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?

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.

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.

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 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.

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 addresses a research gap in the study of eugenics in fictional literature: the analysis of the nexus of eugenics and genetics in 21st-century novels, detached from their authors' ideological beliefs. It is based on an understanding of literature as an interdiscourse in Jurgen Link's sense. The study employs categories developed by Rabinow and Rose in the context of Foucault's concept of "biopower." It thereby demonstrates that, though officially fallen from grace in light of the Nazi atrocities committed in the name of racial hygiene, eugenic ideas remain surprisingly resilient in the sciences as well as in fiction. Thus, the nexus between eugenics and genetics continues to serve as an important force in the structuring of scientific and contemporary popular (inter-)discourses.

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.

For caregivers of deeply forgetful people: a book that combines new ethics guidelines with an innovative program on how to communicate and connect with people with Alzheimer's. How do we approach a "deeply forgetful" loved one so as to notice and affirm their continuing self-identity? For three decades, Stephen G. Post has worked around the world encouraging caregivers to become more aware of-and find renewed hope in-surprising expressions of selfhood despite the challenges of cognitive decline. In this book, Post offers new perspectives on the worth and dignity of people with Alzheimer's and related disorders despite the negative influence of "hypercognitive" values that place an ethically unacceptable emphasis on human dignity as based on linear rationality and strength of memory. This bias, Post argues, is responsible for the abusive exclusion of this population from our shared humanity. With vignettes and narratives, he argues for a deeper dignity grounded in consciousness, emotional presence, creativity, interdependence, music, and a self that is not "gone" but "differently abled." Post covers key practical topics such as: * understanding the experience of dementia * noticing subtle expressions of continuing selfhood, including "paradoxical lucidity" * perspectives on ethical quandaries from diagnosis to terminal care and everything in between, as gleaned from the voices of caregivers * how to communicate optimally and use language effectively * the value of art, poetry, symbols, personalized music, and nature in revealing self-identity * the value of trained "dementia companion" dogs At a time when medical advances to cure these conditions are still out of reach and the most recent drugs have shown limited effectiveness, Post argues that focusing discussion and resources on the relational dignity of these individuals and the respite needs of their caregivers is vital. Grounding ethics on the equal worth of all conscious human beings, he provides a cautionary perspective on preemptive assisted suicide based on cases that he has witnessed. He affirms vulnerability and interdependence as the core of the human condition and celebrates caregivers as advocates seeking social and economic justice in an American system where they and their loved ones receive only leftover scraps. Racially inclusive and grounded in diversity, Dignity for Deeply Forgetful People also includes a workshop appendix focused on communication and connection, "A Caregiver Resilience Program," by Rev. Dr. Jade C. Angelica.

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 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.

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.

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.

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

Narrative Medicine: A Rhetorical Rx rests on the principles that storytelling is central to medical encounters between caregivers and patients and that narrative competence enhances medical competence. Thus, the book's goal is to develop the narrative competence of its reader. Grounded in the rhetorical theory of narrative that Phelan has been constructing over the course of his career, this volume utilizes a three-step method: Offering a jargon-free explication of core concepts of narrative such as character, progression, perspective, time, and space. Demonstrating how to use those concepts to interpret a diverse group of medical narratives, including two graphic memoirs. Pointing to the relevance of those demonstrations for caregiver-patient interactions. Narrative Medicine: A Rhetorical Rx is the ideal volume for undergraduate students interested in pursuing careers in healthcare, students in medical and allied health professional schools, and graduate students in the health humanities and social sciences.

This book offers an examination of physician-assisted death, but it also extends the discussion to a broader range of end-of-life decisions including suicide, palliative care and sedation until death.

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.

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.

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.

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.