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Books > Medicine > General issues > Medical ethics
This book offers a vision of politics that govern the womb; from antiquity ('be fertile and replenish the earth'), through the ages (hysterectomy, to extirpate women's 'hysteria'), up to the present time (abortion wars; assisted reproduction), and into the future (reprogenetics; the artificial womb). It explores how the womb has served humanity, either tacitly or explicitly, through the ages and examines how women have accepted and still perceive the rules created by men as natural - including the new anti-abortion laws in the USA - because 'that is the way things are.' The book also explores how the emerging of assisted reproduction technologies and novel genetic tools (reprogenetics) will pose additional challenges to womb bearers, as all women will be made to reproduce with IVF. What is more, the advent of the artificial womb is in sight; the gender and social implications of this development would be enormous. Certainly not just another organ, the womb has been and remains a powerful tool that cannot be left to the decisions of half of the population. This book engages a wide audience, including women and men, professionals and laypersons who are interested in gender, politics, legislation, women's health, and ethics.
Death is a natural part of life. But it has become a painful, protracted, humiliating process that is often inappropriate for the healthcare patient, puts an undue financial and emotional burden on the family, and provides a model of improper care for physicians in training. And it's expensive--about 22 percent of all medical expenditures are for people in the last year of their lives. Further, while studies show that 90 percent of all people would prefer to die at home surrounded by family and friends, the reality is that more than 70 percent die in institutions. As Dr. Ken Fisher argues so passionately in this book, it's time for a change. End-of-life care in the U.S. has evolved over the years into a nightmare for patients and family members, and it has created a near-crushing financial burden on the medical system that is not just excessive but unsustainable. It has driven the cost of healthcare out of reach for many people, and it is a large factor in preventing the creation of universal coverage. In Defiance of Death reviews the current state of end-of-life care and highlights its many problems from a variety of economic, political, and social perspectives. Fisher and Rockwell illuminate the ethical dilemmas we all face as technology allows us to prolong life--but at a huge human and financial cost. This book documents these problems and provides a historical perspective of how our medical system evolved. It argues that America's "defiance of death" is far too costly and recommend that all stakeholders--including the public, medical community, Congress, and business leaders--join together to create a system that improves end-of-life care for everyone involved. This book, withworkable solutions to improve our medical system, helps point the way.
This updated edition includes a new afterword that identifies the role the Buck story plays in the Supreme Court's review of emerging state laws that seek to limit access to abortion. "Three generations of imbeciles are enough." Few lines from U.S. Supreme Court opinions are as memorable as this declaration by Justice Oliver Wendell Holmes Jr. in the landmark 1927 case Buck v. Bell. The ruling allowed states to forcibly sterilize residents in order to prevent "feebleminded and socially inadequate" people from having children. It is the only time the Supreme Court endorsed surgery as a tool of government policy. Though Buck set the stage for more than sixty thousand involuntary sterilizations in the United States and was cited at the Nuremberg trials in defense of Nazi sterilization experiments, it has never been overturned. It has been more than a decade since Paul A. Lombardo's classic Three Generations, No Imbeciles first exposed the Buck case's fraudulent roots. During that time, several of the remaining twentieth-century eugenic sterilization statutes have finally been repealed, and reparations to sterilization survivors have been paid in two states. Discussion of the Buck case has once again engendered controversy in the courts. The Wisconsin Supreme Court invoked Buck most recently in a debate over the power of the state to enact restrictions on citizens and businesses during the COVID-19 crisis, and the US Supreme Court cited Three Generations, No Imbeciles in arguments over the newest state laws seeking to limit access to abortion. This updated edition collects and analyzes information related to events and trends discussed in the earlier volume and includes a completely new afterword, "Looking Back at Buck," that explains how the case remains a key feature of public discourse about disability, government power, and reproductive rights. It also presents restored copies of the letters of Carrie Buck and points readers to an online archive of legal documents, images, and other material relevant to the case. The book remains a key resource for law school faculties, legal and medical historians, and anyone with an interest in the history of reproduction in the United States. "Startling."-Reason "Compelling and well-researched . . . Three Generations, No Imbeciles gives Carrie Buck's long-untold story the attention it deserves."-Harvard Law Review "Three Generations provides valuable, new, and timely revelations for students and professional scholars across many disciplines."-Disability Studies Quarterly "Meticulously detailed and researched history . . . this book is enjoyable, thought provoking, and troubling in equal measure. I highly recommend it."-Psychiatric Services
Bioethics and the Fetus: Medical, Moral, and Legal Issues is the ninth volume in the Biomedical Ethics Reviews series of texts designed to review and update the literature on issues of central importance in bioethics today. All of the essays in this volume examine moral and/or legal problems involving human fetal life; summaries of these essays may be found in the text's Introduction. 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 Andrea L. Bonnicksen * Department of Political Science, Northern lllinois University, DeKalb, lllinois David W. Drebushenko * Department of Philosophy, Central Michigan University, Mount Pleasant, Michigan Roger B. Dworkin * School of Law, Indiana University, Bloomington, Indiana Mary B. Mahowald * Pritzker School of Medicine, The University of Chicago, Chicago, lllinois Christine Overall * Department of Philosophy, Queens University, Kingston, Ontario, Canada WadeL. Robison* College of Liberal Arts, Rochester Institute of Technology, Rochester, New York Barbara Katz Rothman * Department of Sociology, Baruch College, CUNY, New York, New York Thomas A.
The best things in my Ufe have come to me by accident and this book results from one such accident: my having the opportunity, out of the blue, to go to work as H. Tristram Engelhardt, Jr. 's, research assistant at the Institute for the Medical Humanities in the University of Texas Medi cal Branch at Galveston, Texas, in 1974, on the recommendation of our teacher at the University of Texas at Austin, Irwin C. Lieb. During that summer Tris "lent" me to Chester Bums, who has done important schol arly work over the years on the history of medical ethics. I was just finding out what bioethics was and Chester sent me to the rare book room of the Medical Branch Library to do some work on something called "medical deontology. " I discovered that this new field of bioethics had a history. This string of accidents continued, in 1975, when Warren Reich (who in 1979 made the excellent decisions to hire me to the faculty in bioethics at the Georgetown University School of Medicine and to persuade Andre Hellegers to appoint me to the Kennedy Institute of Ethics) took Tris Engelhardt's word for it that I could write on the history of modem medical ethics for Warren's major new project, the Encyclopedia of Bioethics. Warren then asked me to write on eighteenth-century British medical ethics."
This fascinating book gives readers an appreciation of how biomedical research should work and how the reality is all too often seriously flawed. Explaining the logical basis of the different research approaches used by biomedical research scientists and their relative merits, it will help readers to make more realistic appraisal of media reports linking aspects of lifestyle, environment or diet to health outcomes and thus judge whether such claims are a real effect worthy of consideration for behavior change or deserving of further research resources. Key features: increases awareness of research fraud and some of the characteristics of fraudulent science and scientific fraudsters shows that whilst outright fraud may be uncommon, fudging of results to help achieve statistical significance may be more prevalent incorporates real-life case studies highlighting some of the infamous cases of research fraud and major scientific mistakes and the impact that they have had provides a convenient overview of the research process in the biomedical sciences, with a focus on research strategy rather than individual methods find supplemental detail on the author's blog https://drgeoffnutrition.wordpress.com/about/ By raising awareness of the possibility that research data may have been dishonestly generated and outlining some of the signs and symptoms that might suggest data fabrication, Error and Fraud: The Dark Side of Biomedical Research will help students and researchers to identify the strengths and limitations of different research approaches and allow them to make a realistic evaluations of their own and others' research findings.
The essays in this book, written by researchers from both humanities and science, describe various theoretical and experimental approaches to adding medical ethics to a machine, what design features are necessary in order to achieve this, philosophical and practical questions concerning justice, rights, decision-making and responsibility in medical contexts, and accurately modeling essential physician-machine-patient relationships. In medical settings, machines are in close proximity with human beings: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old and with medical professionals. Machines in these contexts are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity and privacy. As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for empathy and emotion detection necessary? What about consciousness? This collection is the first book that addresses these 21st-century concerns.
Women most fully experience the consequences of human reproductive technologies. Men who convene to evaluate such technologies discuss "them": the women who must accept, avoid, or even resist these technologies; the women who consume technologies they did not devise; the women who are the objects of policies made by men. So often the input of women is neither sought nor listened to. The privileged insights and perspectives that women bring to the consideration of technologies in human reproduction are the subject of these volumes, which constitute the revised and edited record of a Workshop on "Ethical Issues in Human Reproduction Technology: Analysis by Women" (EIRTAW), held in June, 1979, at Hampshire College in Amherst, Massachusetts. Some 80 members of the workshop, 90 percent of them women (from 24 states), represented diverse occupations and personal histories, different races and classes, varied political commitments. They included doctors, nurses, and scientists, lay midwives, consumer advocates, historians, and sociologists, lawyers, policy analysts, and ethicists. Each session, however, made plain that ethics is an everyday concern for women in general, as well as an academic profession for some.
"The Advances in Bioethics" series is devoted to publishing collections of original papers and multi-authored volumes that advance the field of bioethics either by exploring new areas, or by taking new approaches to traditional areas. Although the series is published in English, its scope is international, and manuscripts are welcome from authors throughout the world. Divided into three sections this volume covers: Human Rights, Public Safety, and Public Policy; Practitioner Responsibilities During Times of Epidemics; Global Dimensions of Epidemics - each chapter in the book goes in depth to discuss the issues surrounding the topic in question and combines a theoretical thought process with practical application.
This book encompasses two inter-related disciplines of health law and medical ethics applicable to Singapore. Apart from Singapore legal materials, it draws upon relevant case precedents and statutory developments from other common law countries and incorporates recommendations and reports by health-related bodies, agencies and committees. The book is written in an accessible manner suitable for tertiary students. It should also serve as a useful resource for medico-legal practitioners, academics and healthcare professionals who wish to keep abreast of the evolving legal and ethical developments concerning health and medicine.
This collection of essays represents the work produced in the course of a three-year project funded by the Commission of the European Communities under the Biomed I programme, on the ethics of genetic screening, entitled 'Genetic screening: ethical and philosophical perspectives, with special reference to multifactorial diseases'. The short title of the project was Euroscreen, thereafter known as Euroscreen I, in the light of the fact that a second project on genetic screening was subsequently funded. The project was multinational and multidisciplinary, and had as its objectives to examine the nature and extent of genetic screening programmes in different European countries; to analyse the social policy response to these developments in different countries; and to explore the applicability of normative ethical frameworks to the issues. The project was led by a core group who had oversight of the project and members of which have acted as editors for this volume. Darren Shickle edited the first section; Henk ten Have the second; Ruth Chadwick and Urban Wiesing the third and final part. The volume opens with an overview of genetic screening and the principles available for addressing developments in the field, with special reference to the Wilson and Jungner principles on screening. The first of the three major sections thereafter includes papers on the state of the art in different countries, together with some analysis of social context and policy.
The book s main contribution is its interdisciplinary approach to the issue of sedation at the end-of-life. Because it occurs at the end of life, palliative sedation raises a number of important ethical and legal questions, including whether it is a covert form of euthanasia and for what purposes it may legally be used. Many of the book chapters address the first question and almost all deal with a specific form of the second: whether palliative sedation should be used for those experiencing existential suffering ? This raises the question of what existential suffering is, a topic that is also discussed in the book. The different chapters address these issues from the perspectives of the relevant disciplines: Palliative Medicine, Bioethics, Law and Theology. Hence, helpful accounts of the clinical and historical background for this issue are provided and the importance of drawing accurate ethical and legal distinctions is stressed throughout the whole book. So the volume represents a valuable contribution to the emerging literature on this topic and should be helpful across a broad spectrum of readers: philosophers, theologians and physicians."
The 14 chapters in Ethics at the End of Life: New Issues and Arguments, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters-written by a team of experts-survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section.
This volume contains the proceedings of the 10th International Symposium on Circumcision, Genital Integrity, and Human Rights. Authors are international experts in their fields, and the book contains the most up-to-date information on the issue of genital cutting of infants and children from medical, legal, bioethical, and human rights perspectives.
The idea for an anthology on personhood grew out of two things, viz., the work I did with Martin Benjamin during the Summer of 1982 at Michigan State University on the question, What is a person?, and the amount of time, effort, and expense required for serious research on the topic itself. The former experience taught me the importance of, among other things, attempting to get clear about what we are to mean by 'person, ' while the latter experience suggested a possible course of action whereby getting clear might be made more manage able simply by having relatively convenient access to some of the most insightful and stimulating writings on the topic. The problems of personhood addressed in this book are central to issues in ethics ranging from the treatment or termination of infants with birth defects to the question whether there can be rational suicide. But before questions on such issues as the morality of abortion, genetic engineering, infanticide, and so on, can be settled, the prob lems of personhood must be clarified and analyzed. Hence What Is a Person? has as its primary theme the examination of various proposed conditions of personhood."
Books do not come about by accident. This is especially the case when a volume grows out of a conference for which the participants wrote the original contributions in different languages. This volume descends from a conference held at the Zentrumjiir interdiszipliniire Forschung, University of Bielefeld, Germany, October 4 through 6, 1990, under the title "Technische Eingriffe in die menschliche Reproduktion: Per- spektiven eines moralischen Konsenses". Many with great generosity helped to ensure that the conference was a success and that the papers presented grew into a book. We want in particular to acknowledge our deep gratitude to the Zentrumjiir interdiszipliniire Forschung for spon- soring this important conference, and to its director, Peter Weingart, for his important guidance and support. Our thanks are also due to all of the staff ofthe Zentrum. It is they who made the conference successful. We are also grateful to Prof. Hilmar Stolte, head of the Institut jiir System- und Technologieanalysen in Bad Oeynhausen, Germany, for making available additional financial support for the conference. Our thanks are also owed to the participants who inspired us to transform a collection of papers into a completed volume. The general trans- formation of the original papers required translation. Here we must acknowledge the labors of Sarah L. Kirkby, who rendered many parts of the volume into English. Finally, we want to recognize the invaluable support given by the ecumenical teamwork of Kurt W.
The ethical issues we face in healthcare, justice, and human rights extend beyond national boundaries-they are global and cross-cultural in scope. Editors Wanda Teays and Alison Dundes Renteln have assembled the works of an interdisciplinary, international team of experts in bioethics into a comprehensive, innovative and accessible book. It opens with theoretical frameworks that inform a global bioethics, followed by three units for an in-depth look at contemporary issues in the field. These are human rights, culture, and public health-with each unit including theoretical discussions and lively case studies. Topics range from torture and lethal injection to euthanasia, sex selection, vulnerable human subjects, to health equity, safety and public health, and environmental disasters like Bhopal, Fukushima, and more. The second edition includes new essays on Gender identity and reassignment Infectious diseases, vaccines and anti-vaccine campaigns Stem cell harvesting and usage Immigrant/refugee quarantine Bioterror and chemical weapons Medical tourism Xenotransplantation and bionic body parts Food and agriculture regulation and GMOs
The spectacular development of medical knowledge over the last two centuries has brought intrusive advances in the capabilities of medical technology. These advances have been remarkable over the last century, but especially over the last few decades, culminating in such high technology interventions as heart transplants and renal dialysis. These increases in medical powers have attracted societal interest in acquiring more such knowledge. They have also spawned concerns regarding the use of human subjects in research and regarding the byproducts of basic research as in the recent recombinant DNA debate. As a consequence of the development of new biomedical knowledge, physicians and biomedical scientists have been placed in positions of new power and responsibility. The emergence of this group of powerful and knowledgeable experts has occasioned debates regarding the accountability of physicians and biomedical scientists. But beyond that, the very investment of resources in the acquisition of new knowledge has been questioned. Societies must decide whether finite resources would not be better invested at this juncture, or in general, in the alleviation of the problems of hunger or in raising general health standards through interventions which are less dependent on the intensive use of high technology. To put issues in this fashion touches on philosophical notions concerning the claims of distributive justice and the ownership of biomedical knowledge.
This volume covers a wide range of topics concerning methodological, epistemological, and regulatory-ethical issues around pharmacology. The book focuses in particular on the diverse sources of uncertainty, the different kinds of uncertainty that there are, and the diverse ways in which these uncertainties are (or could be) addressed. Compared with the more basic sciences, such as chemistry or biology, pharmacology works across diverse observable levels of reality: although the first step in the causal chain leading to the therapeutic outcome takes place at the biochemical level, the end-effect is a clinically observable result-which is influenced not only by biological actions, but also psychological and social phenomena. Issues of causality and evidence must be treated with these specific aspects in mind. In covering these issues, the book opens up a common domain of investigation which intersects the deeply intertwined dimensions of pharmacological research, pharmaceutical regulation and the related economic environment. The book is a collective endeavour with in-depth contributions from experts in pharmacology, philosophy of medicine, statistics, scientific methodology, formal and social epistemology, working in constant dialogue across disciplinary boundaries.
Is it lawful for a doctor to give a patient life-shortening pain relief? Can treatment be lawfully provided to a child under 16 on the basis of her consent alone? Is it lawful to remove food and water provided by tube to a patient in a vegetative state? Is a woman's refusal of a caesarean section recommended for the benefit of the fetus legally decisive? These questions were central to the four focal cases revisited in this book. This book revisits nine landmark cases. For each, a new leading judgment is attributed to an imagined judge, Athena, who operates within the constraints of the legal system of England and Wales. Her judgments accord with an innovative legal theory, referred to as 'modified law as integrity', and are linked as a line of precedent. The result is a re-spinning of extant judicial threads into a web of legal principles with a greater claim to coherence and defensibility than those in the original cases. The book will be of great interest to scholars and students of medical law, criminal law, bioethics, legal theory and moral philosophy.
Going back at least to the writings of John Stuart Mill and Jean-Jacques Rousseau, people have argued for and against maintaining a state of nature. Is there an inherent virtue in leaving alone a naturally occurring condition, or does the human species thrive when we find ways to improve our circumstances? This volume probes whether "nature" and "the natural" are capable of guiding moral deliberations in policy making. Drawing on philosophy, religion, and political science, this book examines three questions central to debates over the idea of "nature" in human action. Conceptually, it asks what the term means, how it should be considered, and if it is, even in part, a social construct. From a moral perspective, the contributors question if being "natural" is itself of value or if its worth is only as a means to advance other morally acceptable ends. Politically, essays discuss whether appeals to nature can and should affect public policy and, if so, whether they are moral trump cards or should instead be fitted alongside or weighed against other concerns. Achieving consensus on these questions has proven elusive and seems unattainable. This should not, however, be an obstacle to moving the debate forward. By bringing together disparate approaches to addressing these concepts, "The Ideal of Nature" suggests the possibility of intermediate positions that move beyond the usual full-throated defense and blanket dismissal found in much of the debate. Scholars of bioethics, environmental philosophy, religious studies, sociology, public policy, and political theory will find much merit in this book's lively discussion.
The potential of modern medicine in a pluralistic world leads to the potential for moral conflict. The most prevalent bioethical theories often either overestimate or underestimate the amount of shared moral belief that can be used to address those conflicts. This work presents a means for taking seriously the pluralism in the modern world while recognizing the likelihood of moral "acquaintance" between persons with differing views. It criticizes moral theories that overstate the extent of the problem of pluralism as well as those that imply too much agreement between reasonable moral persons, yet it locates a means for the resolution of many moral conflicts in moral acquaintanceship. Drawing from the work of H. Tristram Engelhardt, Jr., casuists and principle-based theorists, and Erich Loewy and Kevin W. Wildes's initial development of the concept of moral acquaintanceship, Moral Acquaintances and Moral Decisions is philosophically indepth work with direct applications for decisionmaking in real medical settings. A work in moral theory as well as a source of real world guidance, clinically oriented bioethics professionals as well as students of bioethical theory should find the theory of moral acquaintanceship provided here important to their work.
Medicine is a complex social institution which includes biomedical research, clinical practice, and the administration and organization of health care delivery. As such, it is amenable to analysis from a number of disciplines and directions. The present volume is composed of revised papers on the theme of "Responsibility in Health Care" presented at the Eleventh Trans Disciplinary Symposium on Philosophy and Medicine, which was held in Springfield, illinois on March 16-18, 1981. The collective focus of these essays is the clinical practice of medicine and the themes and issues related to questions of responsibility in that setting. Responsibility has three related dimensions which make it a suitable theme for an inquiry into clinical medicine: (a) an external dimension in legal and political analysis in which the State imposes penalties on individuals and groups and in which officials and governments are held accountable for policies; (b) an internal dimension in moral and ethical analysis in which individuals take into account the consequences of their actions and the criteria which bear upon their choices; and (c) a comprehensive dimension in social and cultural analysis in which values are ordered in the structure of a civilization ( 8], p. 5). The title "Responsibility in Health Care" thus signifies a broad inquiry not only into the ethics of individual character and actions, but the moral foundations of the cultural, legal, political, and social context of health care generally."
As a relatively new field in academia and growing presence in American (as well as international) discourse, bioethics must balance the aspiration to guide biomedical research and practice with the need to become an institutionally legitimate influence in society. Since its inception three decades ago, to what extent has bioethics succeeded at making biomedicine more socially accountable? At the same time, to what extent has bioethics been rendered a public-relations tool for academic and corporate biomedical enterprises, which have become increasingly intermingled, high-tech, competitive, resource intensive, and profit-oriented? This book examines bioethicists' efforts to legitimate and stabilize the institutional existence of their field, revealing how their competition and collaboration with other professional groups has staked out an emblematic expertise, which is then tendered to various societal clients. In a case study of an academic bioethics center, higher education and science studies scholar Mary Leinhos reveals how efforts to secure material resources and organizational legitimacy shape the center's intellectual output, drawing on extensive interviews with center personnel and original on-site research. The author also employs discourse analysis to explore what the anticipated legal liability of bioethicists and ethics committees reveals about the social shaping and legitimacy of nascent expertise claims. In the national science policy arena, this book examines the National Bioethics Advisory Commission's discourse on the human stem cell research debate to reveal the boundary work conducted by the commission at the borders between science and ethics, and between ethics and public policy. Written by Dr. Mary Leinhos, this groundbreaking book shifts attention in the sociology of bioethics from clinical to academic bioethics, and highlights the institutional and resource-seeking relationships among bioethics, biomedicine, and public policy. The Logic and Legitimacy of American Bioethics makes new contributions to the fields of higher education studies and science studies, where ethics, and the relationship between legitimacy and expertise, have been little explored. Painting a detailed picture of how bioethics is taking root in the landscape of American institutional power and expertise, this book offers critical insight into the challenges and opportunities bioethicists face in cultivating socially responsible biomedical science and technology. |
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