, how can professional and public views be reconciled and when can an individual's health needs override the choice of a community.
The contributors apply up-to-date ethical theory to practical examples in public health practice to provide a comprehensive and accessible introduction to the key issues in public health ethics.

In the past decade the body of literature in the area of biomedical ethics has expanded at an astounding rate. Indeed, on every major topic, the literature in this area has mUltiplied, and continues to do so, so rapidly that one can easily fall behind important advances in our thinking about and understanding of the problems of contemporary bioethics. Awareness of this need to keep apace of developments in the area prompted a recent reviewer of our earlier collection Biomedical Ethics and the Law (Plenum, 2nd edition, 1979) to suggest that somebody ought to offer the service of providing a biennial review or update of the literature on the various central topics in bioethics. Thomas Lanigan, of The Humana Press, agreed with this last sug gestion and so asked us to edit a series of texts consisting of previously unpublished essays on selected topics, a series that would seek to re view and update recent literature on the central topics, while also striv ing to advance distinctive solutions to the problems on the topics under discussion. Accordingly, this first collection of previously unpublished essays focuses on the selected topics, and the authors commissioned were charged with addressing the basic problems assigned while also bringing the reader either directly or indirectly up to date on the rele vant literature."

whether the patient is suffering? Should the ability to think and reason be considered as the most important factor? For instance, should a patient with Amyotrophic lateral sclerosis (ALS) who is mentally alert yet unable to move from the neck down be allowed to refuse medical treatment; and, if so, at what point in her treatment should one consider her life no longer worth living? Is there a difference between not inserting a respirator into a patient who is unable to breathe and not inserting a feeding tube into a patient who is unable to eat? In other words, where does one draw the line between a life worth living and one that is beyond hope, and what criteria should be used? Several of my cases address this issue. 2. What are the religious influences that affect the decision-making process? Israelis all seem to agree that they are a "Jewish state" and that their Jewishness is extremely important to their collective identity; however, they have a difficult time defining what this means. There is a great deal of ambivalence, especially among the less religious, as to what role religion should be allowed to play in their lives. Many resent the control that the religious have over their lives; yet, they also feel that it is beneficial and should play some role in affecting the morals of the country.

Medical ethics draws upon methods from a wide array of disciplines, including anthropology, economics, epidemiology, health services research, history, law, medicine, nursing, philosophy, psychology, sociology, and theology. In this influential book, outstanding scholars in medical ethics bring these many methods together in one place to be systematically described, critiqued, and challenged. Newly revised and updated chapters in this second edition include philosophy, religion and theology, virtue and professionalism, casuistry and clinical ethics, law, history, qualitative research, ethnography, quantitative surveys, experimental methods, and economics and decision science. This second edition also includes new chapters on literature and sociology, as well as a second chapter on philosophy which expands the range of philosophical methods discussed to include gender ethics, communitarianism, and discourse ethics. In each of these chapters, contributors provide descriptions of the methods, critiques, and notes on resources and training. "Methods in Medical Ethics" is a valuable resource for scholars, teachers, editors, and students in any of the disciplines that have contributed to the field. As a textbook and reference for graduate students and scholars in medical ethics, it offers a rich understanding of the complexities involved in the rigorous investigation of moral questions in medical practice and research.

This book challenges readers to rethink rural health ethics. Traditional approaches to health ethics are often urban-centric, making implicit assumptions about how values and norms apply in health care practice, and as such may fail to take into account the complexity, depth, richness, and diversity of the rural context. There are ethically relevant differences between rural health practice and rural health services delivery and urban practice and delivery that go beyond the stereotypes associated with rural life and rural health services. This book examines key values in the rural context that have not been fully explored or taken into account when we examine health ethics issues, including the values of community and place, and a need to "revalue" relationships. It also advocates for a greater attention to meso and macro level analysis in rural health ethics as being critical to ethical analysis of rural health care. This book is essential reading for those involved in health ethics, rural health policy and governance, and for rural health providers.

THE TRUE CRIME BOOK OF THE YEAR AND SUNDAY TIMES TOP 10 BESTSELLER 'One of the most fascinating books I have read in a long time. Engrossing, a haunting page-turner. A book I could not put down' The Times, BOOKS OF THE YEAR __________ Meet the forensic pathologist, Dr Richard Shepherd. He solves the mysteries of unexplained or sudden death. He has performed over 23,000 autopsies, including some of the most high-profile cases of recent times; the Hungerford Massacre, the Princess Diana inquiry, and 9/11. He has faced serial killers, natural disaster, 'perfect murders' and freak accidents. His evidence has put killers behind bars, freed the innocent, and turned open-and-shut cases on their heads. Yet all this has come at a huge personal cost. Unnatural Causes tells the story of not only the cases and bodies that have haunted him the most, but also how to live a life steeped in death. Thoughtful, revealing, chilling and always unputdownable, if you liked All That Remains, War Doctor and This is Going to Hurt you'll love this. **Pre-order Dr Richard Shepherd's new book THE SEVEN AGES OF DEATH now** __________ 'Gripping, grimly fascinating, and I suspect I'll read it at least twice' Evening Standard 'A deeply mesmerising memoir of forensic pathology. Human and fascinating' Nigella Lawson 'An absolutely brilliant book. I really recommend it, I don't often say that but it's fascinating' Jeremy Vine, BBC Radio 2 'Puts the reader at his elbow as he wields the scalpel' Guardian 'Fascinating, gruesome yet engrossing' Richard and Judy, Daily Express 'Fascinating, insightful, candid, compassionate' Observer

This book offers a unique and comprehensive outline of the ethos, the bioethics and the sexual ethics of the renowned anatomist and founder of modern geology, Niels Stensen (1638-1686). It tells the story of a student who is forced to defend himself against his professor who tries to plagiarize his first discovery, the "Ductus Stenonis": the first performance test for the young researcher. The focal points are questions of bioethics, especially with regard to human reproduction, sexual ethics, the beginning of life and the ensoulment of the embryo, together with frontiers of pastoral care. The book delineates Stensen's ethos as well as its medico-ethical and theological implications and reception by researchers and physicians from the 17th century until today, and asks about his lasting significance. Despite dating back more than 300 years, Stensen's character and his work offer up surprisingly topical answers to current questions on the nature of professional ethics in medical science and practice. Furthermore, "Ethos, Bioethics, and Sexual Ethics in Work and Reception of the Anatomist Niels Stensen (1638-1686): Circulation of Love" is the first academic book on bioethics and sexual ethics with a foreword by the Prefect of the Congregation for the Doctrine of the Faith. A fascinating book for bioethicists, physicians, members of health professions, scientists, and theologians.

None of the literature in the field of terminal care provides a full treatment of the laws, documents, and policies relating to the difficult issues arising at the end of life. When Life Ends was written to fill this gap by an attorney who serves on the bioethics committee of a large public hospital. It is an invaluable resource and practical tool for physicians, nurses, medical staffs, legal professionals, hospital administrators, and hospital bioethics committees because it provides: 1) in-depth legal commentaries on the refusal of life-sustaining treatment, advance directives, surrogate decision making, and the Patient Self-Determination Act; 2) more than 70 medical and legal documents to be used in connection with end of life decisions; and 3) hospital policies and procedures to suggest guidelines to hospital bioethics committees as they carry out their functions of developing policies and procedures to address end of life legal and ethical issues.

Biomedical Ethics Reviews * 1987 is the fifth volume in a series of texts designed to review and update the literature on issues of central importance in bioethics today. Three topics are discussed in the present volume: (1) Prescribing Drugs for the Aged and Dying; (2) Animals as a Source of Human Transplant Organs, and (3) The Nurse's Role: Rights and Responsibilities. Each topic constitutes a separate sec tion in our text; introductory essays briefly summarize the contents of each section. Bioethics is, by its nature, interdisciplinary in character. Recognizing this fact, the authors represented in the present volume have made every effort to minimize the use of techni cal jargon. At the same time, we believe the purpose of pro viding a review of the recent literature, as well as of advancing bioethical discussion, is admirably served by the pieces col lected herein. We look forward to the next volume in our series, and very much hope the reader will also.

This book discusses 'how' to respectfully and responsibly include pregnant women in clinical research. In sharp contrast, the existing literature predominantly focuses on the reasons 'why' the inclusion of pregnant women in clinical research is necessary - viz., to develop effective treatments for women during pregnancy, to promote fetal safety, to reduce harm to women and fetuses from suboptimal care, and to allow access to the benefits of research participation. This book supports the shift to a new default position, whereby pregnant women are included in clinical research unless researchers argue convincingly for their exclusion. This shift raises many as yet unexplored ethical and policy questions about existing barriers to the equitable inclusion of pregnant women in research. This book is original in three key ways. First, it presents an unparalleled depth of analysis of the ethics of research with pregnant women, bringing together many of the key authors in this field as well as experts in research ethics and in vulnerability who have not previously applied their work to pregnant women. Second, it includes innovative theoretical work in ethics and disease specific case studies that highlight the current complexity and future challenges of research involving pregnant women. Third, the book brings together authors who argue both for and against including more pregnant women in formal clinical trials.

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.

TERMINAL SEDATION DURING THE 1990s During the 1990s a discussion took place in scholarly journals concerning a measure within palliative care that had earlier attracted little attention, to wit, the sedation of dying patients. There seem to have been two main reasons why the practice came under debate. On the one hand, some people felt that, when palliative medicine had advanced and methods to control symptoms had improved, it was no longer justified to sedate the patients in a manner that had often been done in the past. The system of 1 terminal sedation had turned into 'euthanasia in disguise' or 'slow euthanasia'. On the other hand, there were people sympathetic to the recently established Dutch system of euthanasia, people who agreed that terminal sedation was euthanasia in disguise, but who felt that, if it is not objectionable to sedate dying patients at their request, then why should it not be permitted for doctors to kill dying patients at 2 request? From these two motives a discussion about terminal sedation gained momentum. The intention behind this anthology is to continue and deepen this discussion. The anthology starts off with a chapter where an influential article from the 1990s has been reprinted.

In contemporary ethical discussion widespread concern about the potential risks of genetic engineering is raising new and fundamental questions about our responsibilities towards unborn generations. Newly acquired knowledge in genetic engineering techniques has brought about not only potential benefits but also immense risks for the well-being of both present and future generations. This book raises a number of ethical issues concerning the impact of genetic engineering on generations yet to be born. The four topical areas that constitute the focus of the volume, namely (1) from laboratory to germ-line therapy, (2) the concept of human nature: theological and secular perspectives, (3) genetic intervention and the common heritage view, and (4) social responsibilities of geneticists towards future generations, raise intriguing ethical and legal questions, as well as important policy issues. As much as any set of issues, they reflect the hopes and fears, prejudices and uncertainties that people associate with germ-line intervention and the future of human kind.

As the field of bioethics has matured, increasing attention is being paid to how bioethical issues are treated in different moral and religious traditions and in different regions of the world. It is often difficult, however, to obtain timely information about these matters. The Bioethics Yearbook series analyzes how such issues as new reproductive techniques, abortion, maternal-fetal conflicts, care of seriously ill newborns, consent, confidentiality, equitable access, cost-containment, withholding and withdrawing treatment, euthanasia, the definition of death, and organ transplantation are being discussed in different religions and regions. Volume 5 discusses theological developments from 1992 to 1994 in Anglican, Baptist, Catholic, Hindu, Jehovah's Witness, Jewish, Latter-Day Saint, Lutheran, Methodist, Muslim, Pentecostal, and Presbyterian traditions.

A comprehensive and thoughtful analysis of human reproduction issues in the U.S. with emphasis on the ethical and policy implications of cutting-edge reproductive technologies. Human cloning. Stem cell research. Abortion. All of these subjects are surrounded by controversy. But now readers can cut through the usual emotion, misinformation, and distortion-and get a fair and balanced picture of human reproduction issues in the United States. Few subjects are as divisive and partisan as the issues surrounding the propagation of the human species. This thorough examination covers the full scope of the debates and offers an up-to-the-minute survey of the controversial technologies that are at the heart of reproductive rights in the United States. The areas explored range from abortion and sterlization to fetal research and human cloning. The moral, societal and public policy implications of each subject are examined thoroughly, with emphasis on those areas where cutting-edge technology has raced ahead of public policy, thereby creating new concerns for ethicists and policy-makers. Legislative oversight or the freedom to pursue reproductive technologies at any cost, this debate is far fr

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.

Like many novel ideas, the idea for this volume and its predecessor arose over lunch in the cafeteria of the old Wellcome Institute. On an atternoon in Sept- ber 1988, Dorothy and Roy Porter, and I, sketched out a plan for a set of conf- ences in which scholars from a variety of disciplines would explore the emergence of modern medical ethics in the English-speaking world: from its pre-history in the quarrels that arose as gentlemanly codes of etiquette and honor broke down under the pressure of the eighteenth-century "sick trade," to the Enlightenment ethics of John Gregory and Thomas Percival, to the American appropriation process that culminated in the American Medical Association's 1847 Code of Ethics, and to the British turn to medical jurisprudence in the 1858 Medical Act. Roy Porter formally presented our idea as a plan for two back-to-back c- ferences to the Wellcome Trust, and I presented it to the editors of the PHI- LOSOPHY AND MEDICINE series, H. Tristram Engeihardt, Jr. and Stuart Spicker. The reception from both parties was enthusiastic and so, with the financial backing of the former and a commitment to publication from the latter, Roy Porter, ably assisted by Frieda Hauser and Steven Emberton, - ganized two conferences. The first was held at the Wellcome Institute in - cember 1989; the second was sponsored by the Wellcome, but was actually held in the National Hospital, in December 1990.

The genie is out of the bottle. A whole new world of genetics research is underway with its exciting potential for a better understanding of heredity and genetically inherited disease, with opportunities for prevention, management and cure. But the current explosion of human genetic information has the potential for abuse also, for damage to rights, privacy and fair treatment for individuals and vulnerable groups. This book brings us up to date with important contributions from the authoritative "Encyclopaedia of the Human Genome" on the urgent social, legal and ethical aspects of the Human Genome enterprise, accessibly written and introduced for the undergraduate, postgraduate and general reader.

Genetic counselors translate the findings of scientific investigation into meaningful accounts that enable individuals and families to make decisions about their lives. This collection of original papers explores the history, values, and norms of that process, with some focus on the value of nondirectiveness in counseling practice. The contributors; examination of genetic counseling issues serves as a foundation from which to address other ethical, legal, and policy considerations in the expanding universe of clinical genetics.

This book examines the ethical obligations binding a doctor to her patient's confidences and asks "Should those ethical obligations be recognized in the courtroom?". Increasingly, English law has shown a responsiveness to the need to accord respect to patient confidentiality. In practice this has involved the prohibition of unauthorized disclosure of medical records in national newspapers and the provision of special protection for data stored on computer. In one area, however, the law has been unwilling to protect patient confidences - the courtroom. A patient cannot stop her doctor from testifying even though the doctor has promised not to divulge medical information under any circumstances. Jean V. McHale examines cases to see whether the denial in law of the doctor-patient privilege is consistent with the protection of other confidential relationships. She discusses the nature of medical information and confidentiality and she considers the practical issues and questions which are raised by confidentiality. This book challenges orthodox ideas of medical confidentiality and questions the overriding right of the law.

Substantial efforts have recently been made to reform the physician-patient relationship, particularly toward replacing the `silent world of doctor and patient' with informed patient participation in medical decision-making. This 'new ethos of patient autonomy' has especially insisted on the routine provision of informed consent for all medical interventions. Stronly supported by most bioethicists and the law, as well as more popular writings and expectations, it still seems clear that informed consent has, at best, been received in a lukewarm fashion by most clinicians, many simply rejecting what they commonly refer to as the `myth of informed consent'. The purpose of this book is to defuse this seemingly intractable controversy by offering an efficient and effective operational model of informed consent. This goal is pursued first by reviewing and evaluating, in detail, the agendas, arguments, and supporting materials of its proponents and detractors. A comprehensive review of empirical studies of informed consent is provided, as well as a detailed reflection on the common clinician experience with attempts at informed consent and the exercise of autonomy by patients. In the end, informed consent is recast as a management tool for pursuing clinically and ethically important goods and values that any clinician should see as meriting pursuit. Concurrently, the model incorporates a flexible, anticipatory approach that recognizes that no static, generic ritual can legitimately pursue the quite variable goods and values that may be at stake with different patients in different situations. Finally, efficiency of provision is addressed by not pursuing the unattainable and ancillary. Throughout, the traditional principle of beneficence is appealed to toward articulating an operational model of informed consent as an intervention that is likely to change outcomes at the bedside for the better.

Before Bioethics narrates the history of American medical ethics from its colonial origins to current bioethical controversies over abortion, AIDS, animal rights, and physician-assisted suicide. The first history of American medical ethics published in more than a half century, Before Bioethics tracks the evolution of American medical ethics from colonial midwives and physicians' oaths, to medical society codes and bioethical principles. Applying the concept of "morally disruptive technologies," it analyzes the impact of the stethoscope on conceptions of fetal life and the criminalization of abortion, and the impact of the ventilator on our conception of death and the treatment of the dying. The narrative offers tales of those whose lives were affected by the medical ethics of their era: unwed mothers executed by puritans because midwives found them with stillborn babies; the unlikely trio-an Irishman, a Sephardic Jew and in-the-closet gay public health reformer-who drafted the American Medical Association's code of ethics but received no credit for their achievement, and the founder of American gynecology celebrated during his own era but condemned today because he perfected his surgical procedures on un-anesthetized African American slave women. The book concludes by exploring the reasons underlying American society's empowerment of a hodgepodge of ex-theologians, humanist clinicians and researchers, lawyers and philosophers-the bioethicists-as authorities able to address research ethics scandals and the ethical problems generated by morally disruptive technologies.

In the early 1970s, well before the field ofbioethics had established itself in medicine or anywhere else, the Hastings Center organized a small meeting of law school professors. The question we put to them was: what could or should be done to stimulate legal interest in the field? The answer we got was a wise one. We should do nothing to forcefeed the interest. It should simply be allowed to develop on its own, by the ordinary route of attracting a following because of its inherent importance. That is just what happened, and one of the first young legal scholars drawn to what remains (oddly enough) a relatively small field was George Annas. The idea of a column on law and ethics for the Hastings Center Report was not by 1976 a particularly bold one. It had been clear to us from the outset of the Center in 1969, and the establishment of the Report in 1971, that the rapidly emerging moral problems in medicine and biology would have enormous legal and policy implications. Even so, we were hardly prepared for the large and steady number of cases that were to come before the courts during the 1970s and that were to continue unabated in the 1980s. But our concern about a column on the subject was of a more pedestrian kind.

This book focuses on justice and its demands in the way of providing people with medical care. Building on recent insights on the nature of moral perceptions and motivations from the neurosciences, it makes a case for the traditional medical ethic and examines its financial feasibility. The book starts out by giving an account of the concept of justice and tracing it back to the practices and tenets of Hippocrates and his followers, while taking into account findings from the neurosciences. Next, it considers whether the claim that it is just to limit medical care for everyone to some basic minimum is justifiable. The book then addresses finances and expenditures of the US health care system and shows that the growth of expenditures and the percentage of the gross national product spent on health care make for an unsustainable trajectory. In light of the question what should be changed, the book suggests that overdiagnosis and medicalizing normal behavior lead to harmful, costly and unnecessary interventions and are the result of unethical behavior on the part of the pharmaceutical industry and extensive ethical failures of the FDA. The book ends with suggestions about what can be done to put the U.S. health care system on the path to sustainability, better medical care, and compliance with the demands of justice.