This book tells the extraordinary story of how the function of the first - and so far almost the only - human organ was replaced by a machine, and the "artificial kidney" entered medical and public folk-lore. A practical artificial kidney, or dialyser, came about by advances in science followed by the acquisition of new synthetic materials which made the application of these ideas possible. However it was the dedication and persistence of a number of talented pioneers who pressed ahead against professional opposition to achieve success, first in the treatment of temporary, recoverable kidney failure, and then permanent renal shut-down which made it a success. The apparent high cost and limited availability of this form of treatment immediately raised ethical questions which had never been questioned before, centering around equity of access to treatment, when and if treatment could be denied, and - worst of all - the agonising decision of when, once established, it should be stopped. Spiralling costs as the true number of people with kidney failure became evident raised major political and financial questions, which were addressed in different countries in different ways which reflected - but also helped change - patterns of how medical care is provided. In developed countries, the problem could be solved by allocating a disproportionate amount of money to the treatment of relatively few kidney patients, but in the developing world the cost of treatment still limits its availability, as it does all forms of modern health care. Nevertheless, today almost one million people world-wide are maintained alive following terminal kidney failure, two thirds of them by various forms of dialysis and the remainder bearing kidney transplants, almost always placed after a period on dialysis. The story is also the sum of the often heroic lives of these hundreds of thousands of patients, a few of whom have today been maintained alive and active for more than 35 years, and many of whom suffered known, but also unexpected complications as a result of their treatment.

It is possible to increase cost-effectiveness and lower the risk of lawsuits while improving patient care and office morale. In this revolutionary work, the authors, a seasoned primary care physician and an experienced defense attorney, detail risk management techniques and introduce the concept of co-active medicine. Their book will provide practical guidance for all primary care physicians, and will serve as an invaluable resource for risk management consultants and malpractice attorneys.

This book provides a collection of original essays on cutting-edge topics in medical ethics research. Leading philosophers give in-depth accounts of issues as diverse as embryo pre-selection, the role of autonomy in organ transplant markets, conscientious objection in the health care professions and neonatal euthanasia. Provocative and original, the contributions to this volume will be of interest to academic, students and health care professionals alike.

This important book proposes revising the current informed consent protocol for predictive genetic testing to reflect the trend toward patient-centered medicine. Emphasizing the predictive aspect of testing, the author analyzes the state of informed consent procedure in terms of three components: comprehension of risk assessment, disclosure to select appropriate treatment, and voluntariness. The book's revised model revisits these cornerstones, restructuring the consent process to allow for expanded comprehension time, enhanced patient safety, greater patient involvement and autonomy, and reduced chance of coercion by family or others. A comparison of the current and revised versions and case studies showing the new model in real-world applications add extra usefulness to this resource. Included in the coverage: The science behind PGT. Understanding genetic risks and probability. The history of informed consent. Revised model of informed consent: comprehension, disclosure, voluntariness, patient safety. Applications of the model in DTC and pleiotropic genetic testing. Implementation of the revised model, and assessing its effectiveness. A milestone in the bioethics literature, Informed Consent in Predictive Genetic Testing will be of considerable interest to genetic counselors, medical and bioethicists, and public health professionals.

Biomedical Ethics Reviews: 1992 is the tenth volume in a series of texts designed to review and update the literature on issues of central importance in bioethics today. Two topics are discussed in the present volume: (1) Bioethics and the Military, and (2) Compulsory Birth Control. Each topic constitutes a separate section in our text; introductory essays briefly summarize the contents of each section. Bioethics is, by its nature, interdisciplinary in character. Recog nizing this fact, the authors represented in the present volume have made every effort to minimize the use of technical jargon. At the same time, we believe the purpose of providing a review of the recent literature, as well as of advancing bioethical discussion, is well served by the pieces collected herein. We look forward to the next volume in our series, and very much hope the reader will also. James M. Humber Robert F. Almeder vii Contributors Paul Christopher * Department of English and Philosophy Division, US Military Academy, West Point, New York Gerard Elfstrom * Department of Philosophy, Auburn University, Auburn, Alabama Nicholas Fotion * Department of Philosophy, Emory University, Atlanta, Georgia Martin Gunderson * Department of Philosophy, Macalester College, St.

Despite reservoirs of moral discourse about duties in religious communities, professional caregiving traditions, and philosophical perspectives, the dominant moral language in contemporary biomedical ethics is that of rights'. Duties to Others begins to correct this imbalance in our ethical language through theoretical expositions of the ideas of duty and of the other', and by applied exemplifications of particular duties to identified others that arise in the context of health care. A pronounced multidisciplinary orientation informs this analysis of our moral call to respond to the needs of others. The essays in this volume offer a stimulating intellectual freshness through a continual engagement of theological, professional, and philosophical understandings of the duties that arise in our relationships with others in medicine, nursing, and social contexts. Duties to Others provides provocative challenges about the terrain of our moral world for both students and professionals in biomedical ethics, medicine, philosophy, and theology.

The Yearbook series alternates between a biennial volume tracing recent theological discussions on topics in bioethics and a biennial volume tracing recent regional discussions in bioethics. Volume 4 provides a comprehensive single-volume summary of recent international and regional developments on specific topics in bioethics. To give uniformity to the discussions all authors were asked to report on the following topics: new reproductive technologies, abortion, maternal-fetal conflicts, case of severely disabled newborns, consent of treatment and experimentation, confidentiality, equitable access to health care, ethical concerns raised by cost-containment measures, decisions to withhold or withdraw life-sustaining treatment, active euthanasia, the definition of death, organ donation and transplantation, and a final broad category of other issues. The internationally respected contributors report on the following 16 areas: the United States, Canada, Latin America, the United Kingdom and Ireland, France, the Netherlands, Germany/Austria/Switzerland, Spain/Portugal/Italy, Scandinavia, Southeast Asia, China, Japan, Australia/New Zealand. The commentators draw on three sets of resources: Statutes, legislative proposals, and regulatory changes that directly influence or have implications for, areas of bioethical concern; Case law and court judgments that shape, either decisively or suggestively, recent legal interpretations of particular issues of areas in bioethics; Formal statements of governmentally appointed commissions, advisory bodies, and representative professional groups, as well as less formal statements and recommendations of other organisations. In addition to providing timelysummaries of recent developments, the volume offers rich and useful bibliographical references to a wide array of documents, many of which would be difficult for readers to learn about, given the lack of centralized international collection of such documents. The Yearbook will be widely consulted by all bioethicists, public policy analysts, lawyers and theologians.

"No doctor, however great his capacity or original his ideas, has the right to choose martyrs for science or for the general good." Human Guinea Pigs: Experimentation on Man.Whistle-blowers tend not to be very popular. Maurice Pappworth's whistle was in the form of Human Guinea Pigs, the controversial book published in 1967 which examined unethical medical experimentation on humans and identified the researchers and institutions responsible. The ground-breaking text took the medical establishment by storm and provoked questions in Parliament. Brilliant, Jewish, already an outsider, Pappworth was recognised as the best medical teacher in the country. But convinced that the reason for these experiments being carried out was purely to advance the careers of ambitious practitioners, Pappworth had to speak up. In the wake of his expose, stricter codes of practice for human experimentation were put into place and the establishment of the research ethics committees was formed, which remains in place today. Maurice Pappworth's daughter, the late Joanna Seldon, re-assesses the importance of Human Guinea Pigs in her book Whistle-blower: The Life of Maurice Pappworth. She considers her father's text a major milestone in the development of current medical research ethics and demands a re-evaluation of the pioneering medical ethicist who compromised his own career in order to ensure the protection of the patient.

That concern about human genetics is at the top of many lists of issues requiring intense discussion from scientific, political, social, and ethical points of view is today no surprise. It was in the spirit of attempting to establish the basis for intelligent discussion of the issues involved that a group of us gathered at a meeting of the International Society for the History, Philosophy, and Social Studies of Biology in the Summer of 1995 at Brandeis University and began an exploration of these questions in earlier versions of the papers presented here. Our aim was to cross disciplines and jump national boundaries, to be catholic in the methods and approaches taken, and to bring before readers interested in the emerging issues of human genetics well-reasoned, informative, and provocative papers. The initial conference and elements of the editorial work which have followed were generously supported by the Stifterverband fUr die Deutsche Wissenschaft. We thank Professor Peter Weingart of Bielefeld University for his assistance in gaining this support. As Editors, we thank the anonymous readers who commented upon and critiqued many of the papers and in tum made each paper a more valuable contribution. We also thank the authors for their understanding and patience. Michael Fortnn Everett Mendelsohn Cambridge, MA September 1998 vii INTRODUCTION In 1986, the annual symposium at the venerable Cold Spring Harbor laboratories was devoted to the "Molecular Biology of Homo sapiens.

Do you find research challenging to read? Do you struggle to get to grips with a research paper? Understanding, critiquing and using research is a key requirement of students studying nursing and healthcare. This bookwill equip you with the skills you need to understand research and use it in your practice and academic assignments. The approach used in this book is unique: each chapter focuses on a published research paper - one you might be asked to read for a seminar or include in your academic work. In clear, straightforward language, the authors take you through each paper step by step, using it as a basis for exploring the underpinning research method or design, and how it has been reported. Key features: * Each chapter focuses on a different research method by working through a relevant research paper * Identifies the main skills you need for your course: understanding research methods and critiquing articles * Written specifically for nursing and healthcare students by experienced nursing and health care lecturers * Develops your confidence in understanding research by helping you to apply your knowledge to real research papers.

This book is Open Access under a CC BY license. It is the first monograph-length study of the force-feeding of hunger strikers in English, Irish and Northern Irish prisons. It examines ethical debates that arose throughout the twentieth century when governments authorised the force-feeding of imprisoned suffragettes, Irish republicans and convict prisoners. It also explores the fraught role of prison doctors called upon to perform the procedure. Since the Home Office first authorised force-feeding in 1909, a number of questions have been raised about the procedure. Is force-feeding safe? Can it kill? Are doctors who feed prisoners against their will abandoning the medical ethical norms of their profession? And do state bodies use prison doctors to help tackle political dissidence at times of political crisis?

All persons, while different from one another, have the same value: this is the author's relatively uncontroversial starting point. Her end point is not uncontroversial: an ideal of justice as human flourishing, based on each person's unique set of capabilities. Because the book's focus is women's health care, gender justice, a necessary component of justice, is central to examination of the issues. Classical pragmatists and feminist standpoint theorists are enlisted in support of a strategy by which gender justice is promoted. Two features of the book are unique: (1) the topics presented cover the entire life span of women, not just those related to reproduction; (2) a range views about moral status are applied not only to fetuses but also to individuals already born. Attention to these features is intended to facilitate ethical consistency or moral integrity and respect for those who hold different moral views. While delineating and defending the book's perspective, the first section provides an overview of bioethics, critiques prevalent approaches to bioethics and models of the physician-patient relationship, and sketches distinguishing aspects of women's health care that are prevalently neglected. Positions about moral status are also presented. The second section identifies topics that are indirectly as well as directly related to women's health, such as domestic violence and caregiving. Brief cases illustrate variables relevant to each topic. Empirical and theoretical considerations follow each set of cases; these are intended to precipitate more expansive and critical examination of the issues raised. The last section is devoted to an egalitarian ideal that may be pursued throughan ethic of virtue or supererogation rather than obligation. By embracing this ideal, according to the author, moral agents support a more demanding level of morality than guidelines or laws require.

Is there only one bioethics? Is a global bioethics possible? Or, instead, does one encounter a plurality of bioethical approaches shaped by local cultural and national traditions? Some thirty years ago a field of applied ethics emerged under the rubric bioethics'. Little thought was given at the time to the possibility that this field bore the imprint of a particular American set of moral commitments. This volume explores the plurality of moral perspectives shaping bioethics. It is inspired by Kazumasa Hoshino's critical reflections on the differences in moral perspectives separating Japanese and American bioethics. The essays include contributions from Hong Kong, China, Japan, Texas, the United States, Germany, Switzerland, and Italy. The volume offers a rich perspective of the range of approaches to bioethics. It brings into question whether there is unambiguously one ethics for bioethics to apply.

Instances of euthanasia or mercy killing date back to antiquity. However, it is only recently that the unprecedented grassroots efforts to legalize euthana sia have begun building. "Terminal Illness, Assistance with Dying," a California ballot initiative for the No vember 1992 election, might for the first time in modem history legalize euthanasia and assisted suicide by physicians. Similar initiatives are planned in other states. To vote intelligently, citizens in California and throughout the United States need to learn who is likely to request euthanasia or assisted suicide, and why. How we care for the terminally ill eventually af fects us all. In over half of all deaths, a chronic dis ease process such as cancer or congestive heart failure leads to a terminal phase that may last for days, weeks, or months. Most people are more afraid of the suffering associated with this terminal phase than they are afraid of dying itself. When polled, most Americans tell us they would prefer to die at home, surrounded by loved ones, rather than in a hospital receiving high-tech tests and treatments until the last. Yet the majority of people, even those with term inal illnesses, die in the hospital. What factors in our culture and health care system have led to this dichotomy? Unrelieved suffering is also the primary reason for euthanasia requests."

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.

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.

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.

This open access book offers a framework for understanding how the Holocaust has shaped and continues to shape medical ethics, health policy, and questions related to human rights around the world. The field of bioethics continues to face questions of social and medical controversy that have their roots in the lessons of the Holocaust, such as debates over beginning-of-life and medical genetics, end-of-life matters such as medical aid in dying, the development of ethical codes and regulations to guide human subject research, and human rights abuses in vulnerable populations. As the only example of medically sanctioned genocide in history, and one that used medicine and science to fundamentally undermine human dignity and the moral foundation of society, the Holocaust provides an invaluable framework for exploring current issues in bioethics and society today. This book, therefore, is of great value to all current and future ethicists, medical practitioners and policymakers - as well as laypeople.

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.

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."

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.

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.